Parents who consider hiring a doula often ask some of the following questions. In response, we are exploring and clarifying the doula role and some of the reasons for hiring one.
1. What exactly does a doula do?
The “textbook” answer – that many of you have probably already heard – is that a doula provides continuous physical, emotional and informational support to a laboring mother and her partner throughout the labor and birth process.
But what this looks like in practice spans a very wide spectrum of scenarios. Since a mother doesn’t often know ahead of time exactly what will be most helpful to her in labor, probably the most important trait that a doula brings is the ability to be adaptable and adjust her style according to the individual needs of the mother and of the moment; to read the situation and act appropriately.
Sometimes, a mother needs to be left completely alone to feel safe and secure – any noise or touch creates more stimulation than she can handle in addition to her labor. Sometimes, a mother needs to have continuous eye contact with her partner. Sometimes the couple is doing well on their own and the doula can help carry bags, fetch water, and take care of other errands so that the parents never need to be separated for a moment. Sometimes a mother needs to be held, massaged, loved and encouraged by another woman who understands what she is going through. At times, labor support requires some trial and error for the doula to figure out what is most effective and as labor progresses, the doula may need to adjust her role, style or technique based on the mother’s changing needs.
2. Why would I need a doula when my partner/husband is prepared and wants to support me?
This can be a tough question to answer. It is true that the partner knows the mother well and has a very intimate connection with her and the baby; however the partner is also very emotionally involved, most likely not an experienced birth attendant and may benefit from some support, reassurance and guidance him/herself. Many parents have expressed concern that a doula will take away from the partner's role or experience. On the contrary, doulas want the partner to be intimately involved and work to keep the couple connected throughout the labor. Ideally, the partner and doula working together create the ultimate support team.
It is also important to realize that there are some unique elements that a doula can bring to the birth that may be difficult for a husband or partner:
Experience. A seasoned doula has usually attended dozens, sometimes hundreds of births and can draw upon those experiences to guide her support. A newer doula has read countless books and websites, attended a training(s), and/or watched birth films and is knowledgeable and eager to help. For the partner, the birth is likely the first or one of a small number, so it may be difficult for him/her to establish a helpful frame of reference. Situations such as a baby in an awkward position, a mother battling nausea, a mother who panics, or other unexpected events, are likely situations that the doula has seen in the past and has learned various methods that can help.
Instinct. Many doulas have had children of their own and have a love and passion for birth and helping other women have a positive experience. Attending many births and/or having given birth to her own children gives a doula a powerful personal experience from which to draw ideas and tools for support. Often, though not always, it is easier for women, especially those who have gone through it, to instinctively know how to support a laboring woman than it is for men.
Objectivity. A doula will be able to maintain a bit more emotional distance in the midst of the passion and intensity of labor than a husband or partner. It’s not that she doesn’t care about the laboring mother, but rather that she is able to take a step back and look at the bigger picture, keeping a more objective viewpoint. This will help her provide the information that parents need to make a decision based on evidence and experience rather than out of emotions or fear. Parents who are given tools to be at the center of the decision-making at every step of the labor and birth process are more likely to come out on the other side feeling respected and cared for. This will create a joyful and positive experience and get the family off to a healthy start.
If a mother does not have a partner or other support person, the doula’s role possibly becomes even more critical, ensuring that the laboring mother will never have a moment when she will face her labor alone.
3. I get the idea of labor support, but won’t my midwife or nurse do that?
Maybe. Some labor and delivery nurses and midwives provide wonderful labor support, while others do not consider that to be part of their role at all or are too busy to have much time with the mother in that capacity. The problem with counting on the nurse or midwife for labor support is that no matter how wonderful she may be and no matter how much she may want to support her patient or client, that cannot be her primary concern. She has a job to do that includes monitoring, paperwork, and protocol. Ultimately, ensuring baby and mother’s health and safety is her primary focus, not providing comfort, support and encouragement to the laboring mother.
4. I’m not sure about having some stranger at my birth; wouldn’t it be better to have someone I’m already close to for support? Like my mom or sister?
Friends, moms, sisters, aunts, cousins and many other possibilities can make great labor support people. Anyone a mother chooses to invite to the birth that is going to enhance her experience, create a safe and secure space for her, and support her goals can make a great asset to the birth team. Doulas often work with family members to enhance their support or step in when they need a break. For a mother who finds companionship comforting, it is terrific to have a number of people nearby. With friends and family, it is important to keep in mind that some of the same limitations exist as with partners; it can be challenging for them to maintain objectivity, and without having attended many (or any) births, they may lack experience. In addition, your doula should not be a “stranger” by the time labor comes around. By then, she should have a well-established understanding of your goals, perspectives and personality, and the parents should be completely comfortable with her.
5. I plan to have an epidural or I may need a cesarean; is a doula still necessary?
No matter what your plans are for labor and delivery, it can be very beneficial to have an experienced, professional person with you whose primary task is to provide you with information and support. Sometimes suggestions, positions changes or a comforting face can make all the difference.
These questions are great starting points for conversations that can help you decide what is best for your birth experience. If you agree, please share this with your friends!
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