Doula

Nathan and I decided early on in the pregnancy that we would like to use a doula during labor. Below is concise information on what a doula does in case you're interested. We have our first meeting with our doula Bridget on November 10th. She's going to come to our house to talk about our labor choices and the services they provide. She is also a marathon runner and massage therapist too.

Looks like we might have to be cracking open the labor books after all. Yikes!

What is a labor doula?

Also called a childbirth or labor assistant, a labor doula is a trained woman who will stay with you throughout labor and birth. Dana Raphael first popularized the word "doula," a Greek word meaning "woman caregiver," in her 1973 book The Tender Gift (9). She used it to describe women who provided help and support to women after childbirth. However, the researchers who first studied the effects of female labor-support companions used the same term. Today, women who offer postpartum home-care services and women who do labor support both call themselves doulas, and some women do both. A labor doula "mothers the mother," that is, she does anything and everything a loving mother who is knowledgeable about childbirth would do (4). She encourages and comforts you, gives you information about what is happening to you, facilitates communication between you and medical staff and supports your decisions.

She makes suggestions on how you can best cope with labor and what will help labor progress smoothly. She rubs your back, wipes your sweaty face with cool cloths, holds your head should you vomit or helps support a leg during pushing. She is likely to be close to you, if not in actual physical contact, throughout labor. She can take pictures as well, and she looks after your partner's needs and the needs of others you have brought with you.

If you are having your baby at home, she prepares food, tidies up and does laundry after the birth.Many doulas carry items useful to their trade. These are such things as a birth ball, a large, sturdy ball that allows you to get into a variety of useful positions for labor; a rice sock, which can be heated and applied to relieve pain in your back or groin; or aromatherapy oils.

A labor doula generally makes one or more visits before the birth so that you can get to know her, and she can learn about your preferences, priorities and concerns. She usually makes at least one visit after the birth to review the experience. In addition, she is available by phone both before and after the birth for help, nonmedical advice, referrals or just to listen.Like a mother, though, labor doulas don't participate in any of the medical aspects of your care.

Some women, sometimes called monitrices, do have the skills to evaluate labor progress and monitor your vital signs.

What are the advantages of having a doula?

The evidence for the benefits of doula care is especially compelling. It is established by numerous random assignment trials, which produce the best research evidence because random assignment ensures that the comparison groups are truly similar. It has also been conducted with different socioeconomic groups in several countries and under various circumstances, which further strengthens its validity. An analysis of the random assignment trials on this topic concludes: "Given the clear benefits and no known risks. . . every effort should be made to ensure that all laboring women receive support, not only from those close to them but also from specially trained caregivers. This support should include continuous presence, the provision of hands-on comfort and encouragement (5)."

Compared with women receiving standard care, women accompanied throughout labor by a caring, experienced woman are more likely to:

feel less pain and anxiety in labor (6,16) f
eel that they were in control and that they coped well (2,5,12)
express greater satisfaction with the labor (2,5)
have higher self-esteem, including pride in their bodies' strength and performance and in themselves as women (2,5,6,16)
have an easier time with mothering and have better mothering skills (6,16)
express more positive feelings toward the baby (10)
report a better relationship with the father (9)
breastfeed longer (6,12,16)
experience less postpartum depression (6,16)

Women having continuous woman-to-woman support are less likely to have epidurals or narcotic pain medication, which reduces the incidence of adverse effects that may arise from their use (1,2,5,13).

This may at least partially explain why a doula's presence can reduce the:
length of labor (12,17)
need for intravenous Pitocin or "Pit" to stimulate stronger contractions (13,17)
number of episiotomies (an incision to enlarge the vaginal opening for birth) (3,4)
number of vacuum extractions or forceps deliveries (5,13,17)
cesarean rate (5,7,12,15)

In addition, because fewer medical interventions are needed, fewer babies:
are born in poor condition (1,5)
are admitted to special-care nurseries (11)
require evaluation for infection (8).



There is your child birth lesson for today : )