Birth and Postpartum Doula'

What Is a Doula? A Brief History

Doula support throughout history women has been cared for and supported by other women during childbirth. It is an ancient practice still honored today in most cultures. However, in modern industrialized society, when childbirth moved from one's home to the hospital, we lost the element of a woman's nurturing touch and guidance as to the demands of the nursing staff grew. While introducing fathers onto the scene did improve matters, it is unrealistic to expect him to provide all the skills necessary to ensure fewer interventions and safer outcomes as they have little prior experience with birth and medical procedures.

As more and more women are seeking alternatives to medicated births and wanting fewer interventions, the role of the doula has grown. The word "doula" is a Greek word meaning "woman's servant". It has been adapted to now refer to a supportive companion (not a friend or loved one) experienced and professionally trained to provide continuous physical, emotional and informational support before, during and after childbirth. As recent studies show, the presence of a doula not only improved the bond between mother and child but helped to reduce the incidence of interventions complications.

What Does A Doula Provide?

The doula offers help and advises on comfort measures such as breathing, relaxation, massage, movement, and positioning. She also provides families with evidence-based information so that they may be better informed about their options and can decide the course of their labor. The doula helps the mother and father become informed about various choices, including associated risks, benefits and accompanying precautions or interventions for safety. The doula's presence offers support and reassurance to both the mother and her partner and works with the midwife or doctor and nursing staff to complete the birth team.

Doula's do not perform medical tasks such as fetal heart tone monitoring, vaginal exams, or monitor blood pressure. She does not diagnose or give medical advice or second opinions. Doulas do not operate medical equipment. Most importantly, doulas do not make decisions for the laboring mother or her partner.

The information above adapted from DONA International's position paper: "The Doula's Contribution to Modern Maternity Care."

Common Misconceptions

I do not need a doula, I am planning a home birth (or a hospital birth) with a midwife. Although midwives usually provide more mother and baby-centered care than most physicians, they are still unable to provide continuous emotional and physical care from early labor through childbirth that a doula will provide.

If I have a doula, that means I have to have all-natural childbirth, and I don't know if I can do that. A doula's role is to provide support and reassurance for you regardless of your birth choices or use (or refusal) of pain medication. Often times women find they go much longer into the labor than expected before the use of analgesics, and many times they make it through delivery without any at all! This is due to the reduction of stress and the increased relaxation provided by the doula.

"What do we need a doula for? I'll be there"! (says the Dad, partner, friend or relative)

Doula's do not replace the father, partner, friend or relative. They complement each other's role in providing support for the mother.

What is a postpartum Doula?

A postpartum doula supports the new family during the first weeks of birth. A postpartum doula comes in and meets the couple before baby is born and a care plan is created for after care. Some women do not want a birth doula but appreciate a postpartum doula who can assists new mothers on breastfeeding, newborn care and support, adjusting to newborn needs and night time help. Twin mothers especially love postpartum doulas and the support and help they provide new sleepless mamas. 

A postpartum doula may do light house work or maybe run an errand make a meal and free up mama and daddy to be focused on being new parents. Some postpartum doulas come during evening  time to help with night time feeds and attention. Sleep breaks too. 

Resources:

https://evidencebasedbirth.com/the-evidence-for-doulas/