Doulas - Benefits of Having a Doula

BIRTH DOULAS

A commonly used definition for the birth doula is an experienced labor and delivery companion who provides continuous physical, emotional and spiritual support to you and your partner. A doula's very presence has been shown to provide a birthing mother with confidence, encouragement, strength and determination during labor. Private birth doulas usually meet with a couple during the nine months of pregnancy to begin building a relationship with the couple, discuss the upcoming birth, and develop the birth plan.

This support from the doula before and during labor is invaluable for pain management and is achieved by performing massage, recommending positions that assist the progress of labor and through verbal encouragement as the labor progresses. A doula differs from a midwife in that she does not provide medical care during pregnancy and labor and does not deliver the baby. However, she may offer recommendations during pregnancy and throughout the postpartum period that allow you to make informed decisions about your care.

A birth doula does not replace or remove the importance of a partner's role in any way. It's easy to understand the difficulty a partner may have remaining objective and calm while witnessing the discomfort, doubt and fears of labor. The desire to help is intensified by these emotions. With a doula present, the partner can be more emotionally available for the mother, possibly feeling less pressure to remember what to do from childbirth classes. A doula can show the way, allowing the partner to be more present for the mother during labor and for the child immediately following birth.

The doula and partner become a team of sorts and work together to achieve the optimal outcome - a safe birth and a healthy baby. Many doulas will also take photographs of those precious first moments of baby's life if a couple so wishes.

Typically, the doula will stay with the couple and new baby for a brief period after birth and will offer suggestions and assist with breastfeeding. She will help the new parents as they adjust to parenthood by staying in touch with them during the first several weeks postpartum. A doula's presence is reassuring and comforting during this period of adjustment, especially if the new family doesn't have family and a support network close by. It is also beneficial to have this support person to identify any signs of postpartum depression or to avoid additional stress to the new family.

POSTPARTUM DOULAS

A postpartum doula is trained to work with the new family in the weeks after the birth experience, helping them to adjust to caring for their baby and their new roles as parents. A postpartum doula understands responsibilities that new parents face. She assists and encourages them during this transition, while respecting individual preferences as to how to care for the new baby. Typically, this type of doula is skilled in breastfeeding education and early family and childhood development and can be helpful with any problems that may arise.

Postpartum doulas are ideal for families where:

• Mother or baby had complications during labor & delivery, or in the immediate postpartum period
• Mother has a history of depression (postpartum or otherwise)
• There are multiple children
• Mother has been having breastfeeding difficulty

FINDING A DOULA

The use of a doula has been linked with shorter labors, decreased incidence of postpartum depression, increased success with breastfeeding and greater overall satisfaction with the birth experience. If you are considering a private birth doula, meet with her early in pregnancy to begin building a relationship and discuss your upcoming birth. Consider asking some of the following questions when interviewing a birth doula.

• What training and education have you had?
• Are you a Certified Doula through any professional organization? 
• How many births have you attended? 
• What is your philosophy about supporting women and their partners through childbirth? 
• When do you join women in labor? May we meet with you to discuss or birth plans & the role that you will play in supporting us through childbirth? 
• May we call you with questions or concerns before or after the birth? 
• Do you meet with us after the birth to review the labor and answer any questions? 
• Do you provide a backup doula for unforeseen emergencies? 
• What is your fee and what does it include? 
• Can you provide us with references of former clients?

A BIRTHING MOM'S PERSPECTIVE

I had the privilege of working with a doula for both my children's births. I first heard about doulas, and my doula specifically, because one of my close friends was her client. She was one of three full-time doulas at Barnes-Jewish Hospital in St. Louis. She also took on one private birth a month. So, when I found out I was pregnant, I called her immediately.

At first, my husband was hesitant as he didn't understand what role a doula would play in the experience. After the birth of our eldest, he announced to everyone: "I'm never having a baby without Nancy!" Nancy (our doula) truly was part of our birthing team. She made it possible for us to labor in the comfort of our home for a long time, only moving to the hospital in the last stages before the transition phase of labor.

As soon as I started feeling contractions I called her, as instructed. This happened to be at three in the morning but Nancy showed up 15 minutes later and urged us to go back to sleep until they intensified. She explained there was no reason to stay up all night and that I would need my strength. Her presence alone calmed me so that I could focus on listening to my body. As labor progressed, Nancy attended to both me and my husband at home: giving me massages, making sure that we both ate and rested, reassuring us that we had made all the preparations we needed for the baby. She brought her birthing ball with her and as my physical discomfort increased with the contractions, she coached me through breathing techniques, walking, and using the ball.
I felt comfortable because I knew that Nancy had attended hundreds of births and reassured me that the sensations I was feeling, both physically and emotionally, were all normal and natural.

When we finally went to the hospital, she was also instrumental. Our doula was indeed our advocate with the hospital staff. She also served as the liaison between us and the concerned grandparents-to-be. She escorted my mom to the waiting room at the appropriate time and made sure that my husband's parents stayed in the waiting room. Within 20 minutes and without an epidural, we had our baby! After the birth, she volunteered to sleep at our house with our dogs so that my husband could stay with me at the hospital.

She was with us for the birth of our second child as well and although the experience was about as different from the first as night is to day, and although she would vehemently disagree, I say I couldn't have done it without her. The second time, I was in labor off and on for four days! Nancy was with us for most of that time and unlike the first time, we were in the hospital for the last 24 hours. She walked the halls with me, massaged my pressure points, helped me focus during contractions, and gave me lots of encouragement during the final stages of labor and delivery. Again, I was able to do it without an epidural.

Our doula has remained an important person to our family. She regularly visits with us and our children. My husband was right... I'll never have a baby without Nancy!

This guide was co-authored by Ria Sharon (from MyMommyManual.com, or PracticalMommy at Viewpoints.com) and Kate Kennedy CD, CBE, LMT (current Treasurer and past President of Doulas of Greater St. Louis).