Your birth team -- Is a doula right for me?

by Julie Snyder

birth team doulaDoulas are advocates for the mom or the couple during the birthing process. They offer non-medical care. Your doula may provide emotional support, physical comfort or information, whether your birth takes place in a hospital, home, or birth center.

Most doulas have received training and certification, although some have not. Fewer than 10 percent have a medical background, yet many new moms who have used doulas say they feel empowered and describe their birth experience as wonderful.

Advantages a doula on your birth team

The presence of a professional labor support person such as a doula can have a huge effect on the outcome of the birth. The combined results of six randomized controlled trials on birth support have shown:

• A 50 percent reduction in the number of necessary cesarean sections
• A 25 percent reduction in the length of labor
• A 40 percent reduction in the need for oxytocin/pitocin to stimulate a slowed birthing
• A 30 percent reduction in requests for pain medications, such as narcotics
• A 60 percent reduction in requests for epidural anesthesia
• A 30 percent reduction in the number of forceps deliveries

What a doula does and doesn't do

Your doula can suggest birthing positions and various pain management techniques that you might not already know. She can be present, supportive, attentive and encouraging.

You'll hire your doula before you go into labor and have an opportunity to build a relationship before delivery. Feeling emotionally supported and taken care of can translate into an easier birth.

A doula will not tell you what choices you should make. She can supply information when there are medical issues or decision to be made, offering you pros and cons of each suggestion made by your doctor. Because your doula has witnessed many births, she can offer a point of view, and act as an advocate and gatekeeper during your birth.

Your doula might help you identify of your priorities for the birth and attend a prenatal meeting with your doctor or midwife if desired. You'll be able to phone as necessary and can expect her to be on call beginning two weeks prior to your due date.

She can provide continuous emotional and physical support during active labor and birth throughout labor at home and at the hospital or birth center. Many doulas assist with breastfeeding immediately following the birth. You may have a postpartum visit or ongoing postpartum/breastfeeding support as needed, along with an extensive referral service. A doula may also:

✓ Help with transportation to the hospital and check in
✓ Help keep your birth plan on track
✓ Update family and friends during delivery
✓ Act as a labor couch
✓ Walk with you during labor
✓ Take pictures

Choosing a doula

Are several doulas are available in your area? Here are sample questions to ask as you make your choice:

• Where were you trained?
• How long have you been a labor assistant?
• How many births have you attended as a doula?
• Do you have any experience or knowledge of using hypnosis for childbirth?
• Tell me about your personal experience with birth, and in your practice.
• What do you think is the most important part of your job?
• What is your philosophy about childbirth?
• Describe your role in my birthing. What exactly do you do?
• How many times will I see you before the birth?
• When will you come to attend me in labor?
• What other services do you offer such as breastfeeding support, postpartum for mom and dad and new baby care?
• Do you have a back-up, for times when you are not available and may we meet with her?
• What care providers have you worked with?
• In what hospitals have you attended births?
• May we call you with questions or concerns before and after the birth?
• Do you meet with us after the birth to review the labor and answer questions?
• What is your fee, and what does it include?
• Are there two of your past clients whom I may call?

Did you or are you planning to have a doula during your birth? Why did you decide to add her to your birthing team?