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How do you doula? Labor & Delivery

How do you doula?

Why hiring a labor and delivery advocate is worth your while.

Labor and delivery is a lot like free-fall parachuting: You take classes to prepare, you file a detailed plan for the (blessed) event, and then you take the leap. Still, jumping into the hurtling wind with only your significant other for assistance seems like a crazy idea. (Sorry, hon.) Even experienced moms with loving partners can benefit from a doula’s help. Here’s how.

Benefit #1: Continuous care
Most moms agree: Labor and delivery nurses are angels in scrubs. However, demands on nurses are high, and they don’t always have as much time to dedicate to every patient as they might like. A doula is an asset because she provides one-on-one care. “In labor and delivery, there are really two patients: mom and baby,” says Heather Talley, RNC-OB, director of labor and delivery at Brookwood Medical Center in Birmingham, Alabama. Nurses must update charts, consult physicians and monitor baby. Your doula stays focused on you, start to finish.

Benefit #2: Shorter (safer) labor
Studies show doula-attended labors are 25 percent shorter on average. Who wouldn’t want that? “Long, drawn out labor can be physically and emotionally challenging, even if a woman is medicated and ‘comfortable’,” says Ann Fulcher, CLE, CD, program manager for the Hearts and Hands Volunteer Doula Program at the University of California, San Diego. Shorter labors are more effective, and there’s less time for infection or other complications to develop, Fulcher says. Doula-assisted moms are also less likely to receive epidural anesthesia, forceps delivery, or a Caesarean.

Benefit #3: Cool tools
A doula’s kit often contains scented oils, ice packs, heating pads and a birth ball, Talley notes. Doulas also know which labor positions relieve pain and increase effectiveness. Mom of two Kristen Lohman Burris of Eagle, Idaho, says her doula used massage, music and aromatherapy. “When the music didn’t suit my needs, she turned it off,” Burris says, “She didn’t take anything personally.” A doula’s bag of tricks gives you access to a range of coping techniques and leaves room in your suitcase for cotton bodysuits and postpartum snacks.

Benefit #4: A smart start
Even if you took Lamaze or watched seven seasons of TLC’s A Baby Story, you might forget what you learned when contractions start. Doulas certified by DONA International study the childbirth process, pain management techniques and breastfeeding, and they’re graded during three precertification births, says Lori Hill, CD, LCCE, DONA’s director of public relations. Doulas typically meet with a client well before D-day to get acquainted, answer questions and make plans. “The personal bonding that took place in advance allowed me to completely surrender to my doula’s loving guidance during labor,” Burris says.

Benefit #5: Less distress
Doula-supported moms report lower levels of stress during labor, and emotional perks pay off physically. When you’re stressed, the body releases adrenaline, activating the fight-or-flight response. “In simplest terms, adrenalin suppresses oxytocin, the hormone that makes labor happen,” Fulcher explains. So if a mother is anxious, scared or angry, stress hormones may cause labor to stall. “That’s where the doula’s informational and emotional support comes in,” Fulcher says, “and why doulas are useful even for medicated labor and surgical deliveries.” It’s a myth that doulas support only unmedicated moms-to-be.

Benefit #6: Crucial compassion
Despite your best efforts, labor may not go as planned. Your midwife may be out of town, or excruciating back pain may dash your dreams of a drug-free delivery. After seven hours of intense labor, Burris was whisked away to the operating room. The Caesarean was “traumatic, unexpected and fast,” she recalls. She felt like a failure at natural childbirth until her doula weighed in, acknowledging she believed the procedure was necessary. “This comforted me so deeply,” Burris says. “Her expertise and supportive response allowed me to accept the emergency C-section.”

Benefit #7: Team spirit
First-time Mesa, Arizona, mom Melissa Wehmeyer wasn’t sure she needed a doula because she’d have lots of help at her daughter’s home birth. After the fact, she says, “I can’t imagine having done it without her.” Wehmeyer recalls holding onto her husband’s arms for the entire 13-hour labor. “Having the doula freed him up to be there for me in that way,” she says, instead of preparing the birthing pool and taking pictures. A doula supports others—she doesn’t replace anyone. According to Talley, an obstetrical nurse with 16 years of experience in four states, most doctors and nurses welcome doulas. “We want them to be a part of the team,” Talley says.

Benefit #8: Dignity defense
If you want to share the emotional intimacy of childbirth with your partner but feel self-conscious about labor and delivery—and who doesn’t?—hiring a doula lets him assist you without seeing R-rated aspects, like trips to the toilet or violent vomiting. An extra pair of hands takes pressure off your partner and allows him to be involved at a level with which you are both comfortable.

Benefit #9: Social graces
It may sound like a doula will do everything but deliver your baby, but that’s not the case. A certified doula’s professional standards of care and ethics don’t allow her to give medical advice or make decisions for you, Hill says. She will facilitate interactions with the doctor by reminding you of questions you wanted to ask, helping you to help yourself. And she’ll intervene politely should a sticky situation (such as who’s welcome in the delivery room) arise.

As you prepare for baby’s birth, take time to ensure you’ll have the labor support you need. Even with heroic partners at their bedsides, many moms decide it’s best to go pro.