What is a Doula?

More and more families today are choosing to use attendants at their births that are not part of the hospital or birth center staff, or someone other than a family member as a labor assistant. Mothers today are often choosing to employ a doula to help and aide during birth. This often is questioned as many times the mother has attendants and staff assisting during the birth. So what exactly then is a doula?

What is a doula and what do they do?

By definition, a doula is a non-medical experienced assistant who acts as an advocate for the family, and assists the family during birth. The Greek world also means one who serves another. The doula almost always meets with the mother or the family 3-5 times before the birth to discuss the families birth plans, needs and wants. Each doula molds her role in the birth around the needs of the family. She is present during and after labor and often during the postpartum period for a few weeks to assist in breastfeeding, bonding, and household activities.

Doula's do not perform any medical activities and are not there for medical care. Your midwife or doctor will perform all checks, ultrasounds, and will dispense actual medical advice, while the doula's role is to increase your comfort before, during and after the labor and assist the family in any way she can. Before birth, often she provides multiple means of relaxation to the mother including massage, aromatherapy, reflexology and stress relieving activties. Often she can relieve other family members of duties, can take pictures, provide coaching to the laboring mother.

Why would I need a doula?

Many women believe they would not benefit from a doula because they have a caring group of family members, or trust that their medical professionals will care for them. Remember in the hospital that the doula is advocating for your rights and your wishes whereas the hospital will not always do so. The doula also is experienced, trained and certified in birth methods, the labor process, and labor coaching. Research shows that doula's actually increase the investment and participation of fathers during birth and doula's do not look to replace the role of the father or family member, but rather to assist the family as a whole for a better birth experience. The doula is an advocate for the family as a whole and works to ensure that the fathers wants and needs are met as well as the mothers. Often this may include advice during labor, calming techniques during labor to the father, and relief if he needs a break to eat or sleep. The doula acts to keep the whole family calm and to push for the family to gain the labor experience they are seeking. Doula's are seeking to reduce interventions and unnecessary medical actions and will advise the family on their best route.

One of the best reasons to use a doula is that research proves that they do assist the family.

Mothers who use doula's are:
-in labor for a shorter period of time
-are less likely to need pain medications
-are less likely to have to use forceps or vaccum in vaginal delivery
-much less likely to have a c-section

Babies benefit by:
-less time spent in the NICU
-lower rates of fetal distress

One study comparing mothers who used doulas to those tht didnt, also found that mothers who did use doula's reported less depression, higher self esteem, better baby bonding, better ability to breastfeed, better regard for their babies and a stronger feeling of being able to care for their babies.

Can anyone be a doula? How do I know I"m getting someone who is trained?

Technically anyone can become a doula. However, most responsible doula's are trained and certified through a number of agencies. The largest is DONA, Doulas of North America. They offer training courses and establish guidelines, ethics and steps that one must meet before being allowed to become a doula.
You can check out their website at www.dona.org .Dona also assists you in finding and hiring a doula in your area and provides questions to help you match with the best person.

Other resources to find a doula:
http://doulanetwork.com/
www.doula.com
ALACE -- The Association of Labor Assistants and Childbirth Educators www.alace.org
Birth Works www.birthworks.org
CAPPA -- Childbirth and Postpartum Professional Association www.cappa.net
ICEA -- The International Childbirth Education Association www.icea.org
www.childbirthinternational.com

M.H. Klaus, J.H. Kennell, "The doula: an essential ingredient of childbirth rediscovered." Acta Paediatr. 1997 Oct;86(10):1034-6.

P. Keenan, "Benefits of massage therapy and use of a doula during labor and childbirth." Altern Ther Health Med. 2000 Jan;6(1):66-74.

Madi, Banyana Cecilia; Sandall, Jane; Bennett, Ruth; MacLeod, Christina, "Effects of Female Relative Support in Labor: A Randomized Controlled Trial." Obstetrical & Gynecological Survey. 54(10):627-628, October 1999.

Manning-Orenstein, Grace, "A birth intervention: the thereapeutic effects of doula support versus Lamaze preparation on first-time mothers' working models of caregiving." Alternative Therapies, July 1998, Vol. 4, No. 4, pp. 73-81.