What is a Doula?
The Greek word doula means woman caregiver. A birth doula is a trained and experienced professional who provides the woman and her husband or partner continuous emotional support, physical comfort measures and assists the woman in getting the information she needs to make good decisions before, during, and just after childbirth.
A birth doula:
Recognizes birth as a key life experience that the mother will remember all her life
Understands the physiology of birth and the emotional needs of a woman in labor.
Assist the woman and her partner in preparing for and carrying out their plans for birth
Facilitates communication between the laboring woman, her partner, and clinical care providers
Services of A Doula
Most doula-client relationships begin a few months before the baby is due. During this period, they develop a relationship where the mother feels free to ask questions, express her fears and concerns, and takes an active role in creating a birth plan. Most doulas make themselves available to the mother by phone in order to respond to her questions or explain any developments that might arise during the course of the pregnancy. Doulas do not provide any type of medical care. However, they are knowledgeable in many medical aspects of labor and delivery. Consequently, they can help their clients gain a better understanding of the procedures and possible complications of 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 that include breathing techniques, relaxation techniques, massage, and laboring positions. Doulas also encourage participation from the partner and offer reassurance. A doula acts as an advocate for the mother, encouraging and helping 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 safe birth. After the birth, many labor doulas will spend some time helping mothers begin the breastfeeding process and encouraging bonding between the new baby and other family members.
Benefits of a Doula
When making important maternity decisions, women should have information from the best available research about the safety and effectiveness of different choices. Studies show that having a doula present reduces the rates of induction, augmentation, cesarean birth, instrumental deliveries, epidurals, narcotic pain relief, and maternal emotional distress. In fact, a recent meta-analysis published in February 2011 in The Cochrane Library looked at 21 randomized controlled studies involving more than 15,000 women. The study found that, compared with women who had no continuous support, women who had a doula were:
• 28% less likely to have a cesarean section
• 31% less likely to use synthetic oxytocin (i.e. Pitocin) to speed labor
• 9% less likely to use any pain medication
• 34% less like to rate their childbirth experience negatively.
Doulas often use the power of touch and massage to reduce stress and anxiety during labor. According to physicians Marshal Klaus and John Kennell, massage helps stimulate the production of natural oxytocin. The pituitary gland secretes natural oxytocin to the bloodstream, causing uterine contractions, and to the brain, resulting in feelings of well-being, drowsiness, and a higher pain threshold. By contrast, because synthetic IV oxytocin cannot cross into both the bloodstream and the brain, it increases contractions without the positive psychological benefits of natural oxytocin.
The role of the doula is never to take the place of husbands or partners in labor but to compliment and enhance their experience. Today, more husbands are an active role in the birth process. However, some partners prefer to enjoy the delivery without having to stand in as the labor coach. By having a doula as a part of the birth team, a father is free to do whatever he chooses. Doulas can encourage the father to use comfort measures and can step in if he wants a break. Having a doula allows the father to support his partner emotionally during labor and birth and to also enjoy the experience without the added pressure of trying to remember everything he learned in childbirth class!