A Doula I am

I completed the ToLabor Doula Training this past weekend and walked away with a profoundly different understanding of who I am, how my own births were, and how every pregnancy and birth should be for all women. I entered the class not really even knowing what a Doula was, much less whether I truly wanted to be one. I actually went into the workshop with the intention of using the knowledge gained towards becoming a birth educator. I still plan on becoming a birth educator. However, since I didn't really understand the whole role a Doula plays in labor and birth, I had no preconceived notions of what a Doula is or is not. In my mind, I thought a Doula was just a woman present during birth. I've read the research that suggests that the simple presence of a woman at another woman's birth helps to create a positive birth outcome. I questioned whether I needed a Doula during my own births, but because I planned on homebirth with Midwives, I assumed I didn't need one.  How wrong I was!

A Doula (pronounced Doo-la) is a term from the Greek language meaning a "woman who serves." They support mothers and their families through the emotional and physical challenges and joys of childbearing. Doulas provide non-medical support and they are the only care providers whose responsibility is to support a laboring woman exclusively and continuously. Studies show that doctors are present only 5% of the time, and nurses only 20-25% of the time, however, labor assistants or birth Doulas provide constant care throughout a woman's entire birth experience.

The experienced, loving support of sisters, mothers, aunts, and friends has diminished as births have moved into the hospital, and under the medical practice of OB/GYNs. Most women do not share or participate in a birth until they experience their own. This is where Doulas come in. Doulas understand the complexities of birth, work to ease the fears and anxieties of the unknown, and can instill confidence and trust in a woman and her body. Doulas work with the mother and her partner by providing useful comfort techniques for the mother that incorporate the help of the partner. Doulas also help facilitate communication with the labor care team.

Randomized controlled trials demonstrate that the presence of a Doula is also associated with:

• Reduced cesarean rates
• Fewer forceps/vacuum deliveries
• Less requests for epidurals
• Shorter labor
• Reduced use of Pitocin/Oxytocin
• Lower rates of newborn complications
• Increased success with breastfeeding
• Reduction in postpartum depression
• Increased maternal satisfaction

Doulas use a wide variety of pain-management techniques to help women feel more safe and comfortable, including:

• Massage
• Acupressure
• Positioning for mother’s comfort and to relieve/avoid back labor
• Shower/bath
• Birth ball
• Hot and cold compresses
• Guided imagery/visualizations
• Aromatherapy

What Doulas do not do:

• Perform clinical tasks, such as blood pressure, fetal heart checks, vaginal exams.
• Make decisions for the mother.
• Speak on behalf of the mother to the medical staff or primary care providers regarding decision matters.

Before this remarkable workshop was complete, I realized that every woman should have the right to have a Doula, and that Doulas should be made available by all hospitals. Our maternity care system in the United States is a topic all its own, but one simple change to help support positive birth outcomes would be to have Doulas on call in all hospitals and birth centers.

My certification process has just begun, but I am looking forward to working through it.