Frequently Asked Questions

1. Are doulas accepted in all hospitals?

Doulas are accepted in Jerusalem hospitals although Har Hatzofim announces on their tour that we are not needed. They feel they can help the woman as much as we can. Unfortunately, they do not take into account that the women meet us during pregnancy, therefore we are familiar to them, including their wants and needs. They also do not take into account that when their shift is over, they leave, even if the birthing mom is in active labor or transition. She has put in her 8 hours and has a life outside labor and delivery.

Ma’ayanei HaYehosua (Bnei Brak) has their own volunteers whom one meets during labor and they are not as pro-active as others. One can bring in their own doula but must get permission first.

Ichilov (Tel Aviv) says NO straight out.

Safed (North) has been very amenable to doulas for years.

Doulas who create a positive relationship with staff and create a friendly atmosphere, are generally well accepted.

2. What happens with my husband if I hire a doula? What will he have to do?

Labor can last many hours. In the book The Doula Advantage, Rachel says that dad’s can take “guilt-free breaks” if there is someone to take over. I have seen husbands become calm when they need to rest or eat knowing there is someone else to relieve him.

When a husband is emotionally involved, he needs someone objective and professional to make decisions. A doula is the person to do that as she is there for emotional and informational support, especially when an unexpected turn in the birth process arises.

A doula is also able to make suggestions to the dad of how he can help his wife during the process. She can help the couple bond in ways they would not have thought about on their own.

3. Are there homebirths in Israel?

Yes. There’s a homebirth group of Midwives who meet monthly to discuss cases, upgrade their skills and share information.

They provide one-on-one prenatal care, are on call 24/7 for the birth and provide postpartum care.

For more information; view www.leida.co.il or www.homebirthisrael.com

4. What is the difference between a doula and a midwife provided by the hospital?

At a home birth, a midwife of your choice, provides prenatal care, delivery of the baby, post-partum care of mom and newborn. The midwife is responsible for the safety of mother and baby.

She is also responsible for all medical decisions, including the potential for a hospital transfer, the rare times that it becomes necessary. She does the vaginal exams, checks vital signs and monitors of fetal heart tones, with the woman agreeing to the position and place.

A hospital midwife, someone you have not met previously, follows hospital protocols. She is medically responsible for longer intermittent monitoring, vital signs and vaginal exams but may not be experienced or knowledgeable in your choice of positions. She also may not have the leeway to allow you freedom of movement or other choices in your birth plan.

Certified doulas do not provide any kind of medical care. For instance, they would not listen to the baby’s heart beat or do a vaginal exam or deliver the baby. They do provide emotional and physical support for the laboring woman and her family and/or post-partum care of the mother and baby. Comfort measures and techniques help a woman to manage a birth many times without pain medication. She also provides information when the labor process has begun. She assists in the woman’s home before transferring to the hospital and can provide information throughout the whole labor process when a couple may feel overwhelmed. Doula care has been shown to improve outcomes for both moms and in many studies.

5. Why do I need a doula if I have a private doctor?

Helping a mom remember what she was taught in her childbirth course is the doula’s role.

A doctor is not trained in comfort measures and he/she is certainly not going to sit by a birthing mom’s side throughout the whole labor.

That is not what he is there for. He is meant to deliver the baby and if any complications come up, he is there to handle them.

Not yet, but we are working on it!

7. What is a Doula?

A 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 2 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,)

8. What is the 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.

9. 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.