Tina Black wishes she’d had a doula when she gave birth to her two children.

Both of the births were by Ceasarean section, and Black said that she didn’t know what to expect and that “things didn’t go my way.

“I didn’t feel that I was in control of my labor,” said the petite Kelso resident.

Black has discovered that a doula — a Greek word for “a woman who serves” — is able to give an expectant mother just that. Black said that she might not have had C-sections if a doula had accompanied her before and during the births.

Her first child, a son, was presenting in the posterior — breech — fashion.

“He was going to come out sunny-side up,” Black said. “With my first delivery, I may not have had to have a C-section had I known that there were different positions that I could use to have my baby come out the right way.”

She might have also questioned whether a C-section was necessary when she had her second child.

“I didn’t know I had the option of a vaginal birth,” she said. “I had asked my doctor, and he said ‘No, since you’ve had a C-section, you should have a C-section the second time as well.’ I didn’t know that I had the choice. Now I know.”

That’s part of what she has been studying in her efforts to become what she believes is the first local doula to offer services.

The Port Orchard, Wash., native came to the area about five years ago with her husband. She worked for a time at the Progress Center until budget constraints ended her job, she said.

Black had been thinking about becoming a doula but wanted to wait until both of her children were in school.

“I was laid off in June, and I figured this was the perfect opportunity to have training and get ready,” she said. “And here I am.”

She attended a part-online, part hands-on school called Childbirth International for birth doulas, post-partum doulas, childbirth educators and breastfeeding counselors.

Unlike a doctor, nurse or midwife, Black said she is not licensed to do any medical treatment.

St. John Medical Center spokesperson Randy Querin said that Black is welcome to be present in the birthing room as a guest for the patient.

“If (the doula is) a comfort to the patient, that’s great,” he said, adding that any medical decisions involving the health and safety of the laboring mother would remain the responsibility of the physician in charge.

Black said she is aware that she is venturing into uncharted territory.

Although the role of doula has been around for thousands of years, the concept is a fairly new one in the U.S. According to a report on the birth and pregnancy Web site, babyzone.com, only 1 percent of pregnancies were attended by a doula in 1988, a figure that rose to 5 percent in 2002.

The doula attends to both the birthing mother and the father or birth partner.

“She is there for the entire birth,” Black said. “She helps with making a birth plan for the entire family, talks about fears, helps mom relax.”

She discusses options with the mother that include pain management should the pregnant woman opt for a natural birth.

Black points out, though, that she does not coerce mothers into avoiding pain measures, including the epidural.

“A doula should never imply what they want,” Black said. “I am there to support them, whatever choices they make.”

A friend asked her to be there during her birth, which she planned to be natural.

“But she got to a point where she said, I just can’t do it. I need my epidural,” Black said. “I gave her the pros and cons, and she still wanted the epidural, and we worked through that.”

She said that a natural birth is nice, “since it’s safer for the baby, but sometimes interventions are needed.”

In her own delivery, Black said, she could have tried massage or different positions to help the baby turn into the proper birthing position.

For pain management, Black will use techniques such as acupressure — which doesn’t involve needles — visualization, breathing and massage.

“There are places on the hand and ankle that you can (apply pressure to) that can help the contractions come faster if mom hasn’t been progressing,” Black said.

She can also employ a “birth ball,” which is like an exercise ball.

“You put it on the floor and mom can rock back and forth sitting up,” Black said. “The more she rocks, the more she can open up her pelvis and that helps her to relax.”

Hot and cold packs and even a warm shower or bath can help ease the pain of a laboring woman.

Prior to the birth, Black visits her clients to go over their expectations and formulate a birth plan. Black is then on call 24 hours a day for two weeks before the birth and two weeks afterward to help with breast feeding and other care issues.

Black charges anywhere from $300 to $700 for her services and said she offers a sliding scale.

“Because I know that times are hard, it’s based off of the family’s income,” she said.

She is hoping that more women will come out of the woodwork to offer doula services, with one day a network of women blanketing the local area.

Black said she is only able to help with two births each month, so her time will be stretched. It also limits her income, but she’s not worried.

“I’m not in it for the money at all,” she said. “I am here because I want women to feel empowered, and I feel that each woman deserves the birth that she wants.”

To connect with Black, visit her Web site at www.blessingsofbirth.net, call her at 431-8275 or e-mail her, blessingsofbirth@comcast.net