Until fairly recently, our entire birthing history consisted of home births attended by skilled midwives and women helpers who we would now identify as "doulas". When we look to ancient birth stories, the woman is often attended by one or more women who's sole focus is to help the laboring woman successfully deliver her baby as safely and comfortably as possible. Doing whatever it takes to make the experience as easy and pain free as possible for her.
The word "Doula" comes from the Ancient Greek meaning "a woman who serves". A Doula is someone who assists a woman (and partner) through her birth and is a constant pillar of physical, emotional and even spiritual support for the expecting mother through her pregnancy, birth, laboring and postpartum experience. In a sense, doula's "mother the mother".
Usually a Doula meets with the mother and partner 2-3 times before the birth - usually in the final trimester of the pregnancy. This is to establish a trusting relationship, help create and fully understand a birth plan and to learn and practice visualization and/or positions that they will try to utilize during the labor process. During this time a mother or fathers fears and anxieties can be addressed and eliminated as much as possible, making the labor process easier and better prepared for.
A doula does not provide medical advice or do medical procedures such as check dilation or blood pressure. They are there to provide support, not to intervene. The doula is present through the entire birthing process and 1-2 hours after the baby is born to help facilitate breastfeeding and bonding in any way necessary. Support for the new parents in the following days is also common to give the mother and partner the opportunity to ask questions and share stories and of coarse to adore the new baby. A postpartum doula provides in home care and support to the new mother and baby for anywhere from a few weeks to a few months depending on the needs of the mother.
A doula is often someone who encourages the natural labor process yet is also is willing to work with couples with all kinds of birth plans. By nature, most doula's are very open minded and compassionate. Usually when people hire a doula they are motivated by the support the doula can give in helping them remain guided in their natural birth plan as well as the peace of mind that someone is there for the laboring mothers needs through the entire birthing process. They are trained in the physiology of birth as well as the emotional needs of the laboring mother and can help provide the parent(s) with reliable information and support throughout their entire experience.
A general selection of services provided by birth doulas
- Nutritional counseling
- Tips for coping with discomforts of pregnancy
- Preparation for birth
- Assistance in creating a birth plan
- Support at home in early labor
- Comfort measures in labor
- Suggestions and support for positioning in labor
- Continuous support throughout labor and birth
- Troubleshooting for difficult births
- Facilitate communication and informed decision making with your health care providers
- Support for dads and partners
- Natural birth coach and advocate
- Support for VBAC (Vaginal Birth After Cesarean)
- Cesarean and post-cesarean support
- Respect for the bond between mom and baby in those tender early hours
- Encouragement and skilled support to breastfeed
- Postpartum home visit(s)
- Community resources and referrals
A general selection of services provided by postpartum doulas
- Breastfeeding support
- Newborn care
- Comfort measures and support for the mother’s physical recovery
- Shopping, errands, meal preparation
- Laundry, light cleaning, household organization (not housecleaning)
- Sibling adjustment support (not babysitting or nanny services)
- Depression screening and referrals
- Education on infant topics
- Community resources and referrals
Many women wonder if they need a doula if they already have a labor partner such as the spouse or family member, and the answer is yes! The doula's role is to not only support the laboring mother, but to help and support the partner as well. Having a doula will help your labor partner understand and be better equipped to help support you.
Many times labor can be an unpredictable experience, especially for those who have never seen or experienced it first hand. Fathers who are often expected to be coaches find it difficult to fulfill her needs because the experience is emptional and intense for them as well. Their panic or fear can contribute to anxiety for the mother. Having a doula to help interpret, communicate with care providers and ease the anxiety of both partner and mother can be a great assistance to the birthing experience. Doula's are trained to be perceptive and know when the anxiety levels are rising and are then able to step in and help everyone get back on track confidently. Every labor can benefit from having a doula present. Even cesarean births can find having a doula for support helpful in getting through with peace of mind and especially when healing from the surgery afterwards.
What have the studies shown in comparing doula supported birth to non-doula supported births?
Doula supported labor has shown excellent results in shortening labors, have higher numbers of vaginal deliveries without the assistance of forceps or vacuums, and were less likely to need narcotics or epidurals. Cesareans are more rare and the overall birthing experience is more positive. Women who use a doula are also more likely to breastfeed confidently and are far less likely to develop Postpartum Depression (PPD) and the babies delivered are shown to have higher 1- minute and 5- minute Apgar scores.
Choosing a Doula
A certified Doula is someone who has gone through a certification process a doula or childbirth association such as DONA International, Association of Labor Assistants and Childbirth Educators (ALACE), and others. Though certification ensures that your doula is well trained, it does not ensure that they will be the right choice for you. Often times the best birthing experience is based on compatibility with your doula because ultimately it comes down to trusting your doula and feeling free to communicate your needs. Meet with at least two or three doula's if they are available in your area and go with your gut instinct and how much the person seems to be eager to support your birth plan.
The cost of doula's may vary, but many offer their services on a sliding scale fee (meaning it is based on your income). The average cost for doula support is between $200 and $1,000.00, and some work as volunteers for low income families or teens.
No matter how much you pay for your doula, the support and experience is priceless.
Also see our article: You're a WHAT-A?! Everything You Need To Know About Doulas