What is the role of a doula? How can pregnancy and birth experiences be shaped by the profession?
In the context of birthing experiences, advocacy is defined as “supporting the birthing person in their right to make decisions about their own body and baby.” Doulas are not usually medically trained, unlike midwives, who are usually nurses by training.
There are several types of doulas. Labor doulas, also called “birth doulas” or “childbirth attendants,” are trained to provide practical and emotional support during childbirth. They empower those who are giving birth to advocate for themselves during the process and ensure that they can be engaged and informed in the birthing experience. Doulas can prompt the birthing person to ask questions in order to ensure that no procedures occur without specific consent, (such as an episiotomy or an epidural. For example, the doula may ask, “The doctor is holding scissors; do you have any questions about what she is planning to do with them?” The doula mat also help reinforce the birthing person’s desires, such as by noting: “The doctor is recommending an epidural, but you told me you felt strongly about not having an epidural.”
Research suggests that labor doulas helps improve outcomes during the childbirth experience. Continuous labor support, such as the support given by a doula, leads to increased oxytocin released into the body, which is linked to decreased pain, decreased stress, and increased self-esteem while in labor. Labor doulas are also associated with shorter labors, reduced use of epidurals, and less need for drugs to induce labor (i.e., Pitocin). Epidurals are used to reduce pain, but can often make labor longer, which may prompt the need for labor-inducing drugs. The presence of a doula has also been shown to increase the likelihood of a spontaneous vaginal birth, rather than cesarean section.
Postpartum doulas support new mothers and their families at home after the birth. Many new parents experience stress, and a postpartum doula can provide reassurance, support, and guidance during this time. They help new mothers bond with their babies, and can provide assistance with breastfeeding and facilitate skin-to-skin contact. Postpartum doulas may also take on some light housework to help support the family.
Doulas serve as much-needed advocates to optimize the health of both mothers and infants. Doulas can also help to advance Reproductive Justice goals. Black women experience disproportionately high rates of both maternal and infant mortality in the United States, due to both lack of access to care and structural racism in medical settings. For this reason, doulas who validate and advocate for birthing people can help mitigate the challenges that jeopardize the health of Black women and infants at risk.
If you are interested in having the assistance of a doula during your own birth experience, DONA International (previously stood for Doulas of North America but has since expanded past the North American continent) provides a database where you can search for a certified doula near you. On the DONA database, users can apply filters if you are seeking a specific type of doula or would like one with advanced qualifications.
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Evita Almassi, MSW, served as the Communications and Digital Marketing Manager for the NWHN. Her 10+ years in nonprofit communications – especially with social media advocacy campaigns – enabled the NWHN to reach and empower more women in their health education and advocacy journeys.
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