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What is a doula?
The word doula comes from ancient Greek, originally meaning the head female slave of a household. Currently, this word is used to describe a professional labor coach. A doula provides non-medical support to a laboring woman, ensuring that her emotional and physical needs are met as she works to bring her child into the world. Modern certified labor doulas receive extensive training in research-based labor and birth practice, and can provide expectant parents with prenatal education, as well as on-the-spot information on risks and benefits of routine interventions. One of the most important aspects of a doula's role is that it is constant and continuous. A doula knows her client's thoughts and hopes for the birth, and her preferences for treatment before labor ever begins. A doula does not change shifts half way through your labor. She does not go on vacation as your due date approaches. She will be at your side from the moment you decide you need her, and will remain there until you are ready for her to leave.
What are the benefits of having a doula at my birth? In the book, Mothering The Mother: How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth, Marshall Klaus, John Kennell and Phyllis Klaus summarize scientific studies which have been carried out on the advantages of doula-assisted births. The evidence cited is drawn from six randomized, controlled studies, with over 1000 participants.The results of the studies were as follows:
What does a doula do to help me cope with labor? The most important thing a doula does for the laboring mother is to give her constant support.. Klaus and Kennel speculate that the mere presence of a doula had a beneficial effect on the emotional state of the mothers in the studies, resulting in a decrease in catecholamines (adrenaline). This relaxed state allows uterine contractions to be more effective and reduces the occurrence of compromised uterine blood flow. But here's the rest of the story: A doula's best tools are her hands. She comforts the mother and massages her back, shoulders, legs... any task that helps the mother relax and let go, releasing her tension and allowing her body to focus on the work of bringing forth new life. A certified doula has special training in massage techniques specifically designed to help laboring women. She reminds the mother to eat, drink, and use the restroom. She helps the mother use different positions to aid in baby's descent and positioning, thus speeding labor. She reminds the mom of her goals, and believes fully that the mother can achieve those goals. A doula works with her client's partner as well, teaching him along the way how he can best comfort and encourage his partner during her labor. When necessary, a doula can provide immediate information on the risks and benefits of various interventions proposed by medical staff. A doula has faith in the ancient wisdom of women's bodies. And that energy is an incredibly powerful force in a birthing environment. What about my husband? A doula does not replace your partner. She helps him to participate more fully in the birth of his child by teaching him in the moment how best to meet your needs. Many men feel extreme pressure to "do the right thing" to help their wives.... if only they knew what that might be! Hiring a doula takes the pressure off of your partner, and allows him to enjoy his baby's birth without stress, armed with the knowledge and assistance necessary to meaningfully participate in the event. A doula enhances the bonding a couple can experience during childbirth... she does not detract from it. Many partners have early doubts about their wife's choice to seek an "alternative" birth, whether that be a birth with less or no pain medication, a birth out of a hospital, or a birth that involves a written "plan" which might conflict with standard policy at your hospital. During prenatal sessions, a doula can help your partner understand your position, and facilitate dialogue about his fears and concerns.
What about my midwife/Obstetrician? A doula has NO MEDICAL ROLE during pregnancy, labor, and birth. Your birth must be attended by a licensed midwife or physician. A doula compliments these medical professionals by reducing their work load. In hospitals especially, midwives and doctors are simply unable to give constant support during labor because they have many other tasks to complete. A doula has only one client, and no other commitments on her time during your labor. A doula offers no medical opinion or advice. She offers information based on research evidence. A doula does not prevent a medical care provider from performing any task, but she facilitates the dialogue between medical staff and the laboring woman and her partner to ensure her client always gives fully-informed consent or dissent for all procedures and interventions. It is important to discuss your desire to have a doula present with your care provider well in advance of your due date. I would be happy to accompany you to this meeting if desired.
What if I want an epidural? A doula wants you to have the best birth experience possible- as you define it. During prenatal sessions, a doula will discuss the risks and benefits of epidural anesthesia, so that you can make a fully informed choice when your labor begins. If, after reflection, you are sure you want an epidural, a doula can help you get an epidural at the best time to reduce the chances of negative side-effects. She can counsel you on options such as reducing the epidural as full dilation approaches, to aid you in feeling pushing sensations. She continues to perform other tasks, such as providing information and encouragement, and supporting your partner. If you expressed a wish prenatally to avoid all medical pain management techniques, but ask for an epidural during a particularly intense phase of your labor, a doula will remind you of your goal, and suggest many non-medical pain management techniques. She will encourage you to take each contraction one at a time, and may try some deferral techniques to help you get through the tough stage. But if you decide you really want one, a doula will never prevent you from having one or judge you for your decision. This is your birth.
What is a birth plan? A birth plan is a short document, usually about one page long, where your desires for your birth are summarized. This document is reviewed by your care provider before your due date, so that he or she can help you achieve your best birth. Writing and presenting a birth plan reminds your care givers that you are an individual experiencing a unique birth, and that you should be given as much control over the process as possible. A birth plan can include information about the setting of the birth (light level, noise level, desire for music, candles, aromatherapy), informed consent or refusal of routine medical interventions (IV, electric fetal monitoring, cervical checks, rupture of membranes, coached pushing, cord clamping, etc), and information about personal preferences, such as birth position (in water, upright and other "alternatives" to bed delivery), immediate bonding time with baby, etc.
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Copyright 2010 Lausanne Doula |
