What is a Doula?
The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily
What about the father’s role when using a doula?
The role of the doula is never to take the place of husbands or partners in labor, but to compliment and enhance their experience. Today, more husbands are an active role in the birth process. However, some partners prefer to enjoy the delivery without having to stand in as the labor coach. By having a doula as a part of the birth team, a father is free to do whatever he chooses. Doulas can encourage the father to use comfort measures and can step in if he wants a break. Having a doula allows the father to support his partner emotionally during labor and birth and to also enjoy the experience without the added pressure of trying to remember everything he learned in childbirth class!
What does a doula do?
Most doula-client relationships begin a few months before the baby is due. During this period, they develop a relationship where the mother feels free to ask questions, express her fears and concerns, and takes an active role in creating a birth plan. Most doulas make themselves available to the mother by phone in order to respond to her questions or explain any developments that might arise during the course of the pregnancy. Doulas do not provide any type of medical care. However, they are knowledgeable in many medical aspects of labor and delivery. Consequently, they can help their clients gain a better understanding of the procedures and possible complications of late pregnancy or delivery.
During delivery, doulas are in constant and close proximity to the mother. They have the ability to provide comfort with pain relief techniques that include breathing techniques, relaxation techniques, massage, and laboring positions. Doulas also encourage participation from the partner and offer reassurance. A doula acts as an advocate for the mother, encouraging and helping her fulfill specific desires that she might have for her birth. The goal of a doula is to help the mother experience a positive and safe birth, whether an un-medicated birth or cesarean.
After the birth, many labor doulas will spend some time helping mothers begin the breastfeeding process and encouraging bonding between the new baby and other family members.
What are the benefits of having a doula?
Numerous studies have documented the benefits of having a doula present during labor. A recent Cochrane Review, Continuous Support for Women During Childbirth, showed a very high number of positive birth outcomes when a doula was present. With the support of a doula, women were less likely to have pain relief medications administered, less likely to have a cesarean birth, and reported having a more positive childbirth experience.
Other studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and requests for an epidural by 60%2.
Doulas often use the power of touch and massage to reduce stress and anxiety during labor. According to physicians Marshal Klaus and John Kennell, massage helps stimulate the production of natural oxytocin. The pituitary gland secretes natural oxytocin to the bloodstream, causing uterine contractions, and to the brain, resulting in a feelings of well being, drowsiness and higher pain threshold. By contrast, because synthetic IV oxytocin cannot cross into both the blood stream and the brain, it increases contractions without the positive psychological benefits of natural oxytocin.
Are doulas only useful if planning an un-medicated birth?
The presence of a doula can be beneficial no matter what type of birth you are planning. Many women report needing fewer interventions when they have a doula. But be aware that the primary role of the doula is to help mothers have a safe and pleasant birth–not to help them choose the type of birth. For women who have decided to have a medicated birth, the doula will provide emotional support, informational support and comfort measures through labor and the administration of medications. Doulas work alongside medicated mothers to help them deal with possible side effects and other needs where medication might be inadquate, because even with medication, there is likely to be some degree of discomfort.
For a mother facing a cesarean, a doula can be helpful by providing constant support and encouragement. Often a cesarean results from an unexpected situation leaving mothers feeling unprepared, disappointed and lonely. A doula can be attentive to mothers at all times throughout the cesarean, letting them know what is going on throughout the procedure. This can free the partner to attend to the baby and accompany the newborn to the nursery if there are complications.
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