This is my position paper for DONA Birth Doula certification.
*Please feel free to leave feedback in the comments section.*
The Purpose and Value of Labor Support
By Lisa Hart
Doula is a Greek word meaning “woman who serves.” The notion of a doula has been around for
millennia, as women have been assisting other women in labor and birth for
thousands of years. Birth is a highly
important experience in that where and how a woman births will have an impact
on her for the rest of her life. Giving
birth requires the energies of the body, mind, heart, and spirit, and as such,
will have a lasting effect on all. Birth
is a physical act that primes the mother for bonding and a lifetime
relationship with her baby. As birth is
most often a family affair, it is also important that the entire family, in
addition to the mother, feel supported.
A doula can be a support person for a mom as much as for a dad. A doula’s role shifts to accommodate the
unique dynamics of the birth she attends: sometimes it is one-on-one intimate
support with the mother, other times it is “coaching” Dad as he takes the
primary place as the woman’s support person.
Either way, there is a delicate balance that comes to fruition at every
birth and it is the doula’s role to recognize, honor, and support it.
It has been said that a woman who is treated well in labor
will carry that nurturing with her to the care of her baby. The love and support a woman receives in
labor sets the stage for that mother’s future relationship with her child. According to recent statistics, women who
birth with a doula in attendance are 34% less likely to experience dissatisfaction
in their birth experience. This is
critical in reducing the incidence of post-birth trauma and overall well-being.
Additional statistics of birth with a doula include:
31% decrease in the use of Pitocin
28% decrease in the risk of cesarean section
12% increase in the likelihood of spontaneous vaginal birth
9% decrease in the use of any medication for pain relief
14% decrease in the risk of newborns being admitted to the
NICU
Many have said that having a doula in attendance allows the
woman’s partner and other family members to relax and enjoy the birth
experience. Help persons can aid as much
or little as they are comfortable. With
the coming of a new age where fathers are expected to be not only present at
the birth but labor “coaches,” many feel the pressure of having to be the sole support
person, sometimes with little or no experience with labor or birth. This can be anxiety-provoking and detract
from the experience. With a skilled and
knowledgeable doula present, the father feels supported in his role supporting
the woman, and is also freed-up to eat, take small breaks if necessary, and
look to his own welfare.
The doula provides comfort techniques such as massage, use of
essential oils, heat and cold packs, hydrotherapy if available, position
changes, visualization, vocalization, and breathing. Her techniques will vary with each birth she
attends, as she strives to match the energy and rhythm of the birthing
woman. She ensures the mother stays
hydrated, nourished, and comfortable.
Lighting and temperature changes may be necessary. She is sensitive to and creates a safe and
comfortable atmosphere in the room and may even provide pictures, music,
battery-powered candles, and aromatherapy diffusers if permitted. Each doula is unique in what she brings to a
birth, but a basic “birth bag” should be toted with a few staples of birth
comfort and relaxation. It is often said
a doula’s best tools are her hands and her heart.
The doula has a responsibility to act in accordance with the
DONA International Code of Ethics, which outlines her responsibilities to
clients, colleagues, and society.
Namely, she is there to provide physical and emotional support to the
birthing mother. She is an advocate for
the mother’s wishes, and adheres to the written or unwritten “birth plan.” She does not speak on the mother’s
behalf. Rather, she educates the woman
and her partner, if applicable, to empower them to make their own
decisions. She acts as a buffer between
the woman and birthing staff, aiding in communication, explaining terminology
where necessary, and facilitating the woman’s wishes. She does not offer medical advice. Clinical tasks, such as vaginal exams, blood
pressure readings, and assessing fetal heart tones are outside the scope of the
role of a doula.
Quite often a doula will provide prenatal and postpartum
education and support, referring her client(s) to reading lists, websites, and
resources that will aid in the woman’s journey through pregnancy, birth, and
the postpartum period. She should
maintain a current list of resources in the community, and refer out when
necessary. A doula may maintain a “lending
library” of books and resources for her clients. She is also available for phone and email
support. A doula makes visits to the
home and should be able to help with breastfeeding and basic newborn care, and
recognize any symptoms that would be cause to refer out. A doula provides continuity of care in that
she arranges back-up during busy times and is able to refer a mother on if she
is for any reason unable to provide service.
She generally makes herself available during the “childbearing year,”
from pregnancy, through birth, and beyond.
A doula is an invaluable tool in helping a woman to achieve
the birth she so desires. From being a
resource to providing education and empowering the woman to make informed
decisions, then being there to see them through, doulas have been heralded as
those who “hold space” for beautiful, even sacred, birth.
Resources
Used:
DONA
International Code of Ethics
DONA
International Standards of Practice
DONA
International Position Paper: The Birth Doula’s Contribution to Modern
Maternity Care
Simkin:
The Birth Partner
Client
testimonials
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