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Doulas can make all the difference when it comes to the birthing experience.
“Each pregnancy to postpartum journey is complex and unique in its own way, and each of those journeys deserves an unbiased supporter who will help the birthing person find their own footing through each step of the process,” says Molly Greene, Molly Clair Doula Care.
Birth doulas are professionally trained labor and birth assistants who offer support during pregnancy, childbirth and postpartum. They assist with non-medical aspects of care.
Prenatal, they provide education, emotional support and assistance with birth plans based on parents’ wishes. During labor and childbirth, doulas offer support and encouragement, advocate for the mother’s needs and implement measures to ensure an empowered experience and as much comfort as possible. This can include massages, helping with movement, providing ice chips or breathing exercises.
Postpartum, doulas help the family adjust to having a newborn by helping with siblings, housework, lactation support and emotional support. They are alert to signs of postpartum depression or challenges with infant nourishment and offer resources for the mother or set up medical appointments.
“Overall, the goal of a doula is to provide people with information, advocacy tools, emotional and physical support and confidence,” says Greene. “We each have our own approach based on our personality and our birth theory, but those goals should always be achieved during a doula’s time with folks. When these goals have been met, it is rare for people to not feel like they had a truly supported experience.”
Doula Colleen Smith of Mighty Mamas says, “I think doulas are especially helpful for people who have things they want to achieve in their birth such as avoiding C-sections, having an unmedicated birth, etc. Many people want their partners to fill this role. Having a doula allows some pressure off the partner to be the only support person.”
That was the case for us. Having a doula allowed my husband, Steve, to be present emotionally while our doula attended to my needs. Since he didn’t have to worry about logistics, he was able to be in the moment and witness the miracle of our children being born.
I wanted a vaginal birth with no pain medication and no episiotomy and thought a doula would help. Steve wasn’t sold on the idea initially; that changed at our first childbirth class where we watched videos of women giving birth and our instructor discussed breathing techniques and interventions. He turned to me and said, “We are definitely hiring a doula. How am I going to remember all of this? I’ve never done this before. I’ll be useless.”
Our doula helped us create a written birth plan with preferences for labor, delivery and newborn care. She encouraged me to prepare for the experience I desired and to stay open to whatever might happen. She suggested breathing exercises, pain management techniques and daily perineum massage.
Courtesy of Molly Greene
Doula Zoe Krylove captures the special moment of Molly Greene in labor with her second child as husband Andrew Greene massages her back.
During labor, she recommended ways to ease pain like using a ball to sit on or standing under the shower. I felt safer and more confident knowing she was there to offer guidance and support. Without her, I wouldn’t have tried certain positions or breathing techniques.
She coached me through breathing while my husband held my hand. When the nurse said my baby was turned sideways and not to push through a few contractions, she told me to look into her eyes and follow her breathing. She said it would hurt but I could do it. I am not sure I could have if she hadn’t been there to guide me, though.
After delivery, she ensured proper latch on during breastfeeding and that I drank water and ate. Postpartum, she checked in on us at home to as we adjusted to parenthood.
We asked her to be our doula again when we found out we were having twins. I am glad since there were some complications but with her help (and my wonderful ob/gyn Dr. Keene), I was able to deliver twins vaginally without pain medication or an episiotomy.
While that was my birth plan, it isn’t right for everyone. Doulas empower birthing parents to make their own choices regarding their pregnancy, birth plan and postpartum care. While having continuous support lowers the likelihood of pain medication, instrument use and cesareans and reduces low five-minute Apgar scores according to a recent Cochrane Review, Continuous Support for Women During Childbirth, it doesn’t guarantee it. Doulas strive for as safe, comfortable and empowering experience as possible whether someone has an unmedicated or medicated birth, vaginal or caesarean delivery.
Alyssa Massey chose Shay Brown as her doula after deciding she wanted a vaginal birth after cesarean (VBAC). “This was my second birth, but first vaginal birth and I knew it would be nice to have that extra support. No offense to my fiancé but I really wanted somebody there that knew what they were doing. She asked what I wanted as my birth plan and was an extra voice to talk when I couldn’t and that just made my birthing experience much more relaxing, so I wasn’t stressing about everything.”
Lesley Butterfield hired a doula for her fourth birth. “I did not realize the importance of a doula until she was there to help me during the birth process. I wish I had a doula with my previous births,” she shares. “As a nurse, I know that women experience birth trauma more often than we like to admit. I would absolutely advocate for every mother-to-be to have a doula. It should be standard practice and enveloped within our current model of care for all pregnant women. It is important that we listen and respond to our birthing mothers during the pregnancy and birth to ensure they have their needs and wants met. I believe this is something that can enable best outcomes for all pregnant mothers and their babies.”
One of the most challenging things for doula Denecia Davis of The Doula Suite is when clients tell her their doctor isn’t listening to their concerns. She is especially concerned about African American women who are 3-4 times more likely to die than their white counterparts.
Courtesy of Anna Whetsel Rucker
Anna Whetsel Rucker served as doula at the birth of her grandson Sawyer.
With goals of reducing mortality and narrowing racial disparities, Virginia Medicaid is expanding to include doula care. Huddle Up Moms is raising awareness locally about Black Maternal Health.
Educating prospective parents about doula services and providing support to as many women in the Roanoke Valley as possible spurred doulas Colleen Smith and Tara Daystar to found The Roanoke Doula Collective (RDC) in 2018. RDC is a group of independent birth and postpartum professionals who work from evidence-based information and provide respectful quality care inclusively.
To find a doula, ask friends and mom group members for recommendations. Do an internet search. RDC lists members’ contact information on their site and Doula of North America (DONA) has an online database.
Smith suggests checking their training or certification and how many births they have attended. “Interview any that seem like a good fit. You will have a gut feeling as to whether you “click” with them, which is so important to listen to. This person will be involved in one of the most important experiences in your life and it’s important to feel comfortable around them. Get information about their experience, birth philosophy, where they have supported birthing people locally, etc. The more questions the better!”
Davis agrees that consultations “help you get a feel of your potential doula to see if you are a good fit. You want to feel safe and feel a bond as you will seek evidence-based information from them if you feel unsure of what’s happening with your body throughout your pregnancy.”
The relationship continues postpartum as doulas follow up with clients once they are home. Massey shares that Brown visited and offered to help with dishes, laundry and meals and made sure she was mentally okay.
“Postpartum time is precious, but often incredibly difficult. We can teach bottle feeding, chest feeding, infant massage, diapering and safe sleeping. We can be a sounding board for any infant related questions or concerns on postpartum healing and the broad range of feelings,” Greene says. “With this unique continuity of care, birthing people and any partner they may have, can expect to feel better about their birth experience.”
The journey through pregnancy to postpartum is full of emotions and changes. Having a doula who can educate and support you can make the journey easier.
Doula Anna Whetsel Rucker says, “Every birthing person deserves a doula. Birth is a life changing experience.”
The story above is from our July/August 2022. For more stories, subscribe today or view our FREE digital edition. Thank you for supporting local journalism!