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• What Is A Doula?
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|What Is A Doula?
A doula is a woman who is trained as a childbirth companion. Doulas are becoming increasingly popular as studies show that women supported by doulas are less likely to require a C-section delivery, induction or epidural pain relief. The name is derived from a Greek word used to describe important female servants who thousands of years ago helped their mistresses with childbirth. Doulas are also known as labor companions, labor support professionals/assistants and birth assistants.
There are 3 types of doulas, although some doulas are trained in all 3 areas:
This depends on what point of your pregnancy you hire one. Most doulas are hired a few months before childbirth and help with the design of a birth plan. They are available to couples to answer any questions arising from the pregnancy, which first time moms find particularly valuable. Although they do not offer any medical care they are knowledgeable about most of the aspects of childbirth delivery, so they can help their clients understand the process and any potential complications that may arise. On request they can visit the woman at home when early labor contractions start. Once the mother arrives at the hospital or birthing center, the doula stays close to her at all times. Typically the doula's role will be to comfort, support and encourage the woman through her contractions. She will go through the breathing techniques which the mother learned in prenatal classes and can provide pain relief by massaging and giving advice on labor positions. A doula also acts as a mediator and advocate with other members of the woman's pregnancy healthcare team and is aware of the mother’s choice for either a medicated or unmedicated birth. Although she will not take the place of a midwife, she will augment their support. This is particularly useful if the midwife is responsible for several labors at the same time, or if the labor is long and the midwife changes with shifts. After the birth, many doulas spend a little time with the mother helping her with the breastfeeding process and encouraging a bond between mother and the newborn.
What About The Father's Role?
Numerous studies continue to show the benefits of having a doula present during labor. According to the Continuous Support for Women During Childbirth Report (Cochrane Review), women who gave birth with the aid of a doula were less likely to need pain relief medications, were less likely to require a cesarean birth and reported having a more positive experience from childbirth. Other studies confirm this by showing the rate of C-sections reduced by 50 percent when a doula was present. Also, the length of labor was reduced by 25 percent, the request for an epidural pain relief by 60 percent and the use of oxytocin by 40 percent. Studies also show births attended by doulas are less likely to require the labor inducing drug Pitocin, vacuum extraction or forceps.
Having a doula present at birth is beneficial, no matter what sort of birth you plan. Although women tend to require fewer medical interventions when a doula is present, their role is to help you have a safe and enjoyable birth, not to choose your birthing method. If you choose a medicated birth, the doula can still offer the same emotional and physical comfort supports such as a massage. It is rare for medications to take all the pain or discomfort away, so this support is still valuable. If an unplanned C-section arises, the doula can help explain the process to the mother and support her because she is likely to feel unprepared. If complications arise, she can stay with the mother while the father accompanies the baby to the nursery.
The role of a postpartum doula is to help and support both parents in their new roles. Primarily they are educational, and can assist in breastfeeding education and baby care. Unlike a baby nurse however, a doula’s role is not restricted to the baby, but her focus is to nurture the family as a whole. She is there for any other children in the family and of course the father if he has any questions. Support can last anywhere between 1 to 3 months and usually involves one or two visits to the family per week. Those visits can be for a complete day, 9 to 5pm. Or they can last 3 to 5 hours, or after school until the father comes home. Doulas do not teach a particular parenting approach, their role is to remain neutral listeners and to encourage mothers to find their own parenting style.
No. Doulas are not qualified to treat postpartum depression. However, they do help mothers considerably by providing emotional and practical support. A doula will do her best to ensure that the mother takes care of herself, is getting enough sleep and eating a proper diet. If she suspects depression is an issue she will refer her client to an appropriate clinician or local support group.
The American Pregnancy Association can also provide a list of doulas in your area. Call: 1-800-672-2296.
Questions To Ask A Doula
The most important criteria when it comes to choosing a doula, is choosing someone you feel comfortable with. Most doulas do not charge for an initial consultation, so use it as an opportunity to interview them. Questions to consider asking include:
1. What training or experience do you have?
Most doulas are independent and are employed directly by the parents. They offer a variety of services which are offered on a full-day basis, part-day, overnight or weekend. Most doulas charge an hourly fee, although these are usually offered on a sliding scale the longer you require their services. The average total fee is between $500 to over $1000, depending on the location and the popularity of the doula. Although this may seem expensive, when you consider the costs of surgical interventions and epidurals (see prenatal care costs) it can prove good value. Presently, most insurance companies do not cover doula expenses. However, to increase the chances of recovering your fees when submitting expenses, it is worth:
1. Only using certified doulas.
DONA International have set a standard of practice for all doulas who are certified by their organization. Those standards include:
Advice on Services Offered
Limitations of Services
Voice of the Mother
When The Doula Cannot Make the Birth
A female friend or relative who has gone through a pregnancy herself may be another alternative. The benefit is you will be comfortable with her, and of course her services are free. On the downside, she will not be as experienced or knowledgeable. One way around this is to have a friend who is a 'lay doula'. A lay doula goes through a half day course and learns the basics. Research shows that the benefits of a lay doula are the same as a professional one.
For more on pregnancy care before childbirth, see the following:
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