The advantages of a doula

The accompaniment during birth by a doula brings many advantages for you as a mom, but also for your partner and your baby. That's exactly what this article is about. But before I go into detail about the individual advantages, I would like to briefly describe what a doula actually is and what she does.

Summary

What is a doula and what does she do?

A doula is a non-medical birth companion. The term doula comes from ancient Greek and means servant of the woman.

This means that the doula has no medical responsibility during the birth and does not make any medical decisions. A doula is therefore in no way a substitute for a midwife, but rather a useful addition. The doula supports the woman emotionally, physically and with her knowledge during the entire birth. Doulas speak encouragement, they massage the women and hold them, to name just a few examples.

Many doulas are not just there for the birth. Doulas accompany women from the moment they want to have a child. They are available to assist expectant moms during pregnancy, but they can also be a useful complement to midwives and maternity nurses during the postpartum period.

For still births or premature births, some doulas also offer companionship if you so desire.

This definition is very brief and by no means describes everything a doula does. But primarily, this article is about the benefits of doula accompaniment, which I will describe to you below.

What are the advantages of doula support?

As already written at the beginning, the accompaniment by a doula offers a whole range of advantages for you, your partner and your baby. These benefits are very individual and not every aspect is equally significant for everyone. Many things cannot be measured in numbers. At the same time, there are several studies that have investigated the effectiveness of doula birth support.

You can read much of this in The Doula Book by Mashall & Phyllis H. Klaus and John H. Kennell. Unfortunately, the book is currently not available in German.

Through my support as a doula, couples are already well prepared for the birth. They know the natural process with its phases and what makes them tick. They know, for example, how important the latency phase is and what they can do during this time. In this way, there is less anxiety in the run-up to the birth and also during the birth, because this knowledge strengthens their confidence in their own self-efficacy.

Parents learn about different interventions during the accompaniment. For the birth, I would especially explain the VRANNI question system to the expectant father and give him the corresponding card as a thought aid. By the way, you can order the card, the so-called safetycard, yourself at Traum(a)Geburt e.V.. During the birth, parents will be reminded of these questions by me, if necessary. The questions can be read on the card if necessary. This helps to reduce the interventions.

Here I have listed these questions for you:

• V - Benefits? What are the benefits of the treatment?
• R - Risks? What are the risks of the treatment?
• A - Alternatives? What are the alternatives?
• N - Emergency? Is it an emergency right now?
• N - Do nothing? What happens if nothing is done?
• I - Intuition? What is my gut feeling telling me?

During pregnancy, the doula consults with the mother-to-be about what can help her relax and what smells she likes. The relaxation techniques that have already been discussed in advance can be used specifically during the birth - breathing techniques, massage, rebozo, etc. This allows the doula to support during the birth that the mom can relax faster and easier. The relaxation ensures that the birth progresses faster and the waves are perceived as less painful.

Since we were able to get to know each other calmly before the birth, we were already able to build a foundation of trust, which also contributes to relaxation. By constantly accompanying you as a doula during the birth, I offer 1:1 care. This creates more security during the birth.

The doula ensures that the atmosphere at the birth center is as relaxed as possible by taking into account all sensory stimuli - dimmed lights, pleasant smells, and possibly music.

As a doula, I also make sure that the partner is not forgotten in front of the delivery room door or similar. I involve the partner in the birth so that the couple can work together as a team. For example, he/she can do the massage or he/she can hold the woman's hand during the birth, kiss her, encourage her to speak.

As a doula, I keep the couple's needs in mind throughout the entire accompaniment. Remind them to drink and eat, to go to the toilet. This also helps the partner to stay strong and feel seen.

Also, the doula pays attention to nonverbal communication in addition to verbal, which makes helplessness and not understanding interventions more likely to be circumvented. If the meaning of interventions is not understood despite the VRANNI questioning system I mentioned above, the doula can ask the midwife/doula to explain again. If the staff does not have time, I can explain to the best of my knowledge. Further, I can explain what will happen with the specific intervention should the staff not do so.

Just having a doula present as a stranger results in less assault and violence during birth, which is still very much seen as a taboo subject overall. It is only Roses Revolution Day that is bringing this important issue more into focus, which has already been addressed on my blog in guest posts The Completely Unplanned Birth of My Child and Every woman is a rose - Why our births are so important. The clinic staff is likely to be more sensitive to the woman and her partner due to the presence of another person.

I myself always speak encouragement to the woman during the birth, if this should become necessary. Remind her that the breaks are bigger than the waves. That with each wave she gets closer to her child. How far she has come, what she has accomplished, and how strong she is.

With the presence of a doula, the woman most likely feels empowered all the time. She can also handle changes in plans, as they are understandable and comprehensible to her. The doula talks to the woman in advance about her wishes and about the fact that things can always turn out differently. Thus, she increases the likelihood of satisfaction with the birth experience. There are fewer situations that are perceived as not controllable and influenceable.

As a doula birth companion, I reflect on the birth with the woman afterwards, special moments and strengths can be highlighted and the focus can be directed in this direction, even if not everything went according to plan. In this way, women can better deal with and process the experience. Open questions and moments that women cannot remember can be discussed calmly in this setting.

The doula also reminds the woman again and again of the connection to her child. This can be, for example, through the pink heart thread according to Brigitte Meissner, which she can already use during pregnancy. You can find out more about this method on the website of midwife Brigitte Meissner herzensfaden.com or in her book Emotional scars from pregnancy and birth dissolve.

This allows mother and baby to feel as one and walk the path of birth together instead of fighting against each other. The baby benefits as much as the mother from the lower rate of intervention, for example, in the form of pitocin (artificial oxytocin to amplify birth waves) or PDA (epidural, spinal anesthesia).

It tends to be more alert and relaxed after birth, and has fewer adjustment difficulties. It also makes it easier to start breastfeeding. Women feel more competent and stronger overall as a result of doula support.

A doula can also provide a lot of reassurance and peace of mind during a cesarean section. She can calm the expectant dad while his wife is being prepped in surgery. She can explain to mom what is happening in case the hospital staff forgets.

For births of star babies, a doula can be a special emotional support and provide ongoing support for the many emotions that come with silent birth. The same is true for many other special situations. On the topic of silent births, I recently recorded the podcast episode Star Children. There is also the guest post Miscarriage and stillbirth - personal thoughts and experiences of Tanja about it on the blog.

What is the cost of a doula companion?

When I look at the value of a doula as a companion during birth compared to other services or material purchases, this birth companionship is very valuable.

If we consider how much money couples often spend on weddings or the like, this price should at least also be worth the accompaniment during birth, an event that is profound, formative and unrepeatable. A birth has the potential to be experienced traumatically. A doula accompaniment can protect against this.

Parents often spend a lot of money on the purchase of a stroller, just as they do on many other material items that they don't yet know how much they will even use. Some parents buy an expensive stroller and do not use it at all, because the child prefers to be carried.

In general, parents may also want such material things sooner for the birth, so that not everything is available several times over.

The cost of breastfeeding consultations can be partially saved by a doula accompaniment, if the breastfeeding start is already more relaxed. Of course, many services around pregnancy and baby time have their justification. However, birth is something that no one can ever give back.

Benefits of doula support in numbers

Now I have written quite a bit about costs and various benefits. Of course, the latter are also not equally significant for everyone. But there are also some benefits that have already been recorded in numbers. Here, for example, there is a study conducted by Mashall H. Klaus and John H. Kennell, the two authors of The Doula Book, which I mentioned above.

The two were able to demonstrate the following benefits of continuous doula support:

• 25% shorter birth duration
• 28% less need for pain medication and anesthesia
• 60 % lower demand for an epidural
• 50 % lower risk of cesarean section
• 39 % less administration of labor-inducing drugs
• 33 % less risk of being dissatisfied with the birth experience
• 41% less risk for use of suction cup or forceps

You can read more about these numbers and the general design of the study in the study itself Continuous support for women during childbirth on the cochrane.org site. The study was presented in 2017, by the way.

Conclusion

First of all, I hope I was able to make it clearer what a doula is in the first place. Then, hopefully, it has become clear that birth support by a doula brings many advantages, which, however, must be evaluated quite individually.

For some women, the doula accompaniment is certainly more important and meaningful than for other women. Women who have a lot of fear about the upcoming birth, or who have already experienced a stressful previous birth, may benefit more from it than those who are quite confident and knowledgeable about the birth.

I also think it's important to note that not every doula is a good fit for every woman. It is important that doula and birthing woman are on the same wavelength. Only then can women really let go and open up to the birth.

You can find more information about my work as a doula and my services on the website doula.natalieclauss.de. If you have any individual questions, please do not hesitate to contact me by e-mail or by using the contact form.

Image sources

• cover picture: unsplash.com
• Image 1: unsplash .com
• Image 2: unsplash .com
• Image 3: unsplash .com
• Image 4: pexels.com
• Image 5: unsplash .com
• Image 6: unsplash .com
• Image 7: unsplash .com
• Image 8: unsplash .com