What Is A Doula?
More recently, it refers to someone who offers emotional and
physical support to a woman and her partner before, during and after
childbirth. A doula (also known as a birth attendant) believes in ‘mothering
the mother’, enabling a woman to have the most satisfying experience that she
can, from pregnancy and into motherhood. This type of support allows the whole
family to relax and enjoy the experience too.
Women have complex needs during childbirth. In addition to
the safety of modern obstetrical care, and the love and companionship provided
by their partners, women need consistent, continuous reassurance, comfort,
encouragement and respect. They need individualized care based on their
circumstances and preferences. The role of the birth doula encompasses the
non-clinical aspects of care during childbirth.”
Despite doulas being fairly unheard of in Australia, they
have been actively supporting women for a very long time and are fast growing
in popularity, as a result of positive word of mouth and the need for increased
support.
Doulas are trained and experienced in childbirth and are
usually mothers themselves. They have a good knowledge and awareness of female
physiology, but a doula does not support the mother in a medical role – that is
the job of the midwife or doctor. She works on keeping birth normal and
empowering, and should the birth become complicated and require medical
assistance, a doula will still remain by your side and help in any way she can.
She will not make the decisions for those she supports, but she assists them
through the decision making process and provides balanced information so the
couple can make their own choices.
Given the long term emotional and physical
effects this can have on the mother, her partner and baby, a doula to me is
like an ‘insurance policy’ – which can help protect you from a disempowering,
disappointing experience or unnecessary procedures and intervention. With a
doula, you know that someone is always on YOUR team, holding the space for you
and your family. She works for you and has your best interests at heart, unlike
hospital staff who have to abide by policies, which are not always best for a
birthing woman, but best to avoid legal issues and to keep things running as a business.
Many women consider doulas to be a must for those giving
birth in a hospital, due to the over-medicalisation of birth – unnecessary
inductions have skyrocketed and are partly to blame for the 1 in 3 Australian
babies now born by caesarean section. In Australia, some hospitals have
caesarean section rates as high as 50% and higher. This is a terribly high
statistic, well above World Health Organisation recommendations, which makes us
amongst the highest in the world. A doula works in birth centres, private and
public hospitals and at homebirths in conjunction with midwives – but never as
the sole carer at birth. Birthing without a midwife or doctor present is known
as free-birthing however its highly recommended at birth with at least a
qualified midwife or doctor.
What Do Doulas Do?
A doula may provide some or all of the following, dependent
on her training and skills (she may be more than just a doula – some doulas are
also qualified in other therapies):
Birth education
and preparation
Birth planning
(including creating a written birth plan/birth preferences document)
De-briefing
previous births
Massage and other
comfort measures
Optimal fetal
positioning
Suggest positions
and changes to help ease pain and facilitate a smoother, more effective labour
Provide
reassurance and encouragement
Talking through
emotional blockages which may come up in labour
Keep your
‘environment’ going – aromatherapy, music, candles etc
Assisting you with
negotiation of your preferences for birth if what you want and the hospital
wants differs
Photography and/or
video if you wish to have momentos of your partner supporting you, the birth
itself and those precious first moments as a family, together
So much more
But I believe the biggest bonus of a doula is that fact that
she is a professional birth support person – she has been trained in the art of
birth support and has a keen eye and intuition on what a labouring mother
needs. Things which a hospital midwife unfortunately does not have time for, and
things which partner may not pick up on (or situations he may not know how to
deal with). She has a mind that is caring and nurturing, yet able to remain
calm and focused even if things go off the rails. Family and friends tend to
have an emotional connection that can mean in the event of a problem or at the
peak intensity moments, they can buckle not knowing what to do, say or think. A
doula can think clearly, see pros and cons of any situation and relay them to
the couple to make their own decision. When we’re stressed, we don’t make the
best decisions, and in hospital, that may make your partner/mother etc.
completely agreeable to what’s being put on the table, because they are
uncertain or scared. A doula can help explain what’s happening with compassion
and without judgment or medical jargon, so its easier for you to understand.
There are two types of doulas, birth doulas and post-natal
doulas, with many doulas performing both roles. The difference is that the role
of the post-natal doula is to nurture the mother at home after childbirth. This
may include further breastfeeding support, light home duties, massage,
emotional and physical support for the mother and so on. Post-natal doulas are
particularly in demand as support for new mothers has reduced in modern
society. Needless to say, studies show that post-natal doulas make a huge impact
on the well-being of mother.
What Are The Proven Benefits Of A Doula?
A recent review of many studies from around the world have
concluded that a doula’s support is more effective than hospital staff, friends
or family. You can read the review here.
Studies (and reviews of the studies) consistently
demonstrate very impressive benefits for the mother, father and baby,
including:
50% fewer
caesarean sections
Reduction in the
use of forceps vacuum by 40%
60% fewer requests
for epidurals
40% reduction in
the use of synthetic oxytocin for inductions or augmentations
30% reduction in
use of pain medication
25% reduction in
labour length
Increased rates of
breastfeeding at 6 weeks post-partum (51% vs 29%)
Higher self-esteem
(74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%)
These are not misprints! The benefits are significant. Most
of the women in the studies were accompanied by male partners, however study
results show that women who had the support of a male partner and a doula fared
best, for example, the caesarean rate of women supported by both a male partner
and a doula was significantly lower (15.4%) than the caesarean rate for women
supported only by their partners (24.4%). The studies also clearly show the
positive benefits of doula support occur regardless of a woman’s economic
status or whether or not they were privately insured. Its simply about having
the right support with you at birth.
Doulas in action - Check this video out!
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