What is a Doula

A doula is a professional assistant who serve mothers (particularly first – time mothers and even women who have had given birth before) and their partners through the expecting stage, undergoing labor and delivery, and postpartum period.

The term Doula is originated from a Greek word which means women’s servant. Women have been serving fellow women for how many centuries to date. In line with this, the term Doula can also be referred to the following:

  • Labor companion
  • Labor support specialist
  • Labor support professional
  • Birth assistant
  • Labor assistant
  • Trained labor coach
  • Lactation consultant
  • Traditional birth attendant

Most doula – client relationship usually comes during the 7th month of gestation. While some doula – client relationship begin during the first few weeks after the baby is born.

Types of Doula support

Antepartum Doula

An antepartum doula provides aid and support to a newborn mother who has been required to stay in bed or is experiencing a high – risk pregnancy.

They provide emotional reassurance, physical and practical support. They also give out information when antepartum situations get distressing, confusing, and emotionally draining.

Pregnancy week by week

Birth Doula

A birth doula serves as a labor support companion who provides physical support and assistance, emotional encouragement and playing the role as a woman’s advocate who undergoes childbirth. That said, enlisted below are the duties of a birth doula:

  • Massage to lessen the pain caused by child labor
  • Maintaining and supporting a laboring woman’s proper posture
  • Provides water

Postpartum Doula

A postpartum doula is the one who comes straight in the comfort of a mother’s home right after childbirth. Oftentimes, the same person provides both birth and postpartum care services.

They work alongside the couple during the first few weeks post – delivery by doing the following:

  • Cooking and meal preparation such as breakfast in bed
  • Managing light household chores
  • Fill in a mother ‘s (particularly for first – time mothers) duties and responsibilities whenever she needs a break
  • Encouraging a mother whenever she feels overwhelmed at the moment

Family life Doula

A family life doula provide long – term support and services to the newborn mother’s family. Most often, family life doulas are being mistaken as nannies. This is because they do the following duties below:

  • Guidance to first – time mothers
  • Being a good companion to the newborn mother’s children. Aside from the mother, a family life doula also provides emotional reassurance and encouragement to the children

Doula – like practitioner

A doula – like practitioner is the one who provides geriatric nursing for critically ill adults.

Duties of a doula

A doula’s duty is to assist a woman with medical and non – medical aspects related to pregnancy (addressing/ answering questions and concerns via phone or assisting in person).  In line with this, enlisted below are the following duties of a doula:

During pregnancy

  • Helps in creating a birth plan. This include the option of having a drug – free birth, suitable pain management techniques
  • Gives out options and opinions when decisions concerning her health and welfare are to be made
  • As the due date approaches, a doula provides information on what to expect before, during, and after childbirth. This is to lessen the pregnant woman’s fear and nervousness about the process

During the course of labor and delivery

During the course of labor, a doula stays close to the mother – to – be and consistently doing the following duties below:

  • For a pregnant woman who opts to choose a medicated birth, a doula will provide physical and educational support during the course of labor while administering medications. A doula works alongside the medicated mother by helping them deal with the side effects of medicines. A doula is also ready to help in case the pregnant woman needs more supply of medicine due to a high degree of pain and discomfort
  • A doula provides information [which includes explanation of procedures] about what is currently happening during labor
  • A doula provides labor pain management techniques such as aromatherapy, reflexology, music and mantras
  • A doula reduces stress and anxiety during the course of child labor by giving massages. Studies suggest that the power of massage stimulates the pituitary gland to secrete a substantial amount of natural oxytocin. The oxytocin produced runs through the bloodstream (which causes uterine contractions) and into the brain (which cause drowsiness and a higher pain inception). By the same token, the presence of doula minimizes the instances of getting oxytocin via an intravenous or intramuscular route (which only supplies an insufficient amount)
  • For a pregnant woman who is about to undergo cesarean delivery, a doula provides continuous support, emotional reassurance and encouragement
  • A doula assists with the breathing techniques through labor contractions
  • A doula’s presence facilitates communication between the pregnant woman and the hospital staff. This ensures that a pregnant woman have fulfilled her specific desires during the process

Postpartum period

  • For a first – time mother, a doula is there to assist with the breastfeeding process that is, how to latch and nurse a newborn properly
  • Encourages the importance of bonding between the newborn and the mother (family members and relatives as well)

Contrary to the abovementioned support, a doula is only knowledgeable about the medical aspects of pregnancy and motherhood. With that being said, a doula does not offer the following duties:

  • Medical advices like that of an obstetrician – gynecologist / obstetric doctor
  • Labor and delivery assistance provided by a midwife
  • Role of the health care provider/s
  • Role of the hospital staff (nurses and doctors)
  • Role of the husband or father

Finding and hiring the right Doula

Finding the right doula is someone who is comfortable to be with and someone who is easy to talk to. It is best to begin finding for the right doula around 4 – 5 months of gestation.

To be able to find and hire the right doula, ask recommendations from the following people:

  • Friends and family members who have hired a Doula
  • Health care providers
  • Childbirth instructor
  • Contact the nearest medical hospital available for referrals. As a matter of fact, a small number of innovative hospitals provide doulas to laboring patients who wants one

Key questions to ask a potential Doula

A fairly large majority of doulas do not charge for initial consultation. If a pregnant woman is fortunate to find one, take the advantage to interview to confirm her potentiality. Ask the potential doula by asking the following key questions below:

  • Pricing on support, insurance coverage and services fees
  • Types of services provide
  • How many births she has attended
  • Availability prior to childbirth to discuss birth plans
  • Availability on the estimated due date
  • Other options if ever Doula is not available at the time of childbirth
  • Educational background and trainings the potential Doula attained
  • What made her decide to become a Doula
  • Philosophy about childbirth

As for the pregnant woman’s side, she must discuss her preferences and concerns about gestation, labor and delivery, and post-delivery care

The benefits of having a Doula

To the pregnant woman

  • A doula’s support system is proven to have a good impact during the course of labor. As a matter of fact, studies show that a healthy number of women resulted to a positive birthing experience when a doula is present
  • Having a doula lessens the number of medical interventions that is, fetal extraction tools
  • Lesser time inside the neonatal intensive care unit
  • Positive psychological impact

In line with this, mothers who belong from less – fortunate families (that is, those who attained low educational level, salary, less preparation for childbirth and motherhood, and lacks social support) may experience greater benefits from a doula.

To the husband or partner

  • A doula educates the husband or partner with some comfort techniques
  • Having a doula encourages the husband or partner to give emotional support during labor and birth

In addition to that, studies have shown the consistent support of a doula is often associated with the following outcomes:

  • Minimizes the chances of negative birthing experience
  • A doula’s aid and support minimizes the need to take pain relief medications, such as the use of intravenous/ intramuscular/ or nasal spray oxytocin by 40% and request of an epidural by 60%
  • A doula’s aid and support decreases the incidence of undergoing cesarean delivery by 50%
  • Having a doula shortens the length of child labor by 25%

However despite of the benefits, some medical institutions do not encourage the participation of doulas. This is because some doulas carry out personal agendas that can endanger both the mother and the newborn.

In fact, a doula’s presence and participation has become an issue to medical staffs / professionals citing that doulas intervene with their roles inside the birthing room.

The educational background of a Doula

In general terms, being a doula requires no formal education (that is, academic credentials such as a college / university diploma) or even high school equivalency is required.

Because of that, researches show that some mothers opt to hire their experienced female friends and relatives as a low – cost alternative to professional doulas.

Training requirements

Generally speaking, the doula profession does not require any medical training or recognition of certification process. In fact, the college of obstetricians and gynecologists do not have an official position on doulas.

Despite the lack of standardization, some medical institutions provide internal doula training programs to assure legitimacy to mothers who want to hire one.

As a matter of fact, some countries like North America offer 2 – 3 day seminars to become a doula. These seminars provide the following medical trainings enlisted below:

  • Trainees have hands – on practice to perform various techniques that are used during childbirth
  • Learn various maternal positioning and movements
  • Practice different forms of relaxation and breathing techniques

Certification

Certification for those who aspire to become a doula takes place in organizations at different levels (local, national, and even international). To be recognized as a certified doula, below are the required processes to attain:

  • Positive evaluations from medical professionals (obstetric doctors, nurses, obstetrician – gynecologists, midwives)
  • Participation in doula training courses
  • Time spent in practicing maternity care
  • Participation in childbirth classes
  • Passing a written exam about childbirth and maternity care