What is a doula?
Doulas are still somewhat unknown in Finland, compared to other parts of the world. A doula is a support person for the mother and her partner.
Many people think that doulas are only needed when the mother gives birth alone. But a doula is also very useful even if the dad or the partner is coming to the birth.
The doula is primarily there for the mother during her birth. The doula is the only person besides the partner, who is there the whole time, because midwives usually tend to other patients as well and don't have time to be there the whole time. The midwives' shifts might also change during the birth and a completely new person might enter the room. The dad or the partner might be nervous and not know how to make mom feel more comfortable.
The doula makes a birth plan with you. Together we figure out how to make your birth the best possible experience for you and the most empowering. The doula helps to stick to your own wishes and supports you and your partner the whole time at the hospital.
The doula has special skills and knowledge in non-medical pain relief methods, which are needed especially while still at home. We can go over beforehand different positions, breathing and relaxation techniques that might be useful to you. The doula gives the partner instructions on what to do, when and how.
The doula offers especially mental support for the mother, and that's why many people who have a fear of birth, want a doula there for support. We can go over physiological stages of birth and possible traps to avoid beforehand and release fears that way. We can also go over the birth experience afterwards.
If you want to experience a physiological birth without any pain medications, the doula is very important as a provider of non-medical pain relief methods. The doula also provides special equipment, like a TENS machine. My special skillset includes homeopathy, hypnotherapy, hypnobirthing and water birth. You can also hire a doula to help you during a homebirth.
What does a doula not do?
A doula is not a medical professional, so she does not do any medical procedures, like vaginal exams. These things are always the midwive's responsibility. However, doulas have extensive knowledge about the different stages of birth, and doulas can offer you information about that. A doula never makes any desicions for you, but supports you in keeping with your wishes and preferences. A doula is also not a therapist, even though she offers mental and emotional support. The doula is not there to replace the father or partner, but to offer him more tools and ways to support the mom better. The midwife is responsible for the medical side of things and for the physical wellbeing of the mom and baby, the partner offers physical support and closeness/tenderness, and the doula offers emotional and mental support for both of them, in addition to information/training and non-medical pain relief.
Benefits of doulas according to studies
There is a lot of evidence about the benefits of doulas during birth. It diminishes the chances of cesareans and premature births and it is of special benefit to mothers who want to have a vaginal birth after a cesarean. Doulas reduce the costs of medical care. The babies are less likely to be too small, the mothers and babies have less complications during birth and breastfeeding is more likely to succeed and last longer. Moms and their partners appreciate doulas' support and are more pleased with their birth experience.
Duration of birth shortens by 25 %,
28 % smaller risk of cesarean,
60 % less asking for epidurals,
40 % less use of synthetic oxytocin,
suction cup is used 40 % less,
50 % reduction in cesarean rates.
In addition mothers are less dissappointed in their birth experience.
Smith H, Peterson N, Lagrew D, Main E. 2016. Toolkit to Support Vaginal Birth and Reduce Primary Cesareans: A Quality Improvement Toolkit. Stanford, CA: California Maternal Quality Care Collaborative.
Kozhimannil, Katy B. et al. (2016). Modeling The Cost-Effectiveness Of Doula Care Associated With Reductions In Preterm Birth And Cesarean Delivery. Birth, n/a – n/a. Web.
Kozhimannil, Katy B. et al. (2013). Doula Care, Birth Outcomes, And Costs Among Medicaid Beneficiaries. Am J Public Health, 103.4, e113-e121.
Kozhimannil K.B., Attanasio L.B., Jou J., Joarnt L.K., Johnson P.J., Gjerdingen D.K. (2014). Potential benefits of increased access to doula support during childbirth. American Journal of Managed Care, 20(8): e111-e121.
American College of Obstetricians and Gynecologists. (2014). Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. Obstet Gynecol, 123, 693–711.
Amram, NL et al. (2014) How birth doulas help clients adapt to changes in circumstances, clinical care, and client preferences during labor.
Kenneth, J. Gruber et al. (2013) Impact of Doulas on Healthy Birth Outcomes.
Hodnett, E. D., S. Gates, et al. (2012) Continuous support for women during childbirth.
Keenan, P. (2000) Benefits of massage therapy and use of a doula during labor and childbirth.
Rosen, P. (2004) Supporting women in labor: analysis of different types of caregivers.