Mother's Helper
Written by Sandra Gordon
Having a doula by your side can make childbirth shorter, easier and—dare we say—more enjoyable.
Two years ago, pregnant with her first child, Shana Martin, of Aliso Viejo, started to get the first-time childbirth jitters—that’s when she decided to hire a doula. “I was very afraid to give birth the first time—and actually the second time as well,” laughs Martin, 33, who was living in Canada at the time of her first childbirth. “It was really good we decided on having a doula,” the mother of two boys adds. “We wanted someone who was more objective.”
For Martin, hiring a doula was the best decision she made during both of her childbirths. Having a person she trusted by her side who was specialized and familiar in birthing techniques and procedures—and in calming down a stressed out mom-to-be—really helped keep Martin focused during her first childbirth which lasted four days. Not to mention, Martin adds, it keeps dad’s nerves at bay, too. “It just gave my husband a break. It took the pressure off of him,” Martin says.
During her second childbirth at Saddleback Memorial Hospital four-and-a-half months ago, Martin’s doula helped ease her labor pains by asking the nurse to get a birthing bar, a U-shaped handle that attaches to the bed that helps facilitate a better birthing position. Without the doula by her side, Martin would not have known about the tool. The nurse at the hospital was even glad that Martin had hired a doula to attend the childbirth since they’re often preoccupied with checking numbers on monitors and can’t give individual attention to the mother, Martin says. “I wanted to make sure I had someone there 100 percent of the time. Someone who wasn’t going to let me down,” she says.
Martin stresses that women who choose to hire a doula should make sure it’s someone they feel comfortable with and will honor the mother’s childbirth plans. “…You really have to connect [with the doula]—both the husband and the wife,” she says. “I think everyone should have a doula.”
What is a Doula?
A doula—Greek for “woman caregiver”—doesn’t necessarily have medical training or make medical decisions, but she is familiar with the usual medical procedures involved in childbirth. She is part of your labor support team, which typically includes your partner, the doctor (or midwife), and a nurse (who may have her hands full tending to several patients). A doula’s job isn’t to deliver your baby but to give you her continuous attention, offering techniques to help ease the pain of labor.
She may encourage you to use a shower or whirlpool, for example. (Water is known as “the doula’s epidural.”) Other pain-relief methods include breathing techniques, walking and using a birthing ball, a large rubber sphere that the mother sits on during labor to help relax the pelvic area.
Considered “alternative” in the early 1980s, when the movement was in its infancy, doulas are now gaining acceptance within mainstream medicine. Several studies in major medical journals have found that a doula’s constant help during childbirth can shorten labor and reduce the need for cesarean or forceps delivery. And, according to a study published in Obstetrics and Gynecology, doula-assisted women are also more likely to forgo an epidural, and to rate their birth experiences as positive.
Dr. Marshall Klaus, MD, an adjunct professor of pediatrics at the University of California, San Francisco, cofounded the doula movement after studying continuous support methods for laboring mothers. “We consistently saw that the more overall care a woman received during labor, the greater her chances of an uncomplicated vaginal delivery,” he says.
Labor Negotiations
At least 100 hospitals nationwide now provide doula services at little or no cost. (The price of a nonhospital-based or private doula ranges from about $200 to $600 per delivery.) Though standard health insurance rarely covers the cost of these services, patient demand for doulas is growing. According to Dona International, a nonprofit international doula association based in Springfield, Illinois, which offers a doula referral service, currently, some 10,000 to 20,000 doulas practice in the U.S. You can now find qualified birthing coaches in every state—usually within a 30-mile radius of where you live. Many receive training and certification through local hospitals. Those who are certified through DONA must be trained in childbirth education or midwifery, complete a 14-hour course, and get on-the-job training by providing labor support to at least three satisfied clients. Doulas certified through the Association of Labor Assistants and Childbirth Educators must meet similar requirements.
If you decide to use a doula’s services, let your obstetrician know as early as possible. If she’s unfamiliar with the practice, “you might tell her that these types of labor coaches have been the subject of studies in medical journals and they’ve been found to be very helpful,” suggests Dr. Howard Minkoff, MD, chairman of obstetrics and gynecology at Maimonides Memorial Center in Brooklyn. You and your partner will likely meet with your doula a few times before your due date to discuss your plans for the birth, If possible, introduce her to your doctor at a prenatal appointment and discuss any potential sticking points. If you and your doula are against an episiotomy, for example, now is the time to bring it up.
Mothering Moms
During labor’s turbulent moments, an experienced, reassuring voice can provide moms with a much-needed reality check. “Sometimes a woman doesn’t know if what she’s going through is normal or not,” says Penny Simkin, a doula trainer in Seattle and a DONA International cofounder. “A doula can provide some perspective.” Rebekah Krakora, 34, a stay-at-home mom, needed that emotional help during the pushing phase of her baby’s birth. “My doula would say, ‘That was a great push. Look how far the baby has moved.’ I needed to know the finish line was near. Nobody else was telling me that,” Krakora says.
Shortly after delivery, doulas also routinely contact the mother to relive some of the details and provide an objective view of the birth. “The labor may have not gone according to plan, but we hope a mom can still walk away with a positive memory,” says Ginger Breeck, a doula at Community Hospital Anderson in Anderson, Indiana. You can also hire a post-partum doula who will come to your home to help out with child care or household chores after the birth.
All of this extra support for moms benefits newborns, too, says Dr. Klaus, author of “Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth.” His studies suggest that a doula’s presence helps a woman feel more in control of childbirth—minimizing postpartum depression and fostering an earlier bond with her infant. “When a mother is well cared for in labor,” he says, “those caring feelings get transferred to her baby.”
Choosing a Doula
It’s important to select a labor coach with whom you feel comfortable, because she’ll be sharing your birth experience. You may need to interview several to find the right match. Ask your obstetrician or childbirth educator for a recommendation. Or, consult the following organizations:
DONA International: 888-788-3662, www.dona.org.
International Childbirth Education Association: 919-863-9487, www.icea.org.
Association of Labor Assistants and Childbirth Educators (ALACE): 877-334-4297, www.alace.org.