Who are doulas ?

 
Pregnancy can be a very overwhelming time, especially for your first baby.  Doula is a word that means “woman who serves”. The word itself has ancient Greek roots.  Now, it means a trained and/or experienced person (usually a woman) who provides emotional and physical support to a woman and her partner during the latter part of pregnancy, during labor, and in the immediate post-partum period.  Doulas also often provide an informational or educational aspect to labor and birth.  There are also post-partum doulas that offer practical support and help adjusting to new parenthood.  In my opinion, they are a need not a want- financial guru Suze Orman agrees with me on this.
 
More and more women and families are using doulas as labor support in addition to having her spouse or partner present during labor and birth.  Research has shown that women who have the help of a doula have shorter labors, have labors with fewer complications, reduced chance of caesarian sections, request pain medications or epidurals less frequently, and have less negative feelings about their labors and birthing experiences.  Having a doula present for labor and birth can greatly reduce fear and anxiety.  Fear and anxiety can greatly exacerbate pain response.  By having a doula present to reassure a laboring mom and her partner that things are normal and suggesting ways to cope with pain or discomfort greatly reduce fear.
 
There are some doctors and nurses who do not like the presence of a doula at a birth.  To prevent any birthing day surprises, discuss having a doula with your doctor early in your pregnancy.  If your doctor does not support having a doula present, you can then decide what you want to do.  This may mean educating your doctor on the benefits of doula care or changing doctors.  Usually, midwives are amenable to a doula’s presence in labor, but to be safe, discuss your plans with your midwife early in pregnancy.
 

Doulas do not make medical decisions for you, nor do they provide medical advice.

Doulas do however help women advocate for themselves and achieve the birth they want.  Doulas do provide information to allow parents to make informed decisions about their care.  Doulas are also frequently trained in comfort measures- which are natural helpful ways to help a mom relax and reduce pain.
 
By offering reassurance that what she is experiencing is normal, by being there with a woman continuously, by offering position changes, massage, or other pain relieving techniques, women are better able to cope with the stress of labor.  This also allows a woman’s partner to focus on the laboring mother.  Fathers and partners often report that it is very distressing to see their wives or partners in pain.  They feel helpless and scared.  The presence of a doula is calming and reassuring to them.
 
Doulas provide an invaluable educational and support element for a laboring woman and her family.  Additionally, having a doula present can help the nursing staff as women who decline pain medicine often need more support than those who opt for pain relief.
 
Women today are not exposed to pregnancy or babies as often as in the past.  Sometimes the first time they hold a newborn is when they hold their own newborn.  Therefore, doulas provide an important educational element in labor and birth.  They are instrumental in providing help getting breastfeeding established.  They are also wonderful for providing tips for swaddling, babywearing, and other newborn care tips.
 
In past years, the role of a doula would likely have been played by a sister, aunt, mother, or grandmother.  With today’s culture changes new moms are less likely to have their female relatives close at hand, thus the importance of the doula.
 
Doulas can be expensive often charging between $500-$800 per birth. While this may be expensive, it is much less than the cost of interventions or a c-section.  Some insurance companies will cover doula costs or they can be reimbursed via Flex spending accounts.
 
By reducing fear, providing education, advice, and practical support doulas are a great addition to a labor and delivery experience.