What is a doula?
How many times has a doula been asked that question? It is a profession
rarely highlighted in career choices and fewer people understand the role of a
doula than that of a dog walker. The services that a doula performs are
fundamental to birth, yet even Micorsoft places a red, squiggly line under the word,
expressing ignorance of the vocation.
I was confronted with naiveté of society recently while attending an adult baseball game. The pitcher threw a
fastball to the batter who hit a line drive straight back to him. The
pitcher neither ducked nor got his glove up in time--taking the ball directly
above his brow. He went back, meeting the mound with all his weight.
There were gasps from the stands and players began to swarm around the
injured pitcher. Within seconds, as the huddled group decided how to
respond, a voice projected towards all the on-lookers, and someone yelled,
"Get Christy Jo, she works in a hospital!" If it wasn't such a
somber time, I would have burst out laughing. I was sitting next to a
friend who was a RN, yet they call for the Lactation Consultant/Doula?
What diagnosis did they expect? The only response I could have offered (in my field of expertise) is,
"Put some breast milk on it!" Of course I can joke about it
now since the player was transported to the hospital, had a few tests performed,
observed for a few hours, and then discharged. As I recount
this story, I validate the need for education on the work and scope of a doula. What is a doula?
I could offer the text book definition:
doula [ˈduːlə]
n
(Medicine/Gynaecology & Obstetrics) a woman who is
trained to provide support to women and their families during pregnancy,
childbirth, and the period of time following the birth
[from Greek doule female slave]
But that would only perpetuate the anemic understanding of
the term. A doula's skills and services are as varied as the women who
perform them. To describe a doula as merely a labor assistant is equivalent to describing a
sculpture, painter, metal smith and musician as an "artist." Does
that tern explain or adaquately portray the gifts and talents of Picasso,
Rembrandt, Degas or Michelangelo--absolutely not. The general term
is an insult to the master of the clay, dictator of the canvass and matriarch of
the Renaissance. An artist is so much more than the word
suggests, yet, I suppose it is a starting point.
What Are a Doula's Qualifications?
There are some general attributes that can be given to most
doulas. Doulas receive specific
education in the perinatal field.
Training can come in the form of mentor-ships or formal education. Many doulas have completed a certification
program that holds them accountable to the certifying agency. In order to complete certification, students
must complete numerous steps--all which enhance the skills and knowledge of the
doula. Certification may involve taking
a specific training course, completing reading assignments, fulfilling
observational tasks, attending coalition/support groups, role playing. accomplishing research projects and passing an exam.
Certified doulas are also required to re-certify for maintenance of the
title.
Doulas Should be Hired Early in the Prenatal Period
Doulas realize the importance of establishing a
relationship with clients prior to attending their birth. This is as very vulnerable time for a woman, and trust is
of the most importance. It is crucial to
learn the family’s history, mom's preferences and develop a comfortable
friendship. Doulas often offer prenatal classes to their clients as part of the doula service.
Once a client explains her ideal birth, the doula can begin working
towards that goal during the prenatal meetings.
Doulas may teach clients birthing and laboring positions or relaxing techniques that can be practiced between meetings. A well-prepared client is empowered and confident as the
"birth day" approaches. The more comfortable the clients are with the doula, the
more at ease they will be at the birth. The prenatal investment is paramount to a tranquil birth.
"My advice to every dad, 'Get yourself a doula'!" Johnathan F.
Doulas take the role of servant to heart, offering emotional
and physical support throughout labor. They are a valuable part of the team in a home birth, birth center birth or hospital birth. Whether a mom chooses a natural or medicated birth, a doula is equipped with information to support the family. Even in the case of a planned or emergency C-section, a trained professional at a mom's side provides a calming effect for everyone present.
Doulas often advocate for the family and remind the laboring mom or couple of
their predetermined birth choices. They guard the
birth from distractions and intrusions.
Doulas anticipate the needs of the birth coaches and laboring
mother--offering ice, wiping a brow, massaging feet and securing additional
blankets--but most importantly, a doula is present.
In a hospital setting, nurses are required to complete
so many routine tasks, that they are denied the luxury of lingering
at the laboring mother's side; in contrast, the labor doula offers the security
and comfort of continuous companionship. So often questions arise when the
medical staff are not in the room. A doula can help to answer questions
and offer confirmation that birth is proceeding as expected. A doula not
only interprets the birth for those present, but also anticipates the most
likely imminent events. I have had fathers watch in amazement as their soul
mates go through a transformation that they could have never imagined; and with
a few encouraging and assuring words, they can return to a state of awe rather
than one of panic and disbelief.
Partners frequently grasp for ways to offer support and comfort to their soul mates. A doula helps to guide the process. The doula also offers a second pair of hands for relaxation and massage as well as relief for a partner that may need a few moments to refocus. Sometimes couples are more comfortable with the doula taking on a larger role in the production. I have been at births where I have been asked to perform a monologue only calling in extras during specific scenes. The couples had a well-thought out plan that involved the doula coaching and comforting Mom, providing direction and soothing measures. Dad was free to record the event, contact relatives and whisper in his wife's ear. A doula is a servant, performing any task that makes the birth more comfortable, enjoyable and memorable for her clients.
There is no right or wrong way for the doula to assist, as long as she is working within her scope. Doulas understand that the birth and the decisions are at the discretion of their clients, they just serve to make the transition form womanhood to motherhood as smooth and enjoyable as possible.
Does a Doula Make a Difference?
Studies have shown that the use of
a Doula during labor and delivery can have
the following beneficial effects:
50% reduction in the
cesarean rate
25% shorter labor
60% reduction in
epidural requests
40% reduction in
pitocin use
30% reduction in
analgesia use
40% reduction in
forceps delivery
Improved
breastfeeding
Satisfaction with
birth experience
Decreased postpartum
depression
*Adapted from Mothering the Mother--
How a Doula Can Help You Have a Shorter, Easier and
Healthier Birth by M.H. Klaus, J.H. Kennell, and P.H. Klaus; Addison-Wesley
Publishing Co., New York (1993).
Let a Doula Be Your Epidural
There are far more benefits to having a doula at a birth than there are to having an epidural--yet only one of these are talked about at hospitals, in moms groups or in the main stream media. That needs to change! Let's remind moms that they don't need to--nor should they--enter this time alone or unprepared. Moms can take birth back, and doulas can help.
Author's Note: I have been in the perinatal field for over a dozen years. Originally, I entered the field as a Lactation Consultant. Many of my breastfeeding clients had issues that originated in the hospital. I quickly realized I wanted to spend a more time in the area of prevention to avoid the numerous postpartum visits where I spent days, sometime even weeks fixing what could have been avoided in the first place.
More information about Christy Jo's Doula Services or Doula Connect (a service that matches clients with doulas) can be found on her website
.JPG)
