is natural for a pregnant woman to feel fear and apprehension when she
thinks about the impending experience of childbirth, especially if shes
a first time mom. Ina Mae Gaskin, author of the classic book Spiritual
Midwifery had a point when she said, Women are far more afraid
of childbirth than they were 25 years ago. We are just one more generation
away from the days when a girl grew up on a farm watching the sheep and
pigs give birth. Anyone who saw that year after year knew that giving
birth was a natural process, a process that could be trusted. She
went on to say, Women dont seem to know today that a womans
body knows how to work. We rely on drugs as if our bodies couldnt
get along without them. Its true that in our Aspirin, Tums,
and Pepto-Bismol culture, women are encouraged to take something for PMS,
something for menstrual cramps, and are told later in life that they cant
go into menopause without Estrogen. In childbirth a woman often is given
oxytocin to speed things, Demerol to take the edge off (which
slows things down) and then an Epidural to numb things out. No one should
be expected to go through agony just to have a natural childbirth,
but how much of the pain is fear and tension based? How much comes from
our pain-free culture? Again, studies show that women who are more
relaxed and in a mental and emotional framework of excitement and involvement
feel less pain and forget to ask for drugs. I think Ina Mae
is right. The body can be trusted. And, generally, when it is trusted,
women have an easier and more memorable birth experience.
The word Doula, comes from the Greek word for the most important
female slave or servant in an ancient Greek household, the woman who probably
helped the lady of the house through her childbearing. The word has come
to refer to a woman experienced in childbirth who provides continuous
physical, emotional, and informational support to the mother before, during
and just after childbirth. (Klaus, Kennell and Klaus, Mothering
birth as a key life experience that the mother will remember all her
the physiology of birth and the emotional needs of a woman in labor...
the woman and her partner in preparing for and carrying out their plans
for the birth...
by the side of the laboring woman throughout the entire labor...
emotional support, physical comfort measures, an objective viewpoint
and assistance to the woman in getting the information she needs to
make good decisions...
communication between the laboring woman, her partner and clinical care
her role as one who nurtures and protects the womans memory of
her birth experience.
Doula provides all this and more. A Doula offers emotional and
physical support to the laboring woman, is an advocate for the mothers
birth wishes, and helps women to achieve a healthier, happier and more
fulfilling birth experience, thereby, leaving them better prepared to
cope with the challenges of motherhood.
Statistics: It has been reported by Drs. Marshall Klauss and John Kennell,
and published in the
Journal of American Medical Association (JAMA) May 1, 1991, that women
attended by doulas have improved outcomes such as:
reduction in overall cesarean rate by 50%
reduction in length of labor by 25%
reduction in use of Pitocin by 40%
reduction in use of pain medications by 30%
reduction in Epidural requests by 60%
reduction in use of forceps by 40%
has also been reported that women attended by doulas have a reduction
in secondary complications such as maternal infection, maternal fever,
newborn problems and post-partum depression.
One can use the assistance of a Doula whether she is birthing in the hospital
with a doctor, or birthing with a midwife. The Doula is simply a helper
and WONDERFUL support. A Doula is not just a nice woman to have
around to rub your shoulders or back and fetch you juice. She does a lot
more. She is an anchor offering emotional support to the laboring mother
as well as praise, pep talks, empowerment. She helps you keep your birth
wishes in perspective if complications set in and difficult compromises
and decisions need to be made. She affirms and works through joyous accomplishments
and disappointments in the post-partum period. This special person is
also a teacher, instructing the mother in labor-saving techniques, answering
questions, explaining labor events as they occur, and preparing the couple
for what is ahead. The anticipatory guidance she provides can alleviate
most of the fear of the unknown. The Doula is also a diplomat, the mothers
advocate, acting as a liaison between parents and medical staff, conveying
the couples wishes and seeing that they are honored whenever possible.
She makes no medical decisions but helps interpret the suggestions of
the medical attendants to the parents. She assists the parents in asking
the right questions so that they are informed enough to take an active
part in decisions. She helps to see that interventions are avoided or
at least decided on mutually. She has a sensitive presence, knowing when
to actively assist the laboring mother and when to retreat quietly into
the shadows and leave the couple alone so that they dont feel watched
or judged. Best of all, she is a comforter, touching and tuning in to
the mother during contractions, helping her relax, and assisting her in
using her natural resources to ease her discomfort and steady the progress
of labor. And when the mothers strength seems almost gone, her own
strength is offered to the woman, encouraging her beyond her perceived
limits to meet the goal of birthing her baby.
An excerpt from The Birth Book, co-written by Dr. William Sears and wife,
Martha Sears, RN.
Using a Doula is another example of simple, appropriate technology which
can save money. It has been estimated that if every woman in the United
States had a supportive woman with her continuously throughout labor,
the reduction in interventions such as cesarean sections and Epidural
would reduce maternity care costs by more than two billion dollars (Klaus
As a childbirth educator and Doula, it is my responsibility, and my delight,
to help frightened, unsure, apprehensive pregnant moms find their own
inner strength and confidence before they go into labor. This is accomplished
through childbirth classes and much one-on-one attention, helping to replace
fears of the unknown by confidence and understanding. Then, childbirth
is an experience of a lifetime, for mom and dad, and for the baby too.