"If a doula were a drug, it would be unethical not to use it." - John H. Kennell, MD
Most people are under the impression that doulas are for home births and that they aren't really needed in a hospital setting. Quite the opposite is true, really. That common thought is usually based on the belief that doulas are only for those planning unmedicated births. While doulas certainly decrease the incidence of pain medication requests, and have been proven to greatly reduce the risk of c-sections, we serve a much greater purpose than just helping mothers achieve the often-desired outcome of a medication-free birth.
The word "doula" is Greek-derived and means "a woman who serves." The term is now used to describe a trained and experienced professional (usually a woman, but there are some wonderful male doulas out there as well!) who comes alongside a woman at any given point in her pregnancy, and provides both her and her partner with a full spectrum of prenatal support (physical, emotional, and informational). This support is given prenatally, during labor and birth, and in the immediate postpartum period. Doulas help to answer non-medical questions, and assist with developing birth plans. Doulas provide support throughout your entire labor by helping with positions to provide pain relief and labor progress, are trained to support through the various emotional changes that occur during your labor, and provide you with the information to be able to make informed choices about the process, (I want to specify again, here, that doulas are *not* medical professionals, and we do not give medical advice. But we are able to guide you to the non-biased information that can help you learn about the interventions being offered.) Doulas also are there to assist immediately after the birth by providing breastfeeding support and bonding support. Did you know that we support Dad as well? Does he need a nap? To go get food? A break? We doula the dads, too!
But back to my original statement. Why is a doula needed more for hospital births than for home births? In a home birth, you have usually continuous support by your midwife (sometimes even 2!), though she tends to arrive further on in your labor than a doula would. You are in your own familiar surroundings, with the only people coming and going being the ones that you have approved to do so. Obviously, medical interventions are hard to come by in a home birth. When that is needed, the mother is transported to the nearest hospital. However, in a hospital birth, doctors and nurses change shifts. Often times, your nurse can even change a few times in one shift as they are relocated where they are needed throughout the maternity unit. This can leave parents having to repeat their wishes multiple times over, and feeling unheard. Labor is a sacred time where parents need to trust and get to know their birth support team. With labor being 80% emotional and 20% physical, even just the lack of security in having continuous support can significantly slow or stall labor, drastically increasing the odds of medical intervention being used to get things going again. A doula provides that continuous support, through all shift changes, and through all circumstances.
What does evidence say about continuous support by doulas? This article is one of my absolute favorite articles on the findings.
"When continuous labor support was provided by a doula, women experienced a:
- 31% decrease in the use of Pitocin*
- 28% decrease in the risk of C-section*
- 12% increase in the likelihood of a spontaneous vaginal birth*
- 9% decrease in the use of any medications for pain relief
- 14% decrease in the risk of newborns being admitted to a special care nursery
- 34% decrease in the risk of being dissatisfied with the birth experience*
~Evidence Based Birth"
I think this is also a good point to mention the myth that doulas "advocate for" you. I often hear people say that they want a doula to "fight for" them in labor. Our role is to empower YOU to make your own choices and make your own voice heard, and, in some cases, help facilitate open communication between you and your hospital support staff/care provider. We do not work against nurses and care providers--we work alongside them. It is out of our scope to challenge medical authority, but we can work hard to help you feel comfortable communicating your desires and needs to those overseeing the medical aspects of your birth.
So, while having the support of a doula at a home birth is still absolutely beneficial and recommended, hiring a doula for your hospital birth is essential in order to feel completely supported, informed, in control, and at ease. Your birth experience is something you will remember until the day you die...why not make it the best that it can be? Hire a trained doula today!