Doula Care
Reviving an Ancient Tradition

By Shelley Lyne

Most people aren’t aware what a Doula is and the benefits they can provide to mother, child and her chosen birth team. Doula is a Greek word meaning “woman servant”. A Doula (or birth assistant) is a woman with knowledge and experience of childbirth who provides emotional, physical and informational support to the pregnant and birthing mother and her partner. Doulas have been practicing for many years. In times before maternity wards, the older experienced women in a village would attend to the pregnant woman. Due to living within an extended community they would know the woman well and have formed a trusted bond with them prior to pregnancy.

Modern day Doulas are experienced and trained through various education courses to give quality care to women during pregnancy, birth and during the postnatal period. Whether a couple choose to birth their baby at home or in hospital, a Doula will support them in the decisions they make. Bringing new life into the world is the most important and rewarding journey a woman will ever embark on. For this reason a Doula will provide unbiased information and support couples to make informed decisions. When necessary, a Doula will advocate for the labouring woman and attempt to ensure her choices are honoured. A Doula’s aim is to treat each member of the birth team with respect and compassion. Generally a Doula will bring a deep understanding of the birth process (both clinically and spiritually), a total belief in the power of women, and a skilled set of hands to the chosen birth environment. Doulas aim to provide nurturing and caring energy that will assist women to find their own strength and creative capacity to give birth.

A Doula’s work with women during pregnancy may include the sharing of information regarding conventional and alternative health care including: nutrition, relaxation, exercise and simple effective measures to help alleviate the many possible discomforts of pregnancy. Throughout labour, at home, in transit and at the hospital, a Doula will stay with the new mum until breastfeeding is established and the woman indicates she is ready for the Doula to leave. Unlike a midwife, who in a hospital setting may be caring for several labouring women at the one time and have her shift end mid labour, a Doula will stay with the labouring woman throughout her entire labour. Having had the opportunity throughout pregnancy to form a trusting relationship with the woman the Doula is able to support the woman and her birth support team in a way that will be of the greatest benefit to the birthing woman and her baby.

A Doula visits the new mum postnatally, in hospital and at home to provide information and support regarding breastfeeding and post natal care. She will also often be available to help with practical tasks like cooking, cleaning, washing, siblings and all other things that assist in the smooth running of caring for a newborn. This allows women to focus on the most important task at hand – being with her new baby.

Most women benefit from their partners support during childbirth and fortunately many fathers want to experience the amazing journey of the birth of their child. Generally, men want to be actively involved to ease their partner’s labour pain and welcome the baby at the moment of birth. A father’s participation at birth classes, prenatal visits and in the delivery suite is now a common occurrence. At times however we sometimes forget that the expectations of his role as a “labour coach” may, due to fear, anxiety and lack of experience, be filled with apprehension and therefore difficult to fulfill. A Doula can support a father to experience this special time with confidence. This also greatly enhances the birthing woman’s experience. A Doula sees the father as the number one support person and never compromises his role in the birth journey.

Understanding that each woman is unique in the amount of support she requires, most Doulas will, offer “extra postnatal care” packages and sleepover rates. All Doula visits are in the couple’s home as this is more personal and convenient for the woman and her partner.

The benefits of Doula care have been recognised world wide. The Society of Obstetrician and Gynecologists Canada, the World Health Organisation and the International Association of spiritual Midwifery are among the many health organisations that value the benefits that Doulas provide to women throughout their pregnancy and labour. Doulas of North America (D.O.N.A) is an international association of over 3000 Doulas who are trained to provide high quality labour support. D.O.N.A. Doulas are specially trained and certified by the organisation in order to ensure the high quality of the services that their members provide. One of the most critical areas where proper training and professional attitude is acknowledged is in the interaction between the Doula and the other childbirth staff such as doctors, midwives and nurses. Kathie Lindstrom is the current president of D.O.N.A. In comments to the Optimal Wellness Centre she said that “The training that Doulas receive enables them to relate to other health care professionals in such a way that they do not feel threatened, but rather, welcome Doulas as they know their jobs will be easier and outcomes better.”

Denise Love is the founder of Doula Express, a Doula training and certification school in Sydney. As well as providing thorough, high quality training for Australian Doulas, Denise also provides an Australia wide Doula contact and information service for couples wishing to engage the services of a qualified or trainee Doula.

Given the valuable role of a Doula a question remains as to why Doulas aren’t more widely used. According to D.O.N.A and Doula Express, one of the biggest obstacles of having Doulas become an integral part of the child birth process, is simply the lack of education among the general population, health care professionals and insurance companies. As people become more aware of the difference that Doulas can make, their role will become more and more prominent. As stated by Michel Odent, “If a Doula were a drug it would be unethical not to use it.”

For further information on Doula Care please contact Shelley on 0413223389. A useful reference for further information is “Mothering the Mother: How a Doula can help you have a shorter, easier and healthier birth” by M. Klauss, P. Klauss and P. Kendell.

Advantages to engaging a Doula

Many studies have shown that there are many proven advantages to engaging the services of a professional Doula. Some of these include:

• 50% reduction in caesarean rate
• 25% shorter labour (due to confidence and relaxation gained by experienced support)
• 60% reduction in epidural requests (enhanced coping ability from support)
• 40% reduction in oxytocin use
• 40% reduction in forceps delivery
• Reduced chances of health complications and hospitalization of baby
• Reduced chance of maternal fever and infection (due to less interventions)
• Reduced maternal bleeding post birth
• Reduced levels of anxiety
• Increased chance of successful breastfeeding
• Results in more positive birth experience
• Mothers feel more in control
• Increased chance of spontaneous vaginal birth
• Mothers feel more secure (from presence of experienced caring birth assistant)
• Reduced incidence of post natal depression

* References on request.