What is a Doula- Birth and Postpartum

What is a Doula?

There are a few different types of Doulas. There are birth or labor Doulas, postpartum doulas, antepartum doulas, and end of life doulas.

This article will discuss the first three types of doula that are related to pregnancy, child birth and the first few week of a new babies life.

Birth Doula

A birth doula is a doula that attends the labor and birth. This type of doula will normally meet with the pregnant mother and her partner 2-3 times before the labor begins. The first meeting will normally be an interview. The doula interviews the couple to see if they are a match for her and the couple interview the doula to see if she is a match for them and how they want to labor. It is important for both sides to feel comfortable with the arrangement and it is advisable for the new parents to interview more than one doula to have options available and see who she feels comfortable having at her birth. Birth is an intimate occasion and she will want to feel comfortable with the people she brings into her laboring environment.

Once a couple has chosen a doula and reviewed the contract and made a payment arrangement the doula then will set up 1-2 prenatal visits. At the prenatal visits the doula will review comfort measures with both parents or with the mothers partner. They will discuss nutrition, questions to ask her provider, they will go over possible things that will happen during labor and birth, what her options are and set up a birth plan. Some doulas that have extra training may offer massage, aromatherapy, acupressure or extra child birth education.

When it gets close to the mothers expected due date, about 2 week before and 2 weeks after the due date, the doula will then be on call. During this time period the mother or partner can contact her at anytime. They will be advised to contact her when they think early labor has started, if her water breaks or if they have any questions including when to go to the hospital or call the midwife.

Depending on what was agreed to prior to laboring starting the doula will arrive either during early labor or during active labor. Some doulas prefer to let the couple have time together in early labor before joining them at the hospital or the birth center. Doulas do attend home births but normally only if a midwife will be attending as the provider. When the doula joins the mother in labor she will provide comfort measures, help the partner to provide comfort measures, make the room more comfortable and relaxing, help her to express what she wants in regards to her birth plan, help her with breathing and moving positions and provide emotional support to both parents. She might grab food for the partner, light candles, massage the mothers back or offer counter pressure on the back among other things.

After the delivery, whether natural, with medications or by c-section, the doula will stay for about 1-2 hours after the birth to help the new mother will  bonding with the baby and breastfeeding. Then she will leave the new parents to get to know the new baby.  A few days later she will have a postpartum visit at the mother’s home. They will discuss the birth and the baby’s first few days. The doula may make suggestions of providers the mother could contact if she is struggling or has medical questions. The doula may help make food, clean up a little, or help with such things as baby wearing or more breastfeeding support.

A birth or labor doula is normally paid a set amount that is agreed upon at the interview and a contract is signed. The fee includes the prenatal visits, the birth and one postpartum visit. This fee could range from  a few hundred dollars to $1,500 or more depending on experience and additional options the doula provides.

Postpartum Doula

A postpartum Doula gives support after the baby is born. Her role may include breastfeeding support, sleep training support, cleaning, cooking, helping older children adjust. This type of doula may stay over night so the new parents can sleep or she may bring the baby to the mom when it is time to feed. A postpartum doula is paid by the hour and her time with the new parents may be just a  few hours or could last for weeks depending on the needs of the family.

A postpartum doula can set more reliable hours and does not have an on call period like a labor doula.

 

Antepartum Doula

This type of doula works will women who are high risk and are at risk of a preterm delivery. She tries to help the mother get as close as possible to a full term delivery.

What kind of support do they offer?

Light housekeeping, making healthy meals, shopping, and giving support to the mother. Giving support to the mother may include helping her be more comfortable if she is on bed rest. The doula will also provide emotional support by listening and helping the mother to remain calm and avoid stress. She may offer suggestions that will help her such as massage or physical therapy.

Why get one?

Birth Doulas lower the chance that a women will have a c-section and epidural and other interventions. A doula does not mean that these things will not happen but she informs her client of all the options, gives them comfort measures to help with pain, helps her understand what is normal in birth, helps her write a birth plan and reminds her of the birth plan when the time comes to make decisions. She helps the mother and the partner to take time to talk first before making a decision and reminds them to ask questions. Even if inductions and other interventions do occur the doula is there to support them emotionally. Many mothers who have a doula at her labor and birth find they were very satisfied with the process. Even if a c-section does occur the doula is still very useful, if not more so. If the c-section is unexpected this may cause stress and the doula can be very useful in helping the client during this unexpected development.

Doula Benefits 

shorter labor

reduction in epidural request

reduction in caesarean rate

reduction in forceps use

reduction in use of pitocin

better apgar scores

greater satisfaction with birth experience

decreased anxiety

increased confidence

improved postpartum health

lactation support

comfort and reassurance

 

Training

There are quite a variety of training methods available.

Doulas do not require a licence or a to be certified but being certified through an organization will give you the training and confidence to attend births or work as a postpartum doula. Expectant parents may want a doula that has been trained by a reqognized organization and may want the organization to have a good reputation and a grievance policy.

A greviance policy means that the doulas that are certified with that organization have agreed to follow certian guidelines and act in a professional manner. If they fail to do so they can be removed as a certified doula through that organization.

A person can work as a doula even if they have never done any formal training. They can not claim they are a certified doula though. Some hospitals are now asking for doulas to provide verification of their certification because some douals have caused problems or not acted in a professional manner while attending a birth. There are advantages to doing a training whether online or at an in person workshop and getting certified.

What are the options for learning to become a doula and getting certified?

Check out the post Doula Training Options and Resources for a comprehensive list of training options along with a book list, podcast, blog and video suggestions.

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