What do they do? Why do doulas exist?

Humans have been giving birth for thousands of years, and have undoubtedly had support people, doulas or not, by their sides. Throughout the evolution of humans giving birth, the role of doulas has evolved to become known as birth support people. They can be an integral member of your birth and parenting team. But, what is a doula?

Well you’re in luck because this post dives into the role of doulas and how they benefit the birth process, both before, during and after.

The History of Doulas

The word ‘doula’ is derived from an ancient Greek term ‘doule’. Its meaning is of a female slave, or of a female bondmaid.

Although the term has some less than appealing historical meaning, the term today represents a group of trained professionals who support others through medically significant events. This means support is offered by providing their clients with information, emotional support and physical comfort.

But don’t be confused with the term ‘medically significant’. This just means that doulas are present at events related to the medical field.

Most notably, doulas are recognized for supporting reproductive events such as birth, miscarriage, stillbirth, pregnancy termination (abortion), or infertility and menopause. There are also doulas who support non-reproductive events such as end-of-life care and death. But please keep in mind, a doula does not offer any type of medical services or treatments. They are there to support their clients who must make decisions about any type of medical service or treatment.

The Changing Landscape of Birth Support

The physiology of giving birth has significantly changed as humans began to walk upright, leading to smaller pelvis’s, and the brain significantly increasing in size.

Smaller pelvis + bigger brains = Birth complexities

Birth complexities mean birthing people need the help of other people who are experienced in labour and delivery of babies. Before modern medicine, female relatives and/or midwives were common people to attend births.

As modern medicine became more popular and influence from the field of obstetrics began to change the way humans gave birth, the role of doulas became recognized as integral to birth work. They became people who attend births at the request of birthing people.

Labour & birth doulas are hired by their clients, not the medical or midwife professions, and therefore are dedicated to supporting only their clients. Their goal is to ensure their clients have the opportunity for the best birth experience possible.

Postpartum doulas have also gained recognition for their committed support during the recovery period following birth. As birth is a significant physical event, it also requires adequate recovery time. Many cultures regard the ‘lying in period’ as a time for a person to recover from birth, establish feeding, and bond with their newborn.

Modern society and distance from relatives can make the ‘lying in period’ more difficult for some parents. This is where postpartum doulas offer informational and emotional support to new parents as they navigate the parental transition.

What is a Birth Doula?

A birth doula is trained professional who specifically supports birthing people and their partners.

Support normally beings in pregnancy and lasts shortly into the postpartum period, within a few days.

Birth doulas are an integral part of a birthing team because they complement the services and support of other health care providers, partners, family and friends. They also sometimes assist primary care staff by making suggestions for possible comfort measures for the birthing family.

How a labour & birth doula supports their client:

Provides information about medical interventions to support informed decision making.
Provides massage and other comfort measures during labour.
Offers words of encouragement and reassurance during labour.
Helps a client’s partner focus on the birth and take breaks when necessary.
Helps protect the birth environment based on the client’s wishes.

Overall, the goal of a birth doula is to provide the opportunity for the best possible birth experience.

What is a Postpartum Doula?

Postpartum recovery is an essential time for both birthing person, baby and their family. Not all birthing people have a large support network of family or close friends to help them during this period of recovery and transition. This is where a postpartum doula can be of value. They can offer both hands-on assistance, advice, and support following your birth.

How a postpartum doula supports their client:

Provides information about birth recovery and newborn care.
Provides support and troubleshooting with feeding.
Offers emotional support, advice, and comfort during the parental transition.
Helps with light chores, meal preparation, tending to your newborn or other children.
Supports all family members with their transition in welcoming a newborn to the family.

Overall, the goal of a postpartum doula is to support the best transition possible for a family with a newborn.

Doula Support as a Path to a Positive Experience

Doulas are trained professionals however, they are not medical professionals. They work alongside a team of your healthcare professionals to provide support to you during and after childbirth.

The goal of every doula (or I hope!) is to help birthing people achieve the healthiest, most satisfying birth experience possible. Because of this, they also have the ability to have a positive impact on the well-being of your family.

Doulas are available to help educate, inform, and support families through their decision making processes about pregnancy, birth, and postpartum recovery. Birth (and parenthood) is an emotionally and physically demanding experience. By hiring a doula, you are ensuring there is a constant support helping you navigate this life changing experience.

Doulas get to know you, your partner, and your family. They work with you to understand your birth and parenting wishes. In addition, they will also offer information about areas of birth or parenting less known to you to ensure you have all the information you need.

The main goal is to ensure you have the most positive experience possible. Doulas do this by supporting you emotionally, offering hands-on support where asked, and providing evidence based information in support of your informed decision making.

Providing Continuity of Support

Healthcare providers have multiple patients.

Nurses have shift changes.

Your partner may have work responsibilities or other children to tend to.

A doula’s sole focus is on their client – the birthing parent. You!

They keep their client’s interests and well-being top of mind while providing continuous support throughout labour and beyond.

If your partner needs a break from massage, your doula will take over.
No matter how many nurse shift changes, your doula will be your constant attendant.

Research has shown there are benefits to both birthing person and baby when a birthing person has continuous support from someone they trust (Cochrane, 2017).

10% decrease in the use of medications for pain relief
Shorter labours by an average of 41 minutes
38% decrease in a low 5 minute APGAR score
34% decrease in the risk of being dissatisfied with a birth experience.

Empowering Confident Decision Making

A doula is a member of a birthing persons’ support team. In other words, no one can replace a partner, a midwife, a healthcare provider, a nurse, a family member, nor a friend.

Every person in a support team has their specific and important role as it relates to the birthing person.

A doula can clarify healthcare related recommendations, bridge a gap in communication, provide evidence-based information, or simply hold space for emotions.

Confident decision making is the foundation for a positive birth experience.

Empowerment means feeling in control of your situation and your decision making. Your doula will empower you by providing the information and emotional support you need to confidently make decisions about your birth experience.

Doulas will advocate and support informed choice for their clients.

Informed choice supports confident decision making. A doula will ensure all available options are explained to you and that you understand the expected benefits and possible risks of your options. They will support informed choice throughout your pregnancy, birth, and postpartum recovery.

The Stats and Benefits

All of the advantages of a doula can be simplified to a few key take-aways.

A doula will:

Offer support both physically and emotionally.
Provide information to support informed consent and confident decision making.
Provide continuity to your birth team.
Promote and protect a space that provides the best opportunity for a positive birth experience.

The benefits of a doula have been supported by both researched and data. For those looking for more reasons to consider a doula, I’ll outline the numbers below.

Cochrane Review, 2012

34% decrease in the risk of being dissatisfied with the birth experience
31% decrease in use of Pitocin (synthetic Oxytocin)
28% decrease in the risk of Cesarean
12% increase in the likelihood of a vaginal birth

Klaus, Kennell and Klaus, 2012
Their research found that people who were supported by doulas are more likely to:

Report labour and birth as less painful
Feel more in control of birth
Have less anxiety after birth
Have more self-confidence
Be at a lower risk for postpartum depression
Be breastfeeding at 6 weeks
Have improved relationships with their partners

Outside the Scope of a Doula

A doula does not:

Provide any type of treatment or conduct medical exams.
Provide health or medical assessments.
Replace the benefits of a partner.
Make decisions for a birthing person or their partner.

Doctors and midwives are responsible for ensuring your health and safety, and that of your baby.
Nurses support your doctor or midwife in monitoring your health and safety.
Your partner offers connection and support as the person who knows you the best.
Family and friends offer support with love, gifts, words of encouragement, and much more.
A doula will be source of comfort and reassurance throughout the birth process and into parenthood.

Your doula will complement your support network in the way that benefits you the most. Here at LILEA Parenthood, I offer doula services tailored to the needs of you and your partner. I offer services related to the reproductive events of pregnancy, birth and infant loss.

If you’re looking for someone to add to your birth team, please take a look at my unique service offerings where I offer both education and support services as part of a holistic birth experience.

References:

DONA International. “What is a Doula.” DONA International. DONA International. February 15, 2022. Web.
Rebecca Dekker. “Evidence on: Doulas.” Evidence Based Birth. Evidence Based Birth. May 4, 2019. Web.
World Health Organization. “Why having a companion during labour and childbirth may be better for you.” World Health Organization. World Health Organization. March 18, 2019. Web.

What is a Doula? Diving into the real reason why Doulas exist.