Doula

For much of the 20th century, an expectant father's place was considered to be in the waiting room with other family members during labor and delivery. However, as expectant parents have gained more control over the childbirth process, expectant fathers and partners have moved from the waiting room to the delivery room and have become an integral part of the process as labor support and coach. Many fathers make great labor coaches while others may be uncomfortable or unwilling to be present in the delivery room. In either situation, a doula can provide supplemental or primary physical and emotional support, as well as information about pregnancy and babies to mothers before, during, and following childbirth.

Doulas were originally the highest ranking female servant or slave in ancient Greek households. In such a position, the doula would assist the lady of the house during childbirth. Over the years, it evolved into a labor assistant.

Many expectant couples choose a doula as an alternative to both a traditional hospital delivery and a certified nurse midwife. Doulas do not perform any clinical tasks such as checking your and your baby's heart rate or performing vaginal exams, but they specialize in massage, aromatherapy, reflexology, and labor positioning to help labor progress as smoothly and quickly as possible. They also may act as your advocate and assist in communicating with hospital staff to obtain information and relay your wishes. They will join you at home or accompany you to a hospital or birth center.

A doula is not meant to replace the father/partner. The father or partner may be better able to provide continuous support but typically has little actual experience in dealing with the often stressful labor process. In addition, many fathers are emotionally overwhelmed by labor and delivery, rendering them ineffective as a coach and advocate. Studies have shown that fathers usually participate more actively during labor when a doula is present.

Studies have shown that mothers attended by doulas produce lower levels of stress hormones than those left alone in labor or attended by inexperienced father/coaches. If you are serious about not using drugs, a doula may be your best ally; and even if you think you might want to receive an epidural, a doula can help make the experience less stressful and more satisfying. Another great benefit of choosing to have a doula during labor and delivery is that a doula will be with you continuously throughout your labor and delivery, as opposed to the nurses who will probably come on and go off shift several times. A doula is also a welcomed relief for most nurses as they will probably have several patients at once and not be able to give you as much attention as you would like. Additionally, doulas can provide support as you begin breastfeeding and tips on newborn care.

Research has shown that hiring a doula results in a smoother, more natural birth. According to the authors of Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier and Healthier Birth, a doula can mean the following:

• 50 percent reduction in c-section rates
• 25 percent shorter labor
• 60 percent reduction in epidural requests
• 40 percent reduction in oxytocin use
• 30 percent reduction in analgesia use
• 40 percent reduction in forcep delivery

Unfortunately, most health insurance companies do not cover doulas, so you may end up paying out of your own pocket. The cost of hiring a doula varies from area to area and doula to doula. What you pay for your doula will be based on how much experience she has and the going rate in your area. The range is usually $200 - $1000. However, because most doulas feel so strongly about what they do, many will set up a sliding scale or payment plans to help those who can't afford the service. So don't let cost keep you from researching and hiring a doula.

If you do decide to use the services of a doula, we recommend you choose one who is certified through a nationally-recognized organization. These women undergo rigorous training and testing and have assisted at numerous births.

In many cases expectant couples find out about good doulas through word of mouth. Other places to look for referrals are organizations associated with childbirth, lactation consultants, childbirth educators, hospitals or birthing centers, your doctor or midwife, or anyone who has recently had a baby or works in the field. There are three national doula organizations: Doulas of North America (DONA); National Association of Childbirth Assistants (NACA) which can be reached at (408)225-9167; and the Association of Labor Assistants and Childbirth Educators (ALACE).