1. What is a doula?
As defined by DONA International, a doula is a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible. Doula comes from the Greek word that means “a woman who serves.” A doula is a woman who is not part of the mother’s social network or part of the hospital staff.
2. What does a doula do?
- Provides emotional support by working through any fears during prenatal visits and offering words of encouragement
- Ensures physical comfort and relaxed birth experience: breathing, relaxation, movement, positioning, massage, acupressure
- Offers psychological support by creating an environment that is judgment and stress free
- Continuously reassures and comforts the mother, never leaving her side
- Informs a mother about various birth choices and advocates for chosen birth plan: facilitates communication between mother and care provider
- Assists mother pre- and postnatally
3. What does a doula NOT do?
- Doulas are NOT medical professionals; they do not deliver the baby or give medical diagnoses
- They do not judge the mother’s birth decisions
- They do not take over the role of your husband or partner
- They never leave the mother’s side or take shifts
4. How is a doula different from a labor and delivery nurse or a partner/spouse?
Unlike a nurse, a doula’s only concern is the mother. What a woman needs most during labor is continuous support, and the doula will be by the mother’s side the entire process. While a nurse has many other responsibilities, such as recognizing the mother’s medical health, communicating with the care provider, documenting care, and taking care of other patients, a doula has only one responsibility. A doula focuses on the comfort and emotional wellbeing of the mother and uses all of her birth-knowledge, which a partner may lack, to foster the optimal birth experience. A partner or spouse is an essential support person for the mother, but they will need to take breaks and may need emotional support as well. Doulas and partners work together to make a labor support team.
5. How do doulas compare to other types of continuous support?
Compared to a midwife or partner, the best results in pregnancy are seen when a woman has continuous labor support from a doula. Research shows that, with continuous labor support from a doula, women experience a:
- 31% decrease in the use of Pitocin (synthetic labor-inducer)
- 28% decrease in the risk of C-section
- 12% increase in the likelihood of a spontaneous vaginal birth
- 9% decrease in the use of any medications for pain relief
- 14% decrease in the risk of newborns being admitted to a special care nursery
- 34% decrease in the risk of being dissatisfied with the birth experience
According to a 2012 study of 15,000+ birth,“Women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth”(Hodnett et Al).
6. Why are doulas so effective?
In most developed countries, ever since birth moved out of the home and into the hospital, the overall experience for mothers has declined and become more harsh. This is due to a multitude of factors, including the lack of privacy, bright lights, needles, institutionalized environment, and being surrounded by strangers when in one’s most vulnerable state. While modern medical settings provide security for intervention if something were to go wrong during birth, they lack critical aspects of a “home” birth environment.
Starting in the 1920s, doctors began telling mothers to lie static on hospital beds on their backs, rather than encouraging movement into positions that use gravity to make delivery easier. These modern practices in combination with harsh conditions slow down the labor process and decrease a woman’s self-confidence. Unfortunately, this often results in the mother being hooked up to an IV drip, which slows down the labor process, often requiring induced labor through pitocin. Induced labor increases pain, so often mother’s request an epidural, which further slows the labor process, increasing the likelihood of a c-section. (Hofmeyr, Nikodem et al. 1991)
The medical model replaced a millennium-old practice of women serving mothers during birth. Having a doula brings back the important emotional and physical aspects of birthing. In fact, having another woman in the room increases oxytocin, a natural labor stimulant. Furthermore, research shows that women with doulas are less likely to request pain medication. (Caton, Corry et al. 2002).
7. What is the history of doulas?
Doulas originated in Ancient Greece, as women of the highest level of servitude to other women. Historically, birth assistants have always been female. Just as women who live together align menstrual cycles, having continuous support from a doula creates significant physical effect, health benefits that are only present when the birth assistant is another woman.
Beginning in the 1970s, women began a movement to return the birth process to its century-old ways, as an empowering, positive experience for the mother. This was in response to the medical model of care in the U.S. that medicalized birth and disempowered women.
