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what is a birth doula and should I have one? July 12, 2007

Posted by guinever in : birth, doula, labor, midwifery, pregnancy , trackback

your questions answered about the purpose and value of labor support

What is a doula?

doulak1A doula is a trained birth professional who is knowledgeable about the progression of labor, pain management and coping techniques, and breastfeeding. She is familiar with your local hospital or birth center routines, medical terminology and procedures. She offers continuous support during labor and the immediate postpartum period.

What kind of support does the doula offer?

She offers physical, emotional and informational support. She will do her best to meet your needs during labor. Physical support during labor can include shoulder and foot rubs to help you relax, and counter pressure to help ease the pain of back labor. She can suggest position changes that will help your labor progress or ease your pain. She can go find more pillows or blankets, get you a cool wash cloth, re-fill your water cup or get your husband a cup of coffee.

Labor can be emotionally challenging especially if you are having your first baby. She can talk you through those really hard contractions. Labor can be especially difficult if you have a long labor or an unusually quick labor. Having an experienced woman there who you trust has a calming effect on both you and your husband. When you think you can’t possibly labor anymore and you want to give up, she’ll be beside you, the voice of experience, reminding you that you are doing it and that you’ll meet your baby soon.

Although not a medical practitioner, she is knowledgeable with medical terminology and procedures and can answer your questions or clarify something for you. When you’re in labor, you may be afraid of the unknown. A doula is there to reassure you that everything is alright. And if something isn’t progressing as it should, she’ll help to explain your options. If you have family members in the waiting room, your doula can give them periodic updates especially if you don’t want them in the labor and delivery room with you.

What are the benefits to hiring a doula?

The benefit is hiring someone who will always be with you. Nurses are busy and have many patients to help. Your midwife or doctor checks in with you only occasionally. Research indicates that when a doula is present, labors are shorter, less pain medication is requested, fewer births require forceps, vacuum extraction or cesarean. Additionally, more women breastfeed, and women are more satisfied with their birth.

What about my husband? He thinks he might want us to be alone during labor and birth. Will the doula take his place?

One of the best thing about having a doula at your birth is that she can help your husband help you if that’s what he wants to do. When hard labor kicks in and you start moaning, she can give him the thumbs up, letting him know that everything is ok. She can show him just the right place to do counter pressure on your back. A good doula stays in the background and jumps in when needed.

Understanding how labor progresses and knowing the physical changes that will take place, she anticipates your needs and is able to meet them. You don’t know how long your labor will be. Your husband may need to step out for a few minutes. With a doula there, you’ll never be alone, and if your husband never wants to leave your side, your doula can go get him coffee or dinner if necessary. It’s important that your husband meet your doula during one of your pre-natal meetings so the three of you can clarify what both their roles will be during birth.

What are the responsibilities of a doula?

A doula will be on call for you around your due date and come to your house or meet you at the hospital when you need her. She is available for phone support in those last days of pregnancy and in early labor. She stays with you during labor, birth and a few hours postpartum. She’ll come back and visit you in the first couple of days to answer any questions you might have about the birth. You’ll meet with her one last time after a few weeks postpartum.

What are some of the things a doula will not do?

A doula does not perform any clinical tasks including taking your temperature or blood pressure, monitoring your baby’s heart tones, or doing cervical checks. She also will not give you any medical advice or make decisions for you. A good doula will accept the kind of birth that you want and not try to force her own birth philosophy on you.

doula200I’m planning on having an epidural. Could I still benefit from having a doula?

Absolutely. Even if you can’t feel the physical intensity of your labor that can often be overwhelming, you’ll still experience the intense emotional changes. Your doula can help put your mind at ease and of course she’ll be there after the birth to make sure breastfeeding gets off to a good start.

It turns out that I’m going to have a cesarean because my baby is breech (or some other reason.) Can a doula still help me?

A doula can be very helpful during surgery to help you stay calm. If your husband wants to go with the baby to the nursery after the birth, she can stay with you so you’re not alone during recovery. When you and baby are reunited, she can help you position the baby for breastfeeding. You won’t be very mobile so she can grab pillows for you and make sure you and baby are fully supported so you can nurse more easily.

Can a doula help me if I’m having a homebirth?

Of course! Most doulas love having the opportunity to attend homebirths. In addition to all the duties already discussed, your doula might cook breakfast or tend to your other children if needed (although if other children are there, you should have someone at your birth whose specific job is childcare). Just remember, a doula does not take the place of a medical care giver so you will need a midwife and, if applicable, her assistant there as well.

How can I find a doula?

You can find a doula through DONA International or by calling 1-888-788-3662. If you can’t find one in your area, ask around. Your friends, childbirth educator, doctor or midwife might also be able to recommend a doula.

It’s a good idea to talk to more than one potential doula so you can see the differences in philosophy and personality to find the best choice for your birth team. Your doula should meet with you a couple times during your pregnancy to discuss your expectations for birth and her role in it. These getting to know you sessions are crucial for her to be able to offer you the kind of labor support that you need.

Do you have another question that isn’t addressed here?

I am a birth doula in Lexington, KY.

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Comments

1. emvest - July 15, 2007

Great post! Thanks for all the info!! I have a question:
1. When should the expectant couple start interviewing and choose a doula?

** I better start my search :-)

So are you expecting? Or am I picking up a signal here that you’re not sending? Congratulations, I think!!! I say it’s never too early to start searching for a doula. I’ve seen other articles say to line one up during your last trimester, but sometimes if you wait that long, the doula who you want will already be booked. I would recommend for you to attend the next “meet the doulas night” through the birth care network. That way, you’ll hear a few of them talk and maybe you’ll find someone that you like.

So to answer your question, I think you should be on someone’s calendar by the beginning of your last trimester, so start searching now. Get serious about choosing a doula in the middle of your pregnancy, then relax in your choice the last few months. ~Blessings, Guinever