What is a Doula?

A doula is a non-medical labour assistant, who provides continuous physical and emotional support to the birthing woman and her partner throughout labour and birth. Doulas may also support the woman to communicate her needs and wishes to the medical team. However, her key role is the creation of a birth environment which meets the woman's needs for safety, warmth and protection of disturbance.

Evidence shows that having continuous support during labour from someone -- whether that person is a midwife, partner, friend or doula has many benefits for the mother and baby. However, with several birth outcomes, doulas have a stronger effect than other types of support persons (Hodnett et al. 2012).

A doula offers the one-to-one continuous care that the hospital staff team may be unable to provide. The doula role provides the birthing woman and her partner with three key things:

• Physical and emotional support during pregnancy, labour and birth;
• Facilitation of effective communication with the midwife or doctor during labour and birth
• The creation of a peaceful and respectful space within which the woman can respond instinctively to the needs of her body and birth her baby with dignity and satisfaction.

Physical and emotional support

Doulas are knowledgeable and experienced in labour and birth and are able to offer tools and strategies for improving the woman’s comfort and managing pain during labour. The doula will also be able to make suggestions to maintain the safety of birth and to increase its efficiency.

The doula’s role is also to offer the couple the emotional to achieve their goals for the birth rather than a particular kind of birth. This ensures that the woman experiences the best birth possible on the day.

The doula can provide the partner with minute to minute reassurance that all is well and enable the partner to participate in supporting the laboring woman to the degree to which they feel comfortable. Additional support during a long labour, can mean that the partner is able to rest. This makes it easier for the partner to enjoy the process and maintain a clear perspective which can aid in informed decision-making.

Facilitation of effective communication with the medical team

The doula can support the woman and her partner by providing them with cues to ask the midwife or doctor the right questions about their care. This questioning process, enables the woman to secure the information she needs in order to make informed decisions during labour and birth. When a woman has been supported to make the decisions which are right for her during labour, her levels of satisfaction with the outcome of the birth will be high.

The creation of a peaceful and respectful birth environment

All labouring women need quiet, warmth, privacy and darkness in order to minimize adrenaline release during labour and maximize the natural anaesthetic effects provided by the body’s endorphins. The doula is able to work with the partner and the medical team in order to meet these basic needs and create a birth environment which will maintain the safety of the process and ensure its efficiency.

What services to Doula's provide?

The services doula’s provide, often include:

• meeting before the birth to discuss your birth preferences or provide support to develop a birth plan.
• access to books, videos and other resources on birth, breastfeeding and early parenting.
• being on-call for you 24 hours a day, from the beginning of the 38^th week and until you go into labour.
• remaining with you continuously once labour has begun and until after your baby is born.
• using non-medical comfort techniques for labour and birth including massage, breathwork, heat/cold therapy, hydrotherapy, positioning, guided visualization and enhancing privacy.
• facilitating effective communication between you and your midwife/doctor.
• documenting your labour and birth through a written birth log, photography or video as desired.
• meeting with you after the birth to discuss the birth and provide you with support around early parenting issues.

What do Doula's not provide?

Doulas are NOT medical professionals and so they do not:

• perform clinical tasks such as vaginal exams or fetal heart monitoring
• give medical advice or diagnose conditions
• replace the role of your husband or partner
• deliver the baby

References

Hodnett, E. D., S. Gates, et al. (2012). “Continuous support for women during childbirth.” Cochrane database of systematic reviews: CD003766.