Is a Doula for You?
Ever wondered who helps you and your husband during labor when the nurse has to attend to another patient's needs? Or, what happens when it's a shift change and the new nurse arrives not knowing anything about you or your labor? What if it's really busy and no one is available to help you to initiate breastfeeding right after the birth? Who is going to help out when you first arrive at home and probably feel a little overwhelmed about being totally responsible for the baby? The answer to all of those queries is a doula!
What is A Doula?
A doula is a specially trained, experienced woman who provides physical, emotional, informational and spiritual support to the mother before, during and after birth. The doula movement began in 1992 in America, but the practice of women helping other women is an age-old tradition. In fact, the word doula comes from the ancient Greeks. When the woman of the household was pregnant, she chose a female servant to attend her at the birth and beyond. This special handmaiden was called the doula. Today, there are several organizations that train and certify doulas, such as DONA Int., ICEA, CAPPA and ALACE, but it is still a relatively new birth "profession."
Why Choose A Doula?
Only recently in history have women become isolated from others when it comes to support and encouragement during pregnancy and labor. Up until the modern practice of hospital births began, women were surrounded by their mothers, sisters, aunts, cousins, friends, neighbors, and of course, the midwife, when delivering at home. When the transition was made to the hospital, the mother was on her own until husbands were allowed into the labor rooms in the 60's and 70's. So the man, who had never been a part of labor support before, was now expected to assist his wife with minimal knowledge from childbirth class and no "natural sense" of what a woman might prefer in labor.
Having an experienced, knowledgeable doula to help and guide you through pregnancy and birth may be just what you are looking for. First of all, having a team to support you spreads the work around so dad isn't solely responsible for your comfort. Secondly, research shows that during labor, you and the baby both benefit from having a doula present. Labors tend to go faster. Women choose to have fewer medical interventions. Babies seem to be more successful at breastfeeding. The family feels more positive about the birth, their child, and themselves. Also, postpartum depression is reduced because of a doula's involvement. Because the doula does not provide medical care, advice or interpretations, she can concentrate solely on your needs and comfort. These are all huge issues when pondering the rite of passage that you will make when becoming a mother; when you and your partner are transitioning into parenthood!
Types of Doulas
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Antepartum Doulas
There are 3 types of doulas – antepartum, birth and postpartum. An antepartum doula helps the mom BEFORE the birth. Perhaps the mother is on bed rest due to a high-risk situation and needs help around the house or with other siblings. Maybe the expectant parents just moved to a new location and have no one to help shop for the baby or to set up the nursery. Possibly the mother needs someone to go to a childbirth class, a La Leche League meeting or a doctor's appointment with her because her hubby travels a lot or because she has no partner at all. This is where the antepartum doula can really fill a gap in the mother's care.
Birth Doulas
As the name implies, a birth doula is there DURING the labor and delivery – whether it be at a hospital, a birth center or the parents' home. She meets with you beforehand to establish a rapport, to work on a birth vision (like a birth plan) and to attend an appointment together. As labor approaches, she keeps in close touch with you and will guide you through the early phase. The doula will help you to better know when it's time to call and go in. She will meet you at the birth place and set up your room, get you organized for what lies ahead, and reassure you as you get settled in. The doula sees to your every need. Physically, she is like a personal handmaiden since you are definitely queen for a day! Emotionally, she is like a trusted friend who really cares about you. Informationally, she is like a walking textbook and if she doesn't know the answer, she'll get it for you. And spiritually, she is that other woman in the room who you have a special connection with simply because she's done this before … many times! If there is a difficult decision, your doula will help you make an informed choice. If you need mediation with the staff, the doula steps right in to advocate on your behalf. If your family is there, the doula can keep them posted on what's happening. Having someone there who is keenly aware of current practices in area hospitals is a nice bonus when using a doula. She will know basically how your health care providers manage births, what the staff generally does, and what facility norms are where you're delivering. This helps you to be more confident when it comes to feeling well prepared regarding the medical aspects of the birth. After the birth, the doula stays to help with bonding and breastfeeding since it is so vital for the baby to do so as soon as possible. The week following the birth your doula will call you probably daily to see how all are doing. And, about a week after the baby arrives, she comes to your home for a follow-up visit. At that time, she'll bring you a birth report and a gift for the baby. You debrief about the birth and she sees if you need any referrals or resources. She'll ask you to check in with her after your 6-week check up just so she knows all is going well.
Postpartum Doulas
A postpartum doula helps AFTER the baby arrives. It may be at home, the birth center or the hospital. If you are still at a facility, you may need help with nursing but the lactation consultants are not available. This is a great way to use a postpartum doula so you go home nursing successfully. If you have already gone home, bringing someone in for mother care, baby care, and sibling care may be something you need. The postpartum doula can run short errands, do light housekeeping or whip up a yummy casserole for dinner. She can also listen to your birth story, teach you little tricks of the parent trade, help you with organizational skills and reassure you when a lack of confidence creeps in. Your doula has been trained to recognize potential problems like a jaundiced baby, clogged breast ducts or postpartum depression. She can make suggestions to correct problems you may encounter during that vulnerable postpartum period and can help with communication between relatives and health care providers. In other words, she can come in and help you all feel more comfortable about being a new family!
Choosing a Doula
When choosing a doula, keep these basic things in mind:
- How was she trained and what is her certification status?
- How many clients has she served?
- What is her personal philosophy about birth/parenting?
- How does her service work: what exactly does she provide, what is the fee (antepartum/postpartum is usually an hourly rate, birth is generally a lump sum), is there a backup, what are the refund policies, etc?
- Will she provide references?
- Has she worked at your facility and with your health care providers before?
- What is your "gut feeling" after speaking to her or meeting with her?
The Doula Difference
You may be wondering if you need a doula if you are using a midwife. Although their roles blend, the big difference is that the midwife gives medical care and the doula does not. So, when the midwife is with other patients, trying to grab a few hours of sleep, or busy doing something ‘medical' like catching a baby, she can't really provide support as well. The doula is usually not an employee of the facility so her allegiance is to you and not the facility. That's why a doula is a member of the birth team with a unique and special function.
Another distinctive feature of being a doula is the opportunity to provide "wrap-around" care for you since she is devoted just to you before, during and after the birth. This special continuous link leads to a touch and trust relationship between you and your doula. A doula feels honored to be a part of such a special and intimate relationship. And so, this connection becomes emotionally grounding for the mom/couple. The doula can be like an anchor that prevents you from drifting away into a sea of confusion and turmoil. Say ‘anchors away' and consider hiring a doula. Share in the benefits of women's wisdom and strength that were handed down from generation to generation and are now available again today!