"If a Doula were a drug, it would be unethical not to use it." ~John H. Kennell, MD
Labor can be an intense experience and the needs of a laboring woman can be complex. In addition to medical care and the love and support provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They benefit from a support person who is there to assist them based upon their personal preferences and circumstances.
The word "doula" comes from the ancient Greek meaning "a woman who
serves" and is now used to refer to a trained and experienced
professional who provides continuous physical, emotional and
informational support to the mother before, during and just after birth;
or who provides emotional and practical support during the postpartum
period.
A birth doula: *Recognizes birth as a key experience the mother will remember all her life *Understands the physiology of birth and the emotional needs of a woman in labor *Assists the woman in preparing for and carrying out her plans for birth *Stays with the woman throughout the labor *Provides emotional support, physical comfort
measures and an objective viewpoint, as well as helping the woman get
the information she needs to make informed decisions *Facilitates communication between the laboring woman, her partner and her clinical care providers *Perceives her role as nurturing and protecting the woman's memory of the birth experience *Allows the woman's partner to participate at his/her comfort level
Compared with women who have no support in labor, women who have support from a companion who is neither a member of the hospital staff nor a friend or family member are: *28% less likely to have a cesarean section *31% less likely to use synthetic oxytocin to speed labor *9% less likely to use any pain medication *34% less like to rate their childbirth experience negatively.
Frequently Asked Questions
I am planning on having an epidural for my labor, why use
a doula?
Doulas help you make informed decisions for your care and your babies care. This doesn't stop just because you
decide on an epidural. Pain relief in labor can be a real help, but you still have decisions to make. There are
risks involved in the use of medication in labor.
The father or birth partner will still need support and relief, and during the often
exhausting work of pushing, a doula can be valuable in lending a hand, offering suggestions, and in general, helping
you avoid intervention that is likely to result with the use of an epidural or other medication, that you wouldn't
experience otherwise - like a forceps or vacuum extraction birth.
During your prenatal visits, your doula will help you arrive at an informed choice
and then fully support your decision. An example would be that most doctors won't tell you before hand that they
won't allow an epidural until 4-5 cm dilation. Or that the epidural may not work. Planning a pain free labor with
no support can turn into a miserable labor when the epidural doesn't work or is patchy. With an epidural you are
subject to more intervention from medical procedures, such as the use of pitocin. Again the doula can give you
the information you need to make informed decisions and offer you alternatives - whether before the birth or during
the event.
Another scenario could be that you are planning a natural birth, but plan on having
pain medication "if it gets too bad" and would like to hold off for as long as you can. A doula can help
you do that and help you obtain a natural, normal birth.
A doula can often help moms get to 7-8 cm comfortably before they ask for pain relief.
For them that is an awesome accomplishment. After hearing how far they are, they opt to continue without medication
and deliver unmedicated, giving the sense of control, pride in themselves and accomplishment.
This is our first baby and I really want this to be a special/intimate
time just between my husband and I. We really don't want a stranger there, why would I use a doula?
Your doula won't be a stranger to you once you've hired her! You will have become acquainted with each other during
your prenatal visits. You probably also wouldn't hire someone you didn't feel comfortable with. If you are giving
birth in a hospital, you will meet many strangers depending on how long you are there. Nurses, doctors, anasthesiologists
to mention a few. Your own doctor may not even be there to deliver your baby!
When things get tough or things happen beyond your control, and different people
are scurrying in and out of your room, it will be extremely comforting to have a doula there - someone you know
and trust who will be able to inform you of what's going on! She won't be a stranger.
Would a doula be offended if asked her to leave for a few
minutes? We may want some private time alone as a couple.
A doula should not take offense to anything the parents need to make
their birth a positive experience! I do encourage couples to spend time
together. During labor you may need a few moments of privacy to regroup
as a couple and get encouragement from each other. Your doula can also
make sure that no one else interrupts you needlessly during that time.
She is your advocate above all. After your baby is born, I will stay until everything
has settled down and mom and baby are fine - and then I give the new family time alone. This is essential for bonding
and for loving each other after such an emotional event!
What about other family, won't it get confusing with a lot
of people?
A birth in the family is an exciting event, and family and friends should participate if this is the wish of the
birthing couple. Often family wants to help but aren't sure how, which can lead to confusion and add to the stress
of the mother. The doula can coordinate the efforts of the group, by giving them things to do and making them feel
more useful. She may also help educate your family prior to labor, so that your family knows your wishes and what
they can do to help you.
Won't the nurses do most of this for us? Why would we need
someone there if she will be there for us? What about my doctor, where will he/she be?
Without a doubt, nurses are usually wonderfully supportive. However it is unusual for you to be her only patient.
She won't be able to be with you continually, and when she does come in the room to see you, it is more often than
not to assess you and the baby and to record things in your chart. On average a nurse only spends 9.9% in actual
supportive care during an average labor, and only a small percent of that is physical support. It is usually more
verbal/instructional support.
On top of this, nurses do change shifts. Depending on the hospital you give birth
in they may work a 12 hour or an 8 hour. And then there are the times where they may call in a nurse just for several
hours until the load is a bit lighter. So chances of you having the same nurse throughout your labor is pretty
slim. They have to go on breaks and when they do - another nurse you may have never met, may have to come in to
do an assessment.
Your doula however, stays with you throughout your labor. One continuous presence.
Even your doctor may not be the same one that was on call when you started! Your doctor will only be called in
occasionally and may not show up until the very last pushes to bring your baby into the world. Most doctors are
very busy and manage most womens labor by phone, sometimes managing several women at one time.
What If I Have a Midwife? If I am having a home birth then
a doula seems redundant.
A doula can still provide a valuable service, including personal childbirth education and labor support. Midwives
will take the place of a doctor, therefore their primary concern is your physical well being and the baby's well
being.
Having a doula ensures that you still receive the emotional support necessary during
labor. Some midwives prefer not to give that extra emotional support. They'd rather a doula did it! Talking to
your midwife is a good suggestion to see what her take on you having a doula is.
Does a doula take the place of the father?
No. A doula can actually bring a couple closer together. This is a stressful time for the couple. A doula can help
the father stay focused and calm while giving the love and support to the mother. A father needs to be pampered
too! A doula can do exactly that. Many times a father will forget to eat to keep his strength up. And when the
dad needs a break - the doula is there to give him a rest.
Fathers may worry they are not doing enough or the right thing. A doula can help
him care for and support the mom by giving suggestions, providing encouragement or giving needed breaks during
a long labor. It is easy for the inexperienced dad to become overwhelmed and easily frustrated when the simple
comfort techniques taught to them don't work - or are forgotten! A doula can help offer the right suggestion at
the appropriate time, helping the father use his support skills better.
As one father put it "How can I coach when I have never played
the game??" One study showed that 60% of fathers that have taken
birth education classes become mostly a spectator, as they became overwhelmed
with the surroundings.
A doula helps the father to be more involved and more effective. The nurses can
not be with you at every moment or may not be at liberty to answer your questions in an unbiased manner. The doula
fulfills this role so that parents receive the information they need to make informed decisions.
In short, the couple will find that the doula enriches the father's role by supporting
both of them, not just the woman.
My current fee is $350, including a $50 retainer fee. What can I expect if I hire you as my doula?
*An initial free consultation *1-2
Prenatal visits to discuss birth preferences, comfort
measures, details regarding my role in your labor, etc. *Unlimited phone
and email availability to answer any questions and/or concerns. *24-hour
on-call availability during your due date range (four weeks total). *Up to
two hours postpartum support, for recovery and breastfeeding after
birth. *1 postpartum visit at your home to discuss the birth and answer any
questions.
