June/July 2010
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Birth Support: Local Doulas offer a helping hand by Amy Moll 
If you could decrease the duration of your labor, lower your chances of having a C-section, and limit fetal distress, would you do it?
Recent studies show that all of this is possible with the help of a doula. Further benefits of having a doula present during and after childbirth include decreasing the need for pain medication during delivery, having a greater likelihood of successful breastfeeding, and less post-partum depression. Why then, do so few women even know what a doula is? In her recent book, Pushed: The American Birth Experience, Jennifer Block proposes that Western medicine has taken the human element out of the birthing process and made it into a sterile medical procedure. As a result, women no longer receive the emotional, spiritual, and non-medical physical support that was once an integral part of a natural birth provided by extended female family members, midwives, and doulas. In fact, many women don't realize that type of birthing support is still readily available. So what exactly does a doula do? A doula is a non-medical birthing assistant, who provides emotional, physical, and educational support before, during, and after labor and delivery. Doulas work in a variety of settings including homes, birthing centers, and hospitals. Pre-labor support may include education on birthing options and explanations of medical procedures employed during labor and delivery. They also act as facilitators between the family and medical team and help in preparation and planning. During labor doulas offer coaching on birthing positions and may utilize therapies such as massage, aromatherapy, and other pain management techniques. They will also support the partner in being helpful throughout the process. A doula's presence and emotional support can greatly relieve anxiety, worry, and fear for both the mother and her partner. Studies comparing labor with and without the presence of a doula show significant differences in outcomes. Labor and delivery involving a doula showed 50% reduction in cesarean rate, 25% decrease in labor duration, 60% decrease in the request for an epidural, 40% reduction in the use of oxytocin, and 40% reduction in forceps delivery. According to statistics from 2002, only 5% of women utilized a doula during labor and delivery however, this service appears to be on the rise as the benefits are brought to light. Post-labor assistance can include guidance in breastfeeding, help with parent-child bonding, running errands, and performing chores around the house. This kind of assistance may last from one day up to several months depending on the specific arrangements made and extent of services offered. Each doula offers a unique set of skills and services. Shalamar Ewing, a doula and licensed massage therapist at the Bend Birthing Center, provides pre-natal, labor, and post-partum massage. Her interest in promoting natural births was sparked at age 19 after reading the book Spiritual Midwifery. During the home birth of her first child at age 27, she clearly remembers feeling like she could have used another set of hands despite having an excellent midwife and both her mother and sister present. Shalamar now offers that extra set of hands to local women in need. She feels the most important role of a doula is to provide non-invasive support wherever it is needed. One of the ways she helps women prepare for birth is by organizing a Blessing Way ritual, a traditional Navajo ceremony that brings family and friends together to offer strength to and honor the mother-to-be's rite of passage into motherhood. Shalamar also offers belly casting, and henna prior to labor. During labor and delivery she may videotape the birth, help the partner or spouse take care of other children, or provide hands-on help with massage and acupressure. After delivery, she helps out around the house. Shalamar believes in a team approach and often provides referrals for parenting classes, yoga, acupuncture, breastfeeding coaches, and more. Finding a Doula who's Right for You? If the idea of having a support person to guide you through the process of labor, delivery, and post-partum sounds appealing, the following are several ways to find a doula in your area:
Doula Interview Crib Sheet
DONA International is a large-scale international organization that claims to set the bar for doula certification. Their requirements include having a work background or education related to maternity, completion of required reading, attendance at a DONA workshop, and a written essay on labor/delivery support. Prior to receiving a certification applicants must also attend a minimum number of births.
Below are some questions to get your interview started, but don’t stop here. Make sure you feel you know everything you need to in order to have a positive relationship with your doula.
When connecting with a doula to discuss their services meet with them in person. Find out if they are certified, and if not, what their educational background and experience includes. You definitely want to feel comfortable in their presence and confident in their skills. It is also a good idea to interview several doulas to determine who you connect with the best (see sidebar). Whether you are currently pregnant or simply considering having children in the future, you should take a moment to envision your ideal birthing experience. Do you want to feel like you have made informed choices and take an active role in giving birth to your child? Do you want someone present whose sole purpose is to offer you emotional support, physical comfort, and an extra helping hand? If so take some time to find out more about local birthing options. Doula support might just be perfect for you. |
