What to Expect from Your Doula

Author // Justine Julian

Women have been giving birth since the beginning of time—but those times have now changed. Many women give birth without having witnessed the childbirth experiences of their own mothers, aunts, sisters and community members. We are now seeing that women truly need extra support through this transformative experience…and can get that help from a doula.

A doula is an advocate for the birthing mom and her partner. Whether a women wants to birth in a hospital with or without drugs or interventions, or whether she wants to birth at home with a midwife or other trained attendant, her doula will be there to help her feel involved, safe and empowered. A doula does not replace the birthing mom’s husband, or the loved one she has chosen to be with her. The doula is there to provide objective nurturing support and education, to make suggestions about comfort measures and positions, to keep the mom hydrated and focused, to provide breaks for the other members of the birth team, and to be the gatekeeper between the mom and the outside world. The doula is there to help make birthing easier. Depending on your healthcare provider and where you live, hiring a doula may be covered by insurance.

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When parents choose to birth in a hospital, a doula can provide comfort and support in the home, long before it is time to head to the hospital. Parents often wonder, “Am I really in labor?” or “Is it time to go yet?” A doula is trained to recognize the signs and stages of labor through close observation of the mother. Parents tend to be more relaxed in their own home, and labor may progress more gently and quickly. Plus, if you are already in active labor (4 to 5 cm) when you arrive at the hospital, there is a lesser chance of their using chemical induction or labor augmentation (with drugs like Pitocin or Cervidil, and procedures like the artificial rupturing of membranes). During your time at the hospital, a doula can help you to understand any procedures or complications that you may run into, and help you communicate with your care provider.

The following are some experiences you’ll have with your doula.

  • Consultation: Your opportunity to determine if a doula is right for you. This can be done via phone, e-mail or in person. There is no charge or obligation for your initial consultation with a doula.

  • Home Visits: A time to build rapport, discuss your health and pregnancy history, create your ideal birth plan, determine your needs and address your concerns. Relaxation, breathing and comfort techniques are also discussed.

  • Care Provider Visit: Meet with your care provider, share your birth plan, and follow up on your expectations and concerns about labor and birth. Review your health history with your care provider. Become familiar with your care provider’s policies.

  • Labor Support: Includes early labor and family support at your home, accompanying you to the birthing location (if you’re not birthing at home), birth plan support, continuous encouragement and guidance during labor and through the entire birthing process. Also includes early breastfeeding and bonding support.

  • Postpartum Visits: An emotional review of the birth at your home. This can include a wide variety of services, including breastfeeding support, and sometimes even housecleaning, laundry, shopping, errands, older child care, etc. New parents need to enjoy their new baby and rest!

A Unique Role

The role of a doula is to mother the mother. As our society has grown and progressed, many advances in science and medicine have made it possible to save lives that might have been lost a hundred years ago. But with those advances, we have lost the trust we had in our bodies, and our trust in the process of birth. Experts agree that interventions can help, but they are grossly overused and unnecessary in the majority of childbirth experiences. Birth has become filled with fear and misinformation. Doulas support the joy of birth by eliminating the fear and myths.

A birth doula helps families come as close as they can to having the kind of birth they desire. To start out on the right foot, parents need to come away from the birthing experience with the best possible feelings about themselves and their capabilities. Doulas can educate mothers and their partners about childbirth, help mediate the stress and discomfort that can be associated with pregnancy, and provide physical and emotional support throughout the birth. Doulas can offer suggestions on comfort measures, pain relief, positions, movement, breathing and relaxation that will provide the optimal experience for you and your baby.

While the outcome of labor and birth can be unpredictable, the care you receive during your labor never should be. Doulas work alongside physicians, midwives, nurses and birth partners, but do not replace any of these important birth team participants. Your doula is your assistant. Childbirth is a transformative life experience. On your birthing day, not only is your baby being welcomed into the world, but also you and your partner are simultaneously being transformed into parents. There is no other single day in our lives when we are asked to do, be and experience so many things. Protecting the sacredness of this event is a doula’s priority.

The Benefits of Doulas

A doula’s attendance at a hospital birth reduces:

  • Episiotomies
  • Cesareans by 50 percent
  • Labor time by 25 percent
  • Epidural requests by 60 percent
  • Use of synthetic oxytocin (Pitocin) by 40 percent
  • Use of analgesia by 30 percent
  • Use of forceps by 40 percent

Benefits of labor support to the mother:

  • Increases positive feelings about labor
  • Decreases interventions
  • Decreases need for medication
  • Increases acceptance of the baby
  • Enhances maternal/infant bonding
  • Decreases neonatal complications
  • Decreases anxiety and tension
  • Shortens labor
  • Increases feelings of self-esteem
  • Increases feelings of control
  • Increases mother’s cooperation and participation
  • Decreases postpartum depression

Pathways Issue 33 CoverThis article appeared in Pathways to Family Wellness magazine, Issue #33.

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