What is a Doula?

The word doula comes from the ancient Greek meaning "woman servant" and now refers to a woman trained and experienced in childbirth who provides continuous physical, emotional, and informational support to the mother before, during, and just after childbirth

What the experts say

Research indicates that the presence of a doula:
  • Decreases the need for cesarean by 50%
  • Increases the chances of unmedicated birth by 30-60%
  • Decreases the length of labor by 25%
  • Decreases the use of oxytocin by 40%
  • Decreases requests for epidural by 60%
  • Decreases the need for other interventions with mother and baby
  • Increases the mother’s and father’s satisfaction with the experience.

Purpose and Value of Labor Support

Women supporting women leading them through the labor and birth experience is an ancient tradition that had been all but lost in our culture. Birth in the U.S. became a medicalized and isolating experience – the extreme point coming in the 1950’s and 60’s when women often gave birth without any family members present, strapped to the bed and medicated. As a result, women lost confidence in their bodies’ ability to birth naturally and without intervention. Now more and more women are choosing to give birth actively and naturally, but the older generation of women in their families has never experienced natural birth. Doulas fill this void by providing women with the knowledge and support needed to help them realize that labor and birth can be normal, natural, and joyful – helping women to reclaim the birthing experience.

A doula is a woman trained and experienced in childbirth who provides support to the mother before, during and just after childbirth. A doula has either been through childbirth herself or has attended other births, has studied birth and done extensive reading. She draws upon this experience, providing numerous benefits to the laboring mother, her partner, and extended family, if they are present.

A doula understands that birth is a natural and normal process and her calming presence alone in the midst of labor can set the tone for others in the room and is one of the most important things she offers to the birthing couple. The doula does not control the birth and cannot tell the mother what to do. Rather, she remains in tune with the woman and uses her observation skills to recognize what stage of labor the mother is in, what comfort measures or rituals are working for her, and whether she needs something different. The doula then responds with suggestions, encouragement, and hands on comfort.

A doula has many things in her “bag of tricks” to keep the mother calm and comfortable. These include hands-on comfort such as massage, counterpressure, heat or cold, and position changes, emotional support and encouragement, and knowledge and information about hospital procedures, interventions, and labor and delivery. The doula understands the various emotional signposts of labor and gives the woman and her partner encouragement that they can make it through, much like a cheerleader to someone running a long race. Because the doula is not emotionally tied to the laboring woman, she can offer them a non-biased perspective when guiding the couple in decisions about pain medication or interventions. Because the partner is emotionally involved with the woman, it is difficult for him to see the woman he loves in pain and he may want to make that pain go away. On the other hand, if a laboring woman has expressed desire to birth without medication, a doula may understand that the woman is in transition and almost complete and can encourage the woman to keep going and know that she’s almost done.

The doula frees the partner up to emotionally support the laboring mother and fully experience the birth, rather than having to provide all of the labor support, remember comfort measures he may have learned, and coordinate with the hospital staff. If the partner wants to provide hands on support, the doula can provide him with suggestions of what to do and teach him comfort measures such as counter pressure, since she is experienced in labor support and knows what may work in a certain situation. The birth of their child is often the first time a father has seen labor and delivery first-hand, so having an experienced doula can really set him at ease since she can tell him what to expect and can answer questions he may have.

For the extended family that may be at the birth, the doula can give them updates about the labor if they are not in the room, answer questions, and reassure them about the birth process. This often alleviates anxiety the family may feel if they don’t know what’s going on and frees the father from needing to leave his partners side to talk to the family members.

Numerous studies have shown that there are absolutely no risks to having a doula present at a birth, thus labor support can only be a benefit to the laboring couple. The Cochrane review concluded that the presence of a doula helps the couple to have a safe and satisfying birth experience and that all women should have labor support at their birth. Further, studies by Klaus, Kennell, & Klaus have shown that use of a labor support increases positive outcomes including less need for pain medication, less pitocin, lower cesarean rate, better overall obstretic outcomes, and couple’s satisfactions with the birth experience, and facilitates better mother-infant bonding and higher breastfeeding success.

Doctors and nurses in the hospital are responsible for the health and well-being of the mother and child. Since they are focused on this important task and often have many patients to attend to, they don’t have time to focus on emotional support of the laboring mother. The doula fills this gap by focusing solely on the emotional and physical comfort of the laboring woman and facilitating communication between the birthing couple and medical staff. The doula’s presence helps to ensure wholistic care of the laboring woman – with her physical and emotional needs for care met.

With all of the advantages that a doula can provide to both the laboring couple and the medical staff at the hospital, it is really a no-risk venture to hire a doula for one’s birth. A doula is an important member of the birthing team, creating a calm tone for the birth, helping the couple to feel cared for throughout the process, empowering women to trust their bodies, and helping them to have the joyful birth experience they want and deserve.

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