Doulas can make a world of difference

As written for the Royal Gazette by Fiona Dill

"I can't believe I did it!", were the first words exclaimed by the mother who had just birthed her baby vaginally having had a C-section two years earlier.

I was privileged to be present at that birth, as a doula. The concept of having an experienced woman at the side of another woman in labour is as old as childbirth itself and spans many cultures. But it is the unfamiliar name (doula) and the emergence of the trained, paid doula that is relatively new, particularly here in Bermuda.

In November 2008, Bermuda had its first Doula Training event, hosted by Sophia Cannonier (herself an experienced doula) who was instrumental in bringing down a DONA (Doulas of North America) trainer for a weekend course. Fifteen women attended the course and as a result, we are privileged to have many new doulas on the island.

Doulas are trained to provide a pregnant woman and her partner with continuous one-to-one support during childbirth. Their remit is non-medical, physical and emotional care that complements the clinical services provided by the hospital staff and obstetrician and the intimate, but usually inexperienced, care offered by the partner. The doula does not displace the partner but supports him also and often relieves much of his own anxiety.

"There was also a far greater level of peace throughout because my husband had the support and advice he needed at a time that can often leave men or birth partners feeling quite helpless. We cannot say enough about the level of support that we received before, during and after the birth of our daughter."

The advantage of the doula's position is that because she has no medical or decision-making responsibility, has no other patients, and does not work on a shift, she can devote herself fully to the needs of the couple. Usually she will have met with the couple a few times before the birth so she has had the opportunity to ask about fears and individual preferences. Thus she is able to focus on the emotional needs of the woman, not medical issues and is able to remain calm and objective. Generally, the doula stays continuously with the woman until her baby is born, regardless of how long that may take.

"Having someone knowledgeable and gentle to support us. It helped me stay calm and focused, as I knew that I could depend on you throughout the labour."

It is often assumed that it is only couples that are planning to have a natural childbirth who can benefit from hiring a doula, but this is not the case.

As doulas, we are there to assist our clients to have the best possible birth experience, as they define it. We are there to help the couple identify their options by encouraging communication with their caregivers, not to tell them which options to choose. And then ultimately to give our unconditional support no matter how the birth progresses.

"Having a doula gave us the encouragement we needed to birth as naturally as we could, and helped support us through the most important day of our lives so far! We couldn't have done it without her! Everything she did was designed for us!

She helped us try different things during labour to try to progress things and to help alleviate the pain (or at least the focus on the pain) of the contractions. She made us feel comfortable about the process in the hospital and it reassured us!"

Increasingly, couples are aware of the improved clinical outcomes for both mother and baby associated with doula care during pregnancy, labour and birth.

Physical

■ Fewer requests for epidurals and narcotic pain relievers

■ Reduced use of pitocin

■ Reduced duration of labor

■ Fewer forceps deliveries and vacuum extractions

■ Reduced cesarean section rates

■ Neonate hospitalisation and rate of complications reduced

■ Reduced chances of maternal fever and infection

■ Reduced maternal bleeding following birth

■ Increased chance of spontaneous vaginal birth

Psychological

■ Mothers report more positive reviews of their birth experience

■ Reduced levels of anxiety

■ Mothers have higher regard and increased sensitivity towards babies

■ Mothers feel more secure and have more confidence

■ Reduced incidence of post-partum depression

There is no doubt that as doulas we do make a difference. The statistics and the testimonials above speak for themselves. If you are interested in knowing more about having a doula at your birth, please visit www.healthcoop.bm or www.greatbeginnings.bm or www.bermudadoula.com for more information and contact details.