Earth Babies Blog

My role is not central to the birth but more as a background support to the key players so that they can each focus their energies where they are most needed at any given time.

1. What is a doula?
A doula is a trained, non-medical, birth support person (labour companion). Her function is to provide emotional and informed-choice support to the parents before, during and after the birth. The focus of the doula falls on the mother’s emotional and physical needs, wants and best interests. Her aim is to help the mother (as far as possible) achieve her ‘ideal birth’ as opposed to the ideas held by those present (doula included).
The doula’s support complements the medical care-giver and assists a birth partner in participating with confidence.

2. Why would you need a midwife/doctor and a doula?

says gail J Dahl. “Many women think their doctor will be there for them throughout labor only to discover it’s just them and their partner in the room for most of the time.”

Though a midwife’s approach is holistic care, their main function at a birth is as your medical caregiver and as such there is always a stage in a birth where their focus out of necessity becomes clinical in nature and the emotional needs of the mother become secondary. The doula’s function does not change – her focus remains the mother’s needs and through assisting the birth partner in how best to support the mother, allows the mother to focus on birthing her baby.

3. Does it really help having a doula?
It has been observed that the support of a doula has a positive impact on a woman’s ability to cope in labour as well as her feelings about the birth experience afterwards. Mothers with doula support are less inclined to feel overwhelmed and panicked. This reduces the requests for medicated pain relief, epidurals and the number of caesareans.
Results from 6 different studies of doula assisted births have been observed that due to better birthing positions and less stress hormones produced by calmer women in labour, there is a:

• 50% reduction in the caesarean rate
• 25% shorter labour (due to better birthing positions and less stress hormones produced by calmer women in labour)
• 60% reduction in epidural requests
• 40% reduction in oxytocin use
• 30% reduction in analgesia use
• 40% reduction in forceps delivery
Information was obtained from Mothering the Mother: How a Doula Can Help You Have a Shorter Easier and Healthier Birth, Klaus, Kennell, and Klaus (1993).

4. How do doulas practice?
In South Africa doulas practice privately and are hired by the birth parents.
Depending on how they structure their package and what extras are provided their costs range from R1500 to R3000 (this will invariably cover 1-2 visits prior to the birth, the birth itself, the settling period after the birth and 1-2 post natal visit).

5. Does a doula replace nursing staff?
No. As indicated the doula’s function is non-medical, though they do assist the staff in terms of taking care of the mothers needs as the doula’s presence at the birth is consistent throughout the birth and they only have one person to care for -whereas medical staff are not present the entire duration, their attention is shared by others on the ward and staff is subject to shift changes.

6. Does a doula make decisions on my behalf?
No – she purely carries out your wishes.

7. Will a doula make my partner feel unnecessary?
No, as said she assists your birth partner in being actively and effectively involved, so on the contrary most birth partners feel that the doula made them feel more comfortable and attending the birth.

8. What do Doula’s do?
• A doula is the only carer who is with the mother consistently for the duration of labour, the birth and till everyone is settled and resting after the birth

• Gives both emotional and physical support and comfort in coping with each contraction through various means such as: words of encouragement, keeping those present quiet through the contractions, touch, massage, aromatherapy, counterpressure, movement, praise and reassurance.

• She guides on position changes, how to relax, prepares and guides the mother through the different phases of labour by keeping her informed of what is happening.

• The doula can assist and guide in the writing of a birth plan, explain procedures and help parents to make informed decisions and assist in realising the birth plan as far as possible – with this as a guide she acts as the voice for the parents with the medical staff and advocates their birth requirements.

• Doulas are informed on all phases of labour and birth and are able to prepare parents through explaining what to expect.

• Doulas assists the birth partner in how to be supportive to the mother and by taking care of more trivial things can free the partner up to concentrate on the birth mother (or by being there to support the mother can give the partner a breather).

• She is able to take pictures at the labour and birth (though it is not practical for the doula to be both the carer and the official photographer).

• The doula is trained to assist with post natal care for the mother and child and provide basic support in the successful initiation of breastfeeding.

9. What is most important to consider when choosing a doula?

Regardless of whether you’re choosing a doctor or midwife, you need to look at personality. “If you feel you’re not being respected by your caregiver, then that is not the caregiver for you,” says Gail L Dahl. “And you can switch to someone new right up to the time you give birth.”

You need to feel that she respects your wants and needs for the birth and does not try to instil her own on you. She is not your medical caregiver (you have chosen that person in the role of your obstetrician or midwife) and will not be attending the birth on her own or making medical decisions on your behalf– above all else you need to feel able to rely on her for support, so connecting with her as a person is important.

10. How can I find a doula in my area?
There are various listing services on the net.
DOSA www.doula.org.za
The Village www.doulas.co.za
Sacred Space www.doulatraining.co.za
WOMBS www.wombs.org.za

Birth Plan Generator

other posts on this topic
Birth Story Friday – Gabriel’s Birth – doula perspective
Women who birth