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Doula: A basic breakdown..

Doulas provide labor support to women undergoing childbirth.  The term “doula” was developed in the 1960’s to describe the comforting presence of a friend during labor.

Historically, this type of labor support personnel has been used since the Greeks in ancient times, although they were servants and not professionals.  In modern times, doulas have seen widespread usage throughout the world. This recent popularity was brought on by clinical studies which showed that the presence of a doula reduced the need for medical intervention during labor as well as a higher success rate for breastfeeding during the first few days after birth.

The Role of The Doula

Since the 1980’s, doulas have been widely used to provide effective labor support.  As their roles began to expand, the duties of a doula began to differentiate.  Birth doulas, sometimes called, labor doulas, provide support mainly during labor.  They educate the mother on the most effective labor positions, main management techniques such as breathing exercises, and medical/non-medical options that can be used during delivery. They also offer a safe and comforting presence by providing companionship and emotional support.  In contrast, the role of a postpartum doula is to provide the same warm and comforting presence to both the mother and newborn after her labor.  She also provides newborn care and breastfeeding education in order to support the new mom.

A doula does not take the place of family members or friends whom the patient has chosen to be with her during labor. In fact, doulas are often hired to assist the key support person—the husband, for example. Because many doulas are also childbirth educators, a doula may already have met with her clients several times during the prenatal period, establishing a bond that can be valuable during labor.

A woman in labour can count on her doula for continuous support. A doula doesn’t work shifts, so will be there throughout the labor and the delivery, and for several hours afterward. Through shift and room changes, she remains with the patient, providing a familiar and reassuring presence. The fact that she’ll be there for the duration can be a significant source of comfort for the mother-to-be.

A doula has no medical or decision-making responsibility, and no other patients, so she can devote herself fully to the non-medical needs of her one patient. She does, however, have her own areas of expertise. She uses non-medical means, such as a birthing ball, to ease back labor, and slow dancing, massage, and positions changes to help change the baby’s position. She also provides soothing extras, such as massage oils, flowers, and music, depending on the preferences of the labouring mother.

Because the doula may have spent many hours with the woman at home and with her constantly during the labor, she can give the nurse and doctor a good sense of how the labor is progressing, how the woman is handling it, and what the contractions are like. She can also help the mother maintain the rhythm of her contractions when changing position or moving, say, from a chair to the bed.

If surgery is necessary, the doula may be able to remain in the OR with the woman and her partner. That depends, though, on hospital policy.

After the birth, a doula will often assist the mother to hold the infant skin-to-skin on the mother’s chest or next to her face. If the baby must be taken to the nursery immediately, the doula can stay with the mother, freeing the father/partnet to accompany the baby. In the meantime, she can ease the mother’s anxiety by providing frequent updates on the baby’s condition and progress.

A doula helps the new mother with breastfeeding, if the mother chooses to nurse. Many also make home visits after the birth, providing emotional support, newborn care, breastfeeding assistance, and light housekeeping. If there were difficulties with the birth, the doula can review them with the mother and her partner afterward, helping them replace bad memories with good ones.



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