Most people do not know who a doula is or what a doula does. Some people may confuse a doula with a midwife. Perhaps this is because in people’s mind a midwife is someone who used to attend births, in the old days, back in the bush with her knitting needles and a towel. While there are many areas that a midwife and a doula overlap, such as emotional and physical support, there is a big difference. A midwife has training and education in the medical aspects of birth and in some cases can do many things that a doctor can do. Unfortunately through heavy regulation and restrictions the role of the tradition midwife has been slowly declining and we are seeing fewer midwives being able to serve.
As the role of midwife began to be eliminated the role of doula became a necessity. In order to understand the role of a doula I think it is important to understand the prevailing thinking about birth. In the mainstream media birth has been portrayed in such a way that people assume its dangerous and the only safe place is a hospital with an obstetrician. Because of this view women, especially, have lost touch with what it means to birth and what is normal in birth.
Through the 1900’s as birth began to move into hospitals and to be managed by doctors there was an increase in interventions and restrictions put on the birthing woman. Through the 50’s and 60’s doctors and researchers began to relearn what normal, healthy birth really looked like and there was many “back to birth” movements that started. As women began to question common birth practices the allopathic approach to birth began to change. While some forms of interventions began to decrease others began to increase and we saw a rise in inductions and caesarean surgeries. However, there was many in the medical community that began to notice that a woman who had a constant companion through labour and birth had better outcomes for themselves and their babies.
Organizations began to be formed to teach not only women about normal birth but also to train companions to be there for them. Organizations such as Lamaze, Bradley method and Hypnobirthing began to come into communities. Penny Simpkin, a leader in doula training, helped start organizations such as DONA and other doula trainings started to become mainstream. Through distance education and in person workshops women became trained as doula’s and began to learn and understand what normal birth was. They learned how they could use their new knowledge to help women to be more comfortable and relaxed during birth and thus help keep mother and baby safe.
Doula’s are often women who have a heart for others. They come in all shapes and sizes and from all different backgrounds. Perhaps, in days gone past, she would be the one who came to help women in labour in the community. She may have been the one to help women through all different aspects of pregnancy and postpartum care using woman’s wisdom handed down from mother to daughter. Some doula’s come from other professions such as massage therapists, reflexology, herbalist, aromatherapists, nurses and many more. Many women who become doula’s go on to specialize in other areas also such as nutrition or breastfeeding support. Many doula’s find they do years of learning through online courses, workshops or apprenticing with experienced doula’s.
Doula’s fill a very necessary role in a woman’s journey to motherhood. They spend the time with them that no one else does. Doctors maybe spend less than an hour with office visits and nurses only see patients on shift at the hospital. Public health nurses don’t come into play until after baby is born but then only a few times. A pregnant women may have many people involved with her journey including chiropractors, nutritionists, massage therapists, acupuncturists, lactation consultants and others. A doula is another member of her team and learns about some of her most intimate thoughts and fears. A doula can help her sort through some of the information she may get from the internet, books or even friends or family. A doula can offer support and information for staying healthy during pregnancy and in the postpartum period.
A doula can help a woman to ask questions and to learn more about what she needs for her birth. A doula reminds women that this is their body, their baby and their birth. A doula helps a woman find the answers she needs to make her feel safe. Doula’s learn how to help baby connect with mother. They learn ways to help facilitate easier labour. This can include hands on techniques as well as emotional and physical support. They also watch and observe what is going on around a labouring mother to help her process her birth postpartum. Many women have felt overwhelmed with what was done to them during birth and often need someone to help them sort through their thoughts and feelings.
There is so much more to what a doula does then just telling a woman to breath and holding her hand(although sometimes that is all a woman may need). Doula’s are becoming an important part of maternity care and wellness. They are there to serve the motherbaby and all that might entail for that woman. Throughout the ages women have helped women, this is just another version of that. Doula’s mother the mother and can help create connection between the mother and her partner. Many women have found, and research backs this up, that women feel more in charge of their labour and feel more able to meet the needs of their baby with the support of a Doula. Doula’s can help lower health care costs and create wellness in new mothers and baby’s.
While many doula’s work within the medical system with their clients, they are not part of the medical system. They understand that birth is, most often, not a medial emergency but a normal biological process that if given the right conditions will work just fine. They understand that even if a woman needs assistance from the medical community she can still birth in a way that she feels respected and heard. A doula is not a medical professional but practice the age old tradition of women supporting women. Doula’s rely on their integrity, honesty and openness to hold themselves accountable to the women they serve. They play a unique role in the daily lives of women and their families.
Doula’s may also be a sister, aunt, mother or friend. Often the experience of a relative will encourage women that they can do it. As women we come from a long line of excellence in birth. Woman know how to support each other and most women have a deep knowing and understanding that birth can be a time of healing, wonder, excitement, joy and empowerment. Doula’s can help women find this again. Those of us who have a passion for birth and for caring for women and their family have role to play in sharing knowledge with and advocating for all women in all situations at all times.
I would encourage any woman who wants to provide support, even if its just for a family member or a friend, to take doula training. You will find out not only about the pregnancy year but you may also find out more about yourself along the way. I hope you find out more about doula training and if you have had a doula please share with others how she impacted your birth journey.
“Peace on earth begins at birth”- Debra Pascali.