The word "doula" comes from the ancient Greek word
meaning "a woman who serves". A doula is a professional educated in
the physiological and emotional changes that occur during pregnancy and birth,
and the techniques that aid the birth process. Although douals work for the mother they compliment the
mother’s support team including the doctors, nurses, midwives, partner, and family.
They attend both hospital and home births, and both medicated and unmedicated
births, as well as surgical births. Giving birth is one of the most life
altering experiences a woman and baby can have, and their experience can affect a
mother’s, father’s and baby’s emotional, psychological, and physical well-being.
Doulas aid the birth process by providing continuous informational, emotional
and physical support, as well as encouragement to the mother and father,
before, during, and after labor. The main purpose of a doula is to help women
have their best birth experience possible and provide for a more satisfying
birth experience.
The role of a doula has come into existence from a need.
This need has risen from the changes that have occurred in our culture and
society. In history it used to be that women would have other women supporting
them through labor, using their personal knowledge and trust in the labor
process to aid labor. Since birth became medicalized the role of the supporting
women disappeared. Medical advancement has played an important role in
improving maternal and new born outcome. However, that has pushed aside a much
needed aspect of birth; that of having a person knowledgeable and experienced
in birth who is there by the parents side the entire time a woman is in labor,
providing the essential nurturing, caring, and supportive component to labor
and birth. That vital type of support is something that is not always available
in hospital births, seeing as doctors come when it is time to deliver the baby
and nurses don’t stay by a woman’s side during the entire labor. However, a
doula is there for support from pre-labor, through labor, and into postpartum.
As stated doula support starts before a woman is even in
labor. It is essential that parents have the information necessary to make
informed decisions and that they know their rights as patients. A doula can be
pivotal in providing information and encouraging parents to educate themselves about
their birth choices. This is the basis for what will shape a woman’s birth
experience. In addition, once a woman is in labor, a doula’s knowledge about
the labor process is crucial for support and in helping parents make informed
decisions, as well as help them feel reassured about what they are going
through.
A woman’s ideal birth experience can vary from woman to
woman. However, current research shows doulas can help women have a positive
birth experience by reducing c-section rates, shortening labor, and reducing:
epidural requests, pitocin use, analgesia use, and forceps or vacuum deliveries.
Doulas help in reducing those procedures by using their knowledge about techniques
and positions that aid the natural and positive development and progress of
childbirth, in addition to providing continuous emotional support to the mother and
partner. Reducing those interventions is important because they all affect a
woman’s and baby’s birth experience both emotionally and physically, mother
baby bonding, and successful breastfeeding. “Women who have used a doula are
more satisfied with their birth experience, feel more confident in their
ability to mother, bond faster with their newborn, are less likely to have
post-partum depression, and are more likely to breastfeed” Klaus, Kennel, and
Klaus 2001.
Giving birth puts women in a very vulnerable state in which
it is hard to always communicate with the caregiver. Doulas are able to serve parents
in moments when support is needed the most. In carefully discussing the parents’
wishes and birth plan before birth a doula becomes very familiar with their
wishes and is then able to guide the parents in making their whishes known and
respected. In no time does a doula take the parents’ decision making power away
from them, on the contrary, the doula makes sure that the decisions are always
that of the parents’ and that those decisions are clearly communicated and
respected. This makes the laboring woman feel safe and empowered.
A doula also provides valuable emotional and physical
support by offering the woman comforting techniques or by helping the partner
offer that support. Such support can include: encouragement, guided imagery,
focus, breathing, massage, and position changes. This gives women the ability
to go through the labor process more comfortably and confidently. Having a
doula present also relieves pressure and offers support to the birth partner,
so that the partner can be more relaxed, feel more confident in their role, and
provide more adequate support to the woman in labor.
In order for a doula to serve a woman adequately it is not
only important that women know what a doula’s role should be but also what a
doula can’t and should not do. Most "Standards of Practice" state that
a certified doula should not perform clinical or medical
tasks such as taking blood pressure or temperature, fetal heart tone checks,
vaginal examinations, or postpartum clinical care. This becomes a question of
ethical standards which require that a doula maintain high standards of personal conduct in the capacity or
identity as a labor support provider.
Choosing a doula to serve during pre-labor, labor, and birth
is one of the most important things a woman can do to ensure a positive birth
outcome. A doula can do this by educating, supporting and comforting her and
her partner throughout the entire birth process. This in turn provides the best
scenario to welcome a baby into this world, providing a strong foundation for a
healthy, happy life ahead.