In celebration of World Doula Week 2015, as well as my own announcement that I have added birth doula services to my business, I decided it was time for this post. Even though doulas have been more widely well-known and utilized in the past several years, as well as getting some stories on big media outlets, I’ve noticed I still get a lot of blank stares or confused looks when I tell someone that I am a doula, especially locally in my small, rural town. “What is a doula?” you ask. Why, I’ll tell you!
I must first begin by explaining that “doula” isn’t a very regulated profession. There are no state or federal mandates, and you don’t have to cut through a bunch of red tape to acquire a license. While technically anyone could call themselves a doula, a majority of us who do it have gone through some sort of training, be it an online course, weekend workshop, or more. Because of this, I have noticed that there are some differences on what some doulas offer and/or are expected to do. You may find a doula who has a completely different philosophy than me, and who may not agree with everything I write, even though I believe we are all, for the most part, on the same wavelength. (I am also going to refer to doulas in the feminine pronoun, although there are such things as male doulas, or as they like to call themselves, dude-las!)
Some people may be turned off by the fact that we aren’t very regulated, but for me, it’s similar to hiring a photographer. Sure, you can find a photographer who has graduated from a university with a prestigious art degree and who is a member of a professional organization – and they very well may be an amazing photographer! But oftentimes, I find the best photographers are the ones whose qualifications extend to passion and experience. When it comes down to it, a doula is not a medical professional but an extremely supportive mother-helper. You can teach positions, you can study breathing, but you can’t “teach” support or encouragement, and in the end – that is what it comes down to.
A doula’s work begins way before the birth. Most doulas will schedule two or three appointments throughout your pregnancy. These appointments are essential in helping to create a comforting and trusting environment between a mother and a doula (and whatever other birth support the mother has, whether it be her spouse, parent, friend, etc). When you are in the middle of labor with contraction on top of contraction, you want someone in that room who you trust and feel comfortable with. There is actually a documented phenomenon linking uneasiness of the mother to prolonged labor (one of the benefits of home birth). In fact, I actually have a friend who just gave birth a couple months ago tell me that she was coping extremely well with labor until her doctor walked into the room; after that, she immediately felt herself tense up and her labor slowed.
Not only are these meetings helpful in developing a bond, they are also a great time to figure out exactly how you want your birth to be. Many women don’t realize that choices come with birth; rather, they assume they must follow their doctor’s advice or go along with certain procedures, even if they don’t want to. Your birth is exactly that – YOUR BIRTH. You have the power to consent or decline to any procedure or treatment, and talking with a doula is a great way to uncover exactly what your preferences are, as well as help you draft a birth plan to give to your doctor, midwife, or nurses stating these wishes. A good doula will never push her opinions or personal viewpoints on a client. For example, I chose to have a completely unmedicated birth, but I would never tell a client that the “only” or “best” way to birth would be unmedicated, nor would I judge her for choosing an epidural or some other form of pain relief. Rather, a doula will listen to her client, walking alongside her rather than guiding her down her path. A doula will be available to provide information to a client when requested (including studies, evidence-based research, etc) to help her in making her decisions, but they are just that: her decisions. In the end, the way you birth is completely and 100% your choice – even if your choice is to not make any choices (if that makes sense, lol!).
Many doulas will also take this time before birth to practice certain relaxation techniques with you – whether you are interested in breathing, aromatherapy, massage, positional changes, guided or visual relaxation, etc. Some doulas may even be trained in a specialty technique, such as hypnobirthing. It is helpful to be introduced to some of these things before the birth so that you know what to expect, even though what you *think* may work for you during labor may actually not at all! It is also helpful to introduce these to your birth partner; you may even be able to practice most of them at home! Most likely, your doula has some sort of “library” collection of books, CDs, DVDs, etc that are available for her clients to take home (I personally have started my collection with several books about pain management techniques, as well as some prenatal exercise videos and newborn videos). Perhaps one of the the most important aspects of a doula is that she keeps herself available 24/7 to answer or address any of your questions or concerns; most likely, your doula will have her cell phone attached to her hip like crazy just in case her clients need her. As the time draws nearer to your due date, your doula will eschew any outings or vacations, keeping herself homebound in anticipation of your birth. As nervous and anxious as you are for you birth, so is your doula experiencing similar emotions.
The birth itself is where your doula will shine. Doula is actually a Greek term for “female slave” or “woman’s servant”. Essentially, she is there entirely for you, the mother. While some doctors or nurses may have several “patients” or be inclined to keep to a certain schedule, a doula’s only focus is on her one client at this moment. I could do a whole blog itself on the day of the birth! From keeping the environment relaxing and peaceful, to suggesting various relaxation or pain management techniques, to encouraging the mother in her desired birth plan, a doula’s responsibility is to comfort and support you during this most amazing, exhilarating, one-of-a-kind, life-changing experience.
Many people assume a doula will advocate on behalf of the mother, and some might, but I don’t. I believe it is important to keep a pleasant relationship between doctor-doula-mother, and arguing or defying a medical professional should not be in a doula’s scope of practice. As I said before, the way you birth is your choice; rather than be an “advocate” and try to push a birth plan through, I feel it is more important to help educate and empower the mother to be her OWN advocate. Not to say that, in the heat of the moment, it isn’t hard to advocate for yourself … I’ve been there myself! But rather than attempting to stop a doctor and possibly begin to erode that relationship (and, subsequently, the peaceful atmosphere in the room), a doula may gently remind the mother of her desired birth plan or explain to her what the doctor is about to do, so that she can speak up if she so chooses. Sometimes, no matter how much we plan or how hard we try, births do not end up as planned. In the end, the mother is the one who has to come to terms with her birth (whether it went how she desired or not), and the best way to do that is to have the knowledge that she was in control and that she made the choices as best as she was able. That way, no matter how it turned out, there will be no regrets.
A doula’s work, surprisingly, does not end after the baby is born. Most doulas will stay with the mother after the birth until she is settled in with her new bundle of joy (and, if there is not a lactation consultant available, may even help to establish breastfeeding if the mom desires). I think one the of the best parts of a doula’s work is, once they are settled at home, visiting the mother and the child she witnessed coming into the world. This is such an important time that is often overlooked! Personally, I loved being pregnant, and I even loved giving birth, but no one warned me what to expect during the postpartum period. I was a mess! This time is just as important in having a good support structure, not only in listening to concerns about motherhood, but also in allowing the mother to talk about her birth experience. If you have been pregnant, you know how much women love to talk about their birth! When I was pregnant, I heard story after story, and they usually weren’t very encouraging! Sometimes, these stories can add even more anxiety to an expecting mother in anticipating her birth. I feel like the reason we want to talk about our births (whether good or bad) is that we haven’t fully processed them emotionally yet, so we are constantly trying to talk about them in a way that that we finally come to peace with them. Even an amazing birth still requires to be “processed”. (Granted, we are also social creatures who just love to connect with others!)
Oh, and did I mention – cuddling with the babies??
The more I delve into the world of birth work and doulas, I realize now only how important and amazing it is, but also how difficult it is to summarize. Even now, I feel like I haven’t done the profession of doula justice, because there is so much that cannot be explained (or maybe can, just with someone more literary-gifted than me!). Seriously though, it is more than just learning a technique, it is more than a list of services – it is such a emotional work, because birth is such an emotional time. This may make defining a “doula” difficult, and it may make finding clients a challenge because they don’t quite understand what they are getting, but I can promise you once it is all said and done, you won’t regret having a doula by your side.
To learn more about my specific doula services in Southwest Iowa, visit my Birth Services Page. I am currently offering a discount of 50% off my birth doula package until 3/30 in helping to bring more awareness to doulas!
What about you – have you had a doula at your birth? I would love to hear stories!!