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Doulas
Providing Educational, Emotional and Physical Support for the New Mom

By Ann Grauer

It's no secret that doctors and nurses are overworked, particularly those in the baby business. Even if other patients, shift changes, paperwork, blood pressure checks and fetal heart rate monitoring don't get in the way, doctors and nurses-even midwives-must focus on the health and well-being of mother and baby. The emotional and physical needs of the woman in labor come second. Sometimes she doesn’t get much attention at all. And while most women are surrounded by their partners, families or friends during labor, this good intentioned group can only do so much.

That's where doulas come in.

Doulas have surged in popularity over the past decade and most likely you know someone who has worked with a doula. But if you're like many expecting families, questions remain: What exactly is a doula? How does a doula help? And how can you find the right doula?

A doula is a woman who provides support before, during and after childbirth. Unlike a doctor, midwife or nurse, she is not a medical practitioner. Instead, her job is to focus entirely on the non-clinical side of childbirth. She provides educational, emotional and physical support for the mom.

There are two kinds of doulas: birth and postpartum. Some women hire both, and some just hire one, depending on individual needs. During labor, birth doulas provide around the clock care, comfort measures such as breathing, relaxation, massage and positioning, and an objective, calm perspective. They also help educate families about their options during labor, guide partners to participate with confidence and at their own comfort levels, and enhance communication between the laboring mother and her medical professional. They typically meet with the family one or two times prior to the women's due date and are available to answer questions by phone.

Postpartum doulas, on the other hand, make life easier for the new mother and family in the first weeks after childbirth. In addition to providing emotional support, they help new parents become comfortable with newborn care and infant feeding. They can also lend a hand by cooking a meal,throwing in a load of laundry, spending time with siblings and performing other household organizational tasks.

Aside from helping to make childbirth and its aftermath as positive as possible, doulas have been proven to improve obstetric outcomes. Studies show that when doulas assist with childbirth, women have shorter labors, fewer complications, require less pain medication, and have lower incidences of cesarean sections. They are also more satisfied with their birth experiences, suffer less from postpartum depression, and have a stronger bond with their partners and babies.

Babies also benefit. In fact, fewer babies are admitted to special care nurseries, evaluated for infection, or have longer than normal hospital stays when doulas are involved.

Doulas help moms, babies and families while reducing the cost obstetrical care.

So how can you find the right doula for you?

Some doulas work for hospitals or serve as community or hospital volunteers, so it's worth checking with your doctor. For the most part, though, expecting families hire doulas privately.

Hiring a doula is very personal. While there are thousands of doulas to choose from, not all doulas are created equal. So it's important to ensure that your doula has received formal training and/or certification.

The following questions will help guide you as you seek the right doula for you. When interviewing a birth or postpartum doula, ask:

• What training have you had? (You should verify certification with the organization.)

• Do you have one or more backup doulas for times when you are not available? May we meet her/them?

• What is your fee, what does it include, and what are your refund policies?

When interviewing a birth doula, ask:

• Tell me/us about your philosophy about childbirth and supporting women and their partners through labor.

• May we meet to discuss our birth plans and the role you will play in supporting me/us through childbirth?

• May we call you with questions or concerns before and after the birth?

• When do you try to join women in labor? Do you come to our home or meet us at the place of birth?

• Do you meet with me/us after the birth to review the labor and answer questions?
   

When interviewing a postpartum doula, ask:

• Tell me about your experience as a postpartum doula.

• What is your philosophy about parenting and supporting women and their families during postpartum?

• May we meet to discuss our needs and the role you will play?

• What different types of services do you offer?

• When do your services begin postpartum?

• What is your experience in breast-feeding support?

• Have you had a criminal background check, a recent TB test? Do you have current CPR certification?

Ann Grauer is the President of DONA International. DONA International is the world's largest association of doulas and is the most respected organization that trains and certifies doulas. You can find a listing of birth and postpartum doulas across the globe at www.dona.org.