What is Doula?
The word ‘doula’ is originally ancient Greek and means ‘serving woman’. Another term is birth coach or childbirth coach. It is a specially trained woman who supports expectant parents in a non-medical way during pregnancy, birth and in the period after.
The purpose of a doula is to create a safe environment where mother and partner are assisted and advised. The emphasis is on reassurance, attention and support.
A doula offers support on a physical, emotional and mental level during the special, exciting and tiring hours around birth. Sometimes the doula offers support in the foreground and sometimes only in the background, by just being present. She comes when you need her and stays until the baby is born.
The birth plan is written during an intake. In a birth plan you describe your wishes around the birth. It is meant for yourself, your partner, your midwife or other healthcare providers. The birth plan shows you what is important to you. The person who supervises your delivery can take this into account as much as possible. The birth plan is to ensure that your voice is heard. A doula helps you with that.
Nothing in the birth plan is fixed:
You can change your mind at any time
The delivery can also run differently than you expected or wanted. In that case not all your wishes may be carried out
The obstetrician may refer you to the gynecologist at the hospital
Interventions may be necessary
Your child can be admitted to the children’s department
Worldwide there has been research into continuous support during childbirth compared to the effects of the usual care around the birth. In 2011, these worldwide researches ‘evidence-based medicine’ were combined.
The conclusion was remarkable women with continuous support:
had a remarkably shorter delivery time
were more likely to have a vaginal birth
had less need for pain relief
were more satisfied with the delivery
had a baby with a higher apgar score
The researchers found that overall, women with continuous support: who have continuous support during childbirth experience a:
25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff.
What is NOT included in doula support?
Doulas are not medical professionals, and the following tasks are not performed by doulas: they do not perform clinical tasks such as vaginal exams or fetal heart monitoring, they do not give medical advice or diagnose conditions, they do not make decisions for the client (medical or otherwise), they do not pressure the birthing person into certain choices just because that’s what they prefer, they do not take over the role of the partner, they do not catch the baby, they do not change shifts (although some doulas may call in their back-up after 12-24 hours).
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