The word doula is a Greek word meaning women’s servant. Women have been serving others in childbirth for many centuries and have proven that support from another woman has a positive impact on the labor process.
What is a doula?
A doula is a professional trained in childbirth who provides non-judgemnetal emotional, physical, and educational support to a mother who is expecting, is experiencing labour, or has recently given birth. The doula’s purpose is to help women have a safe, memorable, and empowering birthing experience.
“I think one of the best things we could do would be to help women/parents/families discover their own birth power, from within themselves. And to let them know it’s always been there, they just needed to tap into it.” ~ John H. Kennell
Most often the term doula refers to the birth doula, or labour support companion. However, we can also offer support through pregnancy and postnatally, when you’re home with your newborn (Post-natal Doula Support).
What does a doula do?
Most doula-client relationships begin a few months before the baby is due. During this period, they develop a relationship in which the mother feels free to ask questions, express her fears and concerns, and take an active role in developing Birth Preferences (also known as a Birth Plan or Decision Tree). We can also help you connect with your community with our Birth Concierge Service.
Although we like to meet you well before your Estimated Due Month, if this is not possible we are happy to support you with short notice. Time shouldn’t be a barrier to having doula support.
Most doulas make themselves available to the mother by phone in order to respond to her questions or address any concerns that might arise during the course of the pregnancy. Doulas do not provide any type of medical care. However, they are knowledgeable in many medical aspects of labor and delivery.
- Doulas are NOT medical professionals, and don’t preform medical exams, tasks, diagnose conditions or deliver babies.
- Doulas do not project their views onto you, and they NEVER judge you or make you feel bad for the choices and decisions you make.
During labour, doulas are in constant and close proximity to the mother. They have the ability to provide comfort with pain-relief techniques including breathing techniques, relaxation techniques, massage, and laboring positions. Doulas also encourage participation from the partner and offer reassurance.
A doula acts as an advocate for the mother, encouraging and helping her fulfill specific desires she might have for her birth. The goal of a doula is to help the mother experience a positive and safe birth, whether an un-medicated birth, caesarean, VBAC (Vaginal Birth After Caesarean), or home birth.
After the birth, labour doulas will spend time helping mothers, assisting with the breastfeeding process and encouraging bonding between the new baby and other family members. Support can continue with Post-natal Doula services.
What are the benefits of having a doula?
Numerous studies have documented the benefits of having a doula present during labour. A recent Cochrane Review, Continuous Support for Women During Childbirth, showed a very high number of positive birth outcomes when a doula was present. With the support of a doula, women were less likely to have pain medication administered and less likely to have a cesarean birth. Women also reported having a more positive childbirth experience.1
Other studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40%, and requests for an epidural by 60%.2
“If a doula were a drug, it would be unethical not to use it.” ~ John H. Kennell
Doulas often use the power of touch and massage to reduce stress and anxiety during labor. According to physicians Marshal Klaus and John Kennell, massage helps stimulate the production of natural oxytocin. The pituitary gland secretes natural oxytocin to the bloodstream (causing uterine contractions) and to the brain (resulting in feelings of well-being and drowsiness, along with a higher pain threshold). Rachael is a qualified Remedial Massage Therapist, with specialties in Pregnancy Massage, Labour massage & Acupressure Support and Post-natal Massage.
Historically it was thought that intravenous oxytocin does not cross from the bloodstream to the brain in substantial amounts and, therefore, does not provide the same psychological benefits as natural oxytocin. However, more recent studies indicate that oxytocin administered nasally and/or intravenously may cross from the bloodstream to the brain. Nonetheless, doulas can help mothers experience the benefits of oxytocin naturally without the use of medication.
What about the partner’s role when using a doula?
The role of the doula is never to take the place of partners in labor but rather to compliment and enhance their experience. Today, more partners play an active role in the birth process. However, some partners prefer to enjoy the delivery without having to stand in as the labour coach.
“My husband (partner) is my left hand and my doula is my right”. ~ Doulas Making a Difference
By having a doula as a part of the birth team, a partner is free to do whatever they choose. Doulas can encourage the partner to use comfort techniques and can step in if they require a break. Having a doula allows them to support their partner emotionally during pregnancy, labour, birth and beyond and to also enjoy the experience without the added pressure of trying to remember everything he learned in childbirth class!
Are doulas only useful if planning an un-medicated birth?
The presence of a doula can be beneficial no matter what type of birth you are planning. Many women report needing fewer interventions when they have a doula. But be aware that the primary role of the doula is to help mothers have a safe and pleasant birth–not to help them choose the type of birth.
Pain relief options such as nitrous oxide, opioids and epidurals are available in the hospital environment. Doulas provide emotional, informational, and physical support through labour and the administration of pain relief. Doulas work alongside mothers to help them with potential side effects. Doulas may also help with other needs where pain relief may be inadequate because even with medication, there is likely to be some degree of discomfort.
For a mother having a cesarean, planned or unplanned, a doula can be helpful by providing constant support and encouragement. Often a cesarean results from an unexpected situation leaving a mother feeling unprepared, disappointed, and lonely. A doula can be attentive to the mother at all times throughout the preparation for the cesarean, letting her know what is going to happen throughout the procedure. Your partner will generally accompany you into theatre, however if this is not applicable to your circumstances, doula support can be provided. Rachael has past experience as a Theatre trained Registered Nurse so she understands the process. In recovery a doula can be present bed side to free the partner to attend to the baby and accompany the newborn to the nursery if there are complications.
“Birth is not only about making babies. Birth is about making mothers – strong, competent, capable mothers who trust themselves and know their inner strength.” ~ Barbara Katz Rothman
What about other types of doulas?
In addition to labor doulas, there are pregnancy doulas and postnatal doulas.
Pregnancy doulas can provide support to a mother who has been put on bed rest or is experiencing a high risk-pregnancy. They provide informational, emotional, physical, and practical support in circumstances that are often stressful, confusing, and emotionally draining.
A Pregnancy Doula can also provide all the benefits of a Labour Doula without attending the actual birth, if this is a preferred option.
Postnatal doulas provide support in the first weeks after birth. They provide informational support about feeding and caring for the baby. They provide physical support by cleaning, cooking meals, and filling in when a new mother needs a break. They provide emotional support by encouraging a mother when she feels overwhelmed.
Some doulas have training in more than one area and are able to serve as more than one type of doula.
Compiled using information from the following sources:
1. Childbirth Connection
2. Hodnett ED. Gates S Hofmeyr GJ. Sakala C. Continuous Support for Women During Childbirth. Cochrane Database of Systematic Reviews. CD003766, (2003).
3. Klaus, M., Kennell, J., Klaus, P. Mothering the Mother.: Addison-Wesley Publishing Company, (1993).
4. Viero, C., Shibuya, I., Kitamura, N., Verkhratsky, A., Fujihara, H., Katoh, A., Dayanithi, G. (2010).
5. Oxytocin: Crossing the bridge between basic science and pharmacotherapy. CNS Neuroscience & Therapeutics, 16.