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Someone please tell me! WHAT IS A DOULA??!

Image by BirthRoots

The following scenarios are real life stories from my personal experience as an in-hospital doula:

Scenario 1:

Mama is very uncomfortable and cannot get any comfort no matter how hard she tries to relax.

Mama feels alone because it is the middle of the night and the only other person in the room is her sleeping husband. She doesn’t want to wake him.

Scenario 2:

Mama says, “I just can’t do it anymore. There’s no rest. I seriously want this to be over!”

Mother of Mama says, “I just don’t like seeing you in pain like this, honey. Why don’t you get the epidural?”

Hubby says, “Just give her whatever she wants. I just want to help her.”

Scenario 3:

Mama’s water bag breaks early in the morning.

She calls the hospital, who reminds her of their policy: To make sure infection does not set in, she needs to come in.

Doc walks in and tells Mama she has X amount of time and if labor does not progress, she will be put on Pitocin to “get things going.”

Image by PSS

Without the Doula…

These scenarios are setting the stage of what too often ends up happening at a birth. A mother may go in with a strong desire to follow her natural birth plan and have as little unnecessary intervention as possible. Yet without a trained birth attendant at her side {without a doula}, these situations most often don’t end up favorable for Mama.

As an in-hospital doula, I see and hear all of these scenarios in their various forms time and time again. While pregnancy and childbirth are very unpredictable, there are certain things I can always expect to come across at a birth. Doulas are prepared and qualified to handle many situations a mother may not expect to come across.

With the Doula…

Image by Dr.Momma

Doulas play a very unique and special role in a birth. While the midwife or physician’s job is to be there for when you birth your baby, the doula’s job is to focus on you (throughout the entire labor and delivery). The doula title translates to “servant of the mother.” How beautiful is that?

The word “doula” comes from the Greek word for the most important female slave or servant in the ancient Greek household, the woman who probably helped the lady of the house through her childbearing.

The word has come to refer to a “woman experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and after childbirth.” (Klaus, Kennell and Klaus, Mothering the Mother)

The key word here is SUPPORT. Continuous physical, emotional and informational support.

Let’s go back and add in the roles of a doula specifically to these three scenarios:

Image by LeaWolf

Scenario 1: Alone at night


The doula stays up throughout the night never leaving Mama’s side, waiting on her hand and foot. She may draw a bath for her to relieve some discomfort. She may massage in areas that are aching. She makes sure that Mama feels like someone understands what she’s going through and that if she should need anything, someone is awake and alert and ready. She provides practical physical services that although simple can change the course of labor dramatically. These include everything from suggesting position changes, giving mama sips of water, and giving her hot or cold rags.

Doulas often use the power of touch and massage to reduce stress and anxiety during labor. Massage has been proven to help stimulate the production of natural oxytocin. The pituitary gland releases natural oxytocin into the bloodstream, causing uterine contractions, and into the brain, resulting in feelings of well being, drowsiness and higher pain threshold. Because the synthetic IV oxytocin called Pitocin cannot cross into both the bloodstream and the brain it increases the contractions without the positive psychological benefits of natural oxytocin.

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Scenario 2: Giving Up


The doula recognizes this almost verbatim phrase from the mother, which is often heard at the transition phase; “I just can’t do it anymore.” The hospital staff knows that nothing is actually wrong, so the doula emphasizes that this is her last and final stage. While everyone else is feeding an “out of control” energy and not knowing what to do or how to help, the doula can guide Mama’s partner on what exactly to do in that moment. Her words of comfort and verbal cues to the Mama in that moment is exactly what Mama needs to hear to get her through that moment. Simply informing her, “You’re almost done!” restores power to her body and strength to her bones.

Emotional measures include being a source of encouragement and reassurance throughout all of labor and serves as a continuous physical presence.

Image by One Happy Doula

Scenario 3: Water Breaks


The doula responds with all possible suggestions to get labor going naturally.  She gives practical advice and suggests walking around and nipple stimulation. She may offer up some red raspberry leaf iced tea or set the mood of the room with music and candles for ultimate relaxation.

She explains how infection sets in and what all of her options are at this point. She does not make a decision for the parents, but she allows them to make their own decision based on informed consent. She can inform the parents on how exactly Pitocin works and the benefits and risks of using it.

Most doula-client relationships begin a few months before the baby is due. During this time they develop a relationship where the mother feels free to ask questions, discuss her fears and create a birth plan. Doulas make themselves available to the mother by phone and email in order to respond to any questions or explain any developments that might arise during the pregnancy.

Since care providers may not be able to be with you every moment (perhaps at home before going to the birth center or in the rare case of transport), the doula helps parents process the information they need to make informed decisions.

While doulas do not provide any type of medical care, they are knowledgeable in many medical aspects of labor and delivery. With this knowledge they can help their clients gain a better understanding of the procedures and possible complications of pregnancy or delivery.

The Proof

Studies have shown that by including a doula at your birth can have the following results:

  • 60% less request of epidurals
  • 50% reduction in C-Section
  • Reduce the mother’s request for pain medication
  • Reduce the use of pitocin by 40% (a labor-inducing drug), forceps or vacuum extraction
  • Reduce the length of your labor by 25%
  • Reduce negative feelings about one’s childbirth experience
  • Reduce postpartum depression
  • Better mother-infant interaction
  • Greater satisfaction with the birth and improved neo-natal outcomes
  • Feeling more secure and cared for
  • Higher success rate in adapting to new family dynamics
  • Greater success with breastfeeding
  • Greater self-confidence
You can find this and more information on the DONA international website.

Image by Portland MamaBaby Center

A doula does not replace a doctor or midwife or your partner, but they do possess special skills that make them a valuable addition to your birth team. She will accompany couples through the entire birth journey using her experience and knowledge to help them have a satisfying birth.

It is safe to say that the valuable role of a doula is highly underestimated. The service of a doula does, in fact, make a difference. I’m told this after every birth.

The real question is … why shouldn’t you hire a doula?

Image by Karen Pfeiffer

Have you had a doula during birth before?  What was your experience like?

*I originally wrote this blog for Modern Alternative Pregnancy. You can find the link HERE.

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