My little shop downtown affords me opportunity to talk to MANY expectant mothers and the one question that I've been asked lately is "Hey Christian, Whats a doula and should I get one"? Thankfully I have an avenue to discuss these sorts of things...right here..on this little blog! Here is everything you need to know about doula services and how it can benefit you!
A doula is a trained labor assistant who provides continuous physical, emotional, and informational
support to a mother or couple in labor and postpartum. The term doula (A), which in Greek means “a woman who serves”, was coined in an anthropological study conducted in 1973, though doulas have been around for as long as women have been giving birth.
Women have always
aided and advised other women of everything from the difficulties and joys of
labor to new motherhood. A pregnant woman gave birth surrounded by the wise
mothers of her family or tribe who attended to her during labor and delivery,
and cared for her and her baby postpartum. Although some of these traditional
practices still routinely take place around the world, Western Medicine has
pushed women to labor in a very different fashion.
In
the 20th century a move took place from labors occurring at home,
attended to by midwives, and in the presence of many female family members, to
labors in hospitals, attended to by doctors ,and often with women alone. This
push for medical science to take control and even dictate the process by which
women give birth took place simultaneously with the slander of doulas and the
role of women’s wisdom in the birth process. Though it is still the “norm” to
give birth in the hospital today, women are now encouraged to be active
participants in their labors. Furthermore, husbands and partners are also
encouraged to be present and active in the birth of their babies.
Even
with this recent paradigm shift towards a more woman centered labor and
delivery, partners and support people are not necessarily educated or familiar
with the actual processes of labor. That’s where a laboring woman will benefit
from a trained and practiced doula. After all, if you were planning a strenuous
hike over a mountain in Yosemite National Park, is it wise to rely only on your
husband to navigate your trip? Though you may have immense faith and trust in
him, you would both be better off forging ahead with a professional guide.
Certified doulas are trained in many different aspects of assisting a woman in
labor and postpartum, have attended many births, and are passionate about
helping a woman have the most successful and beautiful birth experience
possible. And their assistance comes with tremendous benefits to the mother and
baby.
In
a study conducted in Houston, Texas in 1991, researchers studied the effect of
a doula assisted birth on 412 healthy first-time mothers giving birth at full term
at Jefferson Davis Hospital (1). The women were randomly assigned to one of
three groups, having an active doula present, an observing doula present, or no
doula present. Active doula support involved touching, verbal encouragement and
other active support, and observing doulas were simply present in the hospital
room with the laboring mothers, sitting quietly in a corner taking notes (they
did not speak to or otherwise interact with the mothers). The length of labor
for mothers with active doulas averaged 7.4 hours, compared to 8.4 with
observing doulas, and 9.4 with no doula. In the no doula group only 12 percent
were able to deliver naturally, that is, without the use of anesthesia,
medications, or forceps, compared to the 55% of doula-assisted mothers who had
natural births. Mothers without doulas had a Cesarean birth rate of %18,
compared to 13% with observing doulas, and 8% with active doulas. Simply having
a doula present in the room had a positive effect on the laboring woman! Other
studies have shown that having a doula present at birth reduces the overall
cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40%,
and the requests for epidurals by 60% (2).
Perhaps
you are sure of the value of a doula, but you or your partner feel that perhaps
an extra person might interfere with the bonding experience the two of you
imagine birth will be. Research indicates that just the opposite may be true. A
study conducted in Johannesburg, South Africa investigated how a couple’s
relationship was affected by having a doula present at their birth (3). 189
first-time mothers were randomly assigned to doula or no-doula groups. The
women in the two groups reported no statistically significant differences in
satisfaction with their partners before or during pregnancy. However,
immediately after giving birth, 71% of women in the doula-attended group
reported their relationship with their partner was better, compared to 30% in
the no-doula group. Six weeks postpartum, 85% of women in the doula-attended
group reported increased satisfaction with their partners, compared to 49% of
the no-doula group. The skilled doula is able to provide a solid foundation for
couples by allowing them to experience the confidence that comes with an
emotionally successful delivery. This foundation allows them to embark into
parenthood feeling prepared and connected.
So
how do you go about finding a doula? There are two main organizations which
train and certify doulas, Doulas of
North America (DONA) (B), and the Childbirth
and Postpartum Professional Association(CAPPA)(C). Both organizations require the attendance of
multiple midwifery and childbirth education classes, as well as hands on
continuous support to mothers in active labor. Additional study including
papers, documented hours, supervisor reviews, and reviews from assisted mothers
are also used for certification purposes. Both websites allow you to search for
doulas in your area. Other websites that provide doula search engines include Doulas.com (D), and AmericanPregnancy.org (E). Doulas.com
even allows you to search by a doula’s specialty, such as yoga, massage, and
acupuncture.
Though a doula is mainly associated with assisting during labor, there are also antepartum and postpartum doulas. Antepartum doulas assist the mother emotionally throughout pregnancy and in preparation for the baby, and postpartum doulas do everything from household tasks in the new mother’s home, to massage and identifying possible signs of postpartum depression. There is a doula to provide advice, reassurance and love to the mother in all stages of pregnancy, birth, and new motherhood.
Once you have identified doulas that practice in your area, it is time to set up a consultation. It is important that you can emotionally connect with your doula so that you can develop the kind of intimate relationship that allows their assistance to be the most productive for you in labor. For instance, it may be important that your doula have the same religious or spiritual beliefs as you. Or that she has assisted many births. On the other hand, a doula that is new to her profession may have the kind of passion and fresh excitement you are looking for. Additionally, the average cost for a doula is $500 (ranging from $300-$1000 depending on area), but a doula who is just starting out may be much less, or even free.
The following
questions may be helpful for your doula interview.
- What training have you had?
- What services do you provide?
- What are your fees?
- Are you available for my due date?
- What made you become a doula?
- What is your philosophy regarding childbirth?
- Would you be available to meet with me before the birth to discuss
my birth plan?
- What happens if for some reason you are not available at the time
of my birth?
Doulas
have been around since the beginning of the human race in many different forms,
and for millions of women they have been an essential and irreplaceable part of
the birthing experience. In whatever setting, home, hospital, or birthing
center, you plan to give birth, doulas can provide invaluable nurturance and
support. A doula’s presence as part of the birth team is solely to love and
advocate for the laboring mother, making her feel safe and secure, facilitating
a more comfortable and pleasurable birth experience. Don’t give birth without a
doula!
Sources:
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