A Doula's Excellent Adventure

Just two years ago, I was like most of you. 

"DOULA? What is that? Ummm....no thanks. I'm not into voodoo."

I'm not gonna lie, I am a little surprised that "doula" caught on instead of something more generic and white bread like "childbirth coach".  In fact, the word "doula" comes from the Greek word for slave.

Errrr...hold up. This isn't making it any less weird.
Let's try again.

The lovely title of "doula" was coined in 1976 by Dana Raphael. She used it to describe a woman with experience in helping mothers breastfeed in the postpartum period.

The actual role that a modern-day doula fills goes back centuries though. Talking about America specifically, our childbirth culture was strongly influenced by English culture.

That makes sense, right? 1776 may have cut the cord to the mother country, but there were a few things worth keeping.

*neato art piece, huh? I'm loving all the support that dear mama is getting. And the chair setup? Pure genius. Hospitals and birth centers are equipped to mimic that labor position with those amazing moving beds of theirs. 

Social childbirth philosophy follows the "it takes a village" concept. A woman's childbirth support circle came from her friends, relatives, and midwives. These women took their role seriously and worked hard to make sure that mom felt strengthened and assured. The qualities of this model of childbirth include togetherness, care, and support. It sounds like a pretty darn near perfect system.

Well, almost perfect. Progress necessitated the advent of running water, sewage systems, hygiene, etc. These measures provided for a safer childbirth experience for both mother and baby.

However, progress ended up being a double sided sword in the birth community. By 1930, richer women felt drawn to the medical model. I can understand the draw. Doctors with years of training, nurses in clean white dresses, sterile facilities, and people who look like you are hard to compete with. Most people made the shift to hospitals and the traditional role of midwives fell from the pages of history.

all the baby ladies
all the baby ladies
all the babies ladiesall the baby ladies
now put your hands UP
(John Hopkins Gazette)

Fast forward a few decades.

Medical advancements made hospital birth even more appealing. Electronic Fetal Monitoring meant that nurses didn't have to stay with any one patient and were able to care for many at a time.

The cons?  Nurses didn't have to stay with any one patient. Also, when your entire labour requires electronic equipment to be strapped to your belly, moving around isn't exactly encouraged.  So there went moving around in labor--which had been normal until then.

Since so many women give birth in hospitals now, the traditional birth support system from the social childbirth model is no longer the norm. And when women are reduced to numbers on a chart and beds in a hospital, dehumanization becomes a new concern.

Unfortunately, a 2001 study showed that first-time mothers expected their nurse to spend 53% of their time providing the social childbirth model for them. That includes "physical comfort, emotional support, information, and advocacy".  

Because of modern medical technology and the quite wonderful way in which many patients can be cared for at once, nurses simply do not have the time or training to provide that level of support to each mother. The reality is, nurses spend only 6-10% of their time in active labour support.

So what can be done to bridge this gap in maternal care? Who in this dark wide world can possibly help?

Hi. 
Over here. 
That's me. I'm a doula.

We doulas came back onto the scene in the 80s, when women started to get concerned with the growing number of cesareans. They started hiring their childbirth educators, their friends, or even obstetrical nurses they were on good terms with to come into the delivery room with them. They were looking for an advocate. 

Doulas have come a long way since then, and although unnecessary cesarean prevention is still near and dear to our hearts, we have evolved into so. much. more.

The role of a doula

labor support skills

labor support techniques

strategies

guidance

encouragement

team building with the nursing staff

encourage communication

(source)

The skills and techniques mentioned above include:

imagery

massage

patterned breathing

acupressure

labor acceleration positioning 

fetal positioning

fear release

anxiety control

partner bonding

partner communication

(source)

This type of support is beneficial to women who desire to birth unmedicated.

It's beneficial to women who desire to birth medicated.

It's beneficial to women who desire to birth in a hospital.

It's beneficial to women who will have a cesarean.

It's beneficial to women who will birth at home.

It's beneficial to women who give birth in a birth center.

It's simply beneficial to women.

Being a person gives you the right to matter. You matter. Your experience matters. 

Doula: "one who nurtures and protects the woman's memory of her birth experience"(source).





Reference Links:
1. http://www.cochrane.org/CD003766/PREG_continuous-support-for-women-during-childbirth
2. www.ncbi.nlm.nih.gov/pmc/articles/PMC1595283/#!po=26.3889
3. www.ncbi.nlm.nih.gov/m/pubmed/11264629/
4. www.ncbi.nlm.nih.gov/m/pubmed/9271971/