A Doula’s Story
As I entered the room, I had no idea that what I was about to experience would forever alter the course of my life. It was late morning and the room was dim except for the gentle lines of sunshine peeking through the mini-blinds on the windows. All was quiet except for the soft whispers of women and the gentle shuffling heard when one would carefully move from one place to another.
All eyes and attention were focused on the woman lying in the bed. One woman sat at her bedside regularly offering her sips of water every few minutes. Meanwhile, another woman sat behind her curled up body pressing on her lower back. Sitting near the foot of the bed, another woman rubbed her feet while the woman lay there, looking completely at peace.
The woman in the bed, my friend Jamie, wasn’t sick; she was in labor with her fifth baby. It was a homebirth and my first experience witnessing or taking part in the childbirth experience. That morning her husband called saying, “Jamie’s been laboring since yesterday and some of the women here are getting pretty tired. Do you think you could come and help?”
Within moments of arriving in my friends’ home, someone motioned for me to take the place of the woman pressing on Jamie’s back. Without words, she showed me where to press, and I leaned in. Before long, I felt the hands of another woman rubbing my back and arms as I pressed in to offer comfort to the laboring mother.
Every now and then Jamie would say, “I’m so tired,” or ask, “Why is it taking so long?” The women simply encouraged her, “You’re doing such a good job. Just breathe the baby down. You can do this. I’m so proud of you.”
Hours later, the Certified Nurse Midwife (CNM) attending Jamie’s homebirth said it was time for her to begin pushing. I peeked on tiptoe over shoulders of other women to see what was going on, until one of them looked at me and said, “I’ve seen this before, but this is your first time!” Taking me by the shoulders, she moved me right to the foot of the bed. I had a front row, up-close view of the miracle of life!
And I was hooked.
My name is Missy David, and I am a Birth Doula. Although I wasn’t at the time of that story, the experience opened up a whole new world for me. Before then, my only experience with childbirth was what I had seen on television or heard from friends, which left much to be desired.
What I witnessed was a childbirth experience I didn’t know was possible. I didn’t know you could birth your baby in peace, without fear or excruciating pain, surrounded by people who believed in you. I knew that was what I wanted for myself, and somehow I knew I wanted to ensure other women had that same experience.
Two of the women in the room that day also attended my births. Though they were not professional doulas like I am, they acted as doulas for me. Between them they had birthed 14 children and attended dozens of their friends’ births. I felt I had the best of both worlds with a CNM attending my birth in a hospital setting, and also having the emotional support of other women who had experience and knowledge with which to guide and support me in my journey.
“Doula” is an ancient Greek word meaning “a woman who serves,” and has evolved in recent years to refer to a woman who offers professional labor support. Birth Doulas offer physical, emotional and informational support to women before, during and just after labor. Postpartum doulas offer similar support to women in the weeks following childbirth.
While Birth Doulas do not perform any medical tasks and don’t speak on your behalf, continuous support in labor can drastically change the outcome of your birth. Numerous clinical studies show that women who have doula support during labor are less likely to have any analgesia/anesthesia, require instrumental delivery, have a cesarean, have a baby with low Apgar score, or report dissatisfaction with their experience.
Professional doulas receive extensive and specialized training and, in some cases, certification from one of several organizations. DONA International (www.dona.org), CAPPA (www.cappa.net), and Childbirth International (www.childbirthinternational.com) are some of the better-known organizations offering training, support and accountability for professional doulas. Since there are no regulations on doula support, there is nothing preventing a person from calling herself a doula and charging clients for her services. I know several trained and experienced doulas who are not certified but are excellent doulas. When considering hiring professional doula support, be sure to ask about her training, experience and do some research to be sure the organization backing her up is a reputable one. It would be wise to also read up on the training, certification requirements, ethical standards and scope of practice of various doulas. A professional doula will be very clear and up front about what services and tasks she does and does not do.
Do you really need a doula if you are birthing in a hospital with physicians and nurses? Dr. Corey Babb, a local OB/GYN says, “I recommend that all expecting mothers hire doulas, especially ones attempting a vaginal birth after a cesarean. Doulas fill a certain role in the birth continuum that often cannot be filled by nurses or physicians.”
Shaun Lesser, certified nurse midwife (CNM) in Tulsa says, “Doulas are like your brain during this time. They remind you when to eat, drink, change positions. This provides a way to put your worries aside, and use your energy in focusing on bringing this baby into the world.”
While doulas cannot (and should not) speak on your behalf, they can help you remember to ask questions and improve communication between you and the hospital staff.
While the medical team focuses on the medical needs of you and your baby, a doula is completely focused on your needs, both emotionally and physically.
“There is a night and day difference during birth when a good doula is on the case. The amount of serenity and control that they help their client maintain is palpable in the delivery room,” Babb said.
Doulas also offer unbiased, nonjudgmental support for all women, regardless of choice of birth location (home, hospital or birth center) or pain relief. Even if you plan on getting an epidural in the parking lot, a doula can offer you experience and support that few others can.
Lesser explains how she has witnessed a stark difference between women who have doulas present and those who don’t. She says for families who don’t have doulas, “It can be difficult seeing someone you love and care about go through such an intense time…Many times if there is chaos or rising tension in the room, the experience tends to be more stressful for everyone, sometimes even the baby!”
Doulas cannot prevent emergencies or unexpected complications, but they can help ensure your experience is positive, even if things don’t go as planned.
“From what I’ve seen, doula support leads to a more satisfying, less traumatic birth experience,” Dr. Babb said, “and also helps with pain control during labor.”
He said that his patients who use doulas “are more educated about the birthing experience, and are more in control of their labors.”
“Doulas are very educated in emotional and physical support during labor and birth,” Lesser said, “While midwives are very in touch with this as well, a primary focus for your provider is safety for mom and baby. It’s a perfect package for a client to decide to have a doula. It is very much a team effort, and with a doula, you can ensure you have the most complete care possible.”
So what will a doula actually do for you? Most doulas offer packages with services similar to the following:
- One or more prenatal visits to discuss your needs and how she may assist you during your birth
- Information and resources to help you make decisions about your birth experience, and possibly childbirth education
- Information and practice with comfort measures, relaxation and other techniques to help you during your birth
- Education and coaching, as well as resources, to help you prepare for and establish successful breastfeeding
- On-call period of 2-4 weeks where she is available 24/7 to accompany you when you are in labor
- Continuous presence during your labor and birth, including un-biased informational support, physical and emotional support (she does not leave your side except for brief breaks) up until 1-2 hours after the baby is born
- Specific training, knowledge and experience in the physiology of birth, so she can help you cope with labor and keep things moving along in order to avoid unnecessary interventions and complications
- Support with breastfeeding after the baby is born
- At least one postpartum visit to check in on you, assist with breastfeeding and other needs, and to refer you to specialists if there are any major issues
Many doulas offer additional services, including childbirth classes, breastfeeding education, lactation support, professional photography, massage therapy, nutrition counseling, placenta encapsulation, acupressure, acupuncture, postpartum doula services, babysitting services, classes for siblings, prenatal yoga, holistic health services and much, much more. Some doulas have additional and extensive training in specifically caring for teen mothers or women seeking vaginal birth after cesarean (VBAC).
Finding a Doula
The following websites list Tulsa area doulas currently taking clients:
- Doulas of Northeast Oklahoma (DONEOK) – www.tulsadoulas.com
- Tulsa Doula Directory – www.honeybeemama.com/p/tulsa-doulas.html
- Tulsa County BirthNetwork – www.facebook.com/TulsaCountyBirthNetwork
Like medical providers, all doulas have slightly different personalities and experiences. Consider interviewing several doulas to find the right fit for you and be sure to inquire about her training, experience, philosophy, services and fees. Many doulas offer discounts, sliding scale and even barter.
Often overlooked are the services of Postpartum Doulas. While a Labor or Birth Doula offers support before, during and just after birth, Postpartum Doulas offer a different and highly needed support. Postpartum Doulas have extra and extensive training on breastfeeding, parenting skills, postpartum physical care, postpartum mood disorders and much more. Many women assume that since they have family and friends near, they will have all the help they need once the baby is born; however, often our mothers, siblings and friends have little or no experience with birth, breastfeeding or even caring for newborns. They may be more interested in holding the baby than caring for you or helping with simple household tasks. Physical postpartum complications are considerably more significant and common than many people realize and when a woman isn’t able to truly rest and simply bond with her baby, her health and well-being are drastically compromised.
Specifically, Postpartum Doulas offer the following services, and sometimes much more:
- Education, companionship and nonjudgmental support in the weeks following birth
- Assistance in the care of your newborn, family adjustment
- Help with meal preparation, light housework, and possibly errands
- Evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary