Doula (pronounced doo'-la): a professional, experienced woman who provides emotional, physical, informational and practical support to prenatal, laboring or postpartum women.
Prenatal Doula Role
In the months leading up to the birth, the doula provides valuable advice to the mother about what she can expect throughout her pregnancy and during the birth. For example, the doula can offer advice about exercising during pregnancy, suggestions to make the pregnancy more comfortable and assistance with the preparation of a birth plan.
Doula's Role During Labor & Delivery
During labor and delivery, the doula often becomes the labor “manager.” Although she does not perform any medical tasks, her responsibilities complement those of the medical birthing team. She can guide the parents through the process, drawing on her wealth of knowledge and experience. The doula can explain medical procedures, as well as present a full range of options available to the couple. Depending on the level of her knowledge and skill, the doula may be able to support the mother's efforts to birth naturally and safely, as well as help avoid unnecessary interventions. However, the doula accepts and works within the authority of the midwife or obstetrician in charge and cannot give medical advice.
With comforting and calming words, the doula mothers the mother, reassuring her that the pain of childbirth is normal and natural. With an arsenal of experience, the doula offers the mother massage and other non-pharmacological pain-relief measures, as well as suggesting positions that will assist the labor and birth. The doula also encourages the woman's partner in his/her chosen role, thus enhancing the interaction between all three.
The presence of a doula enhances the likelihood of happy memories resulting from the childbirth experience. Her assistance often leads to a shorter and less strenuous labor with less medical intervention, a decrease in the incidence of forceps and vacuum delivery, and a reduction in the likelihood of an emergency Caesarean section.
The doula stays during labor and delivery and continues to support the mother in the first hours after the birth. At this time, she assists with breastfeeding preparation and helps the new mother to adjust to having just given birth. The doula also fosters the bond between mother and baby.
According to the book Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth by Marshall H. Klaus (Perseus Press, 1993), studies have shown that the presence of a doula during labor can improve the birth outcome in the following possible ways:
• 50% reduction in Caesarean rate
• 25% shorter labor
• 60% reduction in epidural request
• 40% reduction in oxytocin (pitocin) use
• 30% reduction in analgesia use
• 40% reduction in forceps delivery
Role of the Postpartum Doula
The role of a doula with mother and infant varies depending upon the needs of the parents. The doula begins by helping determine the new family's needs during both daytime and night-time hours. She may educate on breastfeeding, infant support and caring for the new mother. The doula can also provide emotional support or respond to practical needs, such as helping with family errands.
How Much Does a Doula Cost?
The cost of a doula varies geographically and among doulas, particularly depending upon her experience. The price of a labor doula generally ranges from $200 to $800; however, most doulas will provide a sliding scale or payment plan. Many new doulas are willing to provide inexpensive or free support in order to receive experience.
Where to Find a Doula
You can collect information about doulas from organizations involved with childbirth, local hospitals or birth centers. Childbirth educators, care providers, lactation consultants, La Leche members and anyone who has recently had a baby or works in the pregnancy field also are excellent resources. The organization Doulas of North America International (DONA) will put you in contact with members in your area. It can be reached by calling (888) 788-DONA, e-mailing Info@DONA.org or visiting www.DONA.org.
Questions to Ask a Prospective Doula
• Is she certified?
• Does she provide prenatal and/or postpartum visits? What can you expect during these visits?
• How many births has she attended?
• Can she provide references?
• What form of training has she had?
• What types of births has she witnessed (Caesarean, epidural, intervention free, VBAC, teen birth, etc.)?
• What is her fee? Does she have a sliding scale or other arrangements available?
• Has she ever worked with your care provider or at your place of birth?
• Does she have back-up arrangements if she is not available?
• What will her role be in the early stages of labor?
• Will she provide labor support at your home prior to going to the place of birth?
• Is she familiar with many methods of childbirth?
• How does she define her role during labor and birth?
Most importantly, find a doula who makes you feel comfortable.
Rae Schmidt, founder of Doula By Design, is the mother of two children and has seven years experience as a doula. She also is certified in Imagery and educated in the Bradley Method®. She can be reached for a free interview by calling (440) 353-3404 or e-mailing raschmidt66@hotmail.com.
