The word doula is a Greek word meaning women’s servant.Women have been serving other women in childbirth for many centuries andhave proven that support from another woman has a positive impact on thelabor process.
My husband (partner) is my left hand and my doula is my right.- from Doulas Making a Difference
What is a doula?
A doula is a professional trained in childbirth who provides emotional,physical and informational support to the mother who is expecting, is experiencinglabor, or has recently given birth. The doula’s purpose is to help womenhave a safe, memorable and empowering birthing experience.
Most often the term doula refers to the birth doula, or laborsupport companion. However, there are also antepartum doulas and postpartumdoulas. Most of the following information relates to the labor doula. Doulascan also be referred to as labor companions, labor support specialists,labor support professionals, birth assistants or labor assistants.
What does a doula do?
Most doula-client relationships begin a few months before the baby is due.During this period, they develop a relationship where the mother feels freeto ask questions, express her fears and concerns, and takes an active rolein creating a birth plan. Most doulas make themselves available to the motherby phone in order to respond to her questions or explain any developmentsthat might arise during the course of the pregnancy. Doulas do not provideany type of medical care. However, they are knowledgeable in many medicalaspects of labor and delivery. Consequently, they can help their clientsgain a better understanding of the procedures and possible complicationsof late pregnancy or delivery.
During delivery, doulas are in constant and close proximity to the mother.They have the ability to provide comfort with pain relief techniques thatinclude breathing techniques, relaxation techniques, massage, and laboringpositions. Doulas also encourage participation from the partner and offerreassurance. A doula acts as an advocate for the mother, encouraging andhelping her fulfill specific desires that she might have for her birth.The goal of a doula is to help the mother experience a positive and safebirth, whether an un-medicated birth or cesarean.
After the birth, many labor doulas will spend some time helping mothersbegin the breastfeeding process and encouraging bonding between the newbaby and other family members.
What are the benefits of having a doula?
Numerous studies have documented the benefits of having a doula presentduring labor. A recent Cochrane Review, Continuous Support for WomenDuring Childbirth, showed a very high number of positive birth outcomeswhen a doula was present. With the support of a doula, women were less likelyto have pain relief medications administered, less likely to have a cesareanbirth, and reported having a more positive childbirth experience1.Find a Doula Now.
Other studies have shown that having a doula as a member of the birth teamdecreases the overall cesarean rate by 50%, the length of labor by 25%,the use of oxytocin by 40% and requests for an epidural by 60%2.
Doulas often use the power of touch and massage to reduce stress and anxietyduring labor. According to physicians Marshal Klaus and John Kennell, massagehelps stimulate the production of natural oxytocin. The pituitary glandsecretes natural oxytocin to the bloodstream, causing uterine contractions,and to the brain, resulting in a feelings of well being, drowsiness andhigher pain threshold. By contrast, because synthetic IV oxytocin cannotcross into both the blood stream and the brain, it increases contractionswithout the positive psychological benefits of natural oxytocin.
What about the father’s role when using a doula?
The role of the doula is never to take the place of husbands or partnersin labor, but to compliment and enhance their experience. Today, more husbandsare an active role in the birth process. However, some partners prefer toenjoy the delivery without having to stand in as the labor coach. By havinga doula as a part of the birth team, a father is free to do whatever hechooses. Doulas can encourage the father to use comfort measures and canstep in if he wants a break. Having a doula allows the father to supporthis partner emotionally during labor and birth and to also enjoy the experiencewithout the added pressure of trying to remember everything he learned inchildbirth class!
Are doulas only useful if planning an un-medicated birth?
The presence of a doula can be beneficial no matter what type of birthyou are planning. Many women report needing fewer interventions when theyhave a doula. But be aware that the primary role of the doula is to helpmothers have a safe and pleasant birth–not to help them choose the typeof birth. For women who have decided to have a medicated birth, the doulawill provide emotional support, informational support and comfort measuresthrough labor and the administration of medications. Doulas work alongsidemedicated mothers to help them deal with possible side effects and otherneeds where medication might be inadquate, because even with medication,there is likely to be some degree of discomfort.
For a mother facing a cesarean, a doula can be helpful by providing constantsupport and encouragement. Often a cesarean results from an unexpected situationleaving mothers feeling unprepared, disappointed and lonely. A doula canbe attentive to mothers at all times throughout the cesarean, letting themknow what is going on throughout the procedure. This can free the partnerto attend to the baby and accompany the newborn to the nursery if thereare complications.
What about other types of doulas?
There are three types of doulas: the Antepartum Doula, the LaborDoula and the Postpartum Doula:
Antepartum Doulas provide help and support to a motherwho has been put on bed rest or is experiencing a high risk-pregnancy. Theyprovide informational, emotional, physical and practical support in circumstancesthat are often stressful, confusing and emotionally draining.
Postpartum Doulas provide help and support in the firstweeks after becoming a mother. They provide informational support aboutfeeding and caring for the baby. They provide physical support by cleaning,cooking meals and filling in when a new mother needs a break. They provideemotional support by encouraging a mother during those times when she mightbe feeling overwhelmed.
Some doulas have training in more than one area and are able to serve asmore than one type of doula.
Finding a Doula:
The most important thing in choosing a doula is to find a person with whomyou feel comfortable and who gives you confidence. Most doulas do not chargefor an initial consultation and interview, so take the time to interviewas many as necessary until you one that meets your needs. Finda Doula Here.
Questions to Ask a Potential Doula:
- What training have you had?
- What services do you provide?
- What are your fees?
- Are you available for my due date?
- What made you become a doula?
- What is your philosophy regarding childbirth?
- Would you be available to meet with me beforethe birth to discuss my birth plan?
- What happens if for some reason you are not availableat the time of my birth?
Your Next Steps:
- Find a Doula in your area
- Talk to friends and family members who have used a doula
- Read more about Doulas
- Mothering the Mother: How aDoula can help you have a shorter, easier and healthier Birthby Marshall H. Klaus, Phyllis H. Klaus, and John Kennell.
- The Doula Book by MarshallH. Klaus, John Kennell, and Phyllis H. Klaus.
- The Doula Advantage byRachel Gurevich.
You can also call the American Pregnancy Association at: 1-800-672-2296for a list of doula referrals in your area.
You may find the following books helpful.
Your purchase supports the American Pregnancy Association.
Compiled using information from the following sources:
1Hodnett ED. Gates S Hofmeyr GJ. SakalaC. Continuous Support for Women During Childbirth. Cochrane Databaseof Systematic Reviews.(3) CD003766, 2003.
2Klaus, M., Kennell, J., Klaus, P. Motheringthe Mother.: Addison-Wesley Publishing Company, 1993.
Childbirth Connection, http://www.childbirthconnection.org/