The word doula comes from Greek and means “woman’s servant.” Historically women in labour were supported by other women in the extended family and community. Modern doulas are continuing this tradition of emotional and physical support during childbirth and after. There are typically two types of doulas: birth doulas and postpartum doulas.
Birth doulas support the family before, during and just after the birth.
Postpartum doulas support the family after the birth with whatever is necessary, from caring for the infant to helping around the home to educating about baby care, breastfeeding etc. and caring for the mother as she recovers from childbirth.
Birth doulas provide emotional and physical support during labour and birth. They usually meet with the family a couple of times before the birth to establish a rapport and to become familiar with the family’s hopes and expectations for the birth. They provide guidance and information regarding birth options to help families make informed choices about their care. Birth doulas help the labouring woman in various ways: among other things, they hold icepacks, rub backs, physically support labour positions, go for walks, offer drinks and count through contractions.
Postpartum doulas offer postpartum support and education and strive to “mother the mother.” They assist with caring for the newborn, helping the family adjust, preparing meals, and doing light household chores. They also provide information on infant feeding, emotional and physical recovery from childbirth, infant soothing and coping skills for new parents.
Doulas do not perform medical tasks or tests, nor do they replace the nursing staff at the hospital. They are there to support the mother and her partner and to facilitate communication between the medical staff and the family.
Doulas do not make decisions on the mother’s behalf. They are there to provide information and support the mother in making her own informed decisions regarding her care.
Doulas do not make the partner feel unnecessary. Doulas are there to support both the mother and her partner. They take some of the load off the partner so that he or she can concentrate on supporting the mother without the added pressure to be a labour coach. Doulas are respectful of the partner’s role and input.
Doulas do not treat postpartum depression, though they will make a referral to a health practitioner or support group where necessary. The emotional and physical support provided by postpartum doulas can cushion against postpartum depression.
Doulas do not teach a particular parenting philosophy. They are there to encourage the family to develop their own approach.
Studies have shown that the presence of a birth doula is associated with shorter labours, greater maternal satisfaction with the birth experience and fewer interventions (including fewer cesarean births, fewer requests for epidural analgesia and lower incidence of pitocin use, forceps and vacuum extraction). Doulas are also associated with increased success with breastfeeding initiation and lower incidence of postpartum depression. Finally, babies tend to leave the hospital earlier and mothers tend to be more affectionate with their babies.
There are several different doula associations in Canada. One of the largest is DONA (Doulas of North America). They offer certification and education for both birth doulas and postpartum doulas.
Birth doulas must:
Postpartum doulas must: