Doulas

This article gives information for parents on the role of the doula, a fairly new phenomenon in New Zealand, how to find a doula and what the benefits could be to you and your family.

What is a Doula?

Doulas are trained laywomen who provide emotional and practical support to you and your family during the birth and postnatal period.

The unusual name comes from a Greek word which means to serve other women. In a very deep sense the work of a doula is an ancient one: women who serve other women through the childbirth process. The rediscovery of this term in the Western World at this time has been attributed to anthropologist Dana Raphael, who first used the term for women she saw working in the Philippines.

In the modern world there are two distinct types of doulas – those who attend during the childbirth period and those who work in the postpartum period, though many doulas will cover both periods. Some doulas also specialise in helping women through high-risk deliveries.

The oldest professional doula organisation in the world, DONA International, began in 1992 when “a small group of foremost childbirth experts wanted to promote the importance of emotional support for women and their partners during birth and the post partum period”.

As yet there are no mandatory qualifications required to practise as a doula – apart from having had the necessary life experience, maturity and caring attitude that make people a suitable candidate for such work.

In New Zealand there is a CAPPA (Childbirth and Postpartum Professional Association) qualification for postpartum doulas and internationally there are different certification processes – these involve a combination of first aid or nursing experience, attending childbirths, reading appropriate texts or manuals and passing police checks and other references.

Using a doula has been found to lessen stress and anxiety on the pregnant women and her partner. A doula should be a warm, caring, non-judgemental, experienced, knowledgeable and encouraging force during childbirth and in the post partum period.

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When should I use a doula?

Women use the services of a doula for labour and birth and in the post natal period (usually the first 6 weeks after the birth).

If you are interested in having a doula, it is advisable to arrange this as soon as possible in your pregnancy; this will give you more choice of doulas and help you to feel more relaxed about the birth and life with the new baby.

How do I find a doula?

Talk with your doctor, midwife, family and friends with children to see if they can recommend anyone. Check out websites listed below or try contacting the maternity unit of your local hospital to ask for referrals.

Doulas are an emerging force in this country, so the way they charge for their services may vary. In England and America the trend seems to be a flat charge of around $500 for their services; but some doulas in New Zealand will charge by the hour –approximately $30-$50.

Doula organisations suggest calling around to check out price ranges; however given the small number of women doing the work in this country at present, your choices may be much more limited.

(Because they have been a longer-term phenomenon overseas, some insurance companies are actually now paying for doula care. In the US some hospitals also offer doulas for mothers who would otherwise be unaccompanied at birth.)

What will the doula do?

The key word is `support’ – doulas will support the expectant mother, her partner and the new baby … the whole family / whanau.

Childbirth doulas will support you throughout childbirth – not with clinical or medical tasks, but with things such as massage, positioning, breathing exercises and aromatherapy.

For childbirth doulas may:

• Prepare a birth plan in advance
• Help you understand what is happening
• Support your partner
• Be an advocate in liaising between you and the health professionals
• Stay with you throughout the labour and until the baby is a few hours old.

Postpartum doulas may:

• Help you to successfully initiate breast feeding
• Assist you with emotional and physical recovery from childbirth
• Teach you to care for your baby
• Help you with other children in the house
• Do some housework
• Prepare some meals
• Do other tasks around the home that may be required

Doulas will work alongside (but not replace) the work of your midwife or doctor. They can work with you for as long or short a period as you want in the postpartum period.

What can I do?

In choosing to use the services of a doula you may lessen the stress and anxiety that many women feel around the time of childbirth. A number of scientific studies are proving the benefit of the work doulas do – randomised clinical trials have shown how doulas can really assist the mother’s physical and emotional wellbeing.

Using a doula has also been shown to lessen the risk of experiencing interventions such as caesarean section, forceps delivery, epidural and postpartum depression. In the post partum period mothers who have a doula are more likely to continue breastfeeding, have a better relationship with their partner, feel more confident with their baby, and feel less stressed and anxious.

You will want to organise your doula well in advance of the planned delivery date to ensure she is in place should you go into labour early.

The kind of questions you could ask a doula include:

• What has been their previous experience in this role?
• Can you talk with someone who has used them previously for a reference?
• What kind of training do they have?
• What is their approach to birth and the post partum period?
• What roles will they do or not do?
• What do they charge?

It is important to find a doula that you like and feel you can have a warm and sympathetic relationship with. You want to trust and feel confident in this woman, as she will be with you through a very important time.

Useful websites & articles on doulas

To compare the role of the doula with the role of the midwife, visit our Kiwi Families article on Midwives.

www.dona.org

DONA International – the oldest and largest organisation for doulas in the world which offers a certification programme.