The birthing process is a period of so many mixed emotions from joy and giddy expectation to feelings of anxiety and a little bit of apprehension for labour itself. A research article published by the Guttmacher Institute shows that Nigerian women would like to receive social support during childbirth. In this research, most Nigerian women receiving antenatal care in a Nigerian hospital said they would prefer to have someone with them during childbirth to provide social support; a perfect role for a doula.
Who is a doula? The word ‘doula’ is a Greek word meaning ‘women’s servant’. Women have been serving others in childbirth for many centuries and this has proven that support from another woman has a positive impact on the labour process. A recent Cochrane Review “Continuous Support for Women during Childbirth” which involved more than 15,000 women from 17 countries in a wide range of settings and circumstances showed that women who received continuous labour support were more likely to give birth spontaneously i.e. give birth vaginally with neither ventouse nor forceps nor caesarean. Also, women who received continuous labour support were less likely to use pain relief or have caesarean births and were more satisfied and had shorter labours.
A doula is a professional trained in childbirth that provides emotional, physical and educational support to a mother who is expecting, experiencing labour or has recently given birth. The purpose of the doula is to help women have a safe, memorable and empowering birthing experience. Doulas support women and their families in all kinds of situations, who have different kind of births; be it the conventional hospital births or home water births. The services of a doula vary greatly according to the needs of the woman, couple or family that she is working with.
It is important to note that doulas do not take a clinical role. They work alongside midwives and doctors. They do not advise but can support a woman to find balanced information that would help her make informed decisions about her maternity care.
Doulas work with women through the birthing process and you can have different doulas for different phases of the birthing process.
Birth Doulas: They are also known as labour doulas. They provide continuous support for the women and their couples through pregnancy, birth and immediate post natal period. Birth doulas support women and families who are planning all kinds of birth. Antenatally, the birth doula will usually meet with the mother-to-be and her partner at least twice and would be available for phone calls and e-mail support as questions or concerns arise. This gives them the opportunity to work out any issues of concern, talk about their birth preferences and get to know their doula. Towards the end of the pregnancy (usually around the 38th week), the doula will then go “on call” and will be available 24/7.
During labour the doula provides informational, emotional and physical support (if there is a need) to the mother. She is able to offer help and suggestions on comfort measures such as breathing, relaxation, movement and positioning. The doula can also encourage the partner to participate in the birth to the extent that they feel comfortable with. However, the doulas most important role is providing continuous nurturing and support for the mother.
Birth doulas also pay at least one postnatal visit to the mother and family to support them as they settle in with the new baby, help with infant feeding as needed and generally give them an opportunity to talk over the birth.
Post Natal Doulas: postnatal doulas typically start working with the family few months after the birth of the child. Sometimes, postnatal doulas are book antenatally, at other times they are called in when the family realises that they need more support. The amount of time a postnatal doula spends with a family varies a lot from the initial 6-8 weeks to years. One of the big benefits of having a postnatal doula is the fact that the postnatal doula is there to support the family, not carry out a specific tasks.
So, she’s able to take on a variety of duties within reason. The job of the postnatal doula is not to help you take care of the baby, rather she’s there to help the family relax and have a positive experience of having a new baby. Postnatal doulas also support the family emotionally. Parents these days can feel overwhelmed with differing opinions, especially new parents. The postnatal doula gives the parents the opportunity to talk these things out without being dismissed or told what to do. Postnatal doulas also support the parents through concerns about siblings, going back to work, weaning, sleep and what the grandmas said they did in their days.
When picking a doula, the most important thing is picking someone that you are comfortable with. Most doulas do not charge for an initial consultation so you can take your time to interview as many doulas as you want.
In Nigeria, most times the mother of one of the parents or both in some cases, come to take care of the new mother after birth (omugwo). This is very essential. Diana Speier, a birth educator and psychotherapist says that “mothering the mother fortifies the new mother’s resources for coping with the enormous demands of new-born parenting. Whether it’s done by a relative or a doula, support for the intense transformation taking place is essential”.