The Importance of Doula Support in Modern Births
by Carolee Abbott, RN, CD(DONA), SpBCPE
Women have been helping women through the process of childbirth since ancient times. Mothers-to-be have turned to their grandmothers, mothers, sisters, aunts, and trusted friends to assist them through the profoundly significant physical and emotional experience of childbirth. The modern practice of having a birth doula continuously present throughout labor and delivery is increasing in its popularity for many reasons.
The main function of the doula is to provide the mother and her husband continuous emotional support, physical comfort and assistance in obtaining information before, during, and just after childbirth. She does not make medical diagnosis, give medical advice, or perform clinical tasks such as fetal monitoring or vaginal exams. She recognizes birth as a key life event that will be imprinted in the mother's memory for the rest of her life and strives to enable the mother to have a satisfying birth experience birth as the mother defines it. It is important for the doula not to project her own values and goals in the process. She facilitates good communication between the mother, the husband, and the medical providers; however, she does not make decisions for her clients or talk to medical staff in their place. She helps with various positions throughout labor and delivery, encourages good breathing techniques, provides diverse comfort measures such as massage, warm/cold therapy, and counterpressure, and seeks to increase the mother's security and confidence during the birth process by providing necessary information and a listening ear throughout the process.
Many people think doulas are only helpful for those choosing natural childbirth but mothers choosing epidural pain relief also benefit. Labor must be managed until the time for the epidural has arrived and at times there are side effects of the epidural that must also be dealt with including partial pain relief, fever, and inability to push effectively. The woman's controlled physical pain does not automatically relieve all other emotional distress and anxiety.
It is Important to understand from the beginning that the presence of a doula does not take away from the importance of the husband during birth. The main advantage the man has is his deep emotional involvement with both the mother and the baby which enables him to support her in a unique, loving way. However, that same emotional involvement also can become a disadvantage at some point during the process, making it difficult for him to remain calm and objective when he is needed to be. Labor is usually more like a strenuous marathon than a sprint, and the husband can often be more relaxed and successful in his supportive role if he does not carry the entire role of support for the mom on his shoulders alone. The doula's purpose is to provide emotional and physical support for BOTH parents so they can experience the type of birth they desire.
Study after study demonstrate many medical benefits to those women who choose to be attended by a doula. The average length of labor is shortened, pain is reported as better controlled, the cesarean rate is lowered, the occurrences of interventions such as Pitocin and episiotomies are lowered. Most of these can be directly traced to the increased calm and security of the mom who is continuously attended throughout labor and delivery with both emotional and physical support. It is also found that those mothers with doulas recall a more positive birth experience overall and describe less postpartum anxiety as well as increased enjoyment in their early parenting afterward, due in part to the confidence gained during the birth process.
Overall, the many benefits of a birth doula have been well known by many cultures throughout history. Today's woman needs the same level of support and encouragement and often finds herself more isolated from family than in times past. For many reasons, the use of a birth doula should be considered by today's expectant couples.
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