A Peek into the Roll of a Doula

Editor’s Note: Good morning. Local doula Stephanie Janzen is on site explaining the role that doulas play during childbirth, as well as the benefits of professional labor support before, during and after the birth of your child. Our Big Earth is a sponsor of this year’s Bellies, Birth and Babies Fair hosted by the Comox Valley Doulas. Be sure to save the date May 29 to come out and meet the doulas, learn more about pregnancy and childbirth and check out all of the great vendors who will have the latest baby gear on hand that day. I love babies. Here is Stephanie:

Doula is a household word in my family but many people have never heard of it, and many others only have a vague understanding of what a doula is. Do you deliver babies? What’s the difference between a doula and a midwife? These are two questions that I hear a lot. Well, to answer both questions in one go: no, doulas don’t deliver babies – midwives and doctors do. Unlike a midwife or a doctor, doulas do not perform any clinical tasks – that includes vaginal exams, fetal heart checks, and all of the important tasks that primary maternity care providers do to ensure the health and safety of pregnant women and their children.

So what do doulas do? Doulas (specifically birth doulas) provide professional labor support to pregnant women and their birth companions. In other words, doulas accompany women during childbirth, providing them with continuous, one-to-one support aimed at helping them stay calm and relaxed, informed and empowered throughout labor and birth.

That means that in most circumstances a doula shows up at the beginning of labor (or whenever you need her) and stays straight through until an hour or two after the baby is born. Doulas spend their time holding your hand, breathing with you, massaging you, helping you to visualize, doing acupressure, giving helpful suggestions and information to you and your birth companion(s), encouraging you, walking with you, assisting with different positions and movements, taking photos and getting you and your birth companion(s) drinks, food and other amenities.

In most cases, expecting parents hire a doula sometime during pregnancy and have at least two visits together before the birth of the baby. These visits are opportunities for clients and doulas to get to know each other better - to talk about pregnancy, birth and the postpartum period - and for the doula to gain an understanding of how to best support her clients.

Doulas often have a wealth of information about local resources and can provide their clients with information useful for making informed choices. As the due date approaches, doulas become on-call 24/7 (this usually starts around 37 or 38 weeks gestation, but may vary for individual doulas). During this time, as with any time after a doula is hired, clients are free to call or email with questions and updates along the way.

To be able to reach a familiar person with one phone call can be very satisfying for expectant parents who may have sudden questions or concerns. Once labour begins, doulas are ready and waiting to join their clients whenever their clients desire - this might be during early labor, active labor, at home or at the hospital.

In the weeks following the birth of the baby, doulas meet up with their clients at least once or twice (sometimes more), giving clients a chance to share their perspectives on the birth experience and allowing the doula to answer any questions that arise. The doula can also provide her clients with helpful strategies for newborn care, breastfeeding and postpartum adjustment, as well as continued emotional and practical support.

Some people wonder why, if they have a midwife or a loving and supportive partner, should you hire a doula?

Well, first, the continuous support provided by doulas is an important aspect of what makes their care so effective and often unique to other members of a woman’s maternity care team. When primary health care providers must concentrate on medical responsibilities or on other patients, the doula remains constantly with the mother, focusing on her and her birth companion’s needs for comfort, coping and understanding.

Although midwives typically spend a greater duration of the labor with their clients than doctors might, their schedules are still packed with many essential medical responsibilities, which can hinder their ability to continuously focus on the mother and her birth companion(s)’s needs for coping. Doulas work with clients who have doctors (including OB/GYNs) or midwives, so who ever your care provider is I encourage you to talk with her or him about doula support.

Second, doulas are there to support birth companions too, most importantly helping them to best support the laboring mother. When a couple is supported by an experienced labor assistant they are free to be with one another, as they are able to draw on the expertise of their doula rather than worry about what to do next or trying to remember every last thing they learned in prenatal class a month ago. Rather than replacing loved ones, doulas help to increase intimacy by taking the pressure off partners who may have little or no experience with birth and who may need support of their own.

All of the good stuff that I’ve mentioned has been supported by many studies. Research shows that having a doula increases your chances of coping well with labor, making informed choices and having a positive birth experience. All of these results equate to a significantly decreased likelihood of pain medication use, Caesarean section, forceps delivery and a need for augmentation. As well, having a doula can shorten the duration of labor, contribute to successful breastfeeding and increase your chances of a VBAC if you have had a previous Caesarean.

How can you find a doula that is right for you?

First, check with your doctor or midwife. Often they will have a list of doulas working in your area. Many doulas and doula collectives also have websites that list individual contact information. Doulas understand the importance of choosing the person who is right for you, so once you have a few names and numbers, contact as many as you can and arrange for a no obligation, free interview in person or by phone.

Come with a list of questions and always make sure to ask if the doula is available for your due date, what her fees are, what the payment schedule is and what services she provides for this cost. Having a formal contract is a good way to make sure that everyone is on the same page.

For more information on doulas and questions to ask during interviews, check out DONA International. For more information on doulas in the Comox Valley check out Comox Valley Doulas.

Happy birthing!

References and further reading:

Campbell, D.A., Lake, M.F., Falk, M., & Backstrand, J.R. (2006). A randomized control trail of continuous support in labor by a lay doula. Journal of Obstetric, Gynecological ,and Neo-Natal Clinical Research 35, 456-64.

Koumouitzes-Douvia, J. & Carr, C.A. (2006). Women’s perceptions of their doula support. The Journal of Perinatal Education, 15(4), 34-40.

Klaus, M., Kennell, J., Berkowitz, G., & Klaus, P. (1992). Maternal assistance and support in labor: Father, nurse, midwife, or doula. Clinical Consultations in Obstetrics and Gynecology 4(4), 211-17.

Klaus, M.H., Kennell, J. H., & Klaus, P. H. (2002). The Doula Book. (2nd ed.). Cambridge, MA: Merloyd Lawrence.

Lesser, P.A., Maurer, M., Stephens, S. & Yolkut, R. (2005). Doulas for all. International Journal of Childbirth Education, 20(3), 28-32.

Scott, K.D., Klaus, P.H., & Klaus, M.H. (1999). The obstetrical and postpartum benefits of continuous support during childbirth. Journal of Women’s Health and Gender-Based Medicine, 8(10), 1257-64.

Photo courtesy of Comox Valley Doulas

Tags: birth, birth doulas, birth experience, doula, doulas, health and wellness, labor, labor assistant, labor support, pregnancy, women

Category: INSPIRED ACTION, Pregnancy