Doulas (Labor Assistants) can even save lives

Most people don't even know what a Doula is, let alone know about all the benefits they can provide to both mother and child. Also referred to as a "labor-assistant" or "montrice", these women have been shown, in published studies, to provide so many positive effects that I decided to make a list to illustrate this point as clearly and easily as possible. Please be sure to pass this on to someone who could use this information, including your doctor. (Reference numbers are in brackets).

The Benefits:

• Reduced chances of getting a C-section (1-7)

• Reduced epidural or other painkiller use (1-4,7,8)

• Reduced use of oxytocin (Pitocin) (1,2,4,6,7)

• Reduced duration of labor (1-6)

• Reduced use of forceps (1,2,4,5)

• Reduced use of vacuum extraction (4)

• Reduced chances of health complications and hospitalizations of baby (2,3)

• Reduced chances of maternal fever and infection (2)

• Reduced maternal bleeding following birth (5)

• Increased chances of successful breastfeeding (4,9-12)

• Reduced incidence of post-partum depression (4,10)

• Reduced levels of anxiety (4)

• Found to be superior to Lamaze (14)

• Result in a more positive birth experience (4,8,13)

• Mothers feel more in control (9,13)

• Increased chance of spontaneous vaginal birth (6)

• Mothers have higher regard and increased sensitivity towards babies (4,10)

• Mothers feel more secure (14)

Quotes from some of the studies:

The father-to-be' s presence during labor and delivery is important to the mother and father, but it is the presence of the doula that results in significant benefits in outcome. (10)

... doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor. (3)

The beneficial effects of labor support underscore the need for a review of current obstetric practices. (2)

More About Doulas

Although we have really come a long way from the practices of just a short time ago when women were taken away all alone and "knocked-out" to give birth, there is still plenty of room for improvement.

Certainly, having loved ones such as a spouse with the mother does provide some added comfort and support. However, as the published literature continues to show, it is the support of a trained and experienced woman (usually) that results in the greatest benefits.

Doulas of North America (DONA) is an international association of over 3,000 doulas who are trained to provide the highest quality labor support to birthing women and their families. DONA doulas are specially trained and certified by the organization, in order to help insure the quality of the services that their members provide.

One of the most critical areas where proper training and a professional attitude comes in handy is in the critical interaction between the doula and the other childbirth staff, such as the doctors or midwives and nurses.

Kathie Lindstrom is the current president of DONA. In comments to the Optimal Wellness Center, she said that "The training that doulas receive through DONA enable them to relate to other health care professionals in such a way that they do not feel threatened but rather, welcome doulas as they know their jobs will be easier and outcomes better."

Can I Afford One?

Contrary to the belief of many, the main obstacle to using a doula is "mindset" not "money". First of all, according to DONA, several insurance companies are already reimbursing for doula services. Check with yours and if they tell you that they don't cover this service, don't just give up there. Make sure that you pursue the matter and bring all of the benefits to their attention. Many of these benefits can save them a significant amount of money.

For example, C-sections cost insurance companies significantly more money, due to the cost of the surgery, increased hospital stay, and increased risk of complications with the baby. The use of epidurals and Pitocin will also increase the cost to insurance companies. Remember that epidurals are performed by anesthesiologists.

So the small cost of a doula, which can range anywhere from $200 to $800, depending on location. However, according to Kathie Lindrom, price should not be an obstacle. "For the most part - no one is denied doula services because of an inability to pay. The vision of DONA is that there would be a doula for any woman that desired one," she states.

Why Aren't Doulas More Widely Used?

According to DONA, one of the biggest obstacles in the way of having doulas become more of an integral part of the childbirth process, is simply the lack of education among the general population, healthcare professionals, and insurance companies. As people become more aware of the differences that doulas can make, their role will become more and more prominent.
You, as a reader of this article can help this process of education progress by passing along the information in this article to as many people as possible

For More Information

To obtain a complete list of doulas in your area, send an e-mail to Referrals@dona.org. For more information about doulas or maybe even becoming one yourself, contact DONA at http://www.dona.org or (801)756-7331.

References

1. Scott KD, Berkowitz G, Klaus M. A comparison of intermittent and continuous support during labor: a meta-analysis. Am J Obstet Gynecol 1999 May 180:5 1054-9.

2. Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. Continuous emotional support during labor in a US hospital. A randomized controlled trial. JAMA 1991 May 1 265:17 2197-201

3. Scott KD, Klaus PH, Klaus MH. The obstetrical and postpartum benefits of continuous support during childbirth. J Womens Health Gend Based Med 1999 Dec;8:1257-64.

4. Keenan P. Benefits of massage therapy and use of a doula during labor and childbirth. Altern Ther Health Med 2000 Jan;6:66-74.

5. Wang D, Mao X, Qian S. Clinical observation on Doula delivery. Chung Hua Fu Chan Ko Tsa Chih 1997 Nov 32:11 659-61.

6. Zhang J, Bernasko JW, Leybovich E, Fahs M, Hatch MC. Continuous labor support from labor attendant for primiparous women: a meta-analysis. Obstet Gynecol 1996 Oct 88:4 Pt 2 739-44

7. Nolan M. Supporting women in labour: the doula's role. Mod Midwife 1995 Mar 5:3 12-5.

8. Gordon NP, Walton D, McAdam E, Derman J, Gallitero G, Garrett L. Effects of providing hospital-based doulas in health maintenance organization hospitals. Obstet Gynecol 1999 Mar 93:3 422-6.

9. Langer A, Campero L, Garcia C, Reynoso S. Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers' wellbeing in a Mexican public hospital: a randomised clinical trial. Br J Obstet Gynaecol 1998 Oct 105:10 1056-63.

10. Klaus MH, Kennell JH. The doula: an essential ingredient of childbirth rediscovered. Acta Paediatr 1997 Oct 86:10 1034-6.

11. Raphael D. Support and variation, the needs of the breast-feeding woman. Acta Paediatr Jpn 1989 Aug 31:4 369-72.

12. Barron SP, Lane HW, Hannan TE, Struempler B, Williams JC. Factors influencing duration of breast feeding among low-income women. J Am Diet Assoc 1988 Dec 88:12 1557-61.

13. Campero L, García C, Díaz C, Ortiz O, Reynoso S, Langer A. ''Alone, I wouldn't have known what to do'': a qualitative study on social support during labor and delivery in Mexico. Soc Sci Med 1998 Aug 47:3 395-403.

14. Manning-Orenstein G. A birth intervention: the therapeutic effects of Doula support versus Lamaze preparation on first-time mothers' working models of caregiving. Altern Ther Health Med 1998 Jul 4:4 73-81.

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