The wisdom and compassion a woman can intuitively
experience in childbirth can make her a source of healing
and understanding for other women. Stephen Gaskin
What is a birth doula?
The word "doula" translates from the ancient Greek language as "servant woman" or "caregiver."
"Birth doula" is now used to refer to a trained and experienced professional who provides continuous physical, emotional, and informational support to the mother before, during, and just after birth.
There are also women who work as "postpartum doulas" and they are skilled in providing continuous practical and emotional support for families in the early postpartum period, as they adjust to life with their newest addition.
Currently, my services are as a birth doula. If you are interested in the services of a postpartum doula, please contact me for information. There are now many options for postpartum care in our region.
I am working toward certification with DONA International, which is the premiere professional association of doulas, worldwide. For information about DONA and to understand what certification requires, please visit the DONA International website, www.dona.org.
Recent studies indicate that when a doula is present:
- There are better outcomes for mothers and babies
- Labours are shorter and more comfortable
- Deliveries have fewer complications and interventions
- Breastfeeding goes more smoothly
- There is greater maternal satisfaction
A birth doula:
- Recognizes that birth is a key experience that the mother will remember all her life
- Understands the physiology of birth and the emotional needs of a woman in labour
- Assists the expectant mother in preparing for and carrying out her plans for birth
- Stays with the mother throughout the labour and delivery
- Provides emotional support, physical comfort measures, and an objective viewpoint
- Helps the mother to acquire the facts that she needs to make informed decisions
- Facilitates communication between the labouring woman, her partner, and her clinical care providers
- Perceives her role as nurturing and protecting the mother's memory of the birth experience
- Allows and encourages the woman's partner to participate at his/her comfort level
The above information has been adapted from www.dona.org. Used with permission.
What about my partner?
In North American culture. . .long gone is the time when an expectant father was depicted as a nervous man who spent the duration of the labour and delivery pacing the halls, awaiting the announcement of his child's birth from a nurse. These days, not only are fathers expected to be present for the birth of their children, but they are often longing to be active participants in the whole process. This is a good thing, for sure!
Even though your husband, partner, sister, friend, or mother may be the closest and most intimate relationship that you have present with you at the birth, he or she may find the experience emotionally and physically challenging in ways that are difficult to foresee and prepare for. Your loved one may have every intention of supporting you, but then in the reality of the experience, finds things more difficult than anticipated. Having a doula's care can take the pressure off your partner and can help everyone's mind to be at ease. The doula's presence can have such a reassuring effect because she is experienced and familiar with what is normal in labour and birth.
A loving and caring partner can be such an asset to your birth experience, and your doula is skilled in helping your partner to support you with confidence. A doula certainly never takes the place of your partner, but rather, supplements his or her care and attention with her knowledge and experience. Having a doula present helps to provide the continuous support that is so helpful to the mother, allowing her partner the freedom to take a break if things become physically or emotionally straining.
I am happy to be there for both you and your partner, in whatever way you need me!
There is more hunger for love and appreciation
in this world than for bread. Mother Teresa
Can I still have a birth doula if I want a medicated birth?
Absolutely! Medical pain management is something that many expectant women want to know more about. I'm all about informed choice, and I have plenty of information to share with you regarding medications and interventions, so if after adequately informing yourself, you feel that you would like the option of medication during labour and birth, I am happy to support you in that decision! This is your birth, and I want you to feel prepared and confident. It will be so helpful for you to have someone there who is devoted to reassuring and encouraging you through experiencing birth on your terms.
Studies on the Effectiveness of Birth Doula Care
In their book, Mothering The Mother: How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth, Marshall Klaus, John Kennell and Phyllis Klaus summarize scientific studies which have been carried out on the advantages of doula-assisted births. The evidence cited is drawn from six randomized, controlled studies. Two studies were carried out in Guatemala, the first one with 136 women, and the second with 465 women. One study took place in Houston, Texas, in the United States with 416 women. A further study involving 192 women was carried out in Johannesburg, South Africa. The fifth and sixth studies were done in Helsinki, Finland and in Canada.
All participants were primiparas (a medical term used to describe women who are giving birth to their first child). All participants were in good overall health and had had uneventful pregnancies. They were invited to participate when they were admitted into the hospital in labour. The Guatemalan doulas were trained in a 3 week course. In the South African study, the women who acted as doulas were untrained lay-women. The doulas were asked to stay with the labouring women constantly. They were instructed to use touch and verbal communication, focusing on three primary factors: comfort, reassurance, and praise. All of the doulas in the study had experienced regular labours and vaginal births.
In all of the above studies, the doulas used soothing words, touch, and encouragement. They explained the procedures as they occurred and translated medical terms into layman's terms. The results of the studies were as follows:
- Reduced the overall cesarean section rate by 50%
- Reduced the length of labour by 25%
- Reduced oxytocin use by 40%
- Reduced the use of pain medication by 30%
- Reduced forceps deliveries by 40%
- Reduced requests for epidural pain medication by 60%
- Reduced incidences of maternal fever
- Reduced the number of days newborns spent in NICU (Neo-natal Intensive Care Unit)
- Reduced the amount of septic workups performed on newborns
- Resulted in higher rates of breastfeeding
- Resulted in more positive maternal assessments of maternal confidence
- Resulted in more positive maternal assessments of maternal and newborn health
- Resulted in decreased rates of postpartum depression
If a doula were a drug, it would be unethical not to use it.
John H. Kennell, MD
What is the difference between a birth doula and a midwife?
This is a question that I get a lot!There are a few alternatives to choose from when it comes to your maternity care. Family physicians and obstetricians are excellent options, and these days, more and more women are learning about the benefits and skills offered by midwives. As a doula, I work for the expectant mother or couple and not the care provider, and so I am eager to support you in whatever kind of care situation that you are in. It's been my experience thus far that when someone inquires about the difference between the roles of a midwife and those of a doula, it isn't that they are over-assuming what a doula does, but rather that they are often under-assuming the skills of midwives. For more information about what it takes to be a Registered Midwife in BC, please visit the College of Midwives of BC website, www.cmbc.bc.ca.
Birth doulas and midwives have similar but different roles and priorities
While in the care of a midwife, a woman will receive highly individualized and nearly continuous labour support. However, the midwife has specific duties to attend to. Additionally, midwives occasionally have more than one woman in labour at once, in which case, you may not have the continuous presence of your midwife. A midwife's job is the clinical management of labour and delivery. Her top priority is to the health of both the mother and the baby. She will perform vaginal exams, monitor fetal heart tones, and assess contraction patterns. She will regularly check a mother's blood pressure and temperature and she will keep an extensive record of all the medical information related to a labour. At delivery, a midwife will help a mother birth her baby, catch the baby, and assess if the newborn needs any resuscitation. After the delivery, the midwife will need to tend to the delivery of your placenta and examine it. She will check the mother for any damage to the birth canal and perineum, and stitch any tears that might have happened at birth.
The birth doula's job is to help the mother in any non-medical way that she desires
She works for the mother and her partner, and not for the midwife, physician, or the hospital. She will be available from fairly early in labour to be with the mother and her partner, if they desire it. As labour progresses, her role shifts. She may begin by tidying up the mother's home, helping the mother to be more comfortable, fetching supplies or helping with siblings. As labour becomes more challenging, a birth doula begins to offer the mother and her partner more hands-on support through massage, position changes, verbal support, relaxation exercises, and suggestions for effective movement during contractions. She can help a mother with verbal and emotional support during labour and help a partner find effective ways to help the mother. She will be available in the first few hours after the birth to make sure the mother is comfortable, the couple is fed and refreshed, and will help with breastfeeding as needed.
Midwives and doulas make a wonderful team!
Primarily, the midwife's responsibility peaks at the time of the birth, which is when she must be at her most alert to perform her job effectively. This means that she must conserve her energy throughout your labour to perform her job as best she can. This does not mean that midwives do not provide labour support--they do--just that they have many other responsibilities that must take precedence. In contrast, a doula's responsibility peaks during active labour and transition, when the labouring woman needs the most help coping with her contractions.
When midwives are attending to clinical matters, birth doulas are focusing on the mother and helping her get through her contractions. Where the midwife's first priority is the safe delivery of mother and baby, the doula's first priority is the mother's mental well-being, and the support of the growing family as a unit.
Interested in midwifery care?
Midwives are highly trained experts in care for pregnancy, birth, and the first six weeks postpartum. To find out more about midwifery care and what it takes to be a registered midwife in BC, please check out www.cmbc.bc.ca.
Nuturing Women. . .Trusting Birth
Jane Hedges, B.MW, RM, Breastfeeding Counsellor
Registered Midwife
Jane serves families in Prince George and area with complete midwifery services. Did you know that midwifery care is covered in British Columbia by MSP? Just show your Care Card!
There are some exciting changes happening at Northern Midwifery Care so please visit the website to find out more!
Contact Jane today!
250-562-0834
Jane also has a special interest in helping women in the early postpartum phase. Even if you are choosing physician care for your pregnancy and birth, you still have the option of midwifery care for the first six weeks after your baby is born. Postpartum midwifery care is covered by MSP for BC residents. Contact Jane for more information about how she can help you as you as you transition to life with your new little bundle of joy! Visit her postpartum care website at
for maternity care in our region.
