May 24, 2023

What is a doula and the essentials?

What is a doula and the essentials?

Written by Pamela Lim,

Expectant mothers may be familiar with the term "doula," but what exactly is a doula and how can they support women during pregnancy and childbirth? Doulas are trained professionals in childbirth who provide emotional, physical, and educational support to women throughout their pregnancy, labour, and postpartum journey with the aim of ensuring a safe, positive, and empowering birth experience. While the term doula typically refers to a birth companion, there are also antepartum and postpartum doulas who can offer additional support at different stages of motherhood. Let's delve into the benefits of having a doula present during labour and birth.

What does a Doula do?
Doulas provide emotional, physical, and educational support to expectant mothers, starting a few months before the baby is due. During this time, they help establish a relationship of trust and open communication where the mother can ask questions, express fears and concerns, and actively participate in creating a birth plan.

Doulas can offer a wealth of information about various techniques, including perineal massage, to help ease the stress and trauma that often accompanies childbirth. They are also available by phone to respond to any queries or concerns that may arise during pregnancy, even though they do not provide any medical care.

During childbirth, doulas are a constant and reassuring presence, providing comfort with pain-relief techniques such as breathing, relaxation, massage, and labouring positions. They encourage the partner to participate and offer reassurance throughout the process. Doulas act as advocates for the mother, supporting their specific desires for their birth experience, and ultimately, ensuring a safe and positive birth experience, regardless of whether it's an unmedicated birth or a caesarean.

After birth, many doulas help initiate breastfeeding and facilitate bonding between the baby and other family members.

What are the benefits of having a doula?
The presence of a doula during labour has been linked to numerous benefits. Studies have shown that when a doula is present, women are less likely to have a caesarean birth or use pain relief medications. They also report having a more positive childbirth experience.

Additionally, having a doula on the birth team can decrease the overall caesarean rate by 50%, the length of labour by 25%, the use of oxytocin by 40%, and requests for an epidural by 60%.

Doulas use touch and massage to reduce stress and anxiety during labour. This technique can help stimulate the production of natural oxytocin, which has been linked to feelings of well-being, drowsiness, and a higher pain threshold.

While recent studies indicate that oxytocin administered through medication may cross from the bloodstream into the brain, doulas can help mothers experience the benefits of oxytocin naturally, without the use of medication.

What about the father’s role when using a doula?
While doulas provide support during labour and birth, they are not meant to replace the role of fathers or partners. Instead, they work together to enhance the overall experience. In recent times, many partners choose to be more involved in the birth process. However, some prefer to participate in a less active role, without being the primary labour coach.

With the presence of a doula on the birth team, fathers can be free to participate in a way that is comfortable for them. Doulas can encourage partners to use comfort techniques and step in to give them a break when needed. This allows fathers to support their partners emotionally during labour and birth while enjoying the experience without the added pressure of remembering everything they learned in childbirth class.

Is a doula only helpful if planning an unmedicated birth?
No, a doula can be beneficial regardless of the type of birth planned. While doulas can help mothers who prefer unmedicated births, their primary role is to assist mothers in having a safe and positive birth experience.

For mothers who choose medicated births, doulas can provide emotional, informational, and physical support through labour, including helping to manage potential medication side effects. Doulas can also address needs beyond what medication can provide.

If a mother requires a caesarean birth, a doula can offer constant support and encouragement throughout the procedure, especially in unexpected situations that may leave her feeling unprepared or alone. This can allow the partner to attend to the newborn and accompany them to the nursery in case of any complications.

There are different types of doulas who provide support at different stages of the pregnancy and birth process.

Antepartum doulas support mothers who have been put on bed rest or are experiencing a high-risk pregnancy. They offer emotional, practical, informational, and physical support during a stressful and confusing time. 

Postpartum doulas provide support in the weeks following birth. They offer informational support on baby care, as well as physical support by helping with household tasks such as cleaning and cooking meals. They also provide emotional support by encouraging new mothers and helping them feel less overwhelmed.

Some doulas have training in multiple areas and can provide support as both an antepartum and postpartum doula, for example.

When choosing a doula, it's important to find someone whom you feel comfortable with. Many doulas offer a free initial consultation, so it's recommended to interview several until you find a good match.

Here are some sample questions you may want to ask when selecting a doula:

  • What kind of training or certification have you received as a doula?
  • What kind of services do you provide to clients? How do you support women during labour and birth?
  • What are your fees, and what do they include?
  • Are you available around my estimated due date? Do you limit the number of clients you take on each month?
  • What inspired you to become a doula, and how long have you been doing this work?
  • What is your philosophy or approach to childbirth, and how does it inform the way you support women during labour and birth?
  • Would you be willing to meet with me (and my partner, if applicable) before the birth to discuss my birth plan and answer any questions we might have?
  • What happens if for some reason you are not available when I go into labour? Do you have a backup doula you can refer me to?

 In conclusion, hiring a doula can have many benefits for expectant mothers and their partners, regardless of their birth plans. The emotional, informational, and physical support provided by doulas can make the childbirth experience more positive and less stressful. If you're considering hiring a doula, take the time to find someone you feel comfortable with and who aligns with your philosophy regarding childbirth. With the right doula by your side, you can have a more enjoyable and empowering birth experience.