Labor & Postpartum Doulas
Help for New Mothers
When Anne Stalder-Nelson and her husband, Brett, of Chicago, arrived
at the hospital for the birth of their first baby, they brought along
more than just an extra pillow and a suitcase of labor supplies. They
had with them an age-old tool that many women are rediscovering as a vital
part of the labor process - a labor doula.
The word doula comes from ancient Greek and means "woman who serves". Today's labor doulas are trained, experienced providers who accompany women in labor and offer continuous physical, emotional, and informational support. Doulas attend medicated and unmedicated labors, vaginal and cesarean births, and home and hospital deliveries. Studies have shown that women who receive continuous doula care have shorter labors, fewer interventions and complications, and increased satisfaction with their birth experience.
Stalder-Nelson first heard about doulas from a friend, but hadn't considered having one until midway through her pregnancy. "Having a doula enabled us to try many different things to help me through labor," she says. She counted on her husband to provide emotional support, but adds, "He was great-but that's not the same as having a person there who's done it already. I wanted someone who could help me with alternatives in pain relief."
Scope of Care Provided by a Labor Doula
A labor doula meets with the expectant mother prenatally to plan for labor, joins the woman at her home or at the hospital during labor, remains with her in the initial hours after the birth, and keeps in touch during the postpartum period. During labor, doulas provide non-medical support. They assist with massage, breathing, relaxation, visualization, baths and showers, positioning, movement and other comfort measures, and provide reassurance, information, and encouragement.
Doulas of North America (DONA), an international, nonprofit organization, has certified nearly 1,800 labor doulas since 1992. Doulas certified by DONA or other organizations have completed training in childbirth education and labor support and have attended several births where their labor support skills are evaluated.
Continuous Support Provided by a Labor Doula
Laura Katz, a first-time mom whose son was born at Illinois Masonic Hospital, is grateful for the presence of a doula during her 30-hour labor. "The doula's impact was huge," says Katz. "She met us at home and stayed with us all the way through the labor. She gave my husband much-needed rest breaks. My labor ended up almost the opposite of our birth plan-things were much more 'medical'-but the doula was very supportive. She helped with breastfeeding right after the baby was born, called the next day, and came to our home for a follow-up visit."
Doulas Are Not Just for First-Timers!
Katy Wolfe, whose second child was born at Evanston Hospital, feels strongly that having a doula for her second child was the most important factor in giving birth without an epidural. Her first birth had left her feeling afraid, so Wolfe hired a doula seven months into her second pregnancy. She spent most of her second labor at home, with her husband, her best friend, and the doula supporting her.
"The biggest thing she did was not even tangible," Wolfe says. "She was just there with me, and her calm presence and absolute faith in the process made me feel that this labor was achievable." Reflecting on her experience, she adds, "I just wish more women knew this was an alternative. It's the number one thing I recommend to women who want to give birth naturally."
Fathers and Doulas
Partners who plan to take an active role in the labor sometimes worry that a doula will replace them as the woman's primary support. In reality, however, many fathers say that having a doula took away the pressure of having to remember what to do or say. Doulas also help ensure that the partner's needs are met, provide breaks, and offer an objective viewpoint.
Mark and Sabrina Thompson, of Aurora, IL, chose a doula for the birth of their third baby at West Suburban Hospital Medical Center. Mark says, "Sabrina was scared after having the cesarean the first time, and we wanted an experienced support person there to help us this time."
Sabrina says, "I couldn't have done it without our doula. I needed her constant attention to my needs. Mark was my main support, but the doula was more objective, and she helped us both through the birth. She was right there, in my face, telling me I could do it."
Doulas and Home Birth
Women planning a home birth are including doulas in their birth plans, too. Allison Lundeen of River Forest gave birth to her second child at home with the help of her husband Bill, a labor doula, and a medical team from Homefirst Health Services. "It was definitely not too many people. There was something for everyone to do," says Allison. "The doula had a very different role from the Homefirst staff. She arrived first at my house, helped me in the shower, suggested position changes, made sure I was drinking, and even took pictures. I would never, ever, have another birth without a doula!"
Part of the Health Care Team
Doulas offer continuous emotional support that may not be available from doctors, midwives, or nurses. Shirley Moore, a certified nurse midwife at the West Suburban Hospital, attends many births with labor doulas. She views doulas as a major asset to the laboring woman. "Midwives and doulas really work very well together," she says. "I value doulas because they can assist parents through the birth process, support the husband, and help parents remember what they've learned in childbirth class." Because midwives manage many aspects of labor-including the progress of the labor and the health of the mother and baby-they may need to focus more on the woman's health needs than on her comfort needs. "There's a big difference in the role of a doula, who is there only to support the comfort needs of the patient, versus the role of the nurse midwife," Moore says.
Postpartum Support
Postpartum doulas care for first-time or experienced moms in the first weeks after birth. Postpartum doulas can assist with newborn care, provide household help, run errands, and give the mother much-needed rest. A variety of training programs exist for postpartum doulas, and some programs offer certification.
Practice Options of Doulas in Chicago
In Chicago, most labor doulas have an independent or group practice and are hired directly by parents. Some community-based maternity services, such as the Chicago Health Connection, provide labor doulas for teen mothers. Some insurance companies will reimburse patients for the cost of a labor doula (fees range from $500-$1,000 in the Chicago area, depending on training and experience), but doula care is not yet a standard medical benefit covered by insurance companies. Some doulas offer a sliding scale to help families who couldn't otherwise afford their services.
