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May is International Doula Month

May 18, 2009

In (belated) recognition of International Doula Month, I’d like to extend my appreciation and respect to all doulas all across the globe.  Birth doulas  provide an invaluable service to pregnant and laboring mothers, and postpartum doulas provide an equally invaluable service to new moms–even if (and sometimes especially if) they have already had other children.

Unless you have witnessed or even experienced a doula at work before, however, you may be wondering just what it is that a doula does for a mother and the rest of her support team during labor.  The general answer to this question is that doulas provide continuous physical, emotional, and informational support to laboring mothers.  To expand upon this response, I’ve listed below a few particular examples of what this support may entail.  For what it’s worth, all of these examples are types of support that I have either tried myself or that my own doula used to comfort me during the birth of my second child.

Emotional support

  • Believe it or not, sometimes a woman can get so caught up in the intensity and power of her labor that she actually forgets that she is having a baby.  Gently reminding the mother that “each contraction brings you closer to your baby” or “you are getting closer to holding your baby in your arms” can do wonders for a mother who has temporarily lost sight of the purpose of all of the hard work that she is doing.
  • When a mother claims, “I CAN’T do this!” there is sometimes nothing  more reassuring than to tell her that she IS doing it.  (In general, there can sometimes be nothing more emotionally reassuring than to remind the mother of her incredible strength!)
  • If a mother desires, a doula can remain by her side for the entirety of labor and delivery.  While a doula’s role is never to replace the role of the partner or other loved ones, her calming presence can help to reassure the mother and her other support persons about the normalcy of the various physiological and emotional aspects of labor.
  • In that same vein, a doula can help to guard the privacy and sacredness of the labor experience for the mother and her partner.  For instance, if she notes that the parents are sharing an empowering or tender moment together, she can wait outside the room and kindly ask a nurse or other care provider to wait for a few minutes before entering the room.

Physical support

  • While only some doulas are also licensed as massage therapists, most doulas have some experience or training in helpful massage techniques during labor.  Massaging the mothers legs in active labor, gently stroking her arms in between contractions to increase her endorphin levels, or even performing counterpressure on her lower back during back labor can all provide welcome physical comfort to a laboring mom.
  • Many doulas will have hot water bottles, heat-able rice packs, or cool backs in their “doula bags.”  These hot and cold remedies can provide soothing relief to aching backs or thighs.
  • Doulas often have knowledge of many positions that the laboring mother can take to help rotate a posterior baby, help the baby to descend, facilitate the progress of labor, soothe back labor, or even  help the mother to get in a variety of effective pushing positions.
  • A doula can model various physical support measures for the mother’s partner or other loved ones so that they can play a more active role in the labor.  One position that many couples enjoy (and one that helps to facilitate labor and relieve some discomfort) is slow-dancing.  This not only brings the couple more emotionally close to one another but also allows the doula or other support person access to the mother’s back for counter-pressure or massage.
  • A doula will remind the mother to change positions often in order to relieve discomfort and to encourage labor progression.  She will also remind the mother to drink (and possibly eat) after each contraction so that she stays well-hydrated and keeps up her energy for the hard work ahead of her.

Informational support

  • I ended up needing to switch OBs at 36 weeks during my second pregnancy, and the first person I turned to was my doula!  She not only referred me to another care provider but also (because she had a good working relationship with him) called him up ahead of time to inform him that I would be contacting him.  Doulas–especially experienced ones–often have a sizeable list of community resources for their clients, resources involving everything from local OBs and midwives to prenatal yoga instructors to perinatal loss groups to nutritionists.
  • When an intervention is suggested during labor, a doula can help to remind the mother and her partner that they can (and should) always ask questions about the potential risks and benefits of any procedure that is recommended, especially if they are not comfortable with the use of the intervention.
  • In addition to providing labor support, most doulas also help their clients to create a birth plan.  During the birth plan meeting, the doula can provide information and offer resources regarding pain medications, cesareans, episiotomies, forceps and vacuum-assisted deliveries, and other interventions during labor.

For what it’s worth, studies have shown that all of the wonderful things that doulas do help to lead to “shorter labors with fewer complications and healthier babies who breastfeed more easily.”  Doula support can also help to reduce the need for cesareans and other interventions such as forcep and vacuum deliveries.  These benefits are all worth celebrating and appreciating during International Doula Month–and every month!

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