May is ‘International Doula Month’

What, you ask, is a doula?

Doula (pronounced doo-la) is an ancient Greek word that means “woman who serves another woman.” Today, the term refers to a professional who is knowledgeable in childbirth, providing continuous emotional, non-medical physical and informational support to childbearing women and their partners before, during and just after childbirth. Doulas may also provide emotional and practical support for the postpartum period.

For thousands of years, women giving birth had continuous support from female midwives, their mothers, sisters, aunts, grandmothers or female friends. Then, in the 1900s, the process of childbirth transferred into hospitals. Women were then “supported” by busy nurses who maybe had several other laboring women to care for. This meant women often labored alone, sedated or terrified as other family members were not allowed into the labor and delivery room. During the ‘70s and ‘80s, husbands were “invited” into the birth room, which ideally meant that laboring women had continuous support by a loved one.

However, it has been my experience as a labor and delivery nurse in the late ‘80s and early ‘90s that, while many if not most women wanted their husbands to be with them in labor, the support was not quite what they expected. While society accepts and perhaps even demands that men support their women in childbirth, society has not prepared men to fill that role. Men do not, for the most part, discuss birth issues with one another — the previous male generations haven’t been able to pass down their knowledge, because it doesn’t exist.

I have witnessed the terror in many a man’s eyes as they watch their loved ones painfully gruel through labor, sitting helplessly at her side, not knowing what to do to help her. While it is a welcome change for fathers to be involved during pregnancy and childbirth, it is often a cause of great stress and anxiety for the expectant father. Even the most committed and nurturing partners often have a sense of anxiety as they witness the unfamiliar and distressing changes happening to their beloved. At least one new father became a patient himself after he fainted and crashed to the floor unceremoniously at the peak of a difficult second stage. He required sutures to repair his split lip.

Having said that, a doula in no way should replace the partner. The partner knows the laboring woman best and the doula knows birth the best. Together the partner and the doula can make an awesomely supportive team.

Benefits of having a doula

Studies have shown that having a trained labor support, i.e. doula, during labor and delivery significantly reduces the incidence of medical interventions, may shorten labor and improves overall satisfaction with the birth experience. Women are encouraged and guided by the doula during the normal labor processes and can provide calm support when complications arise, thus reducing anxiety, which perpetuates pain. The doula is not involved with any clinical or medical assessments or treatments and therefore is totally and continuously focused on the immediate emotional and physical comfort needs of the birthing family. They can provide rest breaks, reassurance and encouragement for the father-to-be or support person, too, and thereby maximize that person’s involvement in the birth.

The doula is not distracted by multiple patients at once, nor will there be any disruptions in a woman’s labor due to a “change of shift.” There is also a potential reduction in the cost of birth based on reduced interventions.

Services provided

Doulas typically meet with childbearing families several weeks or even months before the birth to establish a relationship, discuss the birth process, address fears and concerns about birth, help develop a birth plan (if desired) and discuss birthing options. Once labor has begun, the doula offers breathing and relaxation techniques, labor positions to optimize fetal descent and maternal comfort and massage.

Affording a doula

Hiring a doula may seem like an unattainable luxury, but really it’s an investment in you, your health and your well-being. Financial guru Suze Orman says having a doula is “a need, not a want” for mothers and mothers-to-be.

Here are a few tips for investing:

• Ask for a payment plan — most doulas will work one out with you.

• Check with your health insurance provider. Many do not cover doula care, but a few do.

• See if a doula can be paid for out of your Flexible Spending Account or Health Care Reimbursement account.

• Include the financial cost of a doula in your gift registry, or simply ask for donations at your baby shower.

• Have a garage sale. Seriously. Do you really need all that stuff that’s been sitting in boxes, taking up space in the garage while your car sits outside?

• Cut out a few of those truly luxury items. Forgoing that daily latte at your favorite espresso stand for 9 months will cover the expense of a doula pretty adequately — $3 x 30 days x 9 months = $810. That is more than what I charge, so you will have money left over to buy me a latte!

Who to hire

You will be spending several hours with your doula during your most vulnerable and intimate experience. Making your choice carefully is paramount. It’s a good idea to interview a few before deciding whom to hire. Ask friends and co-workers for referrals. Alaska Birth Network (alaskabirthnetwork.org) also has a list of doulas. Most give complimentary consultations to determine if you would work well together.

Some questions to ask:

• Are you available around my due date?

• Who is your backup in case you have another client in labor or an emergency and cannot attend my delivery?

• What is your training and how do you see that benefiting my situation?

• How would you support me in my situation?

• What is your fee and what does that include?

• What do you do when a client makes a decision that you don’t agree with?

• What other commitments do you have around my due date?

• Why did you become a doula?

• What do you do when you’re not being a doula?

After the consultation, ask yourself some questions:

• Did I feel comfortable and relaxed?

• Was the doula friendly?

• Did she listen attentively and ask me appropriate questions to learn more about my situation?

• Does my partner feel comfortable with her?

Jane Weideman once said, “Giving birth should be your greatest achievement, not your greatest fear.” Having a competent doula at your side will facilitate that sense of joyful achievement.

Sheri Walker is a birth doula who offers services through her business, Aurora Birth Song. To learn more about her work, visit aurorabirthsong.com.