How Doulas Work


What Doulas Do (and Don't Do)
Ashley nurses her newborn son, Isaac, as the doula who ended up delivering the baby, background, keeps a watchful eye over them. Student midwife Jessica Lockwood (L), takes Ashley's blood pressure. Jessica Rinaldi/The Boston Globe via Getty Images

If you're about to give birth, don't go firing your midwife or obstetrician just yet. Probably the most common misconception is that doulas deliver babies. In fact, they are not able to perform any type of medical function. "If there is any medical element, be it a syringe, an IV or a heart rate monitor for instance, a doctor, midwife or a nurse will handle that," Bennett says. "But we do hold your hand and help you breathe while these things are being administered, because they can be uncomfortable or bothersome, especially when you are having contractions. Doulas help to ease that."

Doulas should be knowledgeable about medical procedures to the point where they can explain risks, benefits, alternatives and why they're done, but the doula cannot make the decision, pressure a mother into a decision or even give direct advice. Doulas should also avoid contradicting the advice of providers, as they are the trained medical care professionals [source: International Childbirth Education Association].

Medical limitations aside, doulas serve pretty important functions. They typically meet with clients before birth to answer questions, address concerns and equip parents with coping techniques, especially related to pain management.

"We provide a listening ear for any concerns that may come up during pregnancy, anything from fear about birth to the physical discomfort of growing and carrying a small human for nine months," Bennet explains. "We help clients prepare for the birth in whatever ways they are most inclined to do so. So, if using medications is the route you want to go, we are knowledgeable about which options are available in which birthing facilities and help you think about the best times during your labor process to receive those medications, how they work and what to expect, whether you desire to go early on in labor or stay at home for a little while."

And although the common belief is that doula-involved births are done without pharmaceutical intervention, that's actually not the case. "We share information about alternatives to pharmaceutical pain relief such as water birth, sterile water papules for back pressure, movement, positioning, vocalization, and other specialized techniques, some of which continue to be very comforting even when epidurals are used," Bennett explains.

During labor, a doula gives emotional and physical support to the mother. She ensures that mom gets enough water/fluids and employs pain and stress relief measures like heat or cold therapy. The doula also coaches the mother through pain, using coping skills like visualization, relaxing touch and breathing techniques. A doula can also suggest position changes that help the laboring mother-to-be handle the discomfort and progress in labor [source: International Childbirth Education Association].

Doulas are not intended to replace the father or co-parent during the labor and delivery process. Instead, they should complement and support him and others present for the birth, as well. After the birth, doulas usually assist with first feedings and bonding efforts. Many also work with mothers postpartum to facilitate healing, and consult throughout the often-complicated breastfeeding process [source: National Partnership for Women and Families].

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