What does a doula do?

The word doula in ancient Greek means “female servant or slave.” In modern usage the term has come to mean “a woman who serves.” But serves how? There are at least two kinds of doulas: birth and postpartum. Here I am talking about birth doulas (for the difference between birth and postpartum doulas, take a look here).

The standard, official answer to this question, from DONA International’s own birth doula FAQ page, is this:

A birth doula is a person trained and experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth.

To that I would add that I also provide spiritual support, but otherwise I think it is a pretty good definition, and pretty clear, except for the middle bit. Just what does continuous physical, emotional, spiritual and informational support look like? Let’s break it down.

Continuous.

This means that as your doula I will not leave your side (excepting, of course, the occasional potty break. And the I-sense-you-need-a-moment-alone-with-your-partner break. Otherwise, no breaks in care!). You should know that your OB/GYN will only make sporadic appearances, if s/he is on call during your labor at all. Your labor and delivery nurse will have other tasks/patients to attend to, and then she will go home when her shift ends. But I will stay with you no matter how long it takes to get your baby out. Plus, you don’t have to wait until you are in the hospital to call on me for help. I will come to your home, if desired, and help you labor there before we all head to the hospital together. That is, unless you’re planning a home birth, in which case we will stay home together.

Physical.

The sort of physical support I provide includes:

photo courtesy of Shelley Moon Photography

photo courtesy of Shelley Moon Photography

  • creating a calm environment: dimming the lights, working to keep the door closed, explaining in a polite but firm way to your persistent and unwanted visitors that now is not a good time to hang out.
  • suggesting different body positions. Read any book on labor and you will discover that lying flat on one’s back is usually not the optimal labor position. I can suggest a long list of positions to try, tailored to assist you where you are in your labor and what sort of pain you are experiencing.
  • touch: even something as simple as holding a hand can be a huge help to a woman in labor! I am also skilled at certain kinds of comforting touch, counter pressure and hip squeezes, which can make all the difference in avoiding or delaying the use of pain medications.
  • bringing a hot or cold pack and putting it in the right spot at the right time, keeping you well supplied in ice chips.
  • helping you make use of water as a pain management tool, either in the shower or the tub.

Emotional.

Birth is a hugely emotional experience. That seems so obvious a statement, yet I think we often allow the medical/physical aspects of birth to overshadow this other fundamental aspect of our being. I am skilled at listening, identifying emotional issues and facilitating your working through those issues  before, during and after your birth. And this goes for both the mother and her partner. The transition to parenthood is not easy. Having someone trained in providing emotional support at your side will help.

Spiritual.

I believe birth is a transformative experience, which involves each part of our total being, including our spirits. I mean, you are participating in creating and bringing forth a new life, for crying out loud. What could be more spiritual than that?

I am an ordained minister who has worked through four units (that’s one full year’s worth) of Clinical Pastoral Education (CPE). CPE is designed to help pastoral caregivers improve their ability to provide emotional and spiritual support to others, in whatever field of practice they choose. I choose to work with pregnant women and their partners, walking beside them in this journey to welcoming a new life into the world, helping to facilitate the spiritual growth inherent in the miracle of birth.

Informational.

Read through a book or take a class on childbirth (and these are both really good ideas, whether or not you hire a doula!), and you will see that there is just so much to keep track of. You need help. I read somewhere that having a baby without a doula is like traveling to a foreign city without hiring a tour guide. It is certainly possible, but you are more likely to get stressed out, feel lost, and put a strain on your relationship with your traveling partner. While it has its limits, I think there is definitely something to this analogy. As your doula, a big part of what I do is to help you navigate the confusing world of medical jargon. I can explain what is going on, what you should look out for, and suggest things you might want to try to make the experience more pleasant. My hope is that then you will feel more relaxed and enjoy yourself!

I should make absolutely clear here that I am not a medical professional. I do not give medical advice. I do not contradict your medical care provider. What I do is listen to what you want and help you write out your birth preferences so that you can discuss them with your doctor or midwife. During labor I can help you understand your medical team’s suggestions, enabling you to make the most informed decisions possible. I will give you information, but all decisions made are yours