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Sweet as Pie - A Doula's Role
If you have not heard the term Doula yet, you are bound to soon. According to DONA International, a doula is a professional who is trained in childbirth and provides continuous support to a mother before, during, and just after birth (postpartum douluas are not covered in this article). Doula comes from a Greek word that means “a woman who serves” or “handmaiden.” Doulas are sprouting up all over the country and many mothers refer to them as the women who have made their birthing experience a ‘dreamy’ one. What is a Doula, anyway? A Doula is a trained birth coach -- a surrogate mother figure (without the baggage) who accompanies the couple throughout the entire labor and delivery process. They offer what I call a sweet PIE: physical, informational and emotional support: |
"Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth." |
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P.I.E.
Physical comfort procedures used during labor can include massage, counter-pressure, gentle touch, and literally supporting the laboring woman's body weight during a strong contraction. Positioning and frequent position changes are proving to be helpful in labor progress. Doulas often help mothers to squat or to assume other postures that require strong physical support. Informational support is also essential when the labor goes from the comfort of the home to the hospital. Often, as soon as the mother arrives at the hospital and is given a hospital gown, a transformation takes place. The mother goes from a natural birthing mother to a frightened ‘patient.’ Medical providers intervene with strange machines and equipment, offering technological assistance that is somewhat confusing and frightening to the mother-to-be and her partner. A Doula, with her knowledge of the natural physiology of labor and delivery, can explain suggested medical procedures and interventions and help provide the clarity expectant parents need when faced with medical decisions. Emotional comfort is imperative if the mother is to feel safe and secure in the birthing environment. A Doula's unique role is to encourage the mother-to-be self-confidence, protect the sacredness of the process, and help her relax and focus on the natural rhythm and progress of her labor. |
Our mission, as Doulas, is to help women remember their innate ability to give birth naturally, in a relaxed and meditative state. Pregnancy is a rite of passage for all women. It has become a medical event only in the last one hundred years. We are certainly grateful to the medical community; their intervention has helped save many women and children that would have otherwise died in the birthing process. Yet, today a normal labor and delivery is routinely treated as thought it were a sickness. In modern life the concepts that labor and natural birth are sacred rituals have been forgotten, but we can remember and embrace the miracle of the process. The birth of a human life should be embraced as a high sacrament. When a new life is created, the whole Universe shifts to make room; another expression of the divine Spirit has manifested itself, and this new life has the potential of becoming a world leader, a teacher, an effective parent, a best friend, or a loving companion.
To become a Doula, academic studies, combined with practical experience are required. We study the anatomy and physiology of pregnancy from conception to birth, attend childbirth classes such as Bradley or Lamaze and must be actively involved in several births. We are evaluated by doctors, nurse-midwives and clients, before we get our certification. Many Doulas are multitalented and help the mother do more than just birth her baby. Some of us help for a couple of weeks post-partum, with breastfeeding, general baby care, answering the many questions that arise each day.
The most important thing a woman needs during labor is continuous support. This means that you have someone by your side continuously from start to finish. A doula never leaves your side. Nurses have many other responsibilities other than you. Aside from helping care for you, the nurse is communicating with your care provider, taking care of other patients, documenting care, taking breaks, and taking care of other responsibilities. A nurse’s support ends when her shift does. The doula only has one obligation the whole time she is with you—and that is YOU!
Evidence shows that the most important thing is for women to have continuous labor support from someone– whether that person is a nurse, midwife, partner, or doula. However, with several birth outcomes, doulas have a stronger effect than other types of support persons.
In 2012, Hodnett et al. published an updated Cochrane review on the use of continuous support for women during childbirth. They pooled the results of 22 trials that included more than 15,000 women. These women were randomized to either receive continuous, one-on-one support during labor or “usual care.” The quality of the studies was good.
The study suggested the following conclusion, "Overall, women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth."*
For most of these outcomes,* the best results occurred when woman had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of the woman’s social network. When continuous labor support was provided by a doula, women experienced a:
To become a Doula, academic studies, combined with practical experience are required. We study the anatomy and physiology of pregnancy from conception to birth, attend childbirth classes such as Bradley or Lamaze and must be actively involved in several births. We are evaluated by doctors, nurse-midwives and clients, before we get our certification. Many Doulas are multitalented and help the mother do more than just birth her baby. Some of us help for a couple of weeks post-partum, with breastfeeding, general baby care, answering the many questions that arise each day.
The most important thing a woman needs during labor is continuous support. This means that you have someone by your side continuously from start to finish. A doula never leaves your side. Nurses have many other responsibilities other than you. Aside from helping care for you, the nurse is communicating with your care provider, taking care of other patients, documenting care, taking breaks, and taking care of other responsibilities. A nurse’s support ends when her shift does. The doula only has one obligation the whole time she is with you—and that is YOU!
Evidence shows that the most important thing is for women to have continuous labor support from someone– whether that person is a nurse, midwife, partner, or doula. However, with several birth outcomes, doulas have a stronger effect than other types of support persons.
In 2012, Hodnett et al. published an updated Cochrane review on the use of continuous support for women during childbirth. They pooled the results of 22 trials that included more than 15,000 women. These women were randomized to either receive continuous, one-on-one support during labor or “usual care.” The quality of the studies was good.
The study suggested the following conclusion, "Overall, women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth."*
For most of these outcomes,* the best results occurred when woman had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of the woman’s social network. When continuous labor support was provided by a doula, women experienced a:
- 31% decrease in the use of Pitocin*
- 28% decrease in the risk of C-section*
- 12% increase in the likelihood of a spontaneous vaginal birth*
- 9% decrease in the use of any medications for pain relief
- 14% decrease in the risk of newborns being admitted to a special care nursery
- 34% decrease in the risk of being dissatisfied with the birth experience*