The term doula comes from the ancient Greek word meaning woman’s servant or woman who serves. In modern day usage, a doula refers to a birthing attendant who assist the expectant mother in labor preparation, during the birthing process and afterwards as the new mom and baby acclimate to their new world together.
According to the membership organization DONA International, “Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.”
What is a Doula?
Doulas are trained and certified professionals who provide emotional, physical and informational resources. They do not assist with the medical delivery, but rather aid the mom and her partner as an additional resource in the delivery process. Their purpose lies with providing comforting measures during labor, communicating between the mother and medical providers, focusing on the mother’s birth plan and wishes, allowing the partner to participate in at their own level of comfort as and post-partum care. Post-partum care can include assistance with breastfeeding, family adjustments and help with the mother’s physical recovery from birth.
The American Pregnancy Association reports, “Most doula and client relationships begin a few months before the baby is due. During this time, they establish a relationship that gives the mother complete freedom to ask questions, express fears and concerns, and take an active role in creating a birth plan. Doulas often use the power of touch and massage to reduce stress and anxiety during labor. The role of the doula is never to take the place of the husband or partner in labor, but to complement and enhance their experience.”
A review of birthing studies conducted by the Cochrane Pregnancy and Childbirth Group found that, “Women who received continuous labour support were more likely to give birth 'spontaneously’, i.e. give birth with neither caesarean nor vacuum nor forceps. In addition, women were less likely to use pain medications, were more likely to be satisfied, and had slightly shorter labours. Their babies were less likely to have low 5-minute Apgar Scores.”
Similar information is found in the journal Hospital Physician, “Among the far-reaching consequences of a continuous presence during labor is a reduction in cesarean section rates. Doula care has resulted in significant reductions in laboring women’s requests for epidurals and a delay in their administration.”
Finding and Selecting a Doula
When deciding on the use a doula, it important to research the type of certifications available. The largest organizations are DONA International and Childbirth and Postpartum Professional Association (CAPPA). Other organizations include the Association of Labor Assistants and Childbirth Educators (ALACE), Birth Works and The International Childbirth Education Association (ICEA).
Collect a list of local doulas by researching on organization websites, local maternity message boards, asking the OBGYN or friends and family for suggestions. Begin the interview process with your partner. It is important to be upfront about known birthing wishes including the desire for a natural or medicated birth, as some doulas have a preference. Develop questions for the interview that cover the doula’s training, experience, availability for the anticipated due date, approach or style, personalization, cost and references.
Personalization may take the form of how the doula will interact with the mother (phone calls and visits) or may include options such as labor massage. References should be local and within a recent period of time. The doula should know if they have any clients already in the general time period of the mother’s anticipated due date and should the two births overlap, what the plan is for doula services.
According to DONA International, “Over 25 insurance companies have provided some third party reimbursement for labor support. Grant funding is also occasionally available and some Medicaid-funded health agencies have contracts with doula organizations to support women in poverty and women with special needs. Although some health insurance and flex pay plans pay for doulas, at present doula care is usually paid for directly by the client.” Speak to the insurance company early on to determine what coverage may be offered for doula services.
Choosing a doula is subjective. Opinion, personalities and intuition come into play. A doula may be perfect for one mother and not for another. The decision to hire a doula is personal. Most important is the assurance that the mother is comfortable with her birth plan, medical and social support.
Sources:
- “What is a Doula?” DONA International.
- “Having a Doula: Is it for Me?” American Pregnancy Association.
- Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. “Continuous support for women during childbirth (Review)” Cochrane Review. 2011.
- Bruce A. Meyer, MD, MBA, Jane A. Arnold, CNM, MSN, Debra Pascali-Bonaro, BEd, CCE, CD(DONA), CPD. “Social Support by Doulas During Labor and the Early Postpartum Period” Hospital Physician. September 2001.
- "The Birth Doula’s Contribution to Modern Maternity Care: Services and Costs." DONA International.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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