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LIVERPOOL DOULAS FAQ Why do I need a doula? Other research which support the benefits of continuous support Scott, Klaus and Klaus: Journal of Womenâs Health, December 1999 A recent analysis of the randomized clinical trials on the effect of social support during labour on perinatal outcome concluded: "It would appear that continuous support during labour is an essential ingredient of the labour that has unfortunately been left out when maternity care moved from home to hospital in the early 1930s. Randomised trials of continuous emotional and physical support during labour have resulted in multiple benefits, which include a shorter labour, significantly less medication and fewer medical interventions, including caesarean section, forceps, and epidural anasthaesia" (Klaus et al. 1992). The authors point out other benefits: "They [doulas} have also been associated with positive social outcomes such as decreased maternal anxiety and depression, increased breastfeeding and increased satisfaction with interpersonal relations with partners." Many women have moved away from close family which would have provided a nurturing role for the new mother. Why do I need a doula when I have my partner?
What does a Doula do? The doula's most important role is to provide nurturing, continuous support and reassurance. After childbirth, the doula may follow up with a couple of postnatal visits to help the new mum settle at home with her new baby, or alternatively, the mother may decide to employ a postnatal doula for a period of 6 - 8 weeks. What doesnât a doula do? What special circumstances could a Doula help with? Birth after sexual abuse- women who have experienced sexual abuse may find pregnancy and birth a difficult time and may appreciate the continuous presence of a doula who is there for her needs during examinations etc VBAC (Vaginal birth after cesarean section) -having a doula can be invaluable to women who would like a VBAC and their presence increases the likelihood of a positive birth experience. Homebirth/Water birth-continuous support from early labour onwards (usually before the community midwives arrive) means that a woman is less likely to feel stress and fear during a long labour (failure to progress is one of the main reasons that women transfer to hospital from a planned first homebirth.) Single Mothers may appreciate a Doulaâs presece if for whatever reason they do not have a partner to support them during the birth.
Myths About Dads and Doulas (From The gentlebirth.org website)
One question heard a lot is what about Dad? Will a doula take his role? I hope to be able to answer those concerns with information taken from a handout by Penny Simkin.
Myth 1 - If a woman has her partner, the doula becomes redundant.
Reality - The doula may be the only person at the labor besides the partner who is there solely for the emotional well-being of the woman. The nurse, the doctor, the midwife have other priorities that compete with the emotional care of the woman: for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born She is not just another stranger with the couple She has the woman's needs as her sole priority. In some cases, the couple will bring several other friends or family members into labor with them. Sometimes these people can be uncertain of how to help which leads to confusion and actually adds to the woman's stress. The doula can direct and coordinate the efforts of a group of people, giving them all some-thing useful to do, so they work as a team on the woman's behalf.
Myth 2 - The doula "takes over", displacing the partner and interferes with their intimate experience.
Reality - The doula can actually bring the couple closer. By making sure that the partner's needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his own comfort level. Some partners prefer to be there only to witness the birth of their child and to share this experience with the woman they love. They may not want to play an active role and do not want to be responsible for the woman's comfort and emotional security. The doula can fill in and allow the partner to participate as he wishes, without leaving the woman's needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his or her efforts by running errands, making suggestions for comfort measures, and offering words of reassurance and comfort. During a long tiring labor, she can give the partner a break for a brief rest or change of scene. While the doula probably knows more than the partner about birth, hospitals, and maternity care, the partner knows more about the woman's personality, likes and dislikes, and needs. Moreover, he loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff gives the woman the best chance of an optimal outcome.
Myth 3 - The doula has her own beliefs about how the birth should go, and imposes it on the woman or couple
Reality - The doula's true agenda is to help ensure that the woman's or couple's agenda is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple's wishes and their birth plan, she may actually think more about it than the couple, especially when labor is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which later might be important. Sometimes if a birth plan is not followed, the couple later look back with regret or disappointment. The doula helps with decision-making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives for the couple to consider. She does not, however, make decisions for the couple.
In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible. As one father said, "I heaved a big sigh of relief when she (the doula) walked in. I hadn't realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down."
A mothers experience Before I ever became pregnant, we had always wanted children. I love to read and began reading out of interest some beautiful books on pregnancy and birth, especially âGentle Birth Choicesâ by Barbara Harper. Sometimes Iâd look at pregnant women and feel so envious, wanting it to be me. Yet I never seemed to get around to actually planning for a child. Nature decided otherwise. I found myself pregnant at just 4 weeks. The symptoms were too obvious too ignore even at such an early stage, so I did the test. We were over the moon. The stories I had read about labour and birth being a very wonderful experience, instinctive and natural, I wanted this experience. I was against the medicalisation of childbirth and longer for a natural, empowering experience. I wanted also for my husband, Tom to enjoy the experience of witnessing his child come into the world. I wanted for him to witness the wonder and euphoria of his baby being born without him being trapped by guilt that his beloved wife was âsufferingâ and âin terrible painâ. I wanted him to be able to relax and feel able to be involved as much or as little as he felt comfortable with. I wanted a natural delivery, no mind altering drugs, no interference, no telling me what to do. I wanted to let Mother Nature show and guide me. But could I do it alone? Could I feel confident that I was capable of doing something so incredible especially when I had never done it before? The questions and doubts needed addressing. I knew what I wanted, I just needed to feel I could really achieve it. I continued my reading, educating myself as much as possible. Thatâs when I began reading about Doulas. Doulas are women who have been there, given birth at least once, they are ready to provide emotional support to a woman in labour. The idea of having a stranger with you in delivery? What was your closest friend to you before you ever met them? Before you met and got talking and got to know each other? Did you know them? Did they know you? Did you know each otherâs preferences and deepest secrets before you had ever even met? Why did you become friends in the first place? Common interest? Ability to share emotional aspects? Ability to actually get along together and feel comfortable in each others company? You can expect no less from a Doula. Although a Doula is not a friend, they offer companionship, compatibility, impartialness, commonality and support. This was what I felt I needed to get through this first time experience of labour and birth. I wanted someone who could be impartial, keep their head if things were crazy and help me keep mine too. Someone who would listen to me when I felt I needed to talk and respect my wishes without question or judgement. I wanted someone who would help me assert my wishes when necessary. I did not honestly feel that it was fair to lay such a demanding job on my husband and expect him to be able to keep his head, perform all of the above and also feel that he could relax and enjoy the experience himself. So a Doula was my option. When searching, I was contacted by a very experienced Doula. She had many years experience. So much in fact, that her introduction to me was to tell me all about herself with hardly pausing for breath. I could hardly get a word in edgeways. When I did, she hardly listened. Well, I sacked that off, knowing immediately that I could never get on with such a person. Then I got another call. She told me her name was Selina and we chatted. She told me she loved horses (we have 3 arabians) and she breeds Bengal cats (we breed Ragdolls). We chatted easily about so many things. Each time I needed to talk, Selina instantly stopped speaking and listened intently. She appeared very intuitive. I knew we would get along. Before I ever went into labour, Selina visited us at home and answered any questions that we could ask. Tom had the opportunity to get a load of questions off his mind. I noticed he became more relaxed and confident about the birth. We all felt at ease in each others company. By the time my baby was due, I felt safe and confident around Selina and could openly discuss anything with her. She always respected my feelings. When my labour began, I was a huge relief to have Selina as the extra support (please read my birth story â the birth of Darian). I had a natural delivery, despite earlier pre-eclampsia fears and threats of induction, and in spite of raised blood pressure. I had a drug free labour and birth and had no interventions. I completely enjoyed the power, wonder and euphoria of giving birth to my son and doubt that I could have enjoyed to the same extent without the support and encouragement of Tom and Selina. |
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