Years ago new and expectant couples called on their parents and siblings to
lend support and assistance during labor, delivery and postpartum. But
today many extended families are separated by geographical distances or
bound by work responsibilities, so some new parents are turning to doulas
for the help they need.
“A doula is an experienced, non-medical assistant trained to support
families before, during or after the birth of a child,” says Tracy Wilson
Peters, executive director of CAPPA (Childbirth and Postpartum Professional
Association). “An antepartum doula assists women on bed rest, overseeing
household maintenance and administration and providing emotional support. A
labor doula provides non-medical support during the latter part of
pregnancy, labor, delivery and a few hours following. And a postpartum
doula assists the family in the home after childbirth with information and
support on breastfeeding, emotional and physical recovery, newborn care and
domestic responsibilities.”
But are doulas a good fit for everyone? Susannah Vitsoric wasn’t so sure –
at least not at first.
“Early on in my pregnancy my mom suggested we get a postpartum doula, but I
wasn’t interested,” she says. “I didn’t want a stranger infringing on what
I considered personal and private time; my husband and I thought we could
handle things ourselves.”
Then the unexpected happened.
“I had an emergency c-section and was in the hospital four days,” she
continues. “I learned quickly that recovering from surgery, being sleep
deprived, breastfeeding and dealing with a newborn and domestic chores were
going to be more than I could manage. So suddenly my mom’s suggestion
sounded good.”
At that point, Vitsoric’s mother retrieved a list of certified doulas from
the hospital’s lactation consultant and started making contacts.
When looking for a doula, check with childbirth educators, birthing
facilities, local parenting organizations and other childbirth resources.
Also ask friends and relatives for recommendations.
“Once you have a list of names, conduct telephone interviews to narrow your
search,” says Hope Irvine-Sank, certified postpartum doula. “Then do
face-to-face interviews to observe their mannerisms, style and personality
to see who’s the best fit for you. Ask yourself, ‘Is this someone I could
envision at my birth experience or assisting us at home?’ Talk with her
about what she sees is her role and make sure it’s in keeping with what
you’re looking for.”
When to start your doula search will depend on the type of services you
need.
“Doulas work on a first-come, first-serve basis and can get booked up
rather quickly, so if you’re looking for one to assist during labor, start
searching by the fourth month,” says Peters. “For postpartum you can wait
until a couple of months before you’re due.”
Cara Lewis did this.
“I was in my fourth month of pregnancy when I decided I wanted a doula to
assist with labor and delivery,” Lewis says. “With my first child I had a
c-section, but this time I planned to go natural and wanted the support and
knowledge of a doula to guide me through it. I asked my doctor how she felt
about my using a doula and she encouraged me to do it.”
Once a doula had been chosen, they communicated via telephone and email
throughout the pregnancy. The doula also provided Lewis with information on
Vbac (Vaginal Birth After Caesarian) births. Several weeks before her due
date, they met to decide on a birth plan.
“We talked about my preferences – what I wanted in the birth experience and
how I wanted to handle issues that could come up during labor,” says Lewis.
“We also discussed her writing my child’s birth story by taking pictures
and recording the chronological sequence of events.”
Once labor began, the doula suggested non-medical techniques to speed labor
and make Lewis comfortable, and then stayed several hours after delivery.
“When I go into the labor room, I bring things like oils for massaging, a
birth ball and a rice sock that can be heated. I also make suggestions
about positioning, breathing and visualization – anything to make labor go
quicker and smoother,” says Irvine-Sank. “But I’m there for dads, too.
Sometimes they’re so emotionally wrapped up in the experience that they
appreciate the knowledge, experience and objectivity I bring.”
Lewis’s birth went as planned and she delivered a daughter. After
Vitsoric’s birth, the contracted work was just beginning.
“My doula came for a couple of weeks to take care of me, help with the baby
and do some domestic chores,” she says. “But what I really appreciated was
the newborn care instruction we received. Even though we did prenatal
classes, it’s not the same as when the baby is home. Just having a
professional there to guide us through was invaluable.”
Although initially Vitsoric had reservations about using a doula, now she’s
sold on the idea.
“Even if I hadn’t had a c-section, we would have benefited from using her.
It made my recovery and our initial adjustment with the baby go much
quicker and smoother,” she says. “And we didn’t feel infringed upon.
Looking back, I wouldn’t have had it any other way.”
Typical responsibilities of a trained, experienced doula
- An antepartum doula (APD) typically helps women who are on bed rest due to
a high-risk pregnancy. She provides information on support groups and
reading material, as well as emotional and physical support. She also
assists with household maintenance and administration responsibilities.
- A labor/childbirth doula (LCD) is a support person who attends to the
emotional and physical comfort needs of laboring women to smooth the labor
process. She does not perform clinical tasks, but uses non-medical
techniques and suggestions to help the labor process. She may also provide
information support, explaining procedures and interventions, and work as
an advocate for the mother’s wishes in communicating with the medical
staff. She may do prenatal visits and offer phone support and pregnancy
suggestions prior to the birth, and schedule at least one pre-birth meeting
to discuss the mother’s preferences and prepare a birth plan. An LCD joins
the woman either at home or the hospital/birth center and remains until a
few hours after the birth. One postpartum meeting is scheduled to ensure
the mother is well informed and supported.
- A postpartum doula (PPD) assists new mothers with the recovery of the
birth experience and oversees her postpartum needs so she can focus on the
baby. The PPD facilitates the mother’s rest periods, encourages proper
nutrition and is available to demonstrate practical newborn care, from
feeding and bathing to diapering and dressing techniques. She can also
assist new fathers in learning skills and gaining confidence to care for
the newborn. For families with older children, a PPD can create a fun and
stimulating environment so parents can care for their newborn, rest or
enjoy quality time together. A PPD also offers practical household
assistance with regard to cooking, light cleaning, laundry and shopping.
Postpartum doulas differ from nannies or baby nurses in that they do not
take over the care of the baby. While they may offer assistance, their goal
is to guide and encourage the mother to learn to care for her own infant
and to shoulder domestic chores until she is physically able.
For more information on doulas, contact the following organizations:
- Birth Works
- Childbirth and Postpartum Professional Association
- Doulas of North America
- International Childbirth Education Association
