What is a Labor Doula?
A labor doula, or professional labor assistant, is a woman experience in childbirth, who supports the family before, during and just after the birth of the baby. She provides physical, emotional and informational support to the laboring family. She serves as an advocate, labor coach and information source.
The doula will meet with the parents during pregnancy to get acquainted and to learn about any prior birth experiences along with the history and expectations of this pregnancy. Most importantly, the doula will provide comfort, support, and information about birth options before and during labor. She will join the family during labor at the time decided on by the mother and stay by her side until the baby has been born and has successfully started breastfeeding.
Why Hire a Doula?
With a doula at her birth, a laboring woman is never alone. A mother can count on her doula to support her and guide her in the kind of birth she desires. Nurses, midwives and physicians are responsible for the medical care the laboring woman needs and may care for more than one woman at a time. The doula’s only focus is on the mother’s emotional and physical needs, one mother at a time.
Studies from several countries show that when doulas attend births, women have shorter, easier labors, request less pain medications, are less likely to need oxytocin to speed labor and less likely to need vacuum or forceps delivery. Babies are also healthier and breastfeed more easily. Mothers have said they were much more satisfied with their birth experience. Medical caregivers and expert organizations recognize the benefits of labor support and agree that having a labor assistant can improve maternal and fetal outcomes.
50% less cesareans 30% less analgesic use
25% shorter labors 40% less forceps deliveries
60 % less requests for epidurals 40% less oxytocin use
What about the Father’s Role?
A doula does not take away from the father’s participation in the birth process but rather, enhances it. When a doula is present, fathers tend to feel less anxious, take fewer breaks away from their partner, stay closer to her and comfort her with his touch more often.
Fathers may be overwhelmed and surprised by the intensity of their partner’s experience. Thus many fathers feel more relaxed with a doula present as she gives the reassurance that although labor is intense it is progressing normally.
Complications can occur that may upset the hopes and expectation that a couple has for their birth. A trained labor assistant can help the family work out options and feel more in control.
Finding a Labor Doula
It is important to find a doula whose birth philosophy harmonizes with yours. You should feel comfortable and confident in your doula. During an initial interview it is important to ask questions of your potential doula to make sure she is the doula for you.
Some questions to ask before hiring a doula (from “Giving Birth, Naturally” by Peggy O’Mara, “The Doula Book” by Klaus, Kennell and Klaus and “Special Women” by Paulina Perez)
- What kind of training have you had? Are you certified? By what organization?
- How long have you been in practice as a doula? How many births have you attended?
- What is your philosophy about childbirth? How do you support women and their partners throughout labor?
- What are your policies on calling you with questions and concerns before and after the birth? How can I contact you in an emergency?
- Do you work with back-up doulas in case you are not available?
- Can we reach you 24 hours a day? When do you join women in labor? Do you come to our home or meet us at the hospital?
- What is your fee? How and when do you expect payment?
- What do you consider to be the most important elements of care working as a doula?
- What comfort measures have you used for relaxation and pain relief?
- What is your experience and skill in teaching breastfeeding?
- What is your relationship with hospital personnel?
- Have you ever worked with my practitioner? What was your experience like?
- Do you get along well with the hospital staff? Have you ever had any conflict with them? If yes, will it interfere with your ability to support me?
- If someone suggests an intervention that you feel is unnecessary or you know I want to avoid what will you do or say?
- What do you provide that is different from what the hospital staff can provide?
- What kind of support do you offer to partners? How do you encourage him to be more involved in the labor and birth?
- Do you provide references that I may contact?
Some additional questions to ask if you are planning a natural birth:
- How many unmedicated births have you attended?
- What were the experiences like?