— By the eighth month of my pregnancy, I had become accustomed to the blank stares and raised eyebrows I received at each mention of my doula. Maybe it was the “doo” or maybe it was the “lah,” but there was something about the tone and feel of the term that rendered the uninitiated people in my life either instantly confused or quickly judgmental.
The former were usually unfamiliar with the concept of a doula, or trained birth assistant, while the latter often held a preconceived notion of what it is that a doula does — one such person going so far as to ask if my doula would be dancing around me with a rain stick while I breathed through my contractions.
If a rain-stick dance is what I felt I needed to enhance my birth experience, there’s a good chance that a doula would deliver. But my reasons for enlisting the services of a doula were much more simple, going back to the origin of the word.
Doula is Greek for “a woman who serves,” and when considering the best — i.e., speediest and least painful — way to give birth naturally, being served seemed like the only way to go. “A doula is trained in the psychological and emotional aspects of labor and birth and is also trained in common hospital procedures, interventions and physical comfort measures,” explains Debbie Young, president of DONA International, a doula-certifying organization founded in 1992.
Comfortable, safe and informed
At first glance, it may be challenging to see where a doula fits into the birthing process. An obstetrician or midwife monitors the physical health and safety of the mother and baby and is the one who actually catches the newborn. Nurses and other hospital or birthing center staff see to outstanding medical needs like pain control and induction. And husbands, partners, mothers, sisters and friends provide a warm and nurturing support system for the laboring women.
This leaves the doula to fill in the missing piece of the birth experience. Since they focus solely on nonmedical care, doulas can spend their energy comforting and encouraging the mother and her family and helping them navigate the slew of questions and decisions that often need to be addressed during labor and delivery. “When I’m working with parents as a doula I want my role to be uncomplicated by the clinical aspects of birth,” says Young. “I’m there to meet their emotional needs, physical comfort needs, to help them with information.”
Though I was prepared to utilize my doula wholeheartedly, our son surprised us by arriving three weeks early in less than three hours. He was practically born in the car on the way to the hospital and we were unable to connect with our doula in time. From the reaction of my midwife — who sprinted to the delivery room to catch our kid — my experience is not the norm. Most parents-to-be get to reap the benefits of the doula with whom they have been talking and planning for months.
Take Alison Sinatra. The 34-year-old new mother in Woodstock, N.Y., believes that her doula’s strength and experience helped her navigate a three-day labor ending in an unexpected Caesarean section. “My doula was about as essential as my midwife because she was the guardian of my birth experience,” Sinatra says. “She’s been to thousands of births and I had complete confidence in her. I totally trusted that she would guide me. I felt that no matter what happened I would be completely fine because she was there.”
Sinatra, a proponent of natural birth, was thrown off when faced with the possibility of a C-section after days of labor. “To make a clear decision in the throes of labor is nearly impossible,” she says. “When someone asks you if you want a C-section you might immediately opt for yes if you didn’t have an experienced doula to bounce the idea off of.”
Partners are people, too
When a baby is on its way, the mother and child are the obvious stars of the show, but dads and other partners are also in for a life-changing experience. Doulas recognize this fact and work to ensure that the nonlaboring members of the family stay involved and acknowledged.
“Most dads or other partners are probably not as familiar with birth as a doula is, and they are also emotionally tied to the birth process,” Young says. “Including a doula who has been through the process many times gives the birth partner the chance to participate at his or her own level. The doula can ask the partner, “Remember how much she liked it when you were rubbing her feet?” or the doula can rub the mother’s feet herself while the partner holds her hand. That way we allow the birth partner to participate in a way that makes them comfortable while recognizing that they too are having a baby today. And there are times when I’m rubbing a dad’s back or getting a dad a glass of water.”
Sinatra appreciated this dad-centric attention while she was in labor. “My doula was tuned in to both of us and helped us work together in a deeper way,” she says. “And sometimes your husband is not enough. It can be very important to have someone to relieve your husband if he gets overwhelmed or if he needs to step out to get a sandwich. An experienced doula can give you that comfort. She is your point person, your front guard.”
Visit dona.org to find an experienced doula near you and to discover what questions to ask during the interviewing process (e.g., What training have you had? What is your philosophy about birth? Do you have one or more backup doulas? etc.).