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What Is a Doula and Do I Need One?

by Kathy Pehlke, CD (DONA)

The term doula is Greek for servant. Doulas provide emotional and physical support during pregnancy, labor, and birth and immediately after the birth. They call themselves many things including: Childbirth Assistant, Labor Support Professional, Birth Assistant, Birth Companion, etc. A doula does not speak for a couple, provide medical or clinical skills, or act in any unprofessional manner (most organizations have policies that each doula must follow). Controlled studies involving over 1,000 women have demonstrated that the presence of a doula labor assistant resulted in a reduction in Cesarean sections and decreases in length of labor, use of forceps and medications. By mothering the mother during childbirth, the doula supports the parents in having a positive and memorable birth experience. Childbirth is an emotional and spiritual experience with long-term impact on a woman's personal well being.

Why Use a Doula?

In order to have a positive birth experience, most women need continuous labor support consisting of praise, reassurance, measures to improve the comfort of the mother, physical contact such as rubbing the mother's back and holding her hands, explanation of what is going on during labor and delivery and a constant friendly presence. Such tasks can also be fulfilled by a nurse or midwife, but they often need to perform technical/medical procedures that can distract their attention from the mother, especially in hospital settings where shift changes, coffee breaks, heavy paperwork and busy nights regularly occur. Midwives may be able to offer more labor support, but they too have clinical duties to which they must attend.

A Doula Provides:

  • Help with preparation of a birth plan

  • Helps you relax by using touch, massage and words of comfort

  • Positioning suggestions during labor and birth as well as other comfort measures such as hot or cold packs, counterpressure for the back and use of a birth ball

  • Helps support the partner so that they can love and encourage the laboring woman

  • Helps with breastfeeding

  • Nurtures and protects the memory of the birth for the mother. She provides couples with their birth story after the birth and helps fill in the blanks or answers questions.

  • Many other possibilities that vary from doula to doula

Fathers...

The father or partner may be better able to provide continuous support but has little actual experience in dealing with the forces of labor. Even fathers who have had intensive preparation are often surprised at the amount of work involved (more than enough for two people). Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation. What they lack however is knowledge of the normal birth process. They do not know the many possible variations of labor. They cannot possibly remember all the positions, breathing techniques and little reminders that can make a labor go smoothly. With a doula present, a husband can take part as fully or as simply as he chooses. Some fathers or partners are concerned they may be sidelined or replaced by the Doula during labor. Although individual situations vary, and one should question a prospective doula about her philosophy generally the answer to this question is no, she will not replace him. Studies have shown that fathers usually participate more actively during labor in the presence of a doula than without one. A responsible doula supports and encourages the father and enhances his support style rather than replaces him.




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