Q: What is a doula? The word doula (pronounced ‘doo-la’) is an ancient Greek term that translates into “caregiver” or "woman of service" 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.
A doula is part of the labor support team, which typically includes: the partner, doctor (or midwife), and a nurse (who may have their hands full tending to several patients). A doula's job isn't to deliver the baby but to provide the mother with continuous, non-clinical, attention and professional support. The doula offers a wide skill set of techniques used to help the mother and her partner, both physically and emotionally during labor and delivery.
Doulas support families through all kinds of births including water births, vaginal births, cesarean births (planned and unplanned), and VBACs (vaginal birth after cesarean). Doulas can offer support at hospitals, homes and birth centers.
According to DONA International (Doula’s of North America), a Doula...
Recognizes birth as a key life experience that the mother will remember all her life...
Understands the physiology of birth and the emotional needs of a woman in labor...
Assists the woman and her partner in preparing for and carrying out their plans for the birth...
Stays by the side of the laboring woman throughout the entire labor...
Provides emotional support, physical comfort measures, an objective viewpoint and assistance to the woman in getting the information she needs to make good decisions...
Facilitates communication between the laboring woman, her partner and clinical care providers...
Perceives her role as one who nurtures and protects the woman's memory of her birth experience…
Q: How does a Doula fit into the birth team? DONA International explains, “Women have complex needs during childbirth. In addition to the safety of modern obstetrical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences. The role of the birth doula encompasses the non-clinical aspects of care during childbirth.”
Q. Does a doula replace nursing staff? No. Doulas do not replace nurses or other medical staff. Doulas do not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postpartum clinical care. They are there to comfort and support the mother and to enhance communication between the mother and medical professionals. “Frequently asked questions about Birth Doulas.” DONA International. n.p. n.d. Web. 1 Apr. 2014.
Q. Do nurses do the same things as a doula? Many nurses are willing and happy to help laboring couples, unfortunately, their ability to provide the continuous support needed is hindered by their demanding workload and clinical responsibilities. A nurse’s first priority is to monitor your physical health; rarely do they have the time to help with things related to comfort and support. For this reason, nurses are often pleased to learn that a mother has hired a doula.
Q. What effects does the presence of a doula have on the mother? When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, have fewer cesareans and requests for medical intervention, and less postpartum depression. “Frequently asked questions about Birth Doulas.” DONA International. n.p. n.d. Web. 1 Apr. 2014.
Q. What effects does the presence of doulas have on babies? Studies have shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period. “Frequently asked questions about Birth Doulas.” DONA International. n.p. n.d. Web. 1 Apr. 2014.
Q. Does a doula make decisions on my behalf? A doula does not make decisions for clients or intervene in their clinical care. She provides informational and emotional support while respecting a woman’s decisions. “Frequently asked questions about Birth Doulas.” DONA International. n.p. n.d. Web. 1 Apr. 2014.
Q. Will a doula make my partner feel unnecessary? No, a doula is supportive to both the mother and her partner and plays a crucial role in helping a partner become involved in the birth to the extent he/she feels comfortable. Many fathers and partners often feel reassured and comforted by the presence of an educated supporter. “Frequently asked questions about Birth Doulas.” DONA International. n.p. n.d. Web. 1 Apr. 2014.
Q. What is Your Primary Role as a Birth Doula? I accompany women in labor to help them achieve the type of birth experience they desire. I draw upon my professional training, knowledge and experience to provide emotional support and physical comfort to laboring women. I assist couples in gaining the information needed to make informed decisions throughout the pregnancy, birth, and postpartum period. I provide reassurance and perspective to laboring couples, make suggestions for labor progress, and offer various comfort and relaxation techniques. I am independent and self-employed. As a doula, I work for the mother and her partner - not for the health care provider or birth site.
Q: Are there certain things you do not do as my doula? I work within a doula's scope of practice. In summary, this means that I Do NOT:
Make decisions for you. I will help you get the information necessary to make informed decisions. I will also remind you if there is a departure from your birth plan.
Speak to medical staff on your behalf. I will discuss your concerns with you and suggest options, but you or your partner will be responsible for speaking directly to the medical staff.
Perform clinical tasks such as vaginal exams, blood pressure, or fetal heart checks.
Q: Do you work with a backup doula? Yes, I always secure a backup doula in case I am unable to attend your birth. I have never had to call upon a backup, but this is an important part of the doula-client relationship - You are guaranteed a doula at your birth! I work in concert with other doulas who I believe have similar values, styles, skills, and personalities to mine.
Q: What happens in the time before my labor begins/before birth? We will meet prenatally (in your home) to create or review your birth preferences and talk in detail about your desires for birth. We can explore and discuss your priorities and concerns, as well as, plan how we might best work together as a team. I will want to know your personal ways of coping with discomfort and fatigue and what internal resources we can draw upon to assist you with the birthing experience. I will want to know how you and your partner foresee working together and the roles of others who may be attending the birth. I can help you decipher what type of childbirth education is the right fit for you. My role is to help you have a satisfying birth as you define it. We may also decide on other meetings and I will be available for telephone/email support before labor begins. I will officially begin the 24/7 on-call period for your birth two weeks before your guess date. I will have my cell phone with me at all times and you may call or text me at any time.
Q: What happens when my labor begins? Generally, I prefer that you call/text me when you think you are in labor, even if you do not yet need me. I can answer questions and make suggestions over the phone. We will decide at this time whether I should join you then or wait for further change. I usually need approximately one to two hours to get to you from the time you ask me to come, depending on how far I need to travel. We will also decide where to meet - at your home or place of birth.
Q: What about after the birth? I will remain with you for approximately two hours after birth or until you are comfortable and ready to enjoy quiet time with your family. I can also help with initial breastfeeding if you like. During the postpartum period, I continue to be available by phone/email to answer questions. My services include one postpartum visit, taking place one to two weeks after the birth (sooner if desired). The purpose of this meeting is to review your birth, see how you are doing and get feedback from you about my role. I can provide referrals for additional support if necessary.
Q: I really want a doula at my birth, but my partner is still reluctant. It is natural for partners to be wary of inviting an outsider to the birth of their child. Partners often feel their role is to protect the mother and baby and minimizing outsiders is one way to do that. Partners also might worry that their role will somehow be minimized or replaced if a doula is present.
As a Doula, I am there in addition to, not instead of the partner. The mother’s partner is essential in providing support; they bring intimate knowledge about the mother and love for her and their child that no one else can. It is my role to help the partner support her, ultimately making relationships stronger and bonds tighter in only a way that the birth experience can.
With a Doula present, the pressure on the partner is decreased, and I can help them participate at a level he is comfortable with; guiding them ineffective ways to help the mother through labor.
Oftentimes, reluctant partners will feel more comfortable with the idea once they have met the doula and had an opportunity to have their concerns and needs addressed. I offer free, 30 minute consultations, where you will have the opportunity to ask questions and learn more about me. It is also notable that partners who were reluctant at first are often the biggest supporters of doulas after benefiting from their presence at the birth of their child.
Q: What if I decide during labor that I want medication - will you support that? As your doula, I support whatever option is right for you and your partner. As each family has unique needs, this issue will be discussed in detail at our prenatal visits, so that I will have a complete understanding of your wishes and needs during labor.
I believe in the wise and compassionate use of medication for laboring women and that there are times when pain medication and interventions are needed and appropriate. However, too often these decisions are made from fear, convenience, or lack of information. As your Doula, it is my role to help you understand your options, ask the right questions, and take the time needed to make the best decision for you and your circumstances. I feel that any well-educated decision, made without pressure or fear, is the right one for a laboring couple and I support couples in their decisions.
Q: I’m taking a HypnoBirthing class, do you use this technique? Have you worked with couples planning a Bradley Birth? Do you know Lamaze breathing techniques? Yes to all of the above! I am familiar with the basics of each of them. As I do with all my clients, I will review with you which techniques you’ve learned in childbirth classes (or at other times in your life) that you find most helpful for you. There’s no one right way to birth for everyone, even for those who take the same class.