When people ask me what I think about doulas, I simply say,
“Doulas are an invaluable part of the birthing team and I wish I had had not one but two doulas when I was having my children, especially my daughter! We needed one doula for me and one for my husband!”
Doulas are birth attendants, typically women, who stay with a woman providing support, encouragement and non-medical pain relief and comfort measures to childbearing women during labor, delivery and in the early post partum. The World Health Organization has added their endorsement of birth attendants (doulas) by recommending that, “Birth Attendants be present at ALL BIRTHS GLOBALLY,” as part of the WHO Safe Childbirth Checklist Implementation Guide. This is huge, not only for those of us who are doulas and know the invaluable role we play in supporting mothers during pregnancy, labor and delivery and in the immediate post partum period, but also for mothers who may not know about doulas, or who may have been on the fence about getting a doula.
Research on the efficacy of doulas shows that when childbearing women have doulas attend their births they have:
- Decreased overall cesarean rate (down 50%) and they are less likely to have a cesarean section delivery or other invasive interventions.
- Shorter labors (decreased 25%)
- Decreased use of oxytocin by (decreased 40%) a medication used to start or hasten labor.
- Decreased requests for an epidural or other pain medications by 60%.
Doulas attend to mothers and/or couples primarily during childbirth and in the early post partum period. However, there are ante partum doulas (Mamas on Bedrest & Beyond for example) who attend to mothers who are experiencing complications prenatally and who need additional support. Prenatally doulas offer non-medical supportive care such as helping mothers on bed rest become more comfortable, attending to home duties, offering resources and tips for comfort and support, emotional support, family support, childbirth education, and lactation support and education.
Many people are under the mistaken impression that doulas are only for women having “natural” (vaginal) or home births. Doulas attend all types of births, in all types of settings; home births, hospital births or birthing centers. Additionally, doulas are as beneficial to women having cesarean sections as they are to women having vaginal births. Doulas are particularly under utilized by high risk pregnant women and yet this group stands to benefit the most from the support and emotional care.
Mamas on Bedrest, you can and should consider having a doula present at the delivery of your child-even if the father is present. This well trained, impartial birth professional can act as your advocate and as a bridge to the health care system and to providers when you are unable to advocate for yourself. They can help explain procedures, assist in getting you information on certain proposed procedures and treatments and can help be sure that you are giving informed consent when you sign forms. Doulas are present first and foremost for the mother and the needs of everyone else in the family or on the healthcare team are secondary. Doulas DO NOT MAKE MEDICAL DECISIONS for their clients, but rather hold a space so that a woman and her partner (if present) can determine the best course of treatment for them based on all the available information.
The doula model has been present historically as far back as Biblical times (Exodus 1:15-21) when women of a family or tribe attended to a birthing woman and made sure that her children and husband were fed and cared for. Doulas and Midwives nearly became extinct during the middle and latter part of the 20th century with the advent of hospital labor wards and the specialty of obstetrics. There has been a resurgence in doula use during the latter part of the 20th century and now in to the 21st century. Unfortunately, the use of Doulas has been limited to women of means as they have been the only ones able to pay for a doula as insurance companies have yet to agree to reimbursement.
But there is good news. There are many doula services that offer a sliding scale or are being reimbursed by Medicaid such that ALL women can receive this potentially lifesaving care. In Austin there are the following groups offering low or no cost doula services.
Giving Austin Labor Support (GALS)– A non-profit organization that supports women with limited or no resources for doula care so that “No woman gives birth alone.”
Mama Sana/Vibrant woman-a grassroots organization of low income women of color serving women in the community with prenatal, birth and post partum reproductive health support.
Outside of Austin, there are several programs around the country serving women from all income backgrounds:
Ancient Song Doula Services– A non-profit organization in Brooklyn New York serving low income women of color.
The Pettaway Pursuit Foundation-Located in Pennsylvania, this non-profit organization specifically attends to high risk pregnant women on prescribed bed rest. A team of contracted doulas provide care and the organization has contracts with several managed care organizations for reimbursement.
Mamatoto Village– This organization also provides very high quality birth assistance and also has its own training program for its staff.
Uzazi Village – This non-profit organization provides doula services to low income women of color in the Greater Kansas City Missouri area, and has another location in St. Louis Missouri. They also provide doula training, childbirth education, reproductive health education and lactation services. They are also now beginning to train midwives.
These are just a few of the organizations that I know of providing doula services. There are others and I am sure many more that I don’t know about. The point I wish to make is that if you would like a doula to attend your birth with you, there is likely a doula organization or solo doula that can help. Mamas, don’t forgo this vital source of support. Doulas really do make births better!
Looking for a doula? e-mail email@example.com and we’ll do our best to help match you with a doula.
Know of a doula that is excellent at what she does and serves women in need? Share her information here and we’ll start a running list of doulas that are serving low income.
Know of a doula organization that offers services at low or no cost? Let us know so we can share this information.
Did you have a doula at your birth? Please share your experience in the comments section below.
This video showing the birth of a baby elephant is all over Facebook, and I even posted it to the Mamas on Bedrest & Beyond Page. Now I have been known to post all things mamas and babies on this page, so it probably was no surprise when this video appeared. However, I want to call your attention to some very specific details in this video that should be mandatory for any birthing female-of any species! I truly believe that if we practiced the habits exhibited by the elephants in this video, birth outcomes in humans (especially in the US) may very well improve!
1. Allow Mama to labor in whatever position is most comfortable for her. Throughout this video, the laboring mama elephant is moving about the elephant pen and doing what she can to find comfortable positions while her baby makes its way through her birth canal. This mama is not placed in the lithotomy (on her back, legs up in the air) position! And mama is not being given any medications to “speed up the labor” or to dull the pain. This mama elephant’s birth is following nature’s course and in due time, this mama elephant gives birth to a healthy baby elephant.
2. Mama should make whatever sounds she needs to make while laboring and delivering. This mama elephant cries out when she needs to and in a way that is natural to her. No one is telling her to “Get mad” and push her baby out! She is using sound and movements natural to her to manage her labor and delivery.
3. Mamas may snack while in labor. At one point during the video, another elephant offers the laboring mama a branch to snack on as she labors. This is in stark contrast to laboring women her in the US who are not given food and water but instead are hooked up to an IV fluid bag “In case a c-section is necessary”.
4. Mama took all the time she needed to labor. No one told mama elephant that her labor was taking too long, she wasn’t given pitocin and she wasn’t told she’d need a c-section if her labor went beyond a certain time. Mama Elephant simply kept roaming the pen and moving about until finally her body pushed her baby out “at the perfect time”.
5. Other female elephants were there at the birth. African Elephants are known to be very tribal and when a female is giving birth, the other females of the herd care for her and support her during her pregnancy, are present and assist as needed during labor and delivery and help the new mama raise her young one. African Elephants have a 22 month gestation and only get pregnant once every 5 years, so supporting the growth and development of the babies is critical to the survival of the herd. As seen in this video, when a mama elephant is laboring, the other females of the herd offer her food (tree branches), keep her cool (throw sand on her body), check the birth progress (sniff and lick her bottom) and help clean and care for the new baby when it was born.
In many cultures and species, birthing is considered to be “women’s work”. If we look throughout history, women traditionally attended births; be it the mom, aunties, cousins, or other women in the community. In this way, the wisdom of childbearing and childrearing was passed down. Modern day obstetrics severely hinders this passage of information from woman to woman and generation to generation. It has in many ways thwarted the knowledge many new mamas have at childbirth and the shared commitment to the mother and infant from families and communities. In Elephants, once the elephants mate, the male moves on to another herd while the newly pregnant mama elephant is now cared for and supported by the mamas, aunties, sisters and cousins in her herd. A pregnant elephant is never left on her own because her herd recognizes that the survival of the entire herd depends upon everyone being healthy and well. So mama is nurtured throughout her pregnancy, labor and delivery and once the baby is born, the entire herd raises the baby.
We could learn a lot from elephants and quite possibly improve our human birth outcomes!!
Father’s Day is upon us! Have you spoken with your partner about his feelings on being present at the birth of his child? On becoming a dad? I ask this question in light of this post on one of my birth providers chat lists: (Paraphrasing to protect privacy!)
Have any of you ever had this happen: You connected wonderfully with the momma and the energy between you two was phenomenal, yet you weren’t able to click with their partner? I feel a very awkward energy with the dad, even though the momma said that he is pretty much on board with my presence and role in the birth and is glad I’ll be there. He doesn’t attend prenatal visits and hasn’t really seemed interested in the pregnancy or my services. I’m not sure if he is avoiding me or if there is something deeper. Thoughts?
Ladies, there are a few things to consider here.
First, let’s face it. Even those of us facing our first pregnancy, completely in the dark about what is going to happen, we are lightyears ahead of our male partners (unless they are obstetricians!)! We are “accustomed” to “the weirdness of womanhood” and all that entails (i.e. menstrual cycles, feminine products, bras, make up, concealers, body shapers, hair extensions, etc…) So yeah, a high risk pregnancy with bed rest is just one more adjustment we’ll make. We will do like we always do-make the necessary shifts and accommodations and make it happen! Men don’t accommodate as easily or as readily to change as we do. So we have to be patient as they “catch up” to us.
Second, the idea of actually being present during childbirth totally skeeves some men out! Oh yeah, they are all about “gettin’ with us in the moment” but getting down and dirty with something (actually someone) coming out of their “pleasure palace” really messes with some men’s minds. In hindsight, I really pushed for my then husband to be present at my daughter’s birth. And when she came out not breathing and then I hemorrhage, it nearly took him out! I should have listened when he told me he wasn’t up for being in the delivery room and chosen another, more capable childbirth support and advocate. Ladies, some men are not up for childbirth. It doesn’t mean that they don’t love us or support us, they just can’t be present at such a raw, visceral event. We must hear them and respect their limitations. (FYI I had my sister come in with me when I had my son. Much better experience!!!)
So Mamas, Find out where your man is on the spectrum. Is he all in, ready to be of utmost assistance? Is he totally freaked out and secretely signing up to become a merchant marine? Or is he somewhere in between and really just needs to process all that is happening and about to happen to someone he loves dearly, and is petrified that he has caused to have to go through unspeakable pain?
Ladies, do we ever really ask our guys what they think about what we are going through? In our book, From Mamas to Mamas: The Essential Guide to Surviving Bedrest, One dad shared poignantly about his experience when his wife went on hospital bed rest saying, “It felt like she had died and suddenly I had all this responsibility heaped on me.” It is so easy to get caught up in what we are going through; after all, we are the ones who are growing and changing and we are the ones who are enduring the brunt of this experience. But you and your partner are a team and he is going through this experience, too. And many men don’t say anything because they feel like they have no right to “complain” given all that we are going through. I want to reiterate, you and your partner are a team! This pregnancy isn’t just happening to you, but also your partner and any children you already have. Everyone’s thoughts and feelings need to be considered and attended to so that everyone’s needs are met and the wee one you are carrying will come into a cohesive, loving family.
Happy Father’s Day to all the dads out there! We love you and thank you for your love and support! We’d love to hear from you. Share your experience regarding your wife’s pregnancy and bed rest, labor and deliver (if applicable) in our comments section below.
Get your copy of From Mamas to Mamas: The Essential Guide to Surviving Bedrest Today!