The following is an article from Lamaze Parents magazine.
The photograph portrays Pam Walsh laboring at home, assisted by Jill Fransen,
DONA Certified Doula.
As expectant parents you're probably preparing extensively for childbirth and early parenting - attending classes, watching educational video-tapes, reading books and articles, touring your hospital, practicing relaxation and comfort techniques, preparing a birth plan and discussing your concerns with your doctor or midwife and other parents. Such preparation improves the quality of your birth experience in many ways. You understand the birth process, your options for care, ways to cope with pain and the clinical measures used to maintain safety and labor progress. In short, childbirth preparation takes many of the surprised out of labor and helps 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. It helps to have reassurance from experts who can help you relate the intense physical sensations and emotions of labor to what you already know intellectually. Nurses, midwives and doctors can offer some guidance, but they may be limited by their clinical duties and the needs of other laboring woman in their care. Also, some are better than others in giving such support.
The Doula's Role
To be sure you you get the kind of help you need in labor, consider having a doula. A doula is with you continuously through labor. She's trained and experienced in providing emotional support, physical comfort and non-clinical advice. She usually meets with you before labor and discusses your preferences and concerns. She learns the role you both want your partner to play. For example, some partners prefer to be the primary support person or "coach" - with the doula as advisor, errand-runner (for beverages, ice chips, hot packs, warm blankets, partner's food) and stand-in (if the partner needs a break). Other partners want to focus on providing love, affection and comfort to the mother and leave the role of coach to the doula. The doula is a constant - no breaks (unless you're asleep), no shift changes, no clinical responsibilities or other women to care for. And she understands what you're going through. Her knowledge and experience reassure you as she guides you in breathing techniques, positioning, massage, use of the bath, shower, birth ball, hot and cold packs and other comfort measures. 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." Likewise, a new mother said, "I don't know what we would have done without her." Your doula's goals are 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 allays your fears. She also helps you make adjustments if unexpected demands or complications arise.
A Doula's Impact
The continuous 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 as well as the negative impact of high levels of stress hormones, doulas reduce a woman's need for pain-relief medications. Most studies have reported shorter labors, less need for oxytocin to speed labor and few forceps, vacuum extractor and cesarean deliveries when doulas are present. In addition, the research has shown that women's satisfaction with their birth experiences, postpartum psychological state, success in breastfeeding and interactions with their newborns are improved when a doula was present during labor and childbirth. Research on fathers' participation in labor shows that when doulas are present, fathers take fewer breaks away from the mother, remain closer to her and touch her more. The doula seems to relieve the stress and some of the burden on the father allowing him to comfortable give more support to his loved one.
The Doula's Credentials
The doulas are trained by Doulas of North America (DONA), Lamaze International (with DONA-approved trainers), the Association of Labor Assistants and Childbirth Educators (ALACE), the International Childbirth Educators Association (ICEA) and Birthworks. DONA, ALACE, ICEA and Birthworks also certify doulas, which ensures that they have achieved at least a minimal level of competence. In some parts of North America, there are also local associations that train and certify doulas. Certification of doulas, however, is a relatively new phenomenon, which means that there are many excellent doulas who are not certified. If you are interested in having a doula, you should ask questions in the box below before making your choice. Doulas usually share call with another doula or have a backup doula to cover for those inevitable times when they will be unavailable. make sure that you become acquainted with your backup doula as well as your primary doula. There are benefits for both the mother and her partner when a doula is part of the labor and delivery team, especially when you the the time to get to know your doula and feel comfortable with her before labor begins.
PENNY SIMKIN, CD (DONA)., PT. A CHILDBIRTH EDUCATOR, DOULA, BIRTH COUNSELOR, AND DOULA TRAINER, IS THE AUTHOR IF THE BIRTH PARTNER (HARVARD COMMON PRESS).
| Finding a Doula
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| The organizations below can provide more information and referrals for doulas: ALACE, P.O. Box 382724 Birthworks, 42 Tallowood Dr. DONA, 13513 N. Grove Dr. ICEA, P.O. Box 20048 Lamaze International |
Questions to Ask a Doula Asking these questions over the telephone will help you decide if a particular doula is right for you: What training have you received? Are you certified? By what organization? What were the requirements for your certification? Tell us about your experience with birth, personally and as a doula. What is your philosophy about childbirth and supporting women and their partners through labor? May we meet to discuss our birth plans and the role you will play in supporting us through childbirth? May we call you with questions or concerns before and after the birth?
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When do you try to join women in labor? Do you come to our home or meet us at the hospital? Do you work with one or more backup doulas who cover for you when you're not available? May we meet them? What is your fee? When you meet the doula (and it's a good idea for both you and your partner to meet her), pay particular attention to your personal perceptions of her. Is she warm, kind and enthusiastic? Is she knowledgeable? Does she communicate well? Is she a good listener? Is she comfortable with your choices? Do you feel comfortable with her? You may want to interview more than one doula, or, if you like the first doula and backup you meet, you may not need to look any further. |