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Monday, March 28, 2011

What does a doula do?

Right after "What is a doula?", "What does a doula do?" is probably the question I get asked the most!

In larger cities doulas are much more common and in-demand. But living in a small town and trying to develop a practice has presented unique challenges. Too few people have actually ever heard the word "doula" so it's difficult to convince people that they really need something they've never heard of and know nothing about.

A doula's role is unique to each mother she works for, as each mother has different needs for each pregnancy.

Much of a doula's job is to offer education and guidance. Pregnancy and labor often present a mother with many different decisions. Making a decision with confidence that it's right for you and your baby can be difficult if you don't understand all the nuances of each option. A doula is well educated and can explain every option and help her make the decision that falls best in line with the mother's birth plan.

Most often, doulas are called on to act as comforters. Doulas are trained in many different methods of drug-free pain management. You may be suprised to know how small things, like patterned breathing and guided visualization, can help manage pain. But so much of the comfort a doula offers is emotional. Birth is such a personal and transcendent experience for a woman. It can take her through the complete range of human emotions in a very short amount of time. Having continual support from an experienced woman is priceless! It offers the freedom to scream if you need to scream or cry if you need to cry. A doula is not there to hamper your emotions. She is there to allow you to confront them with love and understanding.

In many ways a doula is your cheer leader. Oftentimes she will gently remind you that your body is made to birth your baby. That you can give birth. And to celebrate with you as you get through each contraction. Unlike a doctor or nurse your doula is with you 100% of the time (except for brief bathroom breaks). She may suggest different positions or actions to help you get through when labor becomes particularly difficult. Unlike a doctor or nurse who may not support your wishes or respect your birth plan, a doula is always on your side!

Your doula will also help you to get off to the best possible start with breast feeding your baby. Doulas are trained in breast feeding support and can offer valuable advice and insight. Unfortunately, much of the art of breast feeding has been lost from everyday society. And the medical model of child birth doesn't usually provide adequate information or support.

Doulas are constantly seeking to expand on their practices and a lot of doulas will offer a bevy of other services outside of what I previously mentioned. Miscellaneous services a doula may offer include (but are not limited to):

Placenta Encapsulation- if you so choose, your placenta can be saved. A professional trained in placenta encapsulation will dry your placenta and grind it up, add herbs and put it into pill form for mom to take. I'll write about it in a seperate post but placentophagy (consumption of the placenta) has scores of benefits for mommy!

Accupressure/Massage- Activating certain pressure points has shown to be effective in relieving many difficulties during pregnancy. And we all know that massage can be very healing and relaxing.

Babywearing- Your doula might have received special training in babywearing education. Babywearing is an ancient and extremely beneficial practice that can cultivate healthy bonding between parent and baby.

TENS machine- Transcutaneous Electrical Nerve Stimulation unit is a machine that has electrical diodes that are applied to areas where mom is experiencing discomfort that block pain signals. Specialized training is required to use this device.

Blessingway ceremony- A blessingway is a mother-centered birth celebration. Typically a Blessingway is very spiritual and is tailored to the mother's individual spiritual beliefs. Doulas who perform Blessingways will guide a mother's guest through ceremonies meant to bless the woman on her way to becoming a mother by honoring her strength, adorning her body (i.e brushing her hair, decorating her belly, washing her feet etc...) and offering small gifts, prayers and positive thoughts.

Aromatherapy- The use of essential oils in different fragrances to relax the mother and ease discomfort.

These are just a few examples of the other services a doula may offer. When interviewing a potential doula be sure to ask what extra services she offers. Extra services may cost more but it can be well worth it.

Even if your doula doesn't offer any services outside of the standard model of practice there are many benefits to having a doula present for your birth.

Studies show that labor with a doula is actually shorter than labor without (a whopping 90 minutes shorter on average!!!)  Typically when I ask a potential client what her ideal birth would be one of the most common words used is "short". A shorter labor is ideal for many reasons and labor that is an entire hour and a half shorter than average could mean the difference between a drug free labor and using chemical pain management that can cascade into many different medical interventions you probably want to avoid.

Laboring with a doula often leads to less labor augmentation measures such as pitocin. Pitocin is a synthetic oxytocin (the hormone that starts labor). It's often administered to speed labor along. Unfortunately pitocin labor is much more difficult and painful than average labor and can cause your baby to go into distress.

Having a doula present for your labor can also drastically reduce the odds that you will require the aid of forceps or vaccuum extraction. These methods of removal are undesireable they can potentiallycause lasting injuries to your baby. Even if administered safely it can cause your child to have a head ache. This can inhibit their desire to initiate breast feeding and create bruises and sore spots on their tender little heads.

Overall having a doula present for your labor makes the experience better. The way you remember an experience as life changing as birth, is just as important as the experience itself. For a client to look back on her labor with fondness and satisfaction is a doulas goal. A mother can go against every aspect of her birth plan but as long as she can look back and be happy with what she's accomplished a doula has done her job correctly.

What a doula doesn't do...
There are so many things a doula contributes to child birth but there are clear cut things a doula does not do.

A doula does not replace a spouse or partner in labor. It's true that a woman whose spouse or partner is no longer present in her life, or can not be in attendance for the birth can greatly benefit from the presence of a doula. However, a doula is not there to get in between the mother and her partner. In fact, a doula encourages the partner to be an active participant in the birth. For this reason a doula is not only greatly appreciated by the mother but by her partner also.

A doula is not a medical professional. A doula can not prescribe or administer any medications or perform any medical procedures. She may recommend home remedies for common problems but it's merely on an advisory basis. She offers non-medical support only.

A doula does not make decisions for a mother nor can she offer or deny consent for any procedures on the mother's behalf. For example, if your doctor offers an epidural, even if that is against her birth plan, a doula may only remind mom that it runs counter to the established birth plan. She can not tell the doctor not to give it to her. Sometimes it can be difficult to stand up to a doctor and refuse consent for a procedure that you don't want, but a doula can only support your decision to do so.

I hope you found this informative. There are so many nuances to a doula's role in childbirth. I would like to get in to them all but that could fill entire volumes! This post is just to cover the basics. In the future I will dedicate entire posts to delving further into a specific detail of doula care but for now I hope you come away from this post with a good place to start on understanding what a doula contributes to child labor.

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