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Why a Doula is so Important...Throughout human history childbirth was part of family life and a woman’s experience with childbirth extended far beyond the birth of her own children. Female family members were present at births, alongside a midwife, who offered continuous care to women in childbirth. Since society has begun to view childbirth as a medical event, women often have little or no experience with childbirth prior to the birth of their first child.When a woman arrives at the hospital, the doctors and nurses are unable to provide her with continuous emotional support as they must attend primarily to the woman’s physical needs while also caring for other patients. A midwife will be able to offer more personal attention to the couple, but her primary concern is the health and safety of the woman and her baby. In both scenarios the woman is typically not in the presence of her care provider until active childbirth has begun. The average birth for first-time mothers is twenty hours. During most of that time, whether in the hospital, birth center or home, a woman is alone with her partner, friends or family members, who usually have very limited childbirth experience. Several clinical studies have demonstrated that the presence of a trained childbirth coach supporting the family with the non-clinical aspects of childbirth has measurable positive impact on birth outcomes. Benefits of Having a Doula...The presence of a doula or continuous support during childbirth reduces the incidence of interventions and provides increased positive outcomes:
A doula’s nurturing presence and personal attention gives the mother confidence and a sense of security, which helps reduce the effect of the fight-or-flight hormones on the birthing process and allows it to progress more quickly. Because of a doula’s knowledge, experience and personalized approach, women feel more in control of their birth experience. The presence of a doula allows the father/partner to offer more personal support to the woman in childbirth. The knowledgeable doula can support and encourage the father/partner by teaching him specific tasks through which he can interact with, nurture, and care for his wife/partner. Having a knowledgeable presence brings assurance to the father/partner and helps put him at ease so he can be calm and assuring to his wife/partner. In this way, the doula enables the father/partner to both experience the birth more completely and support his wife/partner with confidence. What a Doula Does...A doula brings her knowledge and experience to each birth. Her goal is to assist each family to have their ideal birth and to ensure that the woman feels safe and confident. The doula recognizes that a baby's birth is a major event, which the family will remember for the rest of their lives; therefore, she works toward helping them have a satisfying experience with healthful outcomes.Prior to the birth, the doula meets with the couple and assists them with the creation of a birth plan that reflects their wishes for childbirth. The birth plan functions as a guide for the doula and the care providers when attending to the mother’s needs during childbith. During birthing time the doula assess the father’s emotional state and desired level of involvement and offers suggestions or compensation as needed. She will work to establish and maintain a peaceful atmosphere in the room. She provides emotional support to the mother by offering her continual presence, encouragement, and knowledge. Comfort techniques, such as: massage, assistance with breathing and relaxation, hypnosis, visualization, counter-pressure, effleurage, hot/cold compresses, movement and positioning may be employed by the doula to help alleviate the mother’s pain and promote progress. If complications arise, the doula can help by providing information and facilitating communication between the couple and their care providers as they make a decision. Immediately following the birth, the doula will help the mother/infant pair establish breastfeeding. In a follow-up visit, shortly after the birth, the doula will meet with the new family to review the birth details, discuss their experience, and provide referrals for support if she is not able to assist the family with their needs. As a non-medical assistant, a doula’s primary focus is to attend to the mother’s emotional state, physical comfort, and wishes during the birth of her baby. She will also be a resource for information about the birthing process, provide an objective viewpoint during the birth, and provide assistance with obtaining information from the medical staff. She cannot diagnose, perform vaginal exams, or make medical decisions involving the couple. The doula does not replace the father or partner, but acts to involve family and friends present, as they feel comfortable. Having a Positive Birth Experience...Every woman hopes to have a positive birth experience. The inclusion of a doula in the labor and birth process will increase the mother’s likelihood of a meaningful and satisfying birth. In addition to reduced medical interventions, a doula can offer the assurance and confidence to a couple that they need to realize the birth they desire. She contributes to a positive emotional climate where both partners feel involved and connected to the birth of their child.Things to Consider When Selecting a Doula...How does her personality fit with yours?The birth of your child is very special event and your doula will be there to support you in a very intimate way. You want to be sure there is chemistry, so that she can support you most effectively and to maintain a sense of peace during the birth. Does she support your philosophy of childbirth? If you are preparing to have your baby using a certain method, inquire to see if the doula is willing to support that method. Or, if you would like to have an epidural, make sure she will provide you the same level of care she would a patient who is having an unmedicated birth. Does she have a back-up doula? If for some reason your doula cannot be with you on your baby’s birthday, you don’t want to be alone. Be sure that the doula you select has a back-up arranged to assist you if she is unable to. References 1. Ballen LE; Fulcher AJ. Nurses and doulas: complementary roles to provide optimal maternity care. Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG [J Obstet Gynecol Neonatal Nurs] 2006 Mar-Apr; Vol. 35 (2), pp. 304-11. 2. Campbell DA; Lake MF; Falk M; Backstrand JR. A randomized control trial of continuous support in labor by a lay doula. Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG [J Obstet Gynecol Neonatal Nurs] 2006 Jul-Aug; Vol. 35 (4), pp. 456-64. 3. Campbell D; Scott KD; Klaus MH; Falk M. Female relatives or friends trained as labor doulas: outcomes at 6 to 8 weeks postpartum. Birth (Berkeley, Calif.) [Birth] 2007 Sep; Vol. 34 (3), pp. 220-7. 4. Hardin AM; Buckner EB. Characteristics of a positive experience for women who have unmedicated childbirth. The Journal Of Perinatal Education: An ASPO/Lamaze Publication [J Perinat Educ] 2004 Fall; Vol. 13 (4), pp. 10-16. 5. Kennel, John H.; Klaus, Marshall H.; Klaus, Phyllis H.. The Doula Book. Da Capo Press: Cambridge, MA. 2002. 6. Romano AM; Lothian JA. Promoting, protecting, and supporting normal birth: a look at the evidence. Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG [J Obstet Gynecol Neonatal Nurs] 2008 Jan-Feb; Vol. 37 (1), pp. 94-104; quiz 104-5. 7. Scott KD; Klaus PH; Klaus MH. The obstetrical and postpartum benefits of continuous support during childbirth. Journal Of Women's Health & Gender-Based Medicine [J Womens Health Gend Based Med] 1999 Dec; Vol. 8 (10), pp. 1257-64. Page 1261 8. Position Paper: The Birth Doula’s Contribution to Modern Maternity Care. |