Do you need a doula?
Yes you do!
Your birth will be better with a doula. Any birth will be better with a doula. Here are some of the reasons.
1. You’re the Boss
Your doula is employed by you. You choose her, you hire her, you pay her. All your other caregivers (midwives, doctors, nurses), as well as supporting you, are also answerable to their professional college, to their clinic or hospital, and their call group, superiors, or seniors. A doula, however, has no conflicting interests. As such, she brings no other agenda to your birth. She will support your needs, your wishes, and your goals. She is there just for you.
2. Steady Presence
Doulas are typically with you the longest. Many doulas will join you at home as soon as you feel like you need support, even if it’s only early labour. The rest of your care team will arrive in active labour, or even in second-stage labour, depending on their practice. Doulas will then stay with you until you are comfortably recovering from the birth. If possible, they can help with breastfeeding initiation.
Likewise, they will not take scheduled breaks, nor change shifts. Personnel changes in the support team can be disruptive to the birthing environment and your sensitized psychological landscape. The sudden absence of someone you’ve been relying on, or the sudden appearance of a whole new stranger, can trigger your alarm system and cause labour to slow down, or hurt more. Your doula will be a steady presence from beginning to end.
3. The Doula’s Role
You might wonder if you need a doula when you already have a midwife. You do! Even though there is some overlap in their roles, the midwife’s main expertise and priority is the medical health and well-being of yourself and your baby. Sometimes during an emergency a midwife will not have time to answer questions or provide comfort, whereas this is your doula’s primary purpose. Most midwives are glad to work in partnership with doulas to offer you the best and safest experience.
You might wonder if a doula would be compatible with a doctor. Yes indeed! Doulas can provide vital support for hours or days before there’s any need for your doctor to arrive. Doulas usually have more training in comfort measures and coping techniques, and can provide aspects of care that are outside of the average doctor’s scope. Many doctors appreciate having a doula as part of the care team to fill an otherwise missing role.
4. Couples & Doulas
Some people worry that a doula will replace your partner, or get in the way of the partner providing support. She won’t! Doulas are there to support both of you.
Your doula will not replace your partner. In fact, she will be the coach’s coach. She will whisper tips to your partner so that they can shine. Partners may not have personally given birth before, and some might never have even seen a live birth. It’s hard to coach an activity you’ve never tried, or maybe never seen. So the doula can offer suggestions of what to do when, remind your partner to offer water, to try different massage techniques, to murmur words of encouragement. She can help your partner be the very best support person ever, so that you will remember your partner as a labour-coach super hero.
She will also remind your partner to eat and rest, and she will perform menial tasks such as filling the water bottle, so your partner doesn’t have to leave your side. Your doula is there for both of you.
5. Doulas Have Experience
Your doula has done this before. She knows what’s going on. She knows what’s normal. It is very common for both you and your partner to wonder when is the right time to call in the midwife, or to head to the hospital. Are these spots of blood normal? Was that my water breaking? I feel barfy--is that a cause for concern? I have sharp pains in my left hip--what does that mean? Your doula can put all these questions in context. Yes, this is perfectly normal, it will be a long time before we need to do anything, or, let’s call the midwife right now.
Having someone there who’s familiar with the sights, sounds, and process of birth can be a huge calming factor for both of you. The weight of making judgement calls is now lifted, which frees you up to focus on labour, and frees your partner up to support you without worrying.
Similarly, your doula can help guide you on when to fill the tub, when to eat or drink, and most of all, when to head to the hospital. It can be difficult to judge these things when you’ve never been through it before, but her experience can be a tremendous asset when it comes to making any decisions.
6. Doulas are Calming
Did you know that the presence of stress can affect your labour, even if the stress is coming from someone else? During labour we are very vulnerable to the influence of hormones--both internal and external. Having someone nearby who is off-gassing stress hormones can make our primal bodies think something is wrong. This can cause labour to stall and/or feel more painful.
Your doula can be a calming influence. Her familiarity with labour, her sense of ease and serenity with the whole process, can be a balm to all the newbies in the room. She not only reduces the risk of over-reactions to normal events, but her very presence can help calm the atmosphere, allowing you to labour more effectively without the sabotaging effects of stress hormones from your partner or family-members. Your doula helps everyone relax just by being there.
7. Doulas are extra hands
In labour, you can’t be left alone, not even for a minute. It is unrealistic to expect one single person to offer continuous and adequate support for you for an indeterminate number of hours, or even days. Your partner might have to eat, make coffee, use the restroom, nap, park the car, or refresh your ice-cubes. Doulas can take on all the background chores, so that your partner can focus exclusively on being by your side. And if your partner needs to step out for a minute, the doula can step in as needed.
Quality labour support usually involves two people. There might be moments when you need your hands held and your back rubbed, or you need to lean on one person while another is squeezing your hips. Having a doula provides that additional level of support that can elevate your labour from tolerable to satisfying.
8. The research!
Ultimately, the research alone is extremely convincing. The same kind of blind, randomized, controlled study has been done many times, all over the world, to determine the effectiveness of doulas. Over and over again the studies find that having a doula reduces all medical interventions, reduces pain, shortens labour, improves both maternal and infant safety, health & wellness, improves breastfeeding success, and creates higher satisfaction ratings for birth. Having a doula improves virtually all measurable outcomes.
The researchers submitted the conclusion that if a doula were a drug, it would be unethical not to offer it to every labouring person. A doula brings significant, measurable improvements to the birth, and has absolutely no risks. There are no side-effects or downsides to having a doula. There are only benefits.
Conclusion
I have heard many people say I wish I had hired a doula, or Things might have gone better if we’d had a doula, or Next time we will definitely get a doula, but I have never heard anyone say they regret having a doula.
Do you need a doula? Yes, you absolutely do.
Stephanie Ondrack is a retired birth doula (or maybe on an extended sabbatical) and has been with The Childbearing Society since 2003. She lives in East Van with one partner, four kids, four chickens, and five cats. You can read more of her rants on birth, parenting, and learning at www.thesmallsteph.com
