What is a Doula?
A doula is a woman, experienced in childbirth, who provides unconditional emotional, physical and informational support to women and their partners during labour and birth.
Support in Labour – why is it important?
One-to-one constant support throughout labour has been shown to not only provide a woman with emotional support, so that she is relaxed, but also to have a strong positive effect on the physiology and outcomes of labour. Research over the last 25 years has shown that the constant presence of a supportive birth companion is one of the most effective forms of care that women can receive during childbirth.
What is support in labour?
Women in labour have a profound need for companionship, empathy and physical comfort. Support in labour has been described as having four dimensions:
Emotional support: encouragement, praise, reassurance, listening, continuous physical presence; Informational support: explanations and information; Physical support: comfort measures such as massage, cool/heat packs, relaxation exercises; Advocacy: representing the woman’s wishes to others and acting on her behalf, when requested.
Research Findings:
A Cochrane systematic review of 15 RCT’s revealed that women who had continuous labour support from a doula:
Had 26% fewer caesarean births; Had 41% fewer instrumental vaginal deliveries; Were 28% less likely to use any analgesia or anaesthesia; Were 33% less likely to be dissatisfied or to rate their birth experience negatively;
Postpartum benefits found in a review of 12 trials show that women are:
More likely to be fully breastfeeding at four to six weeks post birth; More likely to display more positive mother-baby interaction at eight weeks post birth; More likely to have good self-esteem; More likely to find mothering easy and to feel that they were managing well; Less likely to experience anxiety and postnatal depression.
The Midwife – the reality.
Hospital midwives usually have to divide care between different women, cope with administration and work along others in the multidisciplinary team. As a result, they may be unable to give constant emotional, informational or physical support.
What do Doula’s do?
The doula’s role is to provide individualized, physical and emotional support and assistance in gathering information for women and their partners both prior to and during labour and birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement and positioning. Perhaps the most crucial role is providing unconditional continuous emotional reassurance and comfort. It is important to stress that the doula and the woman’s partner work together, she does not and should not, be seen as a replacement for the partner. A doula cannot make some of the unique contributions that the partner makes, such as commitment, intimate knowledge of the woman and love for her and her child so the doula should be there in addition to, not instead of, the partner. Furthermore, the presence of a doula can enhance the role of the partner by reducing his anxiety and freeing him to offer more emotional support and operate at his own comfort level.
Doula’s do not perform clinical tasks, such as vaginal exams or fetal heart rate monitoring. Doula’s do not diagnose medical conditions, offer second opinions or give medical advice. Most importantly, doula’s do not make decisions for their clients and they do not project their own values and goals onto the labouring woman.
If you are a returning client, please contact me on fionadill@logic.bm if you are interested in having a doula at your birth for the first time, please go to www.douladifference.com and find out about the amazing opportunities you have for support.
Happy Birthing :)