Does anyone know who is a Doula? Most people do not and that is okay, unless you write for Slate Magazine and bash what a doula does without any prior knowledge. That is not okay and here is why. First and foremost the word doula comes from a Greek word meaning “woman servant.”
DONA INTERNATIONAL, one of the doula training programs, defines what a modern doula does: “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.” (https://www.dona.org/what-is-a-doula/)
I recently read an article posted on SLATE about why doulas are bad. Posted by Elissa Strauss, a freelancer. I was very surprised for the lack of research and evidence that went into the writing.
She writes: “Doulas currently have a reputation as being advocates for intervention-free childbirth; for many of them, having an epidural is a sign of personal weakness and/or capitulation to the medical industry and maybe just a big, fat failure.” If you ask any doula they will tell you, that is SO WRONG. No worries, I’m not yelling just very passionate about the topic. I am a trained and experienced doula. I will tell you that this is far from the actual truth! I guess half of the stuff you read on the internet is not true unless backed up by sufficient evidence I would claim BS. What? Beautiful Sarcasm? Anyways, before I give you my personal experience let me tell you that there have been many research studies conducted and in 2012 a published research study by Hodnett ED et al concluded that “continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.” Here’s the full text if you would like to read it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175537/. This study gathered from 16 different countries continuously describes that women who had constant one on one support were more likely to have shorter labors and did not need any interventions.
When I had my 40 hour birth marathon (first birth, long story), my doula stuck out with me through the whole journey. The experience was so emotional and intense that I instantly fell in love with the profession. In reference to the statement by Elissa, “Right now, birth doulas are not licensed or regulated in the U.S. Anyone can call themselves a doula without any training, certification, or practice. I could declare myself a doula right now. So could you.” (More Doulas Can Help Lower the Cost of Childbirth. There’s Just One Problem). Doulas are required to go through training. There are several organizations that hold these trainings taught by certified instructors. So sorry to break it to you, officially Elissa, you cannot call yourself a doula.
In addition, did you know that some insurance companies even reimburse for doula services. These companies see how important it is for mothers to have doulas by their side during labor. They see it because financially it reduces their costs! In a study conducted at the University Of Minnesota School Of Public Health, it was found that “On average, across the 12 states studied, access to doula-supported deliveries among Medicaid beneficiaries in these states could save $58.4 million and eliminate 3,288 pre-term births per year.” (http://www.health.umn.edu/news-releases/study-doula-care-cost-effective-associated-reduction-preterm-and-cesarean-births) Those are huge numbers! There is data presenting how important it is for moms to have doulas during births and a reason why this profession has been around for such a long time. One of the families that I supported during a 36 hour labor called me a “Birth Angel.” I provided full support during all 36 hours. We ended up in the hospital after a very long but slow labor at home. She wanted a natural birth but was not progressing. After deciding to get an epidural she felt defeated. I held her hand, wiped tears from her eyes, and we chatted for hours after. I was there supporting her through it all, never questioning her choices. Straight from the doula manual from DONA INTERNATIONAL the doulas scope of practice is clearly defined:
“Advocacy. The doula advocates for the client's wishes as expressed in her birth plan, in prenatal conversations, and intrapartum discussion, by encouraging her client to ask questions of her care provider and to express her preferences and concerns. The doula helps the mother incorporate changes in plans if, and when, the need arises and enhances the communication between client and care provider. Clients and doulas must recognize that the advocacy role does not include the doula speaking instead of the client or making decisions for the client. The advocacy role is best described as support, information and mediation or negotiation.”
Elissa Straus continues to say that all doulas are the same and they FORCE mothers to have natural births and if they don’t then they don’t support them. False on so many levels! What happens during a birth no one can predict and all births are different, yet one factor remains the same THE DOULA. Doulas are there to support the mother and her partner in any decision that they make. Things happen and there may be a need for an emergency C-section. Did you know that doulas can be in the room with you during a C-section if you so choose it? (You get to choose one person). If you choose your partner instead, the doula will wait to meet you after your C-section to help out with your postpartum needs. Did you know that we as doulas are supportive of the mother’s birth and any decisions she makes through it? Did you know that during my labor I got an epidural thanks to Pitocin but my doula stood by my side through it! She not only gave such relief to me but to my husband as well, giving him an opportunity to sleep while she chatted with me and kept me company. We laughed together while we watched “the Nanny.” I was emotionally and physically supported by her throughout the whole time.
This is how the writer ended her article and a sense of sadness hit me hard. My heart aches for her and her loneliness in the labor room. A sense of regret fills her that she didn’t hire a doula but then she pushes back to prove to herself she made the right decision:
“I ended up going into labor a few days after Hurricane Sandy, which meant that the hospital was overcrowded and understaffed, making it far more difficult for those competent doctors to do their thing. There was a moment during my labor when I wished I had a doula there to advocate for me. And then I remembered the reason I didn’t hire one: I suspected she’d more likely be advocating for herself.”
My deepest apologizes Elissa if you had an unpleasant experience with a doula or you were just simply misinformed. Investigate your choices out there, seek answers from professionals, and cover your bases with correct information. You saying that each and every doula is useless is like saying “I’m going to swim through this flood without a life jacket.” Yes it may get you somewhere if you know how to swim but how far will you go without the support? Hiring a doula may not be for everyone, but it is an option for those seeking that extra support when going through pregnancy and labor.
Doulas are trained professionals. They know their scope of practice and they are there to support you along the path to your labor. If you are interested in learning more about what we as doulas do, don’t hesitate to contact one near you!
Mothers, Fathers, & Birth Professionals