Your Doula Natasha

Pregnancy and childbirth is a unique season when the stories of two lives profoundly impact each other -- forever changed as a new story begins.

The Purpose and Value of Labour Support

By Natasha Ramírez

In the western world, medical advancements, social independence and the shift to more nuclear families, with extended families living at greater distances from one another, has made childbirth much more modernized, standardized and procedure-based than it was in previous generations. While some of these shifts have resulted in positive changes and better overall results for mothers and babies, the reality is that childbirth still is and will always be a unique human experience. Childbirth is not strictly a medical procedure, nor merely a physical change or challenge, but rather, it is a normal process and significant event in the life of the mother, her partner and the child, with its own unique emotional and mental experience. While much has changed in the last generations, what has not changed is that labouring mothers continue to need more emotional and physical support than medical advances and standardization provides. This is where the role of a doula continues to be a valuable support to mothers and their growing families.

Doula is an ancient Greek word which means "woman who serves." Today, birth doulas are trained to be a continuous support to labouring mothers and their partners through the exciting, but also emotionally and physically challenging process of childbirth, thus supporting and strengthening the family.

Doulas are not medically trained and do not replace the need for qualified care providers. Instead, they play a completely different role in supporting the labouring mother by providing physical and emotional comfort during active labour and into the early postpartum stages.[1] They also offer suggestions for physical comfort measures and emotional support in the highs and lows of labour, such as suggesting and assisting with different positions to ease labour pains, encouraging the use of movement, hot compress, basic massage and most importantly, offering encouragement and emotional and mental support.

Because doulas do not have medical responsibilities, do not perform any medical exams or procedures (such as vaginal exams etc.) and do not have to attend to other patients at the same time, they are free to be completely attentive to the labouring mother’s needs. This may be as simple as encouraging her while others focus on important medical tasks at hand, offering her water, helping her breathe through a strong contraction, or suggesting a change of positions or comfort measure to help ease discomfort. Doulas are, however, also trained in what is normal in childbirth and the basics of common medical procedures which allows them to reassure the concerned mother or partner.

In this regard, doulas are also able to provide couples with unbiased information and resources to help couples understand the process of both normal childbirth and medical procedures. This can help couples think ahead and plan for some possible unexpected events that can often occur during labour. This is done through listening beforehand to the mother and her partner’s desires and values, providing basic research-based information, and encouraging them to seek more information from medical professionals[2] to further allow the mother and partner to make the best decision for them and their baby. For example, encouraging the use of acronyms such as BRAND – What are the Benefits? What are the Risks? What are the Alternatives? What happens if we do Nothing? And then use this information to make their Decision. This equips the mother and her partner to make the best decision based on useful information and their personal values and needs, as well as help the mother have a sense of control and a voice in the decisions that need to be made during labour.[3]

The continuous support that a doula offers has been shown to decrease the need for medical interventions such as oxytocin for labour stimulation, forceps or cesareans.[4] The presence and support of a doula has also shown to improve a mother’s overall birth experience [5] and to decrease labour time.[6]

Doulas do not replace the important help and support of partners, but instead act as a support to the partner as well. Studies have shown that the support of a doula can free the partner to be more engaged, available and equipped to support the labouring mother and decrease the level of stress or anxiety a father or partner may feel during labour. [7]

The transition of a woman becoming a mother and a couple becoming a growing family is one of the most profound and unique human experiences -- one that is not only physically and emotionally challenging, but also miraculous as a new life is born. The need for encouragement, emotional support, physical touch, basic comfort measures and other support from another woman that was common in generations past continues, making the role of a doula valuable to mothers and their growing families.

[1] DONA International Birth Doula Standard of Practice, 2015
[2] DONA International Birth Doula Standard of Practice, 2015
[3] DONA International Code of Ethics, 2015
[4] The Doula Book, Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus, Third Edition, pg. 80
[5] DONA International Position Paper: The Birth Doula’s Role in Maternity Care, 2016
[6] The Doula Book, Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus, Third Edition, pg. 85
[7] The Doula Book, Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus, Third Edition, pgs. 83, 151-152