Updated: Jan 28, 2019
Regardless of where a woman chooses to deliver her baby — be it in the hospital, at a free standing birth center, or at home — or how — unmedicated, with pharmacological pain relief, or via cesarean section — she can greatly benefit from soliciting the help of a trained birth doula. Birth doulas, or women trained and experienced in the art of continuous labor support, provide emotional, physical, and informational assistance to the laboring woman and her partner. Doulas do not perform clinical or medical tasks, such as taking blood, fetal heart tone checks, or vaginal examinations, nor do they diagnose or treat any medical concerns. Instead, doulas work in concert with medical providers to ensure that the mother is fully taken care of in terms of not just her health but her emotional well-being in an effort to help improve birth outcomes and increase satisfaction in the birthing process.
Historically, women grew up seeing childbirth, helping other women through it, and maybe or maybe not experiencing it themselves. Birth was seen as a natural and normal event, laboring mothers were viewed as competent and capable, and the nurturing support of other women in the birthing space was a given. Today, birth is a far more private and medicalized matter. Many women and their partners enter the birthing space never having seen a live birth before. Frequently, the only prior encounters they’ve had with birth are childbirth education classes, anecdotes shared from family and friends, or overdramatized and alarmist media portrayals. Enlisting the support of a birth doula can help alleviate stress, increase comfort, and normalize the many unknowns of childbirth. Additionally, research indicates that the presence of a doula can help decrease the incidence of cesarean birth or instrumental vaginal birth, the use of pharmacological pain relief, and low 5-minute Apgar scores, all while increasing the likelihood that the mother will have a spontaneous vaginal birth and rate her childbirth experience positively.
As mentioned above, the types of support a doula can provide include emotional, physical, and informational. Birth doulas can help women think through the type of birth they want, providing resources and information prenatally to help mothers and their families prepare a birth plan. With their extensive training and real-life experience, doulas can help translate medical jargon and ensure that women, their partners and their families understand what is happening or what is being proposed with the mother’s care. While doulas will not speak on the behalf of their clients, they can provide evidence-based facts and personal experience to help mothers feel informed and in control of the decision making process when discussing their care with their provider. It is not within a doula’s scope to clinically assess, pass judgement, or impose her own preferences on the mother, rather she is there to help ensure that the mother understands her options and feels confident in all her decisions. Doulas strive to foster maximum self-determination within their clients, and this piece alone is beneficial so that women are able to give informed consent in their medical care and gain a sense of empowerment while doing so.
Physically, doulas can help alleviate pain and discomfort via breathing techniques, hot and cold therapy, massage and touch, offering positional changes, or encouraging the use of a shower or tub, among other things. While the mother’s partner or family can certainly help in the execution of these techniques, it is rare to find a lay person who has extensive prior knowledge of such measures, or who has the composure to remember to implement them in the moment. A doula, with her clear head and professional boundaries, can maintain emotional distance throughout the labor in order to continually assess the mother's needs and make a plan to help. If a partner or family member is interested in helping with pain management, a doula is able to prepare them for what’s coming, give suggestions, provide encouragement when they need it, and spell them when they’re exhausted. A doula always works tactfully and respectfully with the partner and family members to ensure that the mother is getting the support she needs in the moment.
Last, and perhaps most importantly, doulas offer continuous reassurance and emotional support to the mother prenatally, throughout labor, and in the immediate postpartum period. Childbirth is a uniquely transformative process for women — one that requires them to find their deepest inner strength and truly tap into the courage that it takes to become a mother. It can be a scary, exhilarating, exhausting, triumphant, frustrating, and unfamiliar journey. The calm and confident presence of a doula can help a mother keep her focus and trust in her own strength. A doula is there to let the mother just be if that’s what she needs, or to take charge and urge the mother to stay with her breath and focus. She can remind the mother of her birth wishes when she is faltering, and give her the tools to continue to achieve them. If things do not go according to plan, a doula is helpful in processing the changes in the moment and the grief that may come after the birth is over.
Birth doulas provide an emotional safety net for mothers during a life-changing event that can have far-reaching impacts on her physical and mental health. They are an invaluable member of a woman’s birth team, ideally working seamlessly with the medical staff and family to provide comprehensive support to the laboring mother. Contrary to what some may think, the support of a doula is not a luxury, but instead should be viewed as an essential tool used to help achieve the best birth outcome possible. In such a vulnerable time as childbirth, every mother could benefit from the supportive care of a trained doula.