In case Doula is an unfamiliar word for you let me give you some of the basics. A doula, pronounced Do-La is a person professionally trained in supporting a woman and her partner through childbirth. Doulas are sometimes referred to as labor companions, labor support specialists, labor support professionals, birth assistants, or labor assistants. Doulas provides emotional, physical, and educational support to a woman or couple. Many Doulas provide education while a couple is preparing and planning for their birth, then provide direct, continuous support for the woman when she is in labor. Many birth Doulas will also provide initial support for a mother postpartum as well.
A Doula’s purpose is to help women have positive, memorable, and empowering birthing experiences. They are often chosen and hired directly by a couple and are not usually employed by hospitals or birth centers. More recently we have seen a few hospitals and birth centers incorporate Doulas into their birth team. We’re keeping an eye on those hospitals and will report back when there’s more research on the effectiveness of these programs.
The Doulas purpose is a good one, but the evidence to support the work of a Doula is even more exciting! In 2011, the largest review of continuous labor support was published by the Cochrane Review Database. If you’re familiar with health trials, you’ll know this is the best of the best when it comes to evidence based care.
This review evaluated the findings from 21 randomized controlled trials, including over 15,000 women. The trials had to have compared “usual hospital care” to “continuous labor support.” “Usual hospital care” in this case referred to a woman being cared for by a nurse and a midwife or doctor. “Continuous labor support” meant a woman received continuous care from a doula, in other words a person other than family member or friend. According to the final summary, doula-supported women were:
- 28% less likely to have a cesarean section
- 31% less likely to use synthetic oxytocin to speed up labor
- 9% less likely to use any pain medication
- 34% less likely to rate their childbirth experiences negatively
Find the reference for this study here:
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. “Continuous support for women during childbirth.” Cochrane Database Syst Rev. 2011 Feb 16; (2):CD003766.
Why does this research matter?
If you are a woman who is hoping to have a vaginal birth with little or no interventions, a doula is your best bet. Not every woman wants a birth without pain medicine, but if you are someone who does, a doula is well worth the investment. The statistics are staggering.
So, what exactly does a Doula do for you?
Most people hire a Doula in the early to mid months of pregnancy. This allows a Doula time to develop a relationship with the expectant mother. During this period, a Doula will usually arrange meetings and phone calls so that she can better understand the mother’s hopes and dreams for her birth experience. Additionally the Doula provides a safe and supportive place for the mother to express any fears and concerns she may have around her birth. Most Doulas make themselves available to the mother by phone, email or text in order to respond to her questions or address any concerns that might arise during the course of the pregnancy. Doulas do not provide any type of medical care. However, a Doula certified by an organization like IAPDoula, is knowledgeable in many medical aspects of labor and delivery. With this knowledge they can help their clients gain a better understanding of procedures and what to expect should complication arise during the birth.
During the birth a Doula provides continuous support to the mother. Unlike nurses and midwives who change as their shifts begin and end, most doulas are with a woman through the entire duration of her labor. A Doula is trained in natural pain-relief techniques that can help a mother enjoy her labor and be less likely to ask for analgesic medications. Some techniques Doulas use include breathing techniques, relaxation techniques, massage, and changing labor positions. Doulas also encourage participation from the partner, offer reassurance and support partners so they have a positive experience in birth as well.
In addition to all this the Doula acts as an advocate for the mother. A Doula will encouraging a woman to stay the course of her desires for birth. The goal of a Doula is to help the mother achieve a positive birth experience.
After the birth, many labor Doulas will spend time helping mothers begin the breastfeeding process and encouraging bonding between the new baby and other family members. The Doula will be there to support the mother with any emotions that may come up with birth as well as the physical experience that comes after delivery.
John H. Kennell M.D. is quoted as saying, “If a doula were a drug, it would be unethical not to use it”. I couldn’t agree more! Doulas support, encourage, protect and enhance birth experiences for women every day.