What is a Doula?
Introducing: The Birth Doula
The Purpose and Value of Labor Support
Rosana Padua, CD(CONA), LCCE
DONA International, Lamaze International
We may not realize it, but we all have doulas in our lives.
The word ‘doula’ is of Greek origin, which translates to “a woman who serves''. To paint a nicer image, think of the doula as the reliable woman of the community who everyone goes to for advice on fertility and pregnancy, the first one you call when labor begins, and the last one to leave once the baby is born. She is at the center of our circle of women—of mothers, aunties, grandmothers, sisters—who is always ready to lend a helping hand.
Sadly however, the rise of compact living, gated homes, and the fast pace of city life have disconnected women. This is where the modern-day doula comes to the fore.
Doulas bring back the age-old practice of women supporting women especially in the sacred reproductive years. She does so with education and special training to address the needs of women in these changing times.
A birth doula, specifically, supports the woman throughout her pregnancy and childbirth. Our main role is to provide emotional, informational and physical support to the birthing woman and her partner.
For first-time parents, we help them understand the stages of labor and how to cope with contractions. We suggest prenatal exercises and relaxation techniques. We help the woman and her partner create a birth plan or list of preferences, which they can use as a communication tool with their care provider. In the process of creating a birth plan, they gather a lot of information about different hospital procedures and their choices for each one.
In the course of our interaction with the mother, we also talk about what makes her uncomfortable, what triggers her negative reactions, and the things that help her address these. Sometimes, we also talk about past birth experiences. We try to help the woman use her previous birth/s as a source of strength. If it was a traumatic or negative birth experience, how can she find healing in the next; or if it was a beautiful birth, how can that birth inspire her even more?
We also help the woman establish her expectations of her birth partner—be that a spouse, a mother, sister or friend. Two-fold, we also help the birth partner share his/her feelings on how s/he can support the laboring mother. We help match the woman’s expectations to what the birth partner can offer. Through that, hopefully, a strong partnership will blossom.
We always stress that we do not take the place of the birth partner. Instead, we help create a space for them to find rhythm together. When we see that they have a good connection during labor, we cheer them on, protect the partnership, and offer support as needed. For example, when a laboring woman requests for a massage, we would first demonstrate to the partner how to do comfort touch. We believe that the partner’s closeness to the mother will bring greater impact.
Continuous Labor Support
On the day of the labor, doulas always work as part of a maternity care team. As outlined in DONA International’s Position Paper, “The Birth Doula’s Contribution to Modern Maternity Care”, each person involved has a specific role.
Doctors, midwives and nurses are responsible for the health and well-being of the motherbaby. They do vaginal exams, monitor blood pressure and fetal heart tones, diagnose and treat complications should they arise, and deliver the baby.
Meanwhile, doulas provide consistent and continuous presence during labor and help create a positive environment for birth to unfold. We encourage, affirm, give comfort through touch, positioning, and coach the woman with her breathing. We hold the space for partners and strive to protect the woman’s rhythm and rituals as she copes with the challenges of labor.
We also help the woman and her partner effectively communicate with her birth team. We equip them with the right questions in order to get the complete information, in case they face a difficult situation. For example, we teach the acronym BRAIN, which stands for: what are the benefits, risks, alternatives, what does your intuition tell you, and what if we do nothing. It must be noted that it is against our Standards of Practice to speak and make decisions for the family. What we can do is to encourage them to ask questions and express their preference to their care provider.
As soon as the baby comes out, we help assure that s/he receives the critical steps in essential intrapartum newborn care or Unang Yakap—immediate drying, immediate skin to skin, timely cord clamping, and non-separation of mother baby for early initiation of breastfeeding. We often stay for the immediate postpartum period to help the mother get settled with her newborn. At the postpartum visit, we discuss the childbirth experience and help piece together the birth story.
Positive Birth Experience
Overall, our aim is to help you achieve a positive birth experience, one that you can cherish for a lifetime. According to a 2011 systemic review of 21 randomized controlled trials with over 15,000 women respondents, women who gave birth with a doula present were less likely to have cesarean sections, less likely to use synthetic oxytocin to speed up labor, less likely to use pain medications, and overall have less negative experience of their birth. At six months postpartum, most of the respondents who received doula support had more success in breastfeeding, had fewer signs of depression, and regarded their birth partners with more fondness.
We do this work with a deep respect and concern for our clients. Our Code of Ethics stresses our obligation to serve reliably, without fail for the duration of the engagement. We are committed to giving high standards of service and we do so by completing comprehensive training and continuing education.
Simply put, a doula is someone who will be there for you in your journey into motherhood. We are driven by love and compassion, and we honor the power of women within themselves which grows stronger in a circle of support.