The Role of the Doula
A Doula is a person (usually a woman) who is hired to act as an emotional and logistical support for the mother and her partner before, during and after the birth. During the final weeks of pregnancy the Doula may come to the mother-to-be’s home and help work through any fears or worries she may have. The Doula is not trained to deliver a baby but she is trained in caring for women during all the phases of labor and delivery. She has the mother’s best interests in mind. The Doula becomes familiar with the hopes, dreams and wishes of her client and once labor begins she can act as an advocate for the mother’s birth plan and wishes. In a hospital setting the Doula remains a constant presence as nurses and doctors rotate on and off shift during the course of labor. Labor is a time of powerful physical and emotional forces and the Doula helps the mother and baby to navigate and stay afloat in the turbulence. Physical support is also needed and the Doula knows the best positioning, massage and breathing techniques to support the laboring mother. By the time a baby is born and all the intimate and intense challenges of labor have been navigated the mother may feel a very close bond with her Doula.
Many C-section stories involve a cascading domino effect of medical interventions: Using Pitocin to induce labor can lead to extra strong and painful contractions which in turn can lead to the mother wanting an Epidural which can lead to the mother not being able to feel her legs or not being able to know if she’s truly pushing as hard as she can, which can lead to the pushing phase going on for too long resulting in the mother being utterly exhausted. A C-section is frequently the end result of this domino effect. Hospital protocol can be confusing and the Doula can translate what doctors are saying and help the mother to understand the choices that she has and the implications of those choices. In the event of an Emergency C-section the Doula will be there to translate medical terminology and explain things clearly for the mother and father. Events move quickly in an Emergency scenario and the Doula helps to bridge the gap between the mother’s dream birth and the unexpected new reality.
Even if the Cesarean is planned or expected a Doula can still be very helpful to a mother. Sometimes a mother who has had one emergency C-section will be unable to or unwilling to try for a VBAC and so she will have no other option but to deliver her subsequent babies by Cesarean as well. A Doula can be a huge support to a mother preparing for repeat surgery. A Cesarean birth is just as unique and unexpected as a vaginal birth, each birth will be different from the last just as each baby is different from it’s siblings. Undergoing surgery is emotionally and physically draining and a new mother needs extra support in those first weeks when she can’t be on her feet much. The Doula can begin her work before the baby is born and then continue afterwards, offering post-natal massage and support for the mother as well as helping the new family with the logistics of transitioning back home.
Some Doula’s are hired specifically to help after the birth, similar to a mommy’s helper, to make the first few days or weeks at home easier. After Surgery a mother is not permitted to exert herself or lift heavy things for the first couple weeks and the Doula can do household chores, cook a meal or simply hold the baby while the mother takes a much needed nap or hot shower. A Doula is the modern incarnation of the female support circle that new mothers used to have in more traditional communities.
Women's Words of Wisdom
“I would like to advise to another mom to get a doula for her birth and I would advise them to make sure you allow the right people into your delivery room. Make sure you have somebody you trust to make life decisions for you in case you lost consciousness. Trusting or accepting the wrong person into the room can be seriously prejudicial.”
-Jaqueline Lèbre Bacellar
“I only labored at home for a scant two hours before my home-birth experience turned into a hospital emergency experience but during those two hours my Doula held a bowl for me while I puked, washed my face with a warm washcloth, brought me water to drink and made me smile through contractions. When we had to rush to the hospital my Doula helped me to find clothes and get dressed in a hurry.
After I woke up from my surgery I was loopy from drugs and in a great deal of pain as well as feeling extremely worried about whether my baby would survive. During the long hours of that first night in the hospital my Doula stayed with me and slept on the couch in the room. My husband and our baby had flown to Boston in a helicopter so I would otherwise have been alone that night, crying and worrying and feeling all the pain. Despite it being the worst night of my life my Doula helped me to laugh which was the best possible medicine for me after the traumatic and unexpected labor and delivery I had just experienced. I don’t remember what we found so funny, possibly it was just the effect of the anesthesia drugs and pain medications but the laughter was extremely soothing for me. I’m so grateful that I had my Doula to be a friend to me during that long terrible night.
A Doula needs to be fully prepared to help you through whatever outcome your birth brings so I would strongly advise that you ask your Doula to do some advance research for you so she knows something about the medical curve balls that birth can throw at a mother: epidural headaches, extra painful contractions from Pitocin, C-section recovery etc. I had an excellent home-birth team with a Midwife, a Midwifes assistant and a Doula. They were all highly skilled and trained, had experienced numerous births and they each had given birth to children of their own but none of them had experienced a C-section or been closely involved in a C-section birth. They offered all the support that they could give me about normal post-birth care, rest, diet, bleeding and breastfeeding. But they couldn’t offer me the kind of specific advise and knowledge that I needed after my surgery.
-Katrina Nevin
“I strongly believe that if I had better advocated for myself my birth story would be very different. I don't regret the experience because in the end I got the best gift ever, (my baby) but I do think when we decide to try for baby number two I will make sure to do a better job of advocating for both myself and baby.”
-Elizabeth Francis
Resources:
Doula’s of North America (DONA)This organization is dedicated to training and certifying Doula’s as well as connecting pregnant women to trained Doula’s. Find a Doula near you!