“Doula” is originally a Greek word meaning an experienced woman who helps other women. Today it is used synonymously with “Professional Birth Assistant”, “Labor Support” and “Labor Coach”. Labor support is as old as the Torah itself. Yocheved and Miriam, alias Shifra and Puah, were two midwives who supported birthing women. Each had their own purpose; but both provided physical and emotional support. Even in our times, this support is critical. In a National Study in America (2002) called “Listening to Mothers”, interesting data was collected from women post-partum. Their birth experience was positive and empowering regardless of them having received pain medication or not. Delivery by a necessary cesarean was also not a factor. It was a positive, memorable experience because their feelings were acknowledged and wishes respected, their dignity as well, and they were part of the decision making process. This is where a doula fits in.
In “Mothering the Mother”, 1993 and “The Doula”, 2002 Marshal Klaus M.D., Kennell MD. And Phyllis Klaus, M.Ed., CSW presented statistics that showed more than the emotional worth of supporting a woman in labor. In 127 non-industrialized countries, 126 cultures had women attended by other women in childbirth.
In a few studies of over thousands of women, those who had women attending them showed statistical evidence of paramount importance. Labors were shorter (7.7 hours vs. 15.5 hours) used pain medication less often (11% vs. 64%) required less pitocin augmentation (2.4 % vs. 13.3%), had fewer assisted deliveries; vacuum or forceps (7.5% vs. 22.1%) and had fewer cesarean sections (8.1% vs. 18%). Continued study shows less post-partum depression and longer term breastfeeding.
Since these studies, more studies were done proving the effectiveness of a doula attending a birth. (Hodnett, ED; McGrath, SK,)
Role of a Doula
A Doula is trained and experienced in childbirth, although she may or may not have given birth herself. Her role is to provide physical, emotional and informational support to women and their husbands during labor and birth. A doula offers options for comfort measures, assists in a breathing technique (the mother may have learned), alternates the woman’s position to help labor progress and provides relaxation methods.
She also provides the information needed when decisions are to be made during labor, giving them options. As an advocate, she should be flexible enough to work in a variety of settings with different staff members so the environment will stay calm and be supportive of the mom’s needs.
Her goal is to help achieve the safe, positive birth experience the couple desires.
How does a doula help the couple achieve their goal?
Typically, the woman, usually with her husband, meets the potential doula to discuss issues and get acquainted. Past history, especially previous birth experiences would be part of the discussion as well as the couple’s birth philosophy. The meeting helps to determine if this doula is the right support person for the couple. She can also help one formulate a birth plan.
Early in labor, the doula is notified labor may be starting. She can help determine pre-labor from true labor. She encourages rest, fluid intake, and nutrition. She suggests ideas to help through early labor.
After laboring some time on one’s own or with her spouse, before it gets difficult, the doula comes to the home to help with comfort measures and laboring techniques; possibly bringing relaxation music, a birth ball, massage tools and kind words of encouragement.
She helps to decide when to move from home to the hospital or birth center. She also is an extra pair of hands when one may choose to birth at home with a midwife or doctor.
She is not to replace the husband but to work as a team, adding her professional advice. Especially when the husband has not slept and can feel over-whelmed, a doula gives him the opportunity to take care of his needs.
Suggested questions to ask a doula
- What training have you had?
- How many births have you attended?
- How long have you been in the profession?
- What is your birth philosophy? (Ex: pain medication)
- Which settings have you worked in?
- May we call you with questions before and after the birth?
- When do you join a woman in labor? What about Shabbos?
- What is your availability? Births per month?
- Do you meet with us after the birth?
- What is your fee? Deposit taken?
Choosing a doula
Read books, attend a childbirth course, and discuss issues with your spouse to determine your birth experience preferences. Then meet with one or more potential doulas. Ask for recommendations from people who work with birthing couples; i.e. childbirth educators, exercise instructors, doctors. Ask couples who have used a doula to know how it worked for them.
© Sarah Goldstein CDT(DONA)