What a Doula does...
Guiding the birthing person and their partner through labour Suggesting techniques in labour, such as breathing, relaxation techniques, movement, and positioning Helping them find evidence-based information about different options in pregnancy and childbirth. Helping explain medical procedures before or as they occur. Helping the partner understand what’s going on with their loved one’s labour. A doula is a companion who supports a birthing person during labour and birth. Birth doulas are trained to provide continuous, one-on-one care, as well as information, physical support, and emotional support to birthing persons and their partners. What does a doula do? Doulas nurture and support the birthing person throughout labour and birth. Their essential role is to provide continuous labour support to the mother, no matter what decisions the mother makes or how she gives birth. The doula’s role and agenda are tied solely to the birthing person’s agenda. This is also known as primacy of interest. In other words, a doula’s primary responsibility is to the birthing person. A doula provides emotional, educational and physical support. One of the doula’s primary goals is to care for the mother’s emotional health and enhance her ability to have positive birth memories. A doula provides information that helps the woman make informed decisions in conjunction with her healthcare providers. A doula provides Informational support to help keep the birthing person and their partner informed about what’s going on with the course of labour, as well as provide them with access to evidence-based information about birth options. Aspects of informational support include: Doulas do not contradict health care providers. The woman and her family have chosen a provider they presumably trust. A doulas offer guidance and community resource referrals to families regarding maternal self care, lactation, and other issues pertinent to healthy parenting through the first six weeks postpartum. Doulas can provide a bridge in the maternity care gap. Continuous labour support has been shown to have positive pregnancy outcome benefits, including improved satisfaction with the birth and a rise in self-esteem of the mother. This could positively impact the mother-baby relationship in the postpartum period as well as breastfeeding initiation and continuance.
What a Doula does not do...
-They do not perform clinical tasks such as vaginal exams or fetal heart monitoring -They do not give medical advice or diagnose conditions -They do not make decisions for the client (medical or otherwise) -They do not pressure the birthing person into certain choices just because that’s what they prefer. -They do not take over the role of the partner -They do not catch the baby -They do not change shifts.
Question: What does doula support look like?
Answer:
Physical support from a doula includes the use of massage, pressure, and soothing touch.
Doulas create a calm environment, assist with water therapy, and help keep you nourished with food, and drinks. Emotional support from doulas helps people feel a sense of pride and empowerment after the birth.
Examples of emotional support include encouragement and praise, helping you see your situation more positively, keeping you company, showing that they care for you, and helping you debrief after the birth.
Doulas can also support you with information during pregnancy and birth. For example, they can guide you and your partner through labor and suggest techniques like breathing, relaxation, movement, and changing positions.
Doulas help you find evidence-based information about your options, and they can help explain medical procedures.
As far as advocacy goes, most doulas will not speak on your behalf. However, doulas should support you in your right to make decisions about your body and your baby. They will also use advocacy techniques such as encouraging you to ask questions and speak up for what you want.
Doulas can also enhance communication between parents and providers. When the woman and her family speak directly with her healthcare providers, it reduces risk of miscommunication and increases shared decision making.
Doulas do not contradict health care providers.
Question: What is the evidence on doulas?
Answer:
There have been 26 randomized trials that tested the effects of continuous labor support on more than 15,000 people giving birth. Overall, people who receive continuous support are more likely to have a normal vaginal birth and less likely to use pain medication, have negative feelings about childbirth, and undergo Caesareans.
In addition, their labors are shorter and their babies are less likely to have complications at birth or be admitted to a NICU. In these studies, the best results occurred when the continuous support was provided by a trained doula— someone who was not a staff member at the hospital and not part of the birthing person’s social network.
Question: How can doulas work with partners?
Answer:
Ideally, doulas and the birth partner (i.e. spouse, partner, family member) work together to improve the mother’s birth. Studies have shown that the most positive birth experiences for fathers/partners are ones where they have continuous support from a doula or midwife.
In one important randomized trial, adding a doula to a supportive partner reduced Caesarean rates from 25% down to 13%. These differences were even more apparent with a labour induction. When labour was induced, the Caesarean rate was 59% with a partner alone, and 13% when partners worked together with doulas.
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Question: What’s the bottom line?
Answer:
Of all the ways birth outcomes could be improved, continuous labour support seems like one of the most important and basic needs for birthing people. Research has shown that labour support from doulas is both risk-free and highly effective.
Question: IS A DOULA LIKE A MIDWIFE?
Answer:
No, a doula is NOT "just like a midwife"!
A doula does not and is not qualified to perform any medical procedures including, cervical checks, blood pressure checks, fetal heart rate monitoring, delivering/catching the baby etc. A doula is NOT and does NOT replace a medical care provider such as a midwife or an obstetrician.
Question: What if I don't want to birth naturally?
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Answer:
How you want to birth is completely up to you. A doula is there to support your choices and comfort you with evidence based strategies for you to have the best birth experience. Whether that be induction, cesarean, augmented labor, freebirth etc.
Question: What if I schedule a cesarean?
Answer:
As your doula, I will accompany you to the hospital and provide support while you are being prepared for the birth and then when you are in recovery.
If permitted, I will accompany you to the operating room along with your partner. Most of all I will remind you and everyone else that this isn’t a medical event, it is the birth of your precious baby!
1. Bohren, M.A., Hofmeyr, G., Sakala, C., et al. (2017). “Continuous support for women during childbirth.” Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD003766. 2. Johansson, M., Fenwick, J., & Premberg, A. (2015). “A meta-synthesis of fathers’ experiences of their partner’s labour and the birth of their baby.” Midwifery 31(1): 9-18. 3. Jordan, C. (2013). “Therapeutic presence and continuous labor support.” In Best Practices in Midwifery, Ed. by Anderson, B. A. & Stone, Sjourna. E. 4. McGrath, S. K. and Kennell, J. H. (2008). “A randomized controlled trial of continuous labor support for middle-class couples: effect on Cesarean delivery rates”. Birth 2008; 25:3. 5. Morton, C. H. and Clift, E. G. (2014). Birth Ambassadors. Texas: Praeclarus Press