The Value & Purpose of Labor Support: An Essay for Certification

As part of the DONA-certification process, doulas write an essay and they all have the same title. This is from February, 2004. Other steps in the process include attendance at 3 births where you are evaluated by a professional who witnessed your interactions with the family and the family, essays on those births where you share how you helped and maybe what you learned, and these other steps (it has been a while!). I loved my doula training, and I became great friends with my trainer (still a mentor and now a great friend). I whole-heartedly endorse DONA if you are looking into becoming a birth or postpartum doula. 

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The Value & Purpose of Labor Support

A doula is a woman who provides professional labor support during birth to an expectant family.  In today's western world, this idea is often thought of as new, but one birth study cited by Dr. John Klaus showed "in 126 of 127 cultures, laboring women had one or more experienced women with them continuously throughout labor" (Thinking Woman's Guide to Birth, Goer 181).  It was not until our "modern" medical establishment shooed women out of their homes and into hospitals for birth that the presence of this caring, experienced support person disappeared in our culture.

Numerous studies have repeatedly shown the value of labor support to the mother and the family.  These studies have been published in such places as the Journal of the American Medical Association, the New England Journal of Medicine, and the British Journal of Obstetrics and Gynaecology.  Compiled in The Doula Book, by Klaus, Kennell, and Klaus, a doula's presence during birth can decrease a mother's cesarean section rate (86-88), reduce the length of her labor (80-83), reduce her need for labor augmentation (83), and reduce her need for pain medication and her request for epidural anesthetic (83-86).  Studies also show mothers who have doula support during childbirth have higher breastfeeding rates, more confidence in their mothering abilities, their personal health, and the health of their babies (101-111).  By no surprise, these women also have a decreased rate of post-partum depression (106).

Aside from what the data shows, doulas offer continuous care during labor and delivery; this care cannot be matched by any other on the birth team.  Doulas do not have shift changes, clients laboring concurrently in another room, paperwork which must be attended to, or a practice beckoning with women in various stages of pregnancy needing attention.  A doula takes care to cautiously place clients on her calendar within a safe space of time.  This helps ensure she will be available to her contracted client.  Of course unforeseeable things can happen, and a doula may request her back-up doula to either attend a birth or take over at a long birth, but these things are the exception and are likely discussed beforehand.

Although a doula's role can vary from birth to birth, her primary goal is to mother the mother by providing physical, informational, and emotional support.  This can mean walking the halls with a woman and standing as a pillar to slowdance with her client during a contraction.  This can mean cradling a scared mother in the arms of her confidence and compassion.  This can mean exploring the stages of numbness while her fist juts just so in the back of a laboring woman.  This can mean gently preparing a father for a cesarean birth, or calming a mother while her baby is being coaxed to breathe.  A doula is flexible and can fit into the spaces left void by those on a woman's birth team.  And while she does this, she also role-models to those present how to lovingly support this laboring mother.

After the birth, a doula can act as a balm to help heal emotional wounds which might have been acquired during birth.  Doulas can be integral in helping mom and baby experience their first breastfeedings.  Doulas can also help mom and partner process their labor and birth experience.  Many doulas visit the family postpartum to help with the transitions of having a new baby.  Often doulas remain on call or in contact for a certain space of time after the birth.

For a family contemplating having a doula at their birth there are resources available to them.  DONA International is the world's premiere doula organization.  They certify birth and postpartum doulas.  By visiting DONA's website (www.dona.org), a couple can locate a doula in their area.  Also available at this site are questions to ask a potential doula, the description of DONA's doula certification requirements, and other helpful articles, such as Dads and Birth Doulas, and Effects of a Birth Doula.

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