What is a doula?
A doula provides physical, emotional, and informational support during pregnancy, labor and birth, and the postpartum period. A doula does not perform clinical or medical tasks such as taking blood pressure or temperature, fetal monitoring, vaginal exams, or postpartum clinical care. She does not make decisions or intervene on the mother's behalf. Rather, the doula is there to support the woman, the family, and the decisions that they make.
If my partner is going to be at the birth, do we need a doula?
A doula is there to support both the mother and her partner. Because your partner is likely to be more informed and prepared if you use a doula, he or she will be more relaxed and able to fully participate in your labor to the extent that he or she is comfortable. Further, a laboring woman, especially the one who has not taken medications and who has been free to eat and drink, has a delicious cocktail of hormones that sustain her during her labor. Her partner does not have the benefits of these! A doula will be able to continue supporting you while your partner rests, goes to the restroom, or gets a bite to eat.
What effects does the presence of a doula have on birth outcomes?
Studies have shown that the presence of a trained doula may decrease cesarean sections by 46%, cesarean sections after induction of labor by 79%, oxytocin (tradename Pitocin) use by 40%, epidural anesthesia use by 60%, narcotic analgesia use by 30%, and the use of forceps by 30%.
I plan to use medication. Would I still benefit from having a doula?
You could absolutely still benefit from from the presence of a doula. During prenatal appointments we will discuss your preferences and the risks and benefits of different types of medication. I will learn what your desires are and during your labor my job will be to support you in meeting those desires. As doula I support the decisions that you make and I do more than offer pain coping techniques; I provide emotional and informational support to you and your family during one of the most intense and challenging transitions of your life. If you have an epidural you will still need support with the emotional and psychological parts of labor, as well as with interpreting and communicating with the medical system of which you will be a part. In addition, I will be able to offer breaks to your partner so that you can remain supported while he or she goes to the restroom or gets a bite to eat.
What effects does the presence of a doula have on the mother?
Mothers who have doulas are more likely to rate their self-esteem higher, rate their birth experience as "good", and say that they coped well with the labor and birth. They also score lower on measures of postpartum depression by half, and have better interactions with their babies right after the birth and two months later. Mothers who have postpartum doulas also experience a lower incidence of postpartum depression. They find the transition to parenthood easier, are more successful with breastfeeding, and report having greater self-confidence both as individuals and as parents.
What effects does the presence of a doula have on the baby?
Studies have shown that babies who are born to a mother who had a doula have shorter hospital stays, less admission to special care nurseries, an easier time breastfeeding, a two-fold higher chance to still be exclusively breastfed at four and six weeks of age, and mothers who are more affectionate.
I would like my older child(ren) to be present at the birth. Could you come just to support them?
Absolutely. If your child is going to be present at the birth it is very important that he or she has his or her own support person so that you and your partner can be completely dedicated to the tasks of labor and birth. It can be more useful to have a doula for this purpose than to hire a babysitter, because doulas are trained to understand labor and birth. As a trained doula I would be able to assist in preparing your child for the birth in advance; I would also be able to help the child understand and process the experience as it is happening.
References:
Hofmeyr, J. G., Nikodem, C. V., Wolman, W. L., Chalmers, B. E. , & Kramer, T. (1991). Companionship to modify the
clinical birth environment: Effects on progress and perceptions of labour, and breastfeeding. British Journal of
Obstetrics and Gynaecology, 98, 756-764.
Landry, S. H., McGrath, S. K., & Kennell, J. H. (1998). The effect of doula support during labor on mother-infant
interaction at 2 months. Pediatric Research, 43(4: Part II), 13A.
Langer, A., Campero, L., Garcia, C., & Reynoso, S. (1998). Effect of psychosocial support during labour and childbirth
on breastfeeding, medical interventions, and mothers' wellbeing in a Mexican public hospital: A randomised clinical
trial. British Journal of Obstetrics and Gynaecology, 105, 1056-1063.
McGrath, S. K., & Kennell, J. H. (2008). A randomized controlled trial of continuous labor support for middle-class
couples: Effect on cesarean delivery rates. Birth, 35(2), 92-97.
Scott, K. D., Berkowitz, G., & Klaus, M. (1999). A comparison of intermittent and continuous support during labor: A
meta-analysis. American Journal of Obstetrics and Gynecology, 180, 1054-1059.
Zhang, J., Bernasko, J. W., Fahs, M., & Hatch, M. C. (1996). Continuous labor support from labor attendant for
primiparous women: A meta-analysis. Obstetrics and Gynecology, 88(4: Part II), 739-744.
Courtney Stern, Doula
Inner Light Birth Services
courtney@innerlightbirthservices.com
(610) 420-8701
photos on this page courtesy of QStern Photography
