Doulas Support Families Before, During and After Childbirth

Years ago, new and expectant couples called on their parents and siblings to lend support and assistance during labor, delivery and postpartum. But today, many extended families are separated by geographical distances or bound by work responsibilities, so some new parents are turning to doulas for the help they need.

“A doula is an experienced, nonmedical assistant trained to support families before, during or after the birth of a child,” says Tracy Wilson Peters, executive director of Childbirth and Postpartum Professional Association. “An antepartum doula assists women on bed rest, overseeing household maintenance and administration and providing emotional support. A labor doula provides nonmedical support during the latter part of pregnancy, labor, delivery and a few hours following. And a postpartum doula assists the family in the home after childbirth with information and support on breastfeeding, emotional and physical recovery, newborn care and domestic responsibilities.”

But are doulas a good fit for everyone?

Susannah Vitsoric wasn’t so sure — at least not at first. “Early on in my pregnancy, my mom suggested we get a postpartum doula, but I wasn’t interested,” she says. “I didn’t want a stranger infringing on what I considered personal and private time; my husband and I thought we could handle things ourselves.”

Then the unexpected happened.

“I had an emergency C-section and was in the hospital four days,” she continues. “I learned quickly that recovering from surgery, being sleep-deprived, breastfeeding, and dealing with a newborn and domestic chores were going to be more than I could manage. So suddenly my mom’s suggestion sounded good.”

At that point, Vitsoric’s mother retrieved a list of certified doulas from the hospital’s lactation consultant and started making contacts.

Finding a doula

When looking for a doula, check with childbirth educators, birthing facilities, local parenting organizations and other childbirth resources. Also ask friends and relatives for recommendations.

“Once you have a list of names, conduct telephone interviews to narrow your search,” says Hope Irvine-Sank, certified postpartum doula. “Then do face-to-face interviews to observe their mannerisms, style and personality to see who’s the best fit for you. Ask yourself, ‘Is this someone I could envision at my birth experience or assisting us at home?’ Talk with her about what she sees as her role and make sure it’s in keeping with what you’re looking for.”

Timing is important

When to start your doula search will depend on the type of services you need.

“Doulas work on a first-come, first-served basis and can get booked up rather quickly, so if you’re looking for one to assist during labor, start searching by the fourth month,” Peters says. “For postpartum, you can wait until a couple of months before you’re due.”

Cara Lewis did this. “I was in my fourth month of pregnancy when I decided I wanted a doula to assist with labor and delivery,” she says. “With my first child I had a C-section, but this time I planned to go natural and wanted the support and knowledge of a doula to guide me through it. I asked my doctor how she felt about me using a doula, and she encouraged me to do it.”

Once a doula had been chosen, they communicated via telephone and e-mail throughout the pregnancy. The doula also provided Lewis with information on VBACs (vaginal birth after Caesarean). Several weeks before her due date, they met to decide on a birth plan.

“We talked about my preferences — what I wanted in the birth experience and how I wanted to handle issues that could come up during labor,” Lewis says. “We also discussed her writing my child’s birth story by taking pictures and recording the chronological sequence of events.”

Once labor began, the doula suggested nonmedical techniques to speed labor and make Lewis comfortable and then stayed several hours after delivery.

“When I go into the labor room, I bring things like oils for massaging, a birth ball and a rice sock that can be heated. I also make suggestions about positioning, breathing and visualization — anything to make labor go quicker and smoother,” Irvine-Sank says. “But I’m there for dads, too. Sometimes they’re so emotionally wrapped up in the experience that they appreciate the knowledge, experience and objectivity I bring.”

After baby arrives

Lewis’s birth went as planned and she delivered a daughter. After Vitsoric’s birth, the contracted work was just beginning.

“My doula came for a couple of weeks to take care of me, help with the baby and do some domestic chores,” she says. “But what I really appreciated was the newborn care instruction we received. Even though we did prenatal classes, it’s not the same as when the baby is home. Just having a professional there to guide us through was invaluable.”

Although initially Vitsoric had reservations about using a doula, now she’s sold on the idea.

“Even if I hadn’t had a C-section, we would have benefited from using her. It made my recovery and our initial adjustment with the baby go much quicker and smoother,” she says. “And we didn’t feel infringed upon. Looking back, I wouldn’t have had it any other way.”

Denise Yearian is the former editor of two parenting magazines and the mother of three children.

There are three different kinds of doulas. Find out their typical responsibilities and questions to ask when interviewing.

Finding a Doula

For more information on doulas, contact the following organizations:

Birth Works • www.birthworks.org

Childbirth and Postpartum Professional Association • www.cappa.net

DONA International • www.dona.org

International Childbirth Education Association • www.icea.org

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