By Annie Scott, B. Comm, Doula, CBE, Lactation Support
You just found out that you are pregnant. While making list after list of items that you need to start accumulating for your new baby it is very important to focus on your actual labor and birth itself. You need to allow yourself some time to think about what kind of birth experience you would like to have and the kind of birth team are you going to surround yourself with. Are you and your partner ready for the postpartum period? Breastfeeding? These days it is becoming common for expectant parents to hire the services of a Doula for their labor, birth and postpartum needs.
Let’s have a quick look at why people are choosing to hire Doulas.
Studies have shown that having a Doula supported labor significantly decreases the following:
- the length of labor,
- the incidence of medical complication,
- and the amount of medication and medical intervention needed during labor, including epidural anaesthesia, c-sections, and forceps or vacuum delivery.
Doula support has also been shown to:
- improve the effectiveness of medication when it is used,
- improve postpartum outcomes in areas such as healing, bonding, and breastfeeding.
As an example of the positive benefits of Doula care, we can look at a study examining the benefits of Doula support by McGrath & Kennel that looked at labor induction and labor support in 1999, a sample of 531 women were studied and it was shown, with significant statistical difference that there was a decrease in cesarean rate, oxytocin use, epidural rate, and narcotics use.
So what is the role of a Doula and how do they create these positive benefits?
Doulas are trained to support their clients’ psychosocial and emotional needs. They also provide resources to help clients assess their labor, and give advice on comfort measures and positioning. The most important role of a Doula is to ensure constant and continuous support for the laboring mom and her partner without interruption.
What a Doula doesn’t do
Doulas specialize in non-medical skills which means they do not perform clinical tasks, such as vaginal exams or fetal heart rate monitoring. They are not midwives. Doulas do not diagnose medical conditions, offer second opinions, or give medical advice. Most importantly, Doulas do not make decisions for their clients; they do not project their own values and goals onto the laboring woman. A Doula is present to be an advocate for their client, to make sure that their client is being heard, and to help clients have the confidence to ask questions and be involved in different medical procedures and choices.
What reaction will I get from my OB or hospital if I hire a Doula?
Doulas are slowly becoming a respected member of the maternity care team, but I do stress the word slowly. There is still apprehension that exists due to some Doulas practicing outside of an appropriate scope of practice or being argumentative and inappropriate with hospital staff. This is a struggle for Doulas who abide by a professional code of conduct. Through an ever expanding pool of certified Doulas and marketing of best practices, this apprehension can be turned into repeated positive experiences for medical staff with the end goal of a Doula being a supported member of the maternity care team. Midwives are often very pleased when clients express the desire to hire a Doula, and obstetricians are slowly warming up to it as well. In the end, it is your choice to hire and have a Doula present for your birth. You are the one giving birth, not your care provider.
How to choose a Doula
Choosing a Doula comes down to personality and fit. I suggest that you interview quite a few Doulas before settling on “the one”. Get references and ask a lot of questions. Remember that your Doula is going to be a main support to you during one the most vulnerable times of your life, so make sure that you feel comfortable, and most of all, like her. If you are looking for a doula in your area and can’t find one through a basic Google search you can check out www.dona.org.
But Doulas can be expensive…why should you consider one?
The value of labor support is to ensure the presence of an experienced and focused partner in your journey through your birth experience. A Doula adds value to an expectant mother by knowing how to read her needs and adds value for her partner as someone to coach them and support their needs as well.
The hiring of a Doula should be something that all expectant families consider with as much care as they use when choosing a car seat or a stroller. After all, this is the birth of your child and you won’t get a second chance to make sure that you are prepared for this life experience.
About Annie: Annie is a Doula and prenatal educator committed to supporting and nurturing women and their families through their birth experience. Her goal as a Doula is to help each woman develop her own confidence and ability to give birth the way she wants to. She practices in Toronto, On. She runs her blog: www.doulaannie.com, teaches classes through www.prenatalclassestoronto.com, and runs an online prenatal class www.mybirthonline.ca. Have a question? Contact her: annie@doulaannie.com
References:
Kennel and Klaus, DONA Position Paper and Klaus, “Maternal Assistance and Support in Labor”
McGrath SK, Kennell JH, “Induction of labor and Doula support,” Pediatric Res, 43(4):Part II, 14A, 1998.
