As the benefits of continuous physical and emotional support in labor become more apparent, many expectant parents are seeking out the services of doulas, or trained birth assistants. What exactly is a doula? What training and qualifications does the doula undergo to become certified? What attributes should the parents interviewing a doula look for? And most importantly, what are the benefits of continuous labor support? The focus of this article will be on the birth doula, even though postpartum care doulas are also becoming increasingly popular with many new mothers.
The term doula is from ancient Greece and loosely translates as 'slave' or 'servant' (to give service). Doulas provide informational, emotional and physical support (service) throughout their relationship with the mother. Physical comfort measures used during labor can include massage, counter-pressure, gentle touch, and literally supporting the laboring woman's body weight during a strong contraction. Positioning and frequent position changes are proving to be helpful in labor progress; doulas often help mothers in a squat or other positions that require strong support. Emotional comfort is essential if the mother is to feel safe and secure in the birthing environment, which is highly important according to Michel Odent, French Obstetrician and longtime pioneer in the area of improving birth practices and techniques in the 20th century. Informational support helps remind and inform the birthing couple when labor doesn't progress as expected; in these instances, strange people with strange machines and equipment offer technological assistance that is somewhat confusing and frightening to the mother-to-be and her partner. A doula, with her knowledge of the natural physiology of labor and delivery can explain suggested medical procedures and interventions and help provide the clarity expectant parents need when faced with difficult decisions. A doula does not, however, function in any medical capacity and does not ordinarily use any clinical skills. Labor assistants with clinical skills such as those used by nurses (fetal heart tones, blood pressure checks and vaginal exams) are called monitrices, and are usually professionally trained as nurses or midwifes.
In order to become a doula, academic study combined with practical experience is required. Prospective doulas study the anatomy and physiology of pregnancy from conception to birth, and are required to attend childbirth preparation classes such as Bradley or Lamaze. Attendance and participation at many different types of births is mandatory, usually accompanied by a trained doula, midwife or labor and delivery nurse. Birth evaluations on each birth observed are prepared by the student doula and often discussed with her mentor, or a senior doula. Reading assignments and book reports are also required. There are local and regional trainers that offer courses of various lengths and duration, and national organizations offering certification such as DONA (Doulas of North America) and ALACE (Association of Labor Assistants and Childbirth Educators.)
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