Category Archives: Doula Tools

Birth Ways’ Cheat Sheet for Doulas: When clients should go to the Hospital?

March 15, 2022

Many clients want guidance on when to go to hospital during labour, especially if they wish to do most of their labour at home or don’t want to get there too early. Doulas don’t talk people out of going to the hospital. However, many people chose to stay home longer if they are being supported and can be reassured that they are still early in the process.

One little trick is to ask the labouring person if they feel like eating. If the answer is yes, then it’s likely still early in the birth process. Most people will not feel like eating once they’re in active labour! 

Sometimes we urge our clients to get going!

When to go to hospital:

  • When labouring client feels safer/better there
  • Any concern about pregnant person or baby
  • Can’t walk or talk through sensations (combined with other signs in this list)
  • Decrease in fetal movement
  • 311 (prime) or 411 (multip); longer with a history of fast birth
  • Lots of pressure / pushing sensations
  • When waters release? 
  • Want pharmaceutical help coping with pain
  • If we hear grunting at the end of a contraction or any sounds that indicate labour is progressing into stage-2 (a.k.a. bearing-down, pushing)

Giving Birth in Hospital

Before Leaving Home

  • Provincial Health Card or Insurance docs
  • Prenatal records with Birth Plan
  • Prescription medications
  • Have a snack or juice - good blood sugar 
  • Pee!
  • Notice fetal movement

Tips for Hospital Arrival

Registration desk

  • Need health card

Assessment / Triage in Birth Unit

  • Health card, prenatal records & birth-plan
  • Lots of questions; no one should ask / talk during contractions
  • 3 questions:
  1.   Labour pattern - show app
  2.   Amniotic fluid - ROM? Colour?
  3.   Is Baby moving normally?
  • Cervical check - pee first
  • Can wear own clothes but be ready for maternal physical assessment 
  • No need to lay on bed until staff is ready to do physical assessment immediately; stay in positions that feel good.

Warning signs (during labour or anytime in preg): 

See your BWI Doula Training Manual or local health region’s list of warning signs. Below are some signs that doulas must know.

Call 911:

  • Frank (flowing) red bleeding or clots - 911
  • Sudden / severe / intense / sharp pain that doesn’t pass - 911
  • Cord prolapse - 911 

Seek medical attention today and in a timely manner but drive calmly:

  • Decreased fetal movement = seek medical attention TODAY
  • Visual disturbances
  • Maternal fever
  • Coloured/smelly waters; may = meconium, infection


Here is this cheat sheet as a downloadable PDF. Do you have tips to share on knowing when clients should go to the hospital?

PS: Sign-up for our Postpartum Doula Training and our Birth Doula Training are now open. Join the doula circle and help your community!

For more doula information and news, please follow us on social media: Facebook, Twitter and Instagram.

Birth Ways International: Get to know the placenta

February 11, 2021

The placenta is amazing!  Let's take a moment to appreciate the jobs they do during pregnancy!   

The placenta attaches to the side of the womb, gets oxygen to your sweet babe through the umbilical cord and removes waste from their blood.

Remember, your birth is not complete until the placenta is also delivered, by you, so while you are holding your newborn, plan to stay warm, calm, and connected to your child so it comes out easily.   Do not let anyone tug on the cord!


Delayed Cord Clamping - do some research on this because the blood in the cord belongs to the baby so delaying the clamping allows that.  

Who cuts the cord? You? If you do not want to, then it is your choice to ask someone else to do this.

What happens after it comes out?   It will be set aside and examined later to make sure it is complete and healthy.  

Placenta tour - you can ask someone to show you the two sides of the placenta, the amniotic sac and the cord.

Keeping your placenta - it will be discarded unless you tell the staff that you wish to keep it - so plan for that!    Bring a container and keep it cool with ice if you are encapsulating it, or put it in some secure storage bags if you are taking it home.

‘Planting’ your placenta - you can bury or plant it in a garden, yard or special place and plant a tree over it.   There are many options for you here and many women follow their traditional practices with the rituals they use.  Freezing the placenta gives you time to decide what to do.

Making a print - many doulas do this but you can also do it yourself - a fresh placenta is easiest but if you are not going to consume your placenta you can use colors and paints!

Consuming your placenta - do your own research on this - I have had clients who enjoyed them with raspberry smoothies!

Encapsulation - this is a service we offer where we process the placenta carefully and very safely to capsules, which you take.   Most of our clients are repeat customers who thrived in the postpartum and swear that it was the iron, hormones, minerals and components in them.    Women request tinctures too.   We dry the cord as a keepsake!

Lotus birth - again, do some research as I had not had a client who did this so I cannot say.

PS: Sign-up for our Postpartum Doula Training and our Birth Doula Training are now open. Join the doula circle and help your community!

For more doula information and news, please follow us on social media: Facebook, Twitter and Instagram.

Effective Doula Phrases – Birth Ways International Doula Training

September 24, 2020

Doula phrases are helpful for when we find ourselves in situations where we know that our clients need more information (and possibly a little space) before consenting to something and we might feel at a loss for words.

In my 30 years as a doula there some phrases I have found useful many of which can be used together with the BRAINS technique of working towards full information before consenting to a procedure:

B - What are the benefits of this procedure you are suggesting?

R - Can you tell me the risks of doing this?

A - What are some alternatives to taking this action?

I -  What is my intuition telling me?

N - What if we do nothing?   Can we take a break, have a bath, go for a walk and check in on this in ½ hr?

S - Sign a waiver.

effective doula phrases

I found some other phrases in a resource listing responses to racist comments and I found many of them also applied to birth settings.  While we do not speak for our clients, we can suggest these phrases to them or use them where appropriate: 

Could you please repeat that?

Did you just say that ________?

So, what do you mean when you said _______?

I am not sure I understood you correctly, did you mean that____?

Excuse me but did you mean to say something that might be interpreted as offensive?

When I hear you say ________, it makes me feel anxious/worried/afraid.

What evidence do you have to support this suggestion?

It sounds like we are assuming _____, what if we assumed _____instead?

effective doula phrases

Photo created by creativeart -

Birth Ways International offers a variety of workshops and educational opportunities to Birth Professionals online, so you can take them from wherever you are located! Please contact us for more information on our upcoming classes! Thank you.

Nature’s Epidural – Water for Comfort in Birth

January 18, 2020

Did you know using the bath, shower or pool is like a natural pain-killer? Many birth-workers call it “nature’s epidural”. Being in water can help your labouring client feel a sense of privacy and bring great comfort for many, decreasing the sensation of pain. Even for clients who plan to use pain meds, spending time in the water can allow them to cope better if:

  1. They’re waiting for meds;
  2. It’s too soon to go to the hospital;
  3. They wish to put off using medications until later in their birth.  (Remember, it’s never too late to get an epidural.)


  1. If your client enjoys the shower, have them pack a shower curtain and a few rings in their birth-bag. (I carry these in my doula-bag in case they forget.)
  2. If they enjoy the bath, have them pack a “drain overflow cover” so they can get a few more inches of water in those short baths that are in many hospitals.
  3. In many areas, clients with a midwife can likely have a water birth (or at least a water-labour) at home or hospital. The birth-pool can be used at home for labour, even if your client is not going to have a waterbirth.
  4. Smart doulas bring shoes that can get wet and extra clothes in case their client loves the pool.
  5. Those same smart doulas advise birth companions to bring a swim-suit and extra clothes, shoes that can get wet.

Of course, a nice deep birth-pool is the very best way to use the benefits of water in labour. We teach doulas how to set-up, maintain, put away the pool and care for their floating clients in our Birth Pool Class.

Props can be used wisely with water during labour too.

  • If the shower is big enough for a birth-ball, then go ahead and put one in there so your client can sit on it or lean on it.
  • It’s OK to put towels or padding down to keeps knees or feet happier.
  • Wireless monitors can be used in the shower or bath in case continuous monitoring is needed.
  • Any massage tools used by doulas can get wet.