Why you should hire a birth doula
Doula
Birth worker
Birth companion
Birth assistant
Birth coach …
These are all different names used to describe someone who provides continuous labour support to a birther and their partner during the perinatal period.
Doula’s have been around for centuries, disguised under the name of Aunty or Sister. If we look back to the last century, most women would have attended and witnessed many births by the time they reached adulthood. Yet today, most people’s images of birth are those of Hollywood; the classic woman, legs in stirrups, purple faced, screaming her baby out. And while primal sounds can be REAL, the rest of how birth is portrayed in media is false.
Birth is a powerful and potentially transformational life event, yet 1 in 3 women characterize their births as traumatic. Through research, we have come to learn that one of the main predictors of birth trauma is lack of support. Your partner may want to show up for you, but isn’t quite sure how or what they should do. Here is where a doula can step in.
In this blog post we will discuss:
What a doula is
Ways doulas provide support (including what doulas do NOT do)
Evidence on doulas and birth outcomes
Common misconceptions
Doula’s and cost
Let’s start by addressing what a birth doula is.
A labour or birth doula is a non-medical birth companion who provides continuous support to a birthing person and their family during the entire perinatal period.
A doula is NOT a health care worker, meaning we do not replace a midwife or OB as your primary healthcare provider. Instead, we provide a different type of invaluable support.
How A Doula Provides Support
Let’s break it down into 3 categories.
Physical and Emotional Support
This could look like:
Providing you with physical touch or pressure during intense contractions.
Providing encouragement or reassurance that what you are experiencing is normal.
Repeating affirmations or leading you through breathwork.
Applying warm or cold cloths to your forehead or the back of your neck.
Providing food, drinks or ice chips.
Debriefing after your birth and listening to your experience with empathy.
Creating a calm environment - soft lightening and music.
Supporting you before your healthcare provider is able to. Midwives, OB’s and nurses typically don’t provide support until active labour has begun. Prodromal labour (pre-labour) can sometimes last hours, or even days and is often a time when support is needed.
Educational Support
This could look like:
Providing additional pregnancy and birth information that may be left out during rushed prenatal appointments with your provider.
Being available for any questions throughout your pregnancy.
Providing evidence based information so you can make informed choices surrounding your birth.
Being available for a 3am text or call asking “AM I IN LABOUR?”
Providing suggestions for how to progress labour faster, pain management strategies or positions to move into if baby is malpositioned.
Advocacy
As a doula, I will never make a decision on your behalf. Instead, my advocacy role includes:
Asking you what you want and supporting you in that decision.
Amplifying your voice if you are being ignored or dismissed.
Facilitating communication between you, your partner and the healthcare team.
Helping you to feel supported, listened to and respected during your birth - all things that can prevent birth trauma.
What a doula does not do:
Vaginal checks
Monitoring fetal heart rate
Taking blood pressure readings
Taking temperature checks
Providing any medical advice
Inserting IV’s or administering any form of medication
These tasks (and many more) are being completed by the medical staff and tend to keep them very busy so if you are relying on them to provide you with labour support, you might be disappointed.
So, why should you hire a doula?
Hiring a birth doula can make a huge difference in how you experience the birth of your child. Birthers that are supported by doulas during their labour experience:
A 39% decrease in the risk of Cesarean
15% increase in the likelihood of a spontaneous vaginal birth
10% decrease in use of any medications for pain relief
Shorter labours by 41 minutes on average
38% decrease in the baby’s risk of a low five minute Apgar score
31% decrease in the risk of being dissatisfied with the birth experience
Other benefits include:
Labour and birth being less painful (ummm yes please!)
Feeling more in control of your birth
Having less anxiety after birth
Feelings of increased self confidence
Lower incidences of postpartum depression
Increased incidence of breastfeeding at 6 weeks (if this is something you care about or want)
Improved relationships with your partner (if that is relevant)
Common misconceptions about doulas:
Doula’s replace your partner as your main support person. I often hear “I want my partner to be my main support person”. That is wonderful and I want that for you too! As a doula, I am here to support the entire birth team, including your partner. Odds are your partner has never been to a birth, isn’t knowledgeable on medical procedures, doesn’t understand the healthcare system, and is going on their own emotional journey needing support too!
Doula’s want you to have an unmedicated home birth with absolutely no medical interventions. This might be surprising, but I actually don’t care what kind of birth you want. What I care about is that you are supported, that you are free to make your own informed decisions, and that you feel autonomy, respect and choice. If you want to have an epidural I am here for it. If you want to schedule a cesarean, I am here for it. If you want to give birth in a field with doves singing above you … well I’ll see what we can do, but I’m totally here for that too.
I don’t need a doula I’m planning on having an epidural. Great! Here’s the thing. It’s generally recommended that you wait until you are at least 6cm dilated to get an epidural. This reduces the likelihood of the epidural slowing down the labour and leading to more interventions that could increase your risk of a cesarean. It can take hours, or even days to dilate to 6cm, and during this time you will likely need support. Not to mention the entire pregnancy before birth and the postpartum period where a doula supports you as well. It’s also estimated that for approximately 10% of people epidurals either work partially or not at all. So even with a planned epidural doula support can be really valuable.
The elephant in the room.
We can’t talk about doula support without discussing the main hindrance. Cost. Doulas aren’t free.
For many people, a doula is not financially accessible. My wish is that doulas were considered essential support people and provided to families as part of the healthcare team but until that happens here are some suggestions for ways to finance doula services.
If your doula is also another health professional like a naturopath or RMT, you may be able to pay for some of their fees using your health benefits.
Doulas may offer finance plans, ask!
You can hire a student doula who may offer their services for reduced prices.
You can put a doula on your registry and have friends and family gift it to you.
Consider getting some of the your baby stuff second hand, redistributing some of those finances towards birth and postpartum support.
The bottom line is, doula’s provide an invaluable form of support for a birthing person and their partner during labour. They are one of the easiest and most highly effectives ways to improve birth outcomes, decrease risk of cesarean, and increase birth satisfaction.
References:
Bohren, Meghan A et al. “Continuous support for women during childbirth.” The Cochrane database of systematic reviews vol. 7,7 CD003766. 6 Jul. 2017, doi:10.1002/14651858.CD003766.pub6
Evidence on: Doulas. Evidence Based Birth https://evidencebasedbirth.com/the-evidence-for-doulas/
Soet JE, Brack GA, DiIorio C. Prevalence and predictors of women's experience of psychological trauma during childbirth. Birth. 2003;30(1):36–46.
