A doula is a labor coach - someone who helps you plan and prepare for your birth, and then supports you physically and emotionally throughout your labor, delivery, and postpartum period.

Throughout the ages, women have supported women during childbirth. A laboring mother, focused on the energy pulsing through her body, needs both medical supervision and continuous emotional and physical support. A doula is trained and experienced in the non-medical aspects of childbirth. And her continuous intrapartum support has been proven to improve obstetric outcomes for the mother and baby.

A doula’s role often begins prenatally, as she helps prepare the mother and her partner for birth. She can give them general childbirth education, help them draft a birth plan, and otherwise prepare for birth. She listens carefully to their desires. She helps them ask questions and find answers. She encourages the mother to trust herself, her body, her partner, and her birth team. She affirms the partner’s fundamental role at the birth and helps him trust himself to fulfill that role.

During labor and delivery, a doula plays an active role in offering continuous emotional support, physical comfort, and an objective viewpoint. She affirms the mother’s emotions and continuously reassures and comforts her. She offers suggestions to aid physical comfort. These may include movement and position changes, breathing and relaxation techniques, visualization, aromatherapy, or massage. These techniques are performed within the scope of her training and the standards of practice of a doula. A doula does not perform medical or clinical tasks, including taking or assessing fetal heart tones, performing vaginal exams, or taking maternal blood pressure or temperature.

A doula can help a couple navigate birth by providing an objective viewpoint. She encourages and facilitates communication with healthcare providers and the gathering of information about practices and procedures, but she does not arbitrate. She helps the mother and her partner sort through and discuss information, but she does not dictate decisions or offer second opinions or medical advice. She does not inject her views, but rather she reflects the views of the mother and her partner.

Research has shown that continuous labor support improves birth for both mother and baby. In 2012, Hodnett et al. found that women randomly assigned to have continuous labor support were more likely to have a spontaneous vaginal birth and were less likely to use medication for pain relief, to have a cesarean section, or to undergo an instrumental vaginal delivery. Their births were shorter, and they reported higher levels of satisfaction. These benefits were the greatest when the support came from someone who was not a member of the hospital staff, the mother’s family, or her social network. The research also found no increase in neonatal complications or decrease in breastfeeding.

Although little research has been done, fathers often report feeling less stress and greater satisfaction during a birth when a doula is present. A doula models what a father can say and do to help the mother during labor and delivery, thereby making him feel and be more included during the birth.

The psychological impact of childbirth is felt throughout a mother’s life, and the support she receives makes a difference in the way she will remember her birth. A doula’s prenatal preparation and continuous emotional and physical support during labor help preserve this life-changing memory for the mother and her family.

References:

1.     Hodnett, E. D., S. Gates, et al. (2012). Continuous support for women during childbirth. Cochrane database of systematic reviews: CD003766.
2.     DONA International. Position Paper: The Birth Doula’s Contribution to Modern Maternity Care. Web. 28 Oct 2014.
3.     DONA International. Standards of Practice: Birth Doula. Web. 28 Oct 2014.
4.     DONA International. Code of Ethics: Birth Doula. Web. 28 Oct 2014.
5. Jukelevics, Nicette. A Doula Can Reduce Your Odds for a Cesarean. VBAC.com. 4 Jan 2013. Web. 28 Oct 2014.