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A Doula’s Role

A Birth Doula assists in communicating with caregivers, supporting the decisions you set out in your birth plan and those you make as labour progresses.  The doula never makes decisions on your behalf or speaks for you to your caregivers.  A doula acts as like a reference book for the birthing couple providing information on hospital options, possible benefits, risks and alternatives.  As well, she can act as a sounding board while couples make their own decisions.

During pregnancy, your birth doula helps you prepare for birth by working with you and your partner to create a birth plan and providing education and information to allow informed decision-making.

During labour your birth doula cares for your physical and emotional well-being by using comfort measures such as massage and relaxation techniques, breathing guidance, position support, verbal encouragement and a caring hand.

During and after the birth, your birth doula can help you preserve your birth memory by taking pictures, keeping a record of important events or moments during labour, writing a birth story and later discussing the labour with you and your partner.

During the postpartum period, your birth doula helps with the transition to parenthood by supporting breastfeeding, providing an ear to listen and words of experienced encouragement, answering any questions you might have about your birth and reminding you of the positive moments.

A Postpartum Doula is trained specifically to serve the mother and her family throughout the postpartum transition period.  She offers a non-judgmental presence in the home and is trained in breastfeeding support, personal mother-care guidance, newborn care techniques, babywearing, emotional and informational support for the family including connecting with community programs and other perinatal professionals if requested.  She also will help keep the household running smoothly by providing assistance with light household chores, meal preparation, laundry and sibling care. She encourages parents to trust their instincts and protects the "babymoon  period as an extended part of the birthing process.

Some doulas are specifically birth doulas, some are postpartum only and many are experienced in both areas.

 

The Benefits of Having a Doula at Your Birth

Studies have shown that having a doula’s support may:

  • shorten labour by about 1.5 hours
  • decrease chance of cesarean birth by 51%
  • decrease the use for pain medication by 36%
  • reduce the need for pitocin by 71%
  • reduce the need for forceps by 57%
  • help partners participate with confidence
  • facilitate mother-baby bonding & breastfeeding

Benefits of Having a Postpartum Doula

Studies have shown that having a postpartum doula may:

  • facilitate breastfeeding
  • facilitate parent-infant bonding
  • decrease the incidence of postpartum depression
  • encourage appropriate well-baby and mother care
  • increase parents’ confidence in their parenting skills
  • provide support for siblings to enjoy the positive experience of the new baby

Sources: Continuous support for women during childbirth (Cochrane Review) Hodnett, E.D., Gates, S., Hofmeyr, G. J., Sakala, C. The Cochrane Library, Issue 1, 2004. & A comparison of intermittent and continuous support during labor: a meta-analysis. Scott, K.D., Berkowitz, G., Klaus, M. American Journal of Obstetrics & Gynecology. 1999 May. 180(5): 1054-9.

 

Frequently Asked Questions…

 

Q:  How many times will a doula visit me?

A:  Each doula practices a little differently, but generally a doula’s care includes an initial interview, a number of appointments during the third trimester to plan the birth, attendance at your birth and a number of follow-up visits after the birth.

Your doula is also available to answer any question over the phone throughout your pregnancy and postpartum.

 

Q:  What training does a doula have?

A:  This varies widely, but training and/or certification may include:

  • an intensive workshop covering basic childbearing anatomy and physiology, comfort measures for childbirth and breastfeeding support.
  • observation/audit of a pre-natal class.
  • attendance at a number of births where the doula’s performance is evaluated by the caregivers and nurses.
  • completion of a written reports on births attended.
  • completion of an extensive required reading list.

Many doulas also have other training and experience in fields such as: childbirth education, breastfeeding counselling, massage, nutrition, birth art, accupuncture, herbalism, aromatherapy and/or complementary therapies, but these areas are NOT covered in the doula training itself.  Make sure you ask your doula about her qualifications for any other services she may provide to you.

 

Q:  What is the difference between a doula and a midwife?

A:  The role of a doula differs quite significantly from that of a midwife.  While midwives offer medical support and have a medical based background, doulas are not medical care providers.  Instead, doulas offer pre and postnatal emotional support for the mother and her partner.  She provides physical support through comfort measures such as gentle massage, guided breathing, and position support and provides education and information to the mother so that she can make informed choices in her birthing experience.  As well, she advocates for her client’s wishes but does not have the training or the legal right to give advice or prescribe.

Doulas Can:

  • give information about medical examinations and procedures
  • give information about medications and then refer the client to her caregiver for decision-making
  • help the client get the information she needs to make her decisions
  • suggest questions the client might like to ask of her caregiver.
Doulas Do Not:

  • perform clinical tasks such as blood pressure checks, fetal heart checks or vaginal exams, or any postpartum clinical care
  • prescribe or recommend medications
  • make decisions for the client or advise her as to what decision to make
  • speak to the client’s caregivers on her behalf

 

Q:  Why do I need a doula if I have a partner?

A:  Your partner is not only present at the baby’s birth to support you but also to witness the birth of the new member of your family.  This is a momentous event for your partner and can be quite overwhelming.  A doula can support your partner so that the moment of becoming a parent can be fully experienced and not overshadowed by exhaustion and anxiety about the labouring mother.  A doula in no way takes the place of your birth partner, or should in any way interfere with their role.  A doula enhances the role of your birth partner by providing guidance to you both.  A doula’s touch, words, suggestions and helping hands act as a guide to your partner.  In a long or difficult labour a doula and a birth partner work together to give you the utmost care.  On a basic level a doula can get you water, warm a blanket, or rub your feet while your partner holds your hand, breathes with you and keeps eye contact.  Current research has shown that women express greater satisfaction with their birth experience and an enhanced relationship with their partner when a doula has been present.*

*Source: Kennel JH, Klaus MH, McGrath SK, Robertson S. Hinkley C. Continuous emotional support during labour in a US hospital: a randomized controlled trial, JAMA, 265:2197-2201, 1991.

 

Q:  Are doulas covered by medical care?

A:  No, in B.C., doulas practice privately, hired directly by clients.  The fee for a labour doula in Greater Victoria ranges from approximately $500-$800 or more.  This fee scale is entirely dependant on the individual doula, her years of experience and other skills and complementary therapies she brings to her clients.  New doulas may offer clients a lower fee or no fee, but clients can help by covering the doula’s out-of-pocket expenses including parking at the hospital and child care fees if applicable.

The fee for a postpartum doula can be up to $25/hr.  This fee depends on the individual doula, her experience and also the type of postpartum work she is being asked to do.  Breastfeeding counselling is an example of a professional service offered by a doula that may come at a higher fee than in-home doula services.  The postpartum doula may also offer package fees for a set schedule of home care.

 

Q:  How many doulas should I interview?

A:  You may want to interview several doulas before making your choice.  Doulas are professionals who believe in a woman’s right to choose her caregivers.  The doulas you interview will be pleased to know that you are making a careful choice and looking for the doula who is right for you and your family. On the other hand, you should use your intuition and if you know that you have found the right one – by all means stop looking – pregnancy is a busy enough time as it is!

 

Q:  Where can I find out more about doulas?

A:  Certifying bodies such as DONA International or CAPPA (Childbirth and Postpartum Professional Association of Canada) provide detailed information on doulas.  You can also call any of the doulas listed on this site and they will be happy to answer any questions you may have.

Please Note:  When hiring a doula, it is the consumer's responsibility to check the doula's training, experience and/or certification.  The right to practice as a doula is not restricted by law, the way being a doctor or a midwife is.  Not all doulas are trained or certified but they may still be experienced and offer valuable support.  The Greater Victoria Doula Directory is not a partnership, it acts only as a source of information.  Each doula listed on this site is a sole proprietor.

 

 
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