Do I need to hire a doula?
By Laura Barbour, CD(DONA), CLC
Article originally featured in Stars and Stripes Okinawa January 2016
Thinking about childbirth is scary, and if you listen to some of your friend’s stories, oh no, things can seem bad! Whether you are pregnant with your first baby or pregnant with your fourth, you should consider hiring a birth doula. Besides the benefit of having your own extra non-biased support person, there is actual evidence based information that hiring a doula can improve your overall birth experience.
Let’s back up. What is a doula? A doula is a woman who is specifically trained to support other women during pregnancy and birth. Simply put, a doula offers emotional, informational and physical support throughout pregnancy and is your unwavering birth companion. Does a doula provide medical advice and services? No, your obstetrician or midwife serves this purpose. Doulas provide up-to-date evidence based information which you can take to and talk over with to your provider prior to labor.
Doulas love their job. They are passionate about the childbearing year from pregnancy to postpartum. Many doulas are mothers themselves and want to support a woman in that new role. Doulas view pregnancy and childbirth as a natural process and believe a woman’s body was created to grow and birth a baby. A local doula said, “I chose to be a doula because my own doula had such an impact on my life. She taught me how beautiful and powerful pregnancy and birth are and I’ve been hooked ever since.”
How is a doula different than a nurse? Besides the obvious medical difference, your nurse is going to have many other tasks besides your care: taking care of other patients, a liaison for the doctor, charts, breaks, and a possible shift change. Doulas offer continuous support from early labor at home until after baby is born. The doula’s sole focus and responsibility is on mom (and dad).
One of the common concerns when thinking about hiring a doula is taking over dad/partner’s role in the birth. This is not the case. Dad may need a bathroom break, food, or even just reassurance that everything is normal. Sometimes a dad may not be as familiar with the medical terminology, how labor looks, or he may need direction with how to support his laboring mom.
Jason is a second time dad and is looking forward to working with his family’s doula, Sarah, for the second time. Jason said, “In the military we say see one, do one, teach one. We do from experience. I relied on our doula for solid information . It was beneficial to talk through decisions prior to birth and set up our birth plan. During early labor our doula was an instrumental part of allowing me as to do what I need to do to get us to the hospital and in active labor helping us stay on task for our birth plan. During birth it was great to be able to look to Sarah for reassurance and make sure we were still good.”
Continuous support is an important part but there’s even more. Doulas also offer tried and tested pain management and comfort measures. A trained doula knows that counter pressure, massage, rebozo techniques, hydrotherapy, pressure points, position changes, and helping create your ideal birth environment with music, smells and lighting are also key components. Doulas can act as a liaison between family and friends in the waiting room and are able to pick up a camera and capture those first moments. Some doulas also have extra breastfeeding training and can help support mom if she chooses to breastfeed. The role of a doula varies family to family.
Besides offering labor support and comfort measures, a doula offers unbiased support during her pregnancy. First time mom, Jean R., said, “Journeying through pregnancy has its share of highs and lows. Living overseas in Okinawa has made the lows feel even lower because the support of home is unavailable. Couple that with the lifestyle of the Marine Corps, pregnancy is an even bigger roller coaster ride. That is precisely why I hired a doula. I needed an unbiased and constant supporter. Someone who has a passion for pregnancy and would help me achieve my goals for labor, birth, and giving my child a great start. My doula has been an essential part of my pregnancy journey. She has shared information with me that has enabled me to make better decisions for myself and my family. My doula has been there to offer much needed encouragement when I have felt my confidence start to give. She reminds me of the tremendous strength of the female spirit and the power we have to create life.”
Doulas also meet with the family prior to labor to talk with them about their birth preferences and after birth immediate newborn care procedures, answer questions based on current evidence based studies and help guide the family in creating their birth plan. After the baby is born, a doula usually follows up with the family at their home within the first week to offer feeding support, check on mom’s postpartum recovery and offer any support the family needs.
According to ACOG (American College of Obstetricians and Gynecologists), doulas can help reduce your risk of a cesarean birth. “Given that there are no associated medical harms, this resource is probably underutilized.”
Besides reducing the rate of possible cesareans, EvidenceBasedBirth.com studies say the presence of a doula results in:
• 31% decrease in the use of Pitocin
• 12% increase in the likelihood of a spontaneous vaginal birth
• 9% decrease in the use of any medications for pain relief
• 14% decrease in the risk of newborns being admitted to a special care nursery
• 28% decrease in the risk of C-section
• 34% decrease in the risk of being dissatisfied with the birth experience
The relationship that is fostered between a doula and a mom is the most essential component. As each family is unique so is each doula. When hiring a doula it is recommended to interview a few doulas and ask some questions such as: Why did you become a doula? How do you view childbirth? How do you tailor your support to each family? Do you have a back up doula? What do you do when you are not doula’ing? Interviewing a potential doula is important to see if you mesh: your personalities, style and experiences. The doula you choose should be someone you see as a necessity to your birth team.
The benefits definitely point to having a doula present at birth. Where do you begin to hire a doula? Find local resources at the Military Birth Resource Network. There are doulas and birth professionals who offer evidence based information and mother friendly care. Another great place to look for a doula is your friends and coworkers, a mom’s group, or even a search engine can find a local doula. You’d be surprised how many women utilize doulas overseas and can offer a connection.
“The birth doula’s sole purpose is to support the family in their choice of birth whatever that may look like Many families choose to have a Doula because she provides emotional physical and informational support and stays with them the entire process. The birth doula takes on the values of that family for their birth and helps them know what to do from moment to moment to achieve their own goals. She never makes judgments, or tells them what to do, nor does she provide any medical recommendations or care. The doula is not bogged down by providing clinical care. Since the Doula is a constant, she also helps them to process the birth afterwards.” – Midwife Gerri Ryan
For more information on doulas in the Military Birth Resource Network please visit: www.militarybirthresourcenetwork.org
For more information on evidence based birth information, please visit: www.evidencebasedbirth.com
Contributor's website: Laura Belle Birth Services
