Why have a Doula?
The big question for many is why would I have a Doula when I have midwives, nurses, a partner and family to support me? Well the real answer is because a Doula's sole focus is on you and your partner and making sure it is a positive birth experience no matter what happens. I strongly believe that with compassion, understanding and a sense of security, a Doula can make a difference in how you feel about your birth which will remain with you as part of the memory of the day you brought your baby into the world. We offer continuous support which means we never leave your side and our focus is completely on you and your partner and making sure you are comfortable and making informed choices. Your medical practitioners do a great job of ensuring your baby is delivered safely but they aren't there to give massages to reduce pain in between contractions, to light candles and dim the lights when you are laboring in the bathtub, to run and get you ice chips when you are feeling exhausted and to coach your partner on how is the best way they can support you.
A study done in 2017, Bohren et al. published an updated Cochrane review on the use of continuous support for women during childbirth. They combined the results of 26 trials that included more than 15,000 people. The birthing people in these studies were randomized to either receive continuous, one-on-one support during labor or “usual care.” The continuous support included support from either hospital staff, a person in their social circle (this includes Doula's) or a relative/partner. Overall, the people who received continuous support over the "usual care" were more likely to have spontaneous vaginal birth and less likely to have any pain medication, epiderals, negative feelings about birth, forceps and vacuums and ceasereans. In addition their births were on average 40 min shorter and their babies had higher Apgar scores. When they looked at the different types of supporters above and the differences in between they discovered that having a Doula for two of these categories had the most beneficial results. These were a decreased risk in having a Ceserean and an increase chance of having a spontaneous vaginal birth.
25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff
Some of the reasons they think Doula's are so effective is that they decrease the effects of the harsh environment that can sometimes be found in hospitals (strangers, lack of privacy, bright lighting) which can slow down labour and reduce self-esteem in the Mother. Doula's can also act as pain relief themselves by offering things like massage and the attachment that a Mother can feel between herself and her Doula can increase the release of the hormone Oxytocin which promotes labour contractions.
Why a Postpartum Doula?
These studies discuss the benefits of having a labour Doula and its easy to see how beneficial they can be for the whole family. Having a Postpartum Doula can also have a positive effect on the transition at home. Many partners have to return to work after a few days or weeks and the recovering Mother is often left to manage the household, physically recover from birth, learn how to breastfeed, cook meals and sometimes take care of other children. This should be a time when the Mother is bonding with baby and in our modern society this is sometimes difficult. There are also many questions and concerns that pop up in those first few months about the care of your baby and whether they are thriving. A Doula can help you find those answers and resources so that you are emotionally reassured that you are doing a great job. These are precious moments that can fly by quickly so why not enjoy them as much as you can by allowing yourself to have the support you need and deserve.