THE PURPOSE AND VALUE OF LABOUR SUPPORT

The word “doula” is an interesting one. When using the word in conversation it isn’t uncommon to hear the response “a what?” from others. Although, awareness of the term has significantly increased over the years, as has a doulas acceptance by other birthing professionals, it is still sometimes met with a confused gaze.

So, what does the word mean and what exactly is a doulas role?

In the simplest definition, a doula is a trained labour support person. A doula never takes the place of the birth partner, the care provider (doctor, midwife) or of the nurse. A doula is in addition to these other branches of the support team.

The last century has been the only time in history where women in labour were not continuously supported in their homes by other experienced women while giving birth. It has only been during this time frame that the perception of birth has been altered from that of a natural human experience to that of a medical emergency requiring hospitalization.

As birth has moved to a more medical atmosphere, things like hospitals, doctors, narcotics and various procedures have become commonplace for birthing families. At the same time, women have come to view their own bodies as less capable of birthing their babies without all these things, and that is simply not true! While it is recognized that doctors serve an important and necessary role when things go wrong, there is strong evidence that suggests that 90% of births are “normal” and require no intervention.

With the right support, most women can birth their children safely with little to no intervention if that is what they desire. A doula can be the key to this support. Doulas have the training and knowledge to help women prepare for their labours, utilize non-medicinal comfort and relaxation techniques during their labours and assist birth partners with the best ways to support the birthing woman. Doulas give birthing families the confidence, comfort and a sense of control that prepares and supports mothers, because of this the evidence shows that women that have a trained support person are less likely to require Pitocin, request epidurals and receive C-sections.

The biggest role a doula plays in the birth process is the continuous support they provide the birthing woman. Doctors and midwives often have multiple labouring women to tend to. Even nurses have other duties that are required of them. The doulas job is to be there only for one mother and one family and to provide continuous support from the time they arrive until mother and baby are settled after delivery. If mom is breastfeeding, the doula also possesses knowledge and abilities to assist with the initiation of breastfeeding and in most cases will not leave the birth place until it has been established.

“Ok, I get all that, and it’s great for women that want a natural birth, but I’m more comfortable with knowing I can have drugs if I want them. Plus, I’m not opposed to other interventions like induction or vacuum extraction. So, I guess I don’t need a doula.”

Not true at all! Every birthing person can benefit from continuous support and encouragement. While doulas know and can implement many techniques to help a woman that desires a birth without intervention, they do not push their beliefs on their clients. A DONA trained doula is taught to support each family to have the birth they desire. Every person has different wants, needs and life experiences, therefore every person will have a different ideal about how they want to birth their children. A doula supports all types of birth plans. If a doula interviews with a family and for any reason one or the other feels it is not a good fit, the doula should assist the family to find another doula that is a better fit. There is a doula out there for every family.

While a doula has the knowledge and experience to assist with clarification of many medical terms that the family may not be familiar with, the doula will not make any decision for the birthing family. A doula can be the “calm during the storm” by being able to remember and remind the mother of her preferences for the labour if she becomes confused or overwhelmed. The doula can work with the partner to support him/her in speaking up or asking questions of the medical staff if necessary by reminding him of the mother’s preferences as well.

As stated, the doula is an important part of the birthing team but does not replace a caregiver. The doula is not trained to preform medical procedures such as cervical checks or blood pressure. If the doula also practices other modalities, for instance, if she is also an acupuncturist, the doula is only permitted to perform acupuncture when she makes it clear that she is a registered acupuncturist and acting as one. A doula may not operate outside of her scope while she is wearing only her “doula shoes” to avoid anyone thinking that acupuncture is apart of the doulas scope of practice. In the same way that if a registered nurse is attending a birth as a doula, she is not permitted to preform nursing duties.

In conclusion, labour support can greatly benefit all birthing women regardless of their birth preferences by being a continuous, reliable and knowledgeable presence during labour and the immediate postpartum period.