What is a Doula?


From DONA.org:

What is a doula? 

The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.

A Birth Doula

  • Recognizes birth as a key experience the mother will remember all her life
  • Understands the physiology of birth and the emotional needs of a woman in labor
  • Assists the woman in preparing for and carrying out her plans for birth
  • Stays with the woman throughout the labor
  • Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
  • Facilitates communication between the laboring woman, her partner and her clinical care providers
  • Perceives her role as nurturing and protecting the woman’s memory of the birth experience
  • Allows the woman’s partner to participate at his/her comfort level

Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.

Research shows doulas make a difference:

A growing body of research shows that the use of a doula has clear benefits for families during childbirth and postpartum, with no known risks. Visit our web site regularly to see new research.

The value of providing laboring women with continuous emotional support, physical comfort, and encouragement has been recognized worldwide.

Given the clear benefits and no known risks associated with intrapartum support, every effort should be made to ensure all labouring women receive support, not only from those close to them but also from specially trained caregivers. This support should include continuous presence, the provision of hands-on comfort, and encouragement. Hodnett, E.D. Support from caregivers during childbirth (Cochrane Review) in Cochrane Library, Issue 2. Oxford Update Software, 1998. Updated Quarterly.

A doula provides support consisting of praise, reassurance, measures to improve the comfort of the mother, physical contact such as rubbing the mother’s back and holding her hands, explanation of what is going on during labour and delivery and a constant friendly presence. Such tasks can also be fulfilled by a nurse or midwife, but they often need to perform technical/medical procedures that can distract their attention from the mother. Care in Normal Birth: a Practical Guide. Report of a Technical Working Group. World Health Organization, 1996.

Facing unprecedented pressures to reduce expenses, many hospitals are targeting the largest single budget item – labor costs… (An) unintended consequence of nursing cutbacks may be an increased cesarean rate; the inability of pared down nursing staff to provide continuous coverage to laboring mothers (has been) shown to increase the chance of a cesarean…Doulas clearly improve clinical and service quality; they provide an absolutely safe way to reduce cesareans and other invasive birthing interventions. Coming to Term: Innovations in Safely Reducing Cesarean Rates. Medical Leadership Council, Washington D.C. 1996

Professionals have paid much attention to innovative technology and the many new options for monitoring and managing labor. While the technology is important, it can become so prominent that clinicians ignore both the natural aspects of labor and the non-technical needs of women in labor… Changes that support the patient in labor and reinforce the natural, physiologic process…. Includes providing one-to-one psychological support for patients using nursing staff or doulas. Reducing the Cesarean Section Rates while Maintaining Maternal and Infant Outcomes. Bruce L. Flamm et al. Institute for Healthcare Improvement, Boston, 1997

The continuous availability of a caregiver to provide psychological support and comfort should be a key component of all intrapartum care programs, which should be designed for the effective prevention, and treatment of dystocia (non-progressive labor). Guidelines on Dystocia. Society of Obstetricians and Gynaecologists of Canada, 1995.

Doula FAQS from DONA.org

1. What is a birth doula?
A birth doula is a person trained and experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth.

2. Where does the word “doula” come from?
The word “doula” comes from ancient Greek, meaning “Woman’s servant.” Throughout history and in much of the world today, a cadre of women support a woman through labor and birth, giving back rubs and providing continuous emotional support. Like their historical counterparts, DONA International birth doulas know how to help a woman in labor feel better. However, today’s doulas are much more diverse than their predecessors. DONA International membership includes men and women from a wide range of ages and cultural backgrounds.

3. What effects does the presence of a doula have on birth outcomes?
Numerous clinical studies have found that a doula’s presence at birth:

  • tends to result in shorter labors with fewer complications
  • reduces negative feelings about one’s childbirth experience
  • reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction
  • reduces the requests for pain medication and epidurals, as well as the incidence of cesareans

4. What effects does the presence of a doula have on the mother?
When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, have fewer cesareans and requests for medical intervention, and less postpartum depression.

5. What effects do the presence of doulas have on babies?
Studies have shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period.

6. How can I find a doula in my area?
Use DONA International’s online doula locator.

7. How do doulas practice?
Doulas practice in three ways: privately hired directly by clients,
as hospital employees, and as volunteers in community or hospital programs.

8. Does a doula replace nursing staff?
No. Doulas do not replace nurses or other medical staff. Doulas do not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postpartum clinical care. They are there to comfort and support the mother and to enhance communication between the mother and medical professionals.

9. Does a doula make decisions on my behalf?
A doula does not make decisions for clients or intervene in their clinical care. She provides informational and emotional support, while respecting a woman’s decisions.

10. Will a doula make my partner feel unnecessary?
No, a doula is supportive to both the mother and her partner, and plays a crucial role in helping a partner become involved in the birth to the extent he/she feels comfortable.

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