I want a doula
"I want a doula for this birth, what do you think about them?" Jodie asked. I'm a midwife and people stop me in the street to ask advice so I'm use to it. I'm usually happy to give advice but this time I was stuck?
"What's a doula?" I replied" I was imagining a new-fangled epidural.
"Well, it's a woman who looks after you when you're in labour"
"But that's a midwife" says I.
"NO, a doula is not a midwife, she is someone who stays with you all the time in labour and supports you."
"Well, that's you partner, your husband, isn't it?"
"Ha!" says Jodie in a strangely low, almost menacing voice. "Steve had no concept of support in labour, he didn't know what to do and was thankful when they suggested I had a cesarean...he just freaked out with the whole labour and being alone with me."
"Oh, I see, well I still think support is the midwife's job."
"Really" says Jodie, "I have never known a midwife to do that...I mean, they have other women in labour, they can't just stay with one."
She was right; I had never been able to stay with a birthing woman when I worked for a hospital. I admit that I was beginning to feel a bit jealous and a bit apprehensive of this new person in the birthing world. I told Jodie that I would find out more and let her know what I thought about doulas.
I phoned Jodie a few days later... "Jodie, I need a doula" I said.
"But you're not even pregnant!"
"I know but I still need one - do you know they will massage your back for 10 hours straight if you want...and they nurture and cosset and totally spoil you! They're your personal birth slaves, they follow YOUR needs and they SUPPORT you so you get the best possible experience!" I ran out of breath and Jodie chipped in.
"Yes, I thought they sounded good but they do cost about $1000 and Steve's not sure if we need one."
"From what I've read every birthing woman needs one. Do you know that women who hire a doula have much better outcomes for themselves and their babies than women who don't?" I got on my soap box at this point and started listing the benefits... "with a doula you are 60% less likely to want an epidural, you will have greatly reduced need for medical interventions, your labour will be shorter and your baby will be healthier. Apart from that you will halve your chance of needing a caesarean and you will be physically and mentally much healthier. OOOh! And by the way, you will bond with your baby better and both you and Steve will have a more enjoyable birth experience�so tell him he needs one".
"Sounds great" says Jodie a little warily "but is there any evidence?" I am always advising women to look at the evidence on which any clinical birth procedure is based as this is the best way of telling if you need an intervention and if there is any harm in it. Everything that is done to a birthing woman should be based on sound evidence and if it is not then it is potentially damaging.
"Yes, there is quite a lot of evidence showing that doulas bring a lot of advantages and no disadvantages for birthing women."
I promised to send Jodie a list of articles about doulas for her to look through. I have included them here for you too. I have also listed the benefits of having a doula support you in birth that are shown in these articles. I have since learned that doulas are trained in birth support and this is why they do better than a woman's partner or even the woman's own mother. I mean, your partner will probably have different reproductive instincts and may not even understand the value of a calm, gentle birth.
Some partners and some mothers actually prefer medical interventions as they believe these to create safety. This is especially so if a woman is left alone for long periods with her partner or her mother, who may not understand the process of labour. On the other hand, a doula takes the pressure off the partner and helps him or her to actually enjoy the labour.
The doula will visit the woman's home for four two-hour visits in the last couple of months of pregnancy to help the woman and her partner plan the birth they want. The doula will also provide informational support and will help the couple to learn and practice skills that will help with the birth.
When the woman goes into labour, the doula will attend the woman's house to support her in early labour until she is established enough to go to the hospital. She will go with the couple to the hospital and help the husband to set up the birth room with the aroma, music and other comfort measures that the woman has planned to include. The doula will then stay with the woman throughout the labour until the baby is born, supporting her and the husband no matter how long it takes.
After the birth, the doula will visit the couple once or twice to debrief the birth. Some doulas provide birth hypnosis and other support strategies. All doulas are on call 24 hours a day for their clients and many provide an on-going postnatal support service. All in all, they are worth every penny they cost. I know because I now work as a doula and I also run a doula training school so that other women can become doulas. It's been quite a while since I had that first discussion about doulas with Jodie and I am proud to call myself a doula.
Doulas make a positive difference to birth, for both the woman and her baby; they are worth their weight in gold and I believe that they should be available to all women. OH!.... by the way; Jodie did hire a doula and she had a wonderful birth. Her first baby had been born by cesarean because he was too big. Her doula supported her at home and when they got to the hospital Jodie was seven centimeters dilated. The doula arranged a birth mat that she had brought for Jodie together with pillows, cushions and aroma.
The doula worked with Steve, each stroking slowly in unison down Jodie's arms, sides and legs. Jodie needed no pain relief and had an eight and a half hour labour. She alternately squatted and went on 'all fours' until the baby slowly emerged. Jodie and Steve were ecstatic and the baby was almost two pounds heavier than their first baby.
Benefits of hiring a doula
- 60% less need for an epidural and 30% less need for an injection or pain killers (articles 1-4,7, 8)
- Reduction in the need for syntocinon drip (articles 1,2,4,6,7)
- Length of labour reduced by 25% (articles 1-6)
- Less need of forceps or vacuum deliveries (articles 1,2,4,5)
- The need for cesarean section reduced by 50% (articles 1,7)
- Fewer sick babies (articles 2, 3)
- Fewer sick mothers (article 2)
- Mothers have less bleeding after the birth (article 5)
- More normal births (article 6)
- Mothers have a better birth experience (articles 4,8,13)
- Mothers have less anxiety during labour (article 4)
- Mothers bond better with their babies (articles 4,10)
- Mothers are more confident with their babies (article 14)
- Mothers have less depression following birth (articles 4,10)