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Penny Simpkin, the founder of Doulas of North America explains best why having a Doula at your birth in addition to the father and other family and friends is important:
"In comparing a doula to a best friend or the woman's mother or sister, the difference is the experience and the perspective of the doula, and her hands-on knowledge. Doulas have had training in a variety of situations, such as when labor slows down, or if the mother becomes discouraged, or if she's having back pain. And someone who truly cares for the woman may offer love and stay with her, but may not have ideas of things to try. Having that well-rounded knowledge and experience with many laboring women means the doula offers benefits that a friend couldn't have. Comparing a doula with a partner, I think the partner brings things that no one else can bring. He or she loves the woman more than anybody else, he or she knows her better than anybody else, which are wonderful things.
"But one of the disadvantages is that it's awfully hard sometimes to watch the person you love in pain, or frustrated or discouraged with a lack of progress. And there's a tendency to want to rescue her from that. Partners do not have the objective, calm perspective and experience that a woman needs and a doula has. Sometimes the woman doesn't need to be pitied, or rescued. What she needs is someone to say, 'you're OK, this is all right, you're going to get through this, let me help you.' But she also needs someone with a perspective on when to throw in the towel, and to recognize that this is not going normally, or that we need some interventions here. Furthermore, sometimes the doula can speak with the [hospital] staff, in a liaison capacity, with a little more confidence than the partner can.
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In the wee hours of the night a woman is working to bring forth her baby. Her heart is open and her body is opening. She knew her body was designed for this miracle. She only needed a place in which she felt safe and people who she could trust to keep an eye on the details. She would have to let go of her alert attention to detail, she knew, for her labor to progress.
The smell of her mate is comfort itself. Her mate holds the story of who she has been. She wants him to see the birth, to be part of the event that brings about who she will become.
She chose a midwife for her patience with the natural process of birth. Her midwife also knows how to handle common birth complications and knows which signs mean its necessary to move on to another provider, like a family practice physician or obstetrician. Her midwife not only believes in the normalcy of birth in general but can also assess and validate that her labor is normal.
In early labor the comfort from her mate was just right. In active labor, the midwife’s presence is comforting to both her and her partner. Now, as the sky lightens, the labor picks up even more intensely.
Our birthing mother notices her mate pulling back a bit. It happens as she slips deeper into the labor, into that primeval place, where her partner cannot follow. The midwife, too, seems distant for a moment. Ahh, there she is, bringing her instruments closer. The smell of the ginger compresses is rejuvinating. She hears the midwife tearing open the paper package that holds her sterile gloves.
A contraction sweeps over her rocking her to her core. Wait. Can’t quite stay with it. She wonders will she ride it out or will it ride her under?
She feels a warm touch on her shoulder, hears her name spoken kindly. The doula is there. Oh, yes, that’s right, women do this.
Now she knows she can do it, too. The next contraction comes. The doula is face-to-face, speaking the rhythm of calm. Her partner sees how transition is supported and comes close, confident again.
Suddenly comes this powerful force within her; the urge to push. The midwife speaks. Her voice leads her through this almost overwhelming shift. The midwife shows her how to breath in ways to prevent a tear and bring oxygen to her little one just inches inside. The doula reminds her that her body can give birth.
On one of the days to come, she hopes to share reflections of the birth with her midwife. She is hungry to hear her midwife’s view of her labor and get a few details figured out. She looks to the midwife to hear of her birthing strength and of the highs and lows of the course of her labor. What her midwife says seems to validate her initiation into the mystery that birth is.
She will also talk with her doula, probably several times, about the birth. Even though the doula was there, telling the birth together moves the story into the fabric of her new motherhood. She sees the doulas face light up with that awe and celebration that lets her know she has successfully become a mother victoriously and in honor. Her doula is a peer who shares her community.
I am a midwife who has also been a doula for many years. The roles may overlap. Both celebrate the strength and glory of birthing women. But, the roles are different.
The doula is concerned with the mother’s emotional experience first and foremost. The midwife must be concerned with the health and safety of the mother and her baby first and foremost. The doula is a peer, like a new friend with experience in birthing. When birthing in a hospital, the doula may be the only objective person a pregnant woman meets in pregnancy, has beside her through birth and spends time with after the baby comes.
Birth is personal. Trust is an intimate avenue to a physiological function. We can trust birth not just because of a statistical advantage, but because we live in relationship between our physiology and the people we love and have community with. Peace on both sides, physiological and in relationship, is a balance between the two. The doula seeks to clear obstacles to peace while the midwife steers clear of the obstacles of birth.
The midwife is an ancient role renewed to modern times. The doula is a modern role reflecting ancient times.
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Debunking the Myths At Meet The Doula Night
Myth 1: I don’t need a doula because I’m having a hospital birth.
“This week, the National Institutes of Health will hold a conference in
Bethesda, Md., about the country's dismal rates of vaginal birth after
Caesarean, or VBAC (pronounced VEE-back), which have plummeted since 1996.
"I think it's the purpose of this conference to see if we can turn the clock
back," said Dr. Kimberly D. Gregory, vice chairwoman of women's health care
quality and performance improvement at Cedars-Sinai Medical Center in Los
Angeles. “
Currently if you are having a hospital birth you statistically have a 35% chance at having a c-section even if you present with no complications such as gestational diabetes. While we understand that home birth is not something every set of parents are comfortable with you should be aware that the same population in home birth has a 5% chance of having a C-section.
"Labor and birth are whole-being experiences; the autonomic nervous system will shut the whole process down if the woman perceives stress, threat, or danger. In typical hospital settings, with shift changes, strangers walking in and out, bright lights, confinement to bed and monitor, and restricted oral intake, it is no wonder that the process doesn’t go as smoothly as it could. “Failure to progress” – the diagnostic reason given for 50% or more cesareans – is largely an environmental issue."-- Katharine Hikel, MD
Myth 2: I don’t need a Doula I have my husband.
The continued presence of a doula during labor significantly reduces cesarean delivery rates and the need for epidural analgesia in middle- and upper-class US women accompanied by their male partner or another family member, researchers report. They suggest that maybe fathers should not be expected to fulfill the role of primary labor companion. Susan McGrath and John Kennell from Case Western Reserve University,Cleveland, Ohio, USA, investigated the potential benefit during labor of an experienced doula to provide both emotional and instrumental support. A total of 420 women were randomly assigned to either have a doula present throughout labor in addition to their male partner or no such additional support. Women who had the support of a doula had a significantly lower cesarean delivery rate than the control group, at 13.4 percent versus 25.0 percent. They were also less likely to need epidural analgesia, at 64.7 percent versus 76.0 percent, respectively. Among women with induced labor, just 12.5 percent of women with a doula had a cesarean delivery, compared with 58.8 percent of those without a doula. All women and their male partners who received the support of a doula rated their experience as positive. "Continuous labor support by a doula is a risk-free obstetric technique that could benefit all laboring women and should be made available in all maternity units," the researchers conclude.
Myth 3: The cost of a Doula is out of my budget.
The cost of a C-section is on an average of $2,700 more than a vaginal birth. This is not factoring in the longer recovery time which will affect the paycheck you will or will-not earn. And to add to this issue now many insurance companies are denying women insurance after they have a c-section. Some consider this a pre-existing condition. The cost of not having a Doula is far greater than the range of fees that usually start around $500 and go to $1000 to hire a Doula will be.
So why should you hire a Doula to attend your birth?
Although most childbearing women and newborns in the United States are healthy and at low risk for complications, national surveys reveal that essentially all women who give birth in U.S. hospitals experience high rates of interventions with risks of adverse effects. Optimal care avoids when possible interventions with increased risk for harm. This can be accomplished by supporting physiologic childbirth and the innate, hormonally driven processes that developed through human evolution to facilitate the period from the onset of labor through birth of the baby, the establishment of breastfeeding, and the development of attachment. With appropriate support and protection from interference, for example, laboring women can experience high levels of the endogenous pain-relieving opiate beta-endorphin and of endogenous oxytocin, which facilitates labor progress, initiates a pushing reflex, inhibits postpartum hemorrhage, and confers loving feelings. Large national prospective studies report that women receiving this type of care are much less likely to rely on pain medications, labor augmentation, forceps/vacuum extraction, episiotomy, cesarean section, and other interventions than similar women receiving usual care. Such physiologic care is also much less costly and thus provides outstanding value for those who pay for it
But don’t take our word for it read the Cochrane report:
http://www.childbirthconnection.org/pdfs/continuous_support.pdf
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