1. What is a doula
“Doula” is a Greek word which means “a female slave in the service of women”. A doula or Childbirth Companion is a trained professional who provides continuous physical, emotional & educational support to a mother before, during and after birth to help her achieve the most satisfying and healthy birth experience possible. Doulas have deep knowledge and understanding of physiological birth and we believe in a woman’s natural ability to birth a baby.
They follow the Social Model of care also known as the midwifery model, focuses on the whole person, their environment and their intuition and that technology can help when needed, as opposed to the biomedical model of care which has been standardised often by men, it focuses on controlling, does not focus on a woman as a whole and does not take the environment into consideration.
2. Why should you hire a doula/ What are the benefits of including a doula in your birth team?
Multiple randomised control studies have shown that having a doula present at a birth benefits everyone.
The studies have consistently shown that doula care during labour and birth is associated with more positive birth experiences, shorter labours, less use of and requests for epidurals and other pain medications, decreased need for medical intervention like forceps, episiotomies, a lower rate of and as much as a 50% reduction in the C-section rate.
Research has also shown better clinical outcomes for both the mother and the baby including fewer admissions to neonatal special care units, less maternal fever, and better breastfeeding rates.
The studies have also shown is that women who were supported by a doula during birth, in the postpartum period showed lower incidences of postpartum depression, less anxiety, increased confidence and better family bonding.
A doula also provides care for the mother’s partner and other family members, assists busy hospital staff, saves money, and greatly increases a mother’s overall satisfaction with her birthing experience.
One of the many benefits of hiring a doula is that she is the only practitioner in your birth team who does not change shift. She offers her continuous support during your pregnancy, labour birth and postpartum, allowing you to establish a close relationship with her so that she can assist you specifically according to your likes, dislikes and preferences. No matter how long your labour is or whether you need to be transferred to a different hospital your doula stays by your side.
A Doula is essentially there to “Mother the Mother” and she becomes your personal wellness advocate, your best friend and confidante.
Dr John H Kennel, a paediatrician and one of the founders of DONA International (Stands for Doulas of North America) said that “If a doula were a drug it would be unethical not to use it”
3. How does a Doula support a mother?
3.1. Some of the ways a Doula uses physical support to help relieve pain for a mom:
- Making you feel comfortable and safe
- By using soothing touch and massage
- Putting firm pressure on her back or hips, called counter – pressure
- Helping to keep you nourished
- Providing you with pillows
- Assisting you to move and change into positions which will be more effective in speeding up your labour, walking around with you
- Assisting with Hydrotherapy to ease and speed up labour, if the mother would like to labour in the shower or bath or give birth in water
3.2. Some of the ways Doulas Emotionally support you:
- By making you feel safe.
- Doulas work to create a calm environment
- “Doulas facilitate oxytocin release” (the hormone which causes contractions) according to a Swedish researcher, Kerstin Uvnäs Moberg, who is an expert in oxytocin
“Researchers have found that when people feel capable, confident and cared for, they feel less pain during labour. They perceive their pain as more manageable and they’re better able to cope.” Rebecca Dekker – Evidencebasedbirth.com
3.3. How doulas support mothers by educating:
- Doulas and Childbirth educators help moms and their partners prepare to cope with labour pain better by informing, practising coping mechanisms, and by counselling at prenatal visits.
- Coaching you on your mindset during labour and birth, assisting you to interpret labour in a much more positive way and preparing you so that you will be able to perceive pain as less unpleasant….reminding yourself that your body is made to birth, that each contraction is bringing you closer to baby, visualising baby dropping down lower into your pelvis and imagining your cervix dilating with each contraction
4. Is a Doula and a Midwife the same thing?
The short answer is NO
A midwife is a clinically trained professional who in most cases is a nurse as well. She can deliver babies and provide clinical care for mother and baby eg, checking blood pressure, checking if the cervix is dilated, checking baby’s APGAR score, checking blood pressure, baby’s heart etc and administering drips or pain meds. So the midwives’ responsibility is the clinical well – being of mother and baby
A doula is not clinically trained and does not provide any nursing or medical care. Since she doesn’t have these responsibilities, or other patients to attend to, she can give her complete attention to being by a woman’s side for the entire length of her labour.
5. Does a Doula work with a Midwife?
Doulas typically operate as a Private Practice and support birthing women in different environments. The clients who give birth with their gynaecologist or obstetrician in private hospitals, some who choose to have home-births with independent midwives. Doulas also have private clients who give birth with midwives at government hospitals/MOU’s (Midwives Obstetric Units) /clinics
6. Does the doula replace the husband
No. A doula doesn’t replace anyone. She is part of the birth team and assists everyone in their own role.
The partner has intimate knowledge about the mom, and the doula has intimate knowledge and experience and feels so comfortable with birth – creating an amazing symbiotic partnership to best support the mom.
Many a time the partner wants to help, but he is so scared, or nervous he does not know what to do. A doula’s presence helps fathers or partners participate at their own comfort level, showing them how and when to use various comfort techniques, providing information, and in some cases, looking after them as well, getting them coffee, food or pillows.
Several research studies have shown that mothers who hire a doula have shown to have Increased personal support from the father during labour and improved relationships with their partners.
Doulas are there to serve, and we are there to serve in the manner mom and dad would like. So if mom and dad want privacy, the doula is more than happy to step away, when they need more support, we are happy to step in again. In many cases with a very tenuous labour, dad and doulas take turns to support mom and take naps and toilet breaks.
7. Does a Doula only support moms who are having a drug – free, vaginal birth
A doulas role is to support a mother in HER personal choices.
Doulas should not coerce anyone to have a “natural birth” or drug – free birth. Doulas do not make recommendations, they encourage mothers to always consult with their primary caregiver and support mothers in the birth that they have chosen to have.