What is a doula?
Doulas are trained and experienced in childbirth and are usually mothers themselves. While they have good knowledge and awareness of the birth process, a doula does not support the mother-to-be in a medical role. That is the job of the midwife or doctor.
A doula helps the mother-to-be achieve the birth she hopes for, no matter if it's a birth with or without drugs, or a c-section. This makes a doula a valuable addition to the birth team. Should a birth become complicated and require medical assistance, a doula will still remain by your side and help in any way she can. She will not make decisions for those she supports, but she will assist them through the decision making process. A doula provides balanced information so the couple can make their own choices.
Many women consider doulas to be an absolute must, especially for those giving birth in a hospital. due to the over-medicalisation of birth, inductions of labour have skyrocked, and are partly to blame for the 30% (that's one out of every three!) Australian and American babies now born via c-section.
Some hospitals sport c-section rates of 50% and higher. This is a shocking statistic, well above the World Health Organization recommendations of 10-15% -- after this amount, it doesn't save any further lives, which is what the c-section was intended for. given the long term emotional and physical effects that medical births can have on the mother, her partner and baby, a doula is a valuable asset to your birth team.
By amping up your support team with experienced, continuous care from a doula, you're giving yourself an increased chance at a better experience. Your support team are the people you will rely on to get you through your toughest, most intense moments. How well they hold the space and support you can impact on the outcome of your birth.
With a doula, you know that someone is always on YOUR team, holding the space for you and your family. She works for you (and your partner) and has your best interests at heart.
For more information on doulas, download this one-page handout from Evidence Based Birth.
What does a doula do?
A doula may provide some or all of the following services, dependent on her training and skills. Often doulas are also qualified in other therapies too, so it always helps to ask!
- Birth education and preparation
- Birth planning (including creating a written birth plan/birth preferences document)
- De-briefing previous births
- Massage and other comfort measures
- Optimal fetal positioning
- Suggest positions and changes to help ease pain and facilitate a smoother, more effective labour
- Provide reassurance and encouragement
- Talking through emotional blockages which may come up during pregnancy and in labour
- Keep your 'environment' going -- aromatherapy, music, candles, etc.
- Assisting you with negotiation of your preferences
- Photography and/or video of the birth itself, as well as those precious first moments as a family
- So much more!
One of the biggest bonuses of hiring a doula is the fact that she is a professional birth support person.
Doulas are trained in the art of birth support, and have a keen eye and intuition into what a labouring mother needs -- all the little details which a hospital midwife unfortunately does not always have time for (as much as she may want to). And, the things your partner may not pick up on, or situations he may not know how to deal with.
A doula has a heart that is caring and nurturing, yet is able to remain calm and focused if things go off the rails -- something that can be very difficult for family members and partners. Because family and friends have an emotional connection, in the event of a problem or at the peak intensity moments, they can buckle, not knowing what to do, say or think.
What are the proven benefits?
Studies (and reviews of the studies) consistently demonstrate very impressive benefits for the mother, father and baby, including:
- Fewer caesarean sections
- Reduction in teh use of forceps and vacuum
- Fewer requests for epidural
- Reduction in teh use of synthetic oxytocin for inductions or augmentations
- Reduction in the use of pain medication
- Reduction in labour length
- Increased rates of breastfeeding at 6 weeks post-partum
- Higher self-esteem, less anxiety and less depression at 6 weeks post-partum
The benefits are significant. Most of the women in the studies were accompanied by male partners, however study results show that women who had the support of a male partner and a doula fared best, for example, the caesarean rate of women supported by both a male partner and a doula was significantly lower (15.4%) than the caesarean rate for women supported only by their partners (24.4%). the studies also clearly show the positive benefits of doula support occur regardless of a woman's economic status or whether or not they were privately insured. Its simply about having the right support with you at birth.
What about the birthing person's partner?
According to studies (and from personal observations in births I have attended) rather than diminishing a partner's participation in the birth process, a doula's support complements and reinforces her partner's role.
Partners report feeling more enthusiastic, and believe their contribution to the labour and birth was meaningful and helpful.
I often find when partners have a visual on how to support a woman -- simply watching a doula support her -- they feel more confident and relaxed, having seen some ideas to try themselves.
In the studies, not only did partners report higher levels of satisfaction afer the birth, but mothers reported feeling more satisfied with their partners role at birth too.
Over 30% of women reported that their relationships were better post-birth than they were prior to the birth.