No matter how much you love your doctor, he or she is only going to be there for part of your labor. Nurses will be available, but shifts change and so do personalities. And dads come in handy, of course, but let's face it: They're not exactly experts. A doula, on the other hand, is all yours for the duration.
Childbirth preparation helps you understand the birth process and takes many of the surprises out of labor, helping you to participate meaningfully in your care. Yet the journey through birth is unpredictable and stressful, and even well-prepared women or couples, when in the midst of intense labor, often find it difficult to apply their knowledge. You'll enjoy a special kind of guidance and comfort during labor if you have a doula at your side.
The Doula's Role
A doula is trained and experienced in providing emotional support, physical comfort and nonclinical advice. She usually meets with you before labor to learn your preferences regarding the use of pain medication, and any fears or concerns you have. In labor, she helps you accomplish your wishes and make adjustments if unexpected complications arise.
The doula is a constant ‑- no breaks (unless you're asleep), no shift changes, no clinical responsibilities or other women to care for. Her knowledge and experience reassure you as she guides you in breathing techniques, positioning, massage and use of the bath, shower, birth ball and hot and cold packs, plus other comfort measures.
A Doula's Impact
The assistance of a doula throughout labor has been proven in numerous scientific trials to improve both the physical and the psychological well-being of the mother. By reducing stress, doulas reduce a woman's need for pain-relief medications.
Studies have reported that in hospitals with high cesarean rates (above 25 percent), a doula's presence lowers the chances of a cesarean and the rates of other interventions (oxytocin, forceps, vacuum extractor). In addition, research has shown that women's satisfaction with their birth experience, postpartum psychological state, success in breastfeeding and interactions with their newborn are improved.
Research on fathers' participation in labor shows that when doulas are present, fathers remain closer to and touch the mother more. Doulas seems to relieve their stress. As one grateful father said, "I heaved a big sigh of relief when our doula walked in. I hadn't realized how much pressure I'd been feeling."
The Doula's Credentials
Doulas are trained by:Doulas of North America (DONA, 888-788-DONA)Lamaze International (with DONA-approved trainers, 800-368-4404)The Association of Labor Assistants and Childbirth Educators (ALACE, 888-222-5223)The International Childbirth Education Association (ICEA, 952-854-8660)Childbirth and Postpartum Professional Association (CAPPA, 888-MY-CAPPA)Birthworks (888-TO-BIRTH)DONA, ALACE, ICEA, CAPPA and Birthworks also certify doulas, ensuring that they have at least a minimal level of competence.
There are also local associations that train and certify doulas. Certification is still a relatively new phenomenon, however, so keep in mind that there are many excellent doulas who are not certified.
Doulas usually share call or have a backup when they are unavailable. Be sure to get acquainted with your backup as well as your primary doula.There are benefits for both mother and partner when a doula is part of the support team, especially when you get to know and feel comfortable with her before labor begins.