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What is a Doula?
The Greek word, “doula,” which means “servant,”
has in recent years come to describe a professional birth companion or
postpartum companion who is experienced in providing nonmedical physical
and emotional support to the childbearing woman and her partner. Women
comforting women during childbirth and postpartum is a skill as old as
birth itself. Yet the professional childbirth companion or “doula” is the
newest member to the maternal health field as an organized, certified profession.
What does a Doula do?
A doula can provide continuity of care from meeting
with a woman and her partner prenatally to accompanying them throughout
the labor and birth process and remaining in contact during the postpartum
period. Her level of support may include providing educational information
on pregnancy, birth, breastfeeding and parenting topics as well as her
continuous physical presence during labor. She is also experienced with
assisting the mother’s first breastfeeding of her baby.
Specifically, during birth, the doula can remind or assist the mother with various comfort techniques she plans to use, such as breathing patterns, positions and mobility, relaxation and visualization, risks and benefits of specific options/procedures or interventions that may arise. She is also present for the time-honored tasks of holding the mother's hands, rubbing her back, wiping her face with a cool cloth, and encouraging and affirming her experience of childbirth as it unfolds. She celebrates the arrival of the baby and is an advocate for the parents’ wishes with regard to newborn procedures and infant care.
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A major component of a doula's value in labor and birth is the empowerment of the mother. As a woman is empowered in childbirth, she believes in the design of her body, her mental ability, her physical strength, and her emotions. An empowered woman will continue to develop to her full potential in all developmental stages and challenges of her life. The empowered mother will have confidence in herself. This confidence and trust will enhance her nurturing of her child and will affect relationships with her extended family and her community.
Well-documented research studies (Mothering the Mother, Kennell, Klaus, and Kennell, 1993) report doula-attended births have shorter labors with fewer complications and less need for medical interventions. Since interventions and subsequent complications may deny the optimum well-being of both mother and her child, a doula's role is paramount in a birth setting.
As an experienced, trained woman herself, a doula can offer a comforting presence to the birthing environment. She may offer suggestions of relaxation aids, position options, and informational links with the caregiving staff. Often just holding a hand or stroking a forehead will have a calming effect on the mother.
Another important role of the doula is educating the mother and her family about the many choices related to childbirth. A doula must be able to present risks and benefits to many, many issues in an easily understood manner so the mother can make informed choices with confidence. The doula then needs to give unrestricted support, never withholding support because of personal perspectives and sentiments. When a woman is supported in making choices about her birth, she will be empowered.
A doula's support and presence is very important because she will not be emotionally involved with the birthing family. While still being sensitive and caring, she can stand a bit removed from the situation and provide stability and objectivity if the birthing scenario becomes hectic and chaotic. From accurate record keeping of prenatal visits with the birthing family, a doula may remind the mother of earlier decisions and choices the mother made for the birth.
The doula's role in providing continuous support to the mother is very significant. While others, such as the caregiving medical staff, will support the birthing family, many aren't in a position to give continuous support. Staff shift changes, emergencies and other patients' needs do not allow for the same caregiving staff person to always be available. On the other hand, throughout the entire birth, a doula will be committed to staying with the mother throughout labor and delivery until a few hours after birth. With this continuity of the doula's presence, the mother doesn't need to use emotional energy adjusting to new personnel.
A doula will affirm a woman in making informed choices, will encourage the mother in recognition of her own personal strengths and will enhance the birth environment with a calm presence. Also, she will make suggestions related to comfort and care of the mother. She will not speak for the mother and her family but will discreetly remind the mother of her own abilities, rights and power. Ultimately, the empowered mother will have a satisfying birth experience, and the well-being of both mother and newborn will be enhanced.
