What is a Labor/Birth Doula?

I often get asked by expectant couples in my childbirth classes what a “Doula” is. I had one dad refer to it as a “DUDA”, a grandmother call it a “DIVA” and a nurse call it “Doula-oblingada”… All in all it refers to the same thing! A Doula, stemming from the Greek word “A woman’s servant”, is simply that. There are Labor Doulas and Postpartum Doulas. However, for the context of this blog I will stick with the Labor Doula. In layman’s terms… it is a Professional Labor Coach. A woman who is an expert in childbirth, who has gone through training to help the laboring woman and her partner have a less painful, more enjoyable birth. Studies and research have shown:

Women cared for during labor by a birth doula, compared to those receiving usual hospital care were:

  • 26% less likely to give birth by cesarean section
  • 41% less likely to give birth with a vacuum extractor or forceps
  • 28% less likely to use any analgesia or anesthesia
  • 33% less likely to be dissatisfied or negatively rate their birth experience

I have since retired from this very honorable profession and have moved onto other fields of birth, but I would still like to pay tribute to this amazing role in a woman’s birth story. So without further ado…here are some frequently asked questions about the role:

What is a Doula?

A doula is a Professional Labor Support Specialist who accompanies women in labor to help ensure a safe and satisfying birth experience. A doula draws on her knowledge and experience as a childbirth educator and trained labor support specialist to provide emotional support, physical comfort and, as needed, communication with the staff to make sure that the pregnant couple have the information needed to make informed decisions as they arise in labor. The doula can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, massage, positioning, and other techniques to help minimize pain. Doula’s are independent and self-employed. Your doula, is working for you, not your caregiver or the hospital.

What is the partner’s role when a doula is present?

A doula is never there to replace the role of the partner. No one knows the mother emotionally like her partner does. A doula is there to help the father, help the mother. If her partner would like to take the lead, then the doula will provide suggestions to help the partner aid in the mother’s comfort. If the partner would rather the doula take the lead, then she can do the majority of the coaching while the partner simply aids in encouraging. Often time’s dad feels an overwhelming sense of relief when a doula is present because it takes the “soul pressure” off of him. If dad needs a break he can take it, without having to worry about the well being of the mother. The doula and partner work together as a team to help the laboring mother have the support and comfort she needs.

If I have a cesarean section, is a doula still necessary?

A cesarean delivery is still the birth of your baby; it is just a different style. However, a cesarean is major abdominal surgery and can be frightening for the mother and her partner. A doula can provide an added sense of support in the operating room to help make the birth a more family centered event. Often times once the baby is born, the infant is taken directly to the warmer to be assessed. After that, the baby is then taken to a separate recovery room along with the support partner. The mother is left by herself for the remainder of the surgery. This is where a doula becomes helpful. A doula can remain with the mother for the remainder of the surgery, so that the father can feel free to go with the baby and not have to worry about the well being of mom. Her needs will be met while the baby is being watched. If baby is doing well, then most often the mother can hold the baby for the remainder of the surgery. With the help of the doula, breastfeeding can then be initiated immediately in the recovery room rather then having to wait for several hours.

What if I choose to get an epidural? Will that change the doula’s role?

The great thing about having babies in this generation is that you have many options available to you. This is your birth and you get to do it your way.  A doula’s goal is to give the birthing couple a positive birth experience. Sometimes an epidural allows that to happen. The role of supporting the mother does not change if an epidural is administered.The douls is still there to provide support, encouragement, and answers to any questions they may have. She can still suggest positive birth positions to help the labor progress even with an epidural in place as well as provide relaxing massage to promote a more positive restful atmosphere. A doula is there no matter what choices the couple should choose.

What if I need help in the middle of the night?

A doula is on call for you 24 hours a day, 7 days a week. If something should arise in the wee hours of the night, the doula is happy to assist you. Whether it is to answer a simple question due to a pregnancy discomfort, or to assist you with labor beginning. Doulas are available for unlimited consultation, even in the middle of the night.

What will happen if I have a labor that is longer then expected?

Every labor is different. Some labors are short, and others can last over 24 hours. The Doula will be there for you from the moment you have your first contraction to the last contraction, even if it lasts longer then
expected. In the event that something should arise that would cause her to have to leave for duration, then usually a back-up doula will come to assist until she is able to return. Regardless, you will have continual care for
the entire length of your labor and birth experience.

If I choose to breastfeed, can my doula assist me in getting started?

Absolutely!! Most doulas will stay for up to two hours after your delivery, to help initiate breastfeeding for you. Babies are more willing to latch on in those first two hours of life. After you have been able to successfully get through that first feeding, the doula will be available to you for basic breastfeeding help. There usually is always a postpartum visit that follows. When the doula comes for your postpartum follow-up appointment, she can again help with proper latching positions, and suggest some different techniques for helping enable a positive breastfeeding experience. However, if a more complicated breastfeeding scenario should occur, a referal to
a lactation consultant who will be able to provide further assistance will be provided.

What about costs?

That often is determined by the doula herself. Some have a set fee others have a sliding scale, but NEVER should a doula charge an hourly rate. That only adds stress to the labor. No mother should be concerned about meeting a timeline because of an hourly financial rate. The going rate is $800-$1000 per birth. This usually includes unlimited phone consultation before birth and up till a 3 month period after delivery. The labor, birth, and few hours postpartum. This is where the sliding scale comes into play. Most doula’s also offer payment plans.

Hopefully this information will begin you on your path to finding the doula that is best for you. I recommend interviewing several doula’s till you find a match that works best. Your best resource is www.DONA.org ; It is important to find a doula who is certified through a credible training resource. May your have a blessed and wonderful birth experience.

Copyright© 2011 Danielle Gauss,IBCLC – JustBreastFeeding.com. All Rights Reserved.

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