Question 1

In addition to providing physical and emotional support during labor, the doula also acts as a patient advocate for her clients. This role is BEST defined as:

Accepted Answer

In order to best support a laboring couple, the doula helps them to help themselves. She uses her specialized knowledge of birth and the maternity care system to help the couple set priorities and goals, and then gives them the tools necessary to advocate for themselves. This creates independence, rather than vulnerability or helplessness. The doula uses her power to effect change on behalf on the laboring mother, rather than using her power over others to get her wants and needs met. Forming mutually respectful relationships with doctors, midwives, nurses, and couples is the best way to become a strong patient advocate.

Question 2

With the ease of medicated birth and modern technological interventions, natural birth may seem like a lesser alternative. Which of the following is NOT an advantage of natural birth?

Accepted Answer

Interventions by their very nature signify a trade-off - some benefits at the expense of some possible risks. Natural birth is the medically safer option. Natural birth is associated with improved self-confidence. It allows the woman to make educated decisions for herself, rather than having decisions made for her. She is empowered to take charge of her own and her family's health.

Question 3

In order to help mothers have the births they want, it is necessary for the doula to enlist the support and trust of the entire healthcare team. Ways to do this include all of the following EXCEPT:

Accepted Answer

Showing signs that you appreciate the staff - even simple words of thanks or appreciation - go a long way towards forging mutually supportive relationships with the maternity care staff. Get to know staff members, and make it known that you are glad they're caring for your client. When the healthcare staff is aware of their significance to the mother, they will do their best to help her have the birth memory she seeks. Creating an environment of teamwork rather than one of rivalry will empower caregivers to support the mother's birth goals. Natural birth can be so much more rewarding than simply caring for a medicated mother, and the more natural births the caregivers see, the better they will understand this distinction.

Question 4

Which of the following does NOT factor into how the continuity of care by a doula contributes the psychological well-being of a laboring mother?

Accepted Answer

The doula does not usurp the partner's role, but adds to it. If the mother's primary maternity care provider is not present at the delivery of the baby, the laboring woman may become unnerved and her labor may suffer. The nursing staff does change, especially if the labor is long, and if a mother becomes accustomed to a particular nurse, this change may cause her labor to falter. The one constant in labor can be the doula, who knows the parents wishes, who can advocate for their birth plan, who can explain proposed procedures, and who serves as the physical and emotional support for both partners during labor.

Question 5

Three components of relaxation include cognitive, affective. and psychomotor processes. Which of the following does NOT describe how these categories can inform relaxation training?

Accepted Answer

The physical and emotional environments are equally important to the ability to relax. A woman and her partner can utilize this to set up the birth location to be not only physically comfortable, but also emotionally safe and private. The physiological changes associated with tension versus relaxation aid in understanding how best to release muscular strain. A woman who feels confident those around her will support her can let go of her thinking brain, and let her more primitive brain move forward with birth.

Question 6

Which of the following is the most important aspect of the doula - client relationship?

Accepted Answer

A relationship of mutual trust should be built before the onset of labor so the woman can feel secure in letting her body do the work of labor, and the doula can be sure she understands the woman's needs. Trust is best formed when all parties are equal, and there is no power struggle between the individuals. While a doula can help a mother maintain her internal locus of control, this is secondary to a trusting partnership. Gratitude also derives from a mutually caring relationship built first on trust.

Question 7

The mother, and the doula, can use positive affirmations to form an optimistic attitude during birth. Which of the following is NOT a positive affirmation that would helpful in labor?

Accepted Answer

This statement reflects feelings of inadequacy - the mother feels like she's not doing labor "right." Since there's no one way to labor correctly, a statement like this can cause her to give up, and to lose self-confidence. Positive affirmations work to increase self-esteem and confidence, and help the mother feel empowered and in charge. Affirmations focusing on trust, confidence, strength, and adequacy will create an atmosphere of optimism and satisfaction with the birth process.

Question 8

Partners experience childbirth in ways different than mothers, because it is not an embodied experience for them. Which of the following is NOT true of the partner's role in birth?

Accepted Answer

Doulas help the partners to help the mother rather than usurping their role in the birth. It may be difficult for partners in a committed relationship to make rational, objective judgments about interventions and medical emergencies because they are very emotionally attached. Partners are freed to offer personalized, intimate support when the doula is supporting the physical needs of the couple. If anything goes "wrong" with the birth, the partner may feel guilt that he or she wasn't able to do enough, which can impact both self-esteem and relationship dynamics.

Question 9

The state of mental focus on the baby that begins in late pregnancy and continues for the first few weeks postpartum is called:

Accepted Answer

Coined by D.W. Winnicott, the term primary maternal preoccupation is used to describe the period when the pregnant woman is highly sensitive to and focused on her baby. During this time she needs support and nurturing as she works on role transition from woman to mother. Modern medicine sometimes misinterprets this stage as anxiety, though psychological researchers see it as a necessary maternal task. "Mothering the mother" is sometimes used to describe doula care. Role attainment is a generalized term describing learning a new function. Attachment theory is sometimes used to describe bonding.

Question 10

Which of the following BEST describes evidence-based maternity care?

Accepted Answer

Evidence-based maternity care means putting into practice the best research-based care. This care should be based on the highest quality, most current medical evidence showing benefit to mothers and babies, by reducing incidences of injuries, complications, and death. While research outcomes can be found to support just about any position, doulas should learn to critically read and appraise literature.

Question 11

Research has shown that a woman's satisfaction with birth has less to do with __________ and more to do with _____________.

Accepted Answer

Research consistently supports that women are more satisfied with their birth experience when they were empowered to make decisions for themselves, irrespective of the amount of pain they perceived. While care providers do impact the birth experience, they are not the primary motivators for satisfaction. Labor support helps to empower women. Pain medication can empower or disenfranchise women, depending on their individual perception of how invested in the decision-making process they were.

Question 12

The Bradley method of childbirth education is also known as:

Accepted Answer

The Bradley method is a childbirth education model that supposes the mother and her partner make a team, and is sometimes called husband-coached childbirth. While these classes do train a partner to be the main supporter during birth, a doula can still be an important addition to the team. The midwifery model of care is the woman-centered philosophy of some caregivers, especially midwives. Medicalized birth is an intervention intensive childbirth. Psychoprophylaxis is the original name of the Lamaze method of childbirth education.

Question 13

The Lamaze method of childbirth education focuses on which of the following:

Accepted Answer

Developed in France in the 1940s by Dr. Fernand Lamaze , this method is also referred to as psychoprophylaxis. As an alternative to medical intervention during childbirth , the Lamaze method seeks to increase a mother's confidence in her ability to give birth through classroom instruction on normal labor and coping. Coping methods may include breathing, movement, touch, and other modalities. The woman is empowered to choose what works for her to promote comfort throughout the birth process.

Question 14

Though birth is universal, the context given to the event by the culture in which a woman births, as well as the culture in which she was raised, can have a profound effect on birth. In order to function within this framework, a doula should:

Accepted Answer

Cultural competence is a core standard of work as a doula, and is an ever-changing process. The doula can best individualize her care for a client by learning as much as she can about the client's cultural understanding of pregnancy, birth, breastfeeding, parenting, etc. Judging a client by the precepts of a dominant culture, as well as stereotyping based on assumptions, can marginalize the woman, and can create antagonism between doula and client. The helping relationship should be focused on the client's needs. The doula will have her own cultural beliefs and values, but should not impose them on the woman she is supporting.

Question 15

Researchers have found that the childbirth experience has the potential to be pleasurable. Enjoyment of childbirth is most likely in women with which of the following characteristics?

Accepted Answer

When the woman has the support of a partner and the two are in a committed relationship (whether marital or not), the woman is more likely to view her birth experience as enjoyable despite the pain. Other factors that can create a positive experience include a lack of menstrual problems in the past, non-traditional attitudes about sex roles, attendance at childbirth preparation classes, and higher social status. Enjoyment and pain have been shown to coexist, and, interestingly, women with low levels of pain do not seem to have the most enjoyable births.

Question 16

All of the following are ways in which the doula can enhance the early parenting experience EXCEPT:

Accepted Answer

The role acquisition of new parenthood should start with integrating the birth experience into their self-concept, rather than forgetting the details. Reconciling the reality with the parents' perceptions can be an important role for the doula. Before the birth, a doula had the unique opportunity the help parents plan by exploring their support network, giving them a realistic picture of caring for a baby, and helping them develop a game plan for taking care of themselves while adding a new baby to the family.

Question 17

Biofeedback is technically defined as the use of technology to provide information about bodily reactions so that a person can learn to control those responses. Which of the following is NOT another method for biofeedback?

Accepted Answer

Aromatherapy is use of olfactory stimulation to bring about mood or emotional changes. Breathing awareness is a biofeedback mechanism where a person can consciously change the pattern of their breathing in order to effect changes in their physical state. Temperature feedback is an easy tool for partners and doulas to use - hand temperature typically rises as the mother becomes more relaxed. Auditory feedback can be affirmations or words that relate to mental images, while verbal feedback is vocalizations on the woman's part to bring about relaxation, such as moaning, chanting, and screaming

Question 18

Imagery as a technique for relaxation in childbirth can BEST be described as:

Accepted Answer

Imagery uses all of the senses along to bring about changes in cognitive affect or mood and emotion, as well as physical state changes. It has been likened to daydreaming and is used for more than just focusing a laboring mother's attention. Imagery is an effective way of coping with labor pain that influences the voluntary and involuntary nervous system response. Imagery makes the connection between information processing and feelings.

Question 19

Paced or patterned breathing can have all of the following effects EXCEPT:

Accepted Answer

Hyperventilation happens when breathing is both rapid and deep. Paced breathing actually helps to minimize this by shifting the focus to shallow breaths that increase respiration at a controlled rate. A variety of breathing techniques have been found to decrease pain, conserve energy, improve oxygenation, increase relaxation, and decrease physiologic stress responses.

Question 20

Holism - the belief that body, mind and spirit are interconnected - along with the view of health as a balance of energy in the life forces, informs which of the following techniques for childbirth?

Accepted Answer

Accupressure is a non-invasive practice of massaging or applying pressure to points in the body associated with improving function and transfer of energy. Chinese medicine has relied on acupressure as a healing modality for more than 5000 years. Hypnosis (inducing an altered state of consciousness) and yoga (a Hindu philosophy) might both be used as methods for relaxation in labor. Feng shui has more to do with energy in the environment - how items are arranged to maximize energy flow - than with internal energy.

Quiz 6: Psychology Philosophy