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what is a doula?

“If a doula were a drug, it would be unethical not to use it.”
John H. Kennell, MD. Marshall Klaus MD

A doula is a  term given to a person attending to the continuous, emotional support of a woman in labour. Traditionally, women – especially first-time mothers, would be assisted by other women when they were giving birth. The best birth attendants were comfortable and confident that they knew the way forward through the journey of labour and birth. Ideally, they were there to encourage, nurture, and support the birthing mother. They took care of her with kindly words, appreciation, guidance, massage and focused attention. These days we have tended to replace these women with pain relieving drugs and epidurals.

Significant results from many research studies show that birth outcomes are improved when women are supported and feel safe due to the presence of doulas during labour. Women tend to have fewer medical interventions, fewer caesarean sections, fewer birth complications, and their babies are healthier, more content and breastfeed more easily.[1] These might seem like inflated claims when doulas simply contain the space in which women labour, but the vastly improved birth outcomes make more sense when we remind ourselves of the impact that our hormones have on birth. We know that fear causes adrenaline production and high levels of adrenaline coursing through our labouring bodies can result in physiological spin offs like foetal distress or stalled dilation. Epidurals, whilst minimising fear, can numb us emotionally as well as physically and can detract from birth’s transformational potential. Statistically, they have been shown to impact negatively on bonding and breastfeeding.

A doula does not replace the birth partner; she acts in a supportive role to both parents, and her role is to encourage the birth partner to recognize how integral their involvement can be in creating a satisfying birth experience. Part of a doula’s role is to assist the partner to stay more involved during labour, rather than to pull away in times of stress. Because doulas are familiar with the process of birth, they can honestly reassure both parents about the normality of the experience during times when it might seem overly intense.

The power of birth generally has a long term impact on our emotional and spiritual well being. Whether it creates a positive or a negative impression depends on our circumstances, our level of trust and our ability to remain open to the experience.

A doula’s work is to simply pay attention every moment to exactly what we need, identifying when to soothe, reassure, listen or build confidence, and when to encourage us to connect with our partner and our babies. Each moment of full support and attention we receive assures us that it is okay to yield to birth’s power. Feeling that we are held with deep attention in the labour room gives us permission to trust that we are being cared for and watched over and that we are safe in what is often unknown territory and unchartered depths. Sometimes we need a pair of hands to sway our hips, sometimes the encouragement to feel our partner’s love, sometimes a lullaby or some firm direction to be brought back from a place of fear or panic. Whether we need laughter or a place to wail or groan reveals itself moment by moment and is infinitely variable in every labour.

References:

[1] The DONA (Doulas Of North America) website lists many of the studies that have been undertaken researching the impact of doulas on birth:http://www.dona.org/resources/research.php

[i] John H. Kennell, M.D., Marshall H. Klaus MD. Co –authors of Parent to Infant Bonding and ‘fathers’ of the modern doula movement