The use of doulas in maternity care has grown with the recognition of their important contribution to the well-being of mothers and infants. Hospitals worldwide are striving to provide comprehensive and individualized maternity care, and doula programs are becoming an important element in this care.
What's a Doula?
The word "doula" is a Greek word for a woman who sit beside women in pregnancy and help them through their birth experience. They provide informational and emotional support during pregnancy, and "mother the mother" continously during labor, and provide support during the initial postpartum period. A doula provides a nurturing birth environment that supports and encourages women and their partners. Without making decisions for a birthing woman, a doula offers information so birthing women can make informed choices.
A certified doula receives professional training in the physiology of birth and the emotional needs of a woman in labor. A doula is a non-medical professional working in the company of medical professionals. Her purpose is to provide continous emotional support to help a woman come as close as she can to the birth she desires, and to leave her with the best possible feelings about herself and her capabilities.
What Does a Doula Do?
Doulas can suggest certain labor positions and massage techniques to faciliate labor. She can facilitate communication between the laboring woman, her partner and her clinical care providers. Doulas can also teach self-hypnosis techniques and also guide women in hypnosis to help them move away from a "fear-tension-pain" cycle and to maximize feelings of well-being, safety, and trust during her birth experience. When this happens, her body and baby can do the work of labor most efficiently.
A doula works with a woman's partner during birth. She helps build confidence in the partner and helps the partner to be as involved in the birth experience as s/he feels comfortable. And, sometimes, a doula does nothing at all! In all of our efforts to support women, sometimes all that is needed the presence of another woman who is compassionate and encouraging. Simply being with a woman and her partner sounds so simple, but is something that, more often than not, is left out of the birthing environment.
Benefits: Doulas Make a Difference
Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences.
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 childibrth experience
• reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and
• reduces the need for cesareans
• reduces the mother's request for pain medication and/or epidurals
• increases breastfeeding success
• increases partner confidence and maternal satisfaction
The benefits 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.)