If you are anything like I was during my first pregnancy, I had no idea what a doula was or why on earth I would need one. Thankfully, with the support of an amazing midwife, I had a great birth without a doula. With my second pregnancy, circumstances meant I didn’t have the luxury of a continuity of care midwife during the pregnancy or birth. Thinking everything would be fine, I decided not to go ahead and hire a doula. Worst. Decision. Ever. Not even exaggerating, my birth was horrendous and I wish I had known exactly what a doula was and why every woman needs one!
WHAT IS A DOULA?
A birth doula, pronounced ‘doo-la’, is a pregnancy and birth support person. Doulas have been supporting women for centuries, in many different cultures.
There are many different types of doula, including antepartum, postpartum and bereavement doulas. I will be speaking specifically about birth doulas. Typically, a doula is a woman who has given birth (although not always) and is a trained professional in supporting women during labour. She knows all about natural birth processes and the interventions that go along with hospital births.
During pregnancy, a doula will help to alleviate any fears you may have about the birth and post-partum period. A doula is someone you can call on any time of day for reassurance and support.
Most doulas will also offer a birth planning session, where you will sit together and go through your ideas and preferences for the birth. She is available to educate you about labour, breastfeeding, postpartum, and provide any advice you may need from a non-judgmental, unbiased perspective.
A doula will attend your labour and birth, whether that be at home, hospital or both. Her role is strictly non-medical, purely physical, emotional support and advocacy. Doulas are very skilled in alternative pain relief techniques, giving you an endless supply of ideas to try before you ask for the epidural.
WHAT DOES A DOULA DO?
• Provides emotional support during pregnancy, birth and beyond
• Uses comfort measures including (but not limited to) massage, relaxation techniques, position change, heat packs, showering, hip squeezes, etc.
• Create a home-like environment in the hospital, by using aromatherapy, music, flameless candles, ensuring privacy etc.
• Gives clear, unbiased information to assist you in making decisions both before and during labour.
• Continuously reassures and comforts, a doula never leaves your side once labour is established.
• Advocates for the mother and helps facilitate communication between the mother and care provider
• Ensures you are drinking and eating, she may even brew herbal tea for you and make coffee for your partner.
• Provide emotional support to your partner, as well as ensuring they are hydrated, rested and fed.
• Works together with your partner in supporting you.
• Help you to get cleaned up and comfortable after birth
• Offer assistance with establishing breastfeeding
• Provide in home support after the birth.
Ultimately, the doula you hire will perform the tasks you wish of her, whether that is to remain by your side the whole time, or primarily to give support to your partner.
BENEFITS OF HAVING A DOULA ATTEND YOUR BIRTH
The benefits are plentiful. Studies have shown that women that use a doula are much more likely to have a positive birth outcome and birth satisfaction. Women are less likely to ask for pain relief medication (60% less likely to ask for an epidural).
Also, by having a doula attend your birth you will reduce the length of labour by 25% (average of 40 minutes), decrease your chance of a caesarean by 50% and lower the need for augmentation with syntocinin (synthetic oxytocin) by 40% (1).
WILL A DOULA MAKE YOUR PARTNERS ROLE REDUNDANT?
This is such an important point to mention, partners are often concerned a doula will replace them and push them out of the way. Simply not true, doulas are there to ensure your partner is comfortable, informed and participating (if they want to).
Some partners may feel completely overwhelmed and intimidated by seeing you in pain. They may feel completely helpless and have no idea how best to support you. This is where a doula can step in, give him some encouraging words and suggest some massage techniques or positions he can support you in. Perhaps your partner needs some space, and would rather sit back away from the action. That’s ok, especially because your doula can step in and play an active role in supporting you.
By taking the extra pressure off your partner, they will be able to eat, rest, and move the car etc, whilst feeling reassured that you’re being looked after your doula. Your partner will be more emotionally present and may actually even enjoy the incredible birth journey.
ARE DOULAS ONLY FOR WOMEN PLANNING A HOMEBIRTH/NATURAL DRUG-FREE BIRTH?
Absolutely not. In my opinion, women birthing in a hospital need a doula more than those choosing a home birth. Hospital births are difficult to navigate through without someone there to support and advocate your decisions. Doulas are familiar with local hospital policies, and can keep you informed about them. A doula will also facilitate communication between you and your health care provider, this is important especially when you haven’t met the midwife/doctor before. Ensuring effective communication can make the birth much less stressful for everyone involved.
As for women choosing to use pain medications, a doula will support you in whatever decisions you make. She is not there to sway you decision or judge your choices, she is there for YOU. If you choose an epidural, you will still need emotional support during the application of the epidural and help with it comes to pushing. It is reassuring to know your doula is there to help you ask the right questions regarding hospital procedures to ensure you have all the relevant information to make decisions should they arise.
Photo Credit: Jen from Heart of Motherhood
WHAT QUESTIONS SHOULD I ASK A POTENTIAL DOULA?
• What services do you provide?
• What is your philosophy regarding birth?
• Do you have experience with VBAC/twin birth/planned C-section?
• Do you have a backup plan in case you can’t attend my birth?
• How many clients do you take per month?
I hope this article has made you consider having a doula attend your birth, it is certainly a worthwhile investment into having a positive birth experience.
- Sam Ross (Birth Doula)
1. Hodnett ED. Gates S Hofmeyr GJ. Sakala C. Continuous Support for Women During Childbirth. Cochrane Database of Systematic Reviews. CD003766, (2003).
To connect with Sam and her services at Sage, Birth & Beyond click here
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