What is a doula?

So, National Doula Week was at the end of March, and the goal was to start this blog during that week, but life got in the way and I didn't have time to write my first post until now. So Happy Belated Doula Week! I thought it was fitting to address the question of "What is a Doula?" as my first blog post. Seeing as it was Doula Week, and maybe some of you out there need an explanation on what a doula is and who might benefit from her services. Or maybe you think you know what a doula does, and that you don't need one, for whatever reason, but read on anyway. I might just change your mind about that. What is a Doula?? The word "Doula" is derived from the Greek word meaning a highly regarded female servant to the lady of the house that probably helped the woman through her childbearing years. This is an antiquated definition for our times though. From the book "Mothering the Mother" by Klaus, Kennell and Klaus, the word Doula has come to mean "a woman experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth." A doula assists the laboring woman and her husband or partner on many levels throughout labor and birth. She has gone through special training in which she learned about the natural process of birth and its normal variations. She has a special skill set or 'bag of tricks' of coping techniques and comfort measures including, but not limited to, different types of touch, positioning, and movement to help mom through contractions. She is knowledgable about common hospital interventions, the risks and benefits of them, and helps the laboring couple make informed choices about their care and the care of their baby. The doula is also knowledgable about breastfeeding and can help establish a good nursing relationship and assisting with any latching or other problem that may arise in the immediate postpartum period. After the birth, the doula typically visits the family to check on mom's well-being, see how nursing is going and talk to the couple about what transpired during the birth. Isn't that what a midwife does? Doulas are not midwives, although some midwives are very hands-on and possess doula-like qualities. Midwives catch babies, doulas do not, nor do they want to. Their role is emotional support and helping mom cope with her contractions. A midwife has thorough training and experience in the medical and physical process of birth. Depending on the type of midwife, and where you live, a licensed midwife will have attended midwifery school and usually apprenticed under a senior midwife, some midwives have also gone to nursing school. A midwife is focused on the birth process, while the doula tends to mom's emotional state. The midwife isn't always with the laboring mom as long as the doula is. The midwife may have to check on another mom in labor, and may not come until later in active labor or in a hospital setting, until the pushing phase. The doula is usually with mom from the beginning of active labor, sometimes before. At the time of birth, while the midwife (and usually dad and everyone else) is focused on what is happening down below, the doula is up at mom's head, encouraging her, focusing on her. When is comes to natural birth, I say the more quality support that mom has, the better! The midwife and doula can be a great team. Why hire a Doula? If you want a natural birth, let's just look at the stats when it comes to birth with a doula: 47% less epidural request 28% less incidence of cesarean 34% less likely to view their birth negatively 31% less likely to use artificial oxytocin to speed up labor Overall, women that had continuous labor support from a person that was not part of the medical staff (midwife, doctor, nurse) and not in her social network (friend, husband or family member) ....like a doula (!) were less likely to : ~receive any pain medicine (analgesia/anesthesia, including narcotics) ~have a baby with a low 5-min APGAR score ~give birth with the help of vacuum extraction or forceps These women were more likely overall to: ~have a slightly shorter labor ~give birth spontaneously (without vacuum or forceps or via cesarean) **According to a systematic review of the most recent data by Hodnett and collegues (2011). The entire review can be seen here: (PDF) http://childbirthconnection.org/pdfs/CochraneDatabaseSystRev.pdf In a study refferred to in "Mothering the Mother," women were randomly placed with or without a doula upon arriving at the hospital. In an interview 24 hours postpartum, both groups reproted similar levels of anxiety before birth. The group that had a doula reported: ~fewer considered labor and delivery difficult ~fewer thought it was harder than they had imagined ~More believed that they had coped well The doula group also reported feeling closer to their partner during and after the birth. Satisfaction with their partners before getting pregnant was reported reletively the same: 63% in the no-doula group and 65% in the doula group. But there was a significant difference in the number of women that were satisfied with their partner during and after birth. The moms in the no-doula group reported satisfaction with their relationship with their partner was better right after the birth at 30% compared to 71% for the moms in the doula group. ANd since the birth, the no-doula group reported 49% satisfaction versus 85% in the doula group. The doula group also reported less anxiety after the birth, less postpartum depression and baby blues and higher self-esteem than the no-doula group. So while I may be a bit biased, being a doula myself :) but according to these studies, having a doula present at your birth seems to not only increase the likelyhood that you will reach your natural birth goal, but it can be better for your relationship with your partner, your baby and your overall well-being after the birth. I know I will never have another baby without a doula present, and I see where I could've benefited from a doula's presence in my past births. Everyone deserves a doula! "If a doula was a drug, it would be unethical not to use it" - Dr. John Kennell

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