HOW A DOULA CAN HELP ENHANCE BIRTH
By: Evelyn Conrad, ICCE, CD (DONA), CNMI

A doula is a professional labor assistant. She nurtures the couple during their birth experience. Her role is to offer guidance and help the partner support the mother. She also makes sure that the couple's needs are met. The doula enables the partner to assist at his/her own comfort level. Women who use doulas actually receive more physical support from their partners because the doula makes suggestions and encourages partner support.

Doulas do not perform clinical tasks, such as blood pressure, fetal heart checks, or vaginal exams. They provide physical and emotional support. They can offer reassurance, perspective, suggestions for labor progress, help with relaxation, massage, and positioning as well as other techniques for comfort.

When a couple goes through labor for the first time, they may have an unrealistic perception of what ordinarily happens during birth. Their preparedness is often based on material presented in childbirth classes, pregnancy books, and hearing both positive and negative birth stories from others. The helpful hand that the professional labor assistant gives is in no way a substitute for the quality medical care given by the hospital staff and the couples' personal health care attendant. The doula compliments the care and interfaces with all active participants. Doulas help to bridge these gaps and provide the continuity of support that is often an important element during this intense time. The doula also has the good fortune of building a relationship with the couple long before the "birth-day". She is responsible only for her clients and meeting their emotional and physical needs.

Research studies* show that the use of a doula significantly decreases the request for epidural anesthesia by 60%, a reduction in cesarean birth by 50%, reduction in oxytocin use by 40%, shortens labor by 25%, decreases the need for pain medication by 30%, and provides greater maternal satisfaction.

A doula meets with her clients before the birth to develop a rapport with the father and mother and to determine their needs and expectations. She is available for questions and support via telephone before and during labor. She accompanies the couple at the hospital during the birth. During the immediate postpartum period the doula encourages family bonding and assists with initial breastfeeding. She provides on call support for families after leaving the hospital and a postpartum visit.

The doula enhances the birth experience, by providing the necessary support to relax and enjoy the birth of your baby. She compliments rather than displaces the partner. She believes in a woman's ability to know her body, her labor and her baby. She knows that birth is a key life experience and understands the impact the birth experience can have on women's lives. She helps couples "Celebrate" the birth of their family.

*See Marshall Klaus, M.D.; Phyllis Klaus, M.Ed.; and John Kennell, M.D. Mothering the Mother. NY: Addison-Wesley Publishing, 1993.