Studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40%, and requests for an epidural by 60%.2
Doulas often use the power of touch and massage to reduce stress and anxiety during labor. According to physicians Marshal Klaus and John Kennell, massage helps stimulate the production of natural oxytocin. The pituitary gland secretes natural oxytocin to the bloodstream (causing uterine contractions) and to the brain (resulting in feelings of well-being and drowsiness, along with a higher pain threshold).
Historically it was thought that intravenous oxytocin does not cross from the bloodstream into the brain in substantial amounts and, therefore, does not provide the same psychological benefits as natural oxytocin. However, more recent studies indicate that oxytocin administered nasally and/or intravenously may cross from the bloodstream into the brain. Nonetheless, doulas can help mothers experience the benefits of oxytocin naturally without the use of medication.
What about the father’s role when using a doula?
The role of the doula is never to take the place of husbands or partners in labor, but rather to complement and enhance their experience. Today, more husbands play an active role in the birth process. However, some partners prefer to enjoy the delivery without having to stand in as the labor coach.
By having a doula as a part of the birth team, a father is free to do whatever he chooses. Doulas can encourage the father to use comfort techniques and can step in if he wants a break. Having a doula allows the father to support his partner emotionally during labor and birthand to also enjoy the experience without the added pressure of trying to remember everything he learned in childbirth class!
Are doulas only useful if planning an unmedicated birth?
The presence of a doula can be beneficial no matter what type of birth you are planning. Many women report needing fewer interventions when they have a doula. But be aware that the primary role of the doula is to help mothers have a safe and pleasant birth–not to help them choose the type of birth.
For women who have decided to have a medicated birth, the doula will provide emotional, informational, and physical support through labor and the administration of medications. Doulas work alongside medicated mothers to help them deal with potential side effects. Doulas may also help with other needs where medication may be inadequate because even with medication, there is likely to be some degree of discomfort.
For a mother facing a cesarean, a doula can be helpful by providing constant support and encouragement. Often a cesarean results from an unexpected situation leaving a mother feeling unprepared, disappointed, and lonely. A doula can be attentive to the mother at all times throughout the cesarean, letting her know what is going on throughout the procedure. This can free the partner to attend to the baby and accompany the newborn to the nursery if there are complications.
What about other types of doulas?
In addition to labor doulas, there are antepartum doulas and postpartum doulas.
Antepartum doulas provide support to a mother who has been put on bed rest or is experiencing a high risk-pregnancy. They provide informational, emotional, physical, and practical support in circumstances that are often stressful, confusing, and emotionally draining.
Postpartum doulas provide support in the first weeks after birth. They provide informational support about feeding and caring for the baby. They provide physical support by cleaning, cooking meals, and filling in when a new mother needs a break. They provide emotional support by encouraging a mother when she feels overwhelmed.
Some doulas have training in more than one area and are able to serve as more than one type of doula.
Finding a Doula:
The key to choosing a doula is to find a person with whom you feel comfortable. Most doulas do not charge for an initial consultation, so take the time to interview as many as necessary until you find a good match.
Questions to Ask a Potential Doula:
- What training have you had?
- What services do you provide?
- What are your fees?
- Are you available for my due date?
- What made you decide to become a doula?
- What is your philosophy regarding childbirth?
- Would you be available to meet with me before the birth to discuss my birth plan?
- What happens if for some reason you are not available at the time I give birth?