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
experiencing labor, or has recently given birth. The Doula’s purpose is to help
women have a safe, memorable and empowering birthing experience.
Most often the term Doula refers to the birth Doula, or labor
support companion. However, there are also antepartum doulas and postpartum
doulas. Most of the following information relates to the labor doula. Doulas can
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 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, whether an
un-medicated birth or cesarean.
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.
What are the benefits of having a Doula?
Numerous studies have documented the benefits of having a Doula present
during labor. A recent Cochrane Review, Continuous Support for Women During
Childbirth, showed a very high number of positive birth outcomes when a
Doula was present. With the support of a Doula, women were less likely to have
pain relief medications administered, less likely to have a cesarean birth, and
reported having a more positive childbirth experience.
Other studies have shown that having a Doula as a member of the birth team
decreases 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 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 a feeling of well being, drowsiness and higher pain
threshold. By contrast, because synthetic IV oxytocin cannot cross into both the
blood stream and the brain, it increases contractions without 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 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!
Are Doulas only useful if planning an Un-medicated birth?
The presence of a Doula can be beneficial no matter what type of birth you
are planning. Many women report needing fewer interventions when they have a
Doula. But be aware that the primary role of the Doula is to help mothers have a
safe and pleasant birth–not to help them choose the type of birth. For women who
have decided to have a medicated birth, the Doula will provide emotional
support, informational support and comfort measures through labor and the
administration of medications. Doulas work alongside medicated mothers to help
them deal with possible side effects and other needs where medication might be
inadequate, 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 constant
support and encouragement. Often a cesarean results from an unexpected situation
leaving mothers feeling unprepared, disappointed and lonely. A Doula can be
attentive to mothers at all times throughout the cesarean, letting them know
what is going on throughout the procedure. This can free the partner to attend
to the baby and accompany the newborn to the nursery if there are
complications.
What about other types of Doulas?
There are three types of Doulas: the Antepartum Doula, the Labor Doula and
the Postpartum Doula:
Antepartum Doulas provide help and support to a mother who
has been put on bed rest or is experiencing a high risk-pregnancy. They provide
informational, emotional, physical and practical support in circumstances that
are often stressful, confusing and emotionally draining.
Postpartum Doulas provide help and support in the first
weeks after becoming a mother. They provide informational support about feeding
and caring for the baby. They provide physical support by cleaning, cooking
meals and filling in when a new mother needs a break. They provide emotional
support by encouraging a mother during those times when she might be feeling
overwhelmed.
Some Doulas have training in more than one area and are able to serve as more
than one type of doula.
Finding a Doula:
The most important thing in choosing a Doula is to find a person with whom
you feel comfortable and who gives you confidence. Most Doulas do not charge for
an initial consultation and interview, so take the time to interview as many as
necessary until you one that meets your needs.
Questions to Ask a Potential Doula:
physical and informational support to the mother who is expecting, is
experiencing labor, or has recently given birth. The Doula’s purpose is to help
women have a safe, memorable and empowering birthing experience.
Most often the term Doula refers to the birth Doula, or labor
support companion. However, there are also antepartum doulas and postpartum
doulas. Most of the following information relates to the labor doula. Doulas can
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 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, whether an
un-medicated birth or cesarean.
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.
What are the benefits of having a Doula?
Numerous studies have documented the benefits of having a Doula present
during labor. A recent Cochrane Review, Continuous Support for Women During
Childbirth, showed a very high number of positive birth outcomes when a
Doula was present. With the support of a Doula, women were less likely to have
pain relief medications administered, less likely to have a cesarean birth, and
reported having a more positive childbirth experience.
Other studies have shown that having a Doula as a member of the birth team
decreases 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 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 a feeling of well being, drowsiness and higher pain
threshold. By contrast, because synthetic IV oxytocin cannot cross into both the
blood stream and the brain, it increases contractions without 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 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!
Are Doulas only useful if planning an Un-medicated birth?
The presence of a Doula can be beneficial no matter what type of birth you
are planning. Many women report needing fewer interventions when they have a
Doula. But be aware that the primary role of the Doula is to help mothers have a
safe and pleasant birth–not to help them choose the type of birth. For women who
have decided to have a medicated birth, the Doula will provide emotional
support, informational support and comfort measures through labor and the
administration of medications. Doulas work alongside medicated mothers to help
them deal with possible side effects and other needs where medication might be
inadequate, 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 constant
support and encouragement. Often a cesarean results from an unexpected situation
leaving mothers feeling unprepared, disappointed and lonely. A Doula can be
attentive to mothers at all times throughout the cesarean, letting them know
what is going on throughout the procedure. This can free the partner to attend
to the baby and accompany the newborn to the nursery if there are
complications.
What about other types of Doulas?
There are three types of Doulas: the Antepartum Doula, the Labor Doula and
the Postpartum Doula:
Antepartum Doulas provide help and support to a mother who
has been put on bed rest or is experiencing a high risk-pregnancy. They provide
informational, emotional, physical and practical support in circumstances that
are often stressful, confusing and emotionally draining.
Postpartum Doulas provide help and support in the first
weeks after becoming a mother. They provide informational support about feeding
and caring for the baby. They provide physical support by cleaning, cooking
meals and filling in when a new mother needs a break. They provide emotional
support by encouraging a mother during those times when she might be feeling
overwhelmed.
Some Doulas have training in more than one area and are able to serve as more
than one type of doula.
Finding a Doula:
The most important thing in choosing a Doula is to find a person with whom
you feel comfortable and who gives you confidence. Most Doulas do not charge for
an initial consultation and interview, so take the time to interview as many as
necessary until you one that meets your needs.
Questions to Ask a Potential Doula:
- What types of trainings have you had?
- What services do you provide?
- What are your Strengths and Weaknesses in this work?
- What are your fees?
- Are you available for my due date?
- What is your Postpartum availability following my birth?
- What made you become a Doula?
- What is your philosophy regarding childbirth?
- Would you be available to meet with me before the birth to discuss my birth plan?
- What happens if for some reason you are not available at the time of my birth?