Many birthing women and their partners have discovered the benefits of hiring a doula to assist them during childbirth. Before the birth, the trained doula helps clients articulate their needs, and provides educational and informational support.

During labor, the doula provides reassurance, perspective, suggestions for labor progress, massage and help with relaxation and techniques for comfort. Afterward, doula support continues with assistance in breastfeeding and postpartum issues.

Long ago, when birth took place in a woman’s home, a doula was a woman of the community who came to care for the laboring woman and her family. She gave emotional and physical comfort to the woman and her partner. She stood beside the mother and offered her hands and heart to help during birth, and she may have stayed for days beyond the birth to help with child care and household duties.

Later, birth moved from home to hospital. With this transition, hands-on nurturing was replaced by medications for pain. Mothers were separated from their partners and drugged so heavily that often they didn’t remember the experience.

Though women felt comfortable with technology that saved mothers and babies who may have died from complications, it came with a price. Women gave birth alone, with less of the personal element that women of the community had provided.

Today, childbirth has evolved back to being a family-centered process, but with technology close at hand if needed. A woman may have her partner, her family members and her doula with her to provide reassurance, comfort and encouragement.

Doulas are professionally trained and certified by many organizations throughout the world. Studies show that the presence of a doula significantly shortens labor; decreases requests for epidural anesthesia, the need for pain medications and those to speed up labor; reduces the likelihood of a Caesarean birth and provides greater mother-infant bonding and maternal satisfaction.

Prenatal visits with a doula enable clients to build a trusting relationship before the day of birth. The more a doula knows about her clients and what they need from the birth experience, the more she can ensure that the clients’ needs are met.

The doula encourages communication and understanding between a woman and her care provider. During labor and birth, the doula remains with the couple throughout the experience, even if the shift changes for nurses and doctors. Her support is constant, assuring continuity and a familiar face for the couple.

A medical care provider’s primary role is to assess the condition of the mother and baby, and to diagnose and treat complications if they arise. The doula’s duties entail meeting the physical and emotional needs of the woman and her family. She offers massage, breathing and relaxation techniques, comfort measures and reassurance that things are going well. She encourages couples to gather information in order to make informed choices, always supporting the mother’s decisions.

The doula’s care is in no way a substitute for quality medical care given by medical personnel. She is a complement to birthing team participants.

Women who use doulas actually receive more physical support from their partners because the doula takes a lot of pressure off the father and family members.

Partners who want to provide hands-on support rely on the doula’s knowledge and guidance to make their role more effective. Those in attendance tend to enjoy the experience more knowing they can participate at their own levels of comfort. Partners who need to eat or sleep appreciate knowing the birthing woman is well taken care of by the doula.

Doulas do not provide any clinical tasks, such as blood pressure checks, assessing fetal heart tones or vaginal exams. They do not make decisions for clients, provide medical advice or project onto them their values and biases.

Doulas are making a difference in the health care of birthing women. By meeting their emotional needs we see benefits in obstetric outcomes – shorter births, more partner participation, fewer Caesarean births, less medical intervention, stronger mother-infant bonding and breastfeeding for a longer duration. Women who are satisfied in the birth experience have increased self-esteem and are empowered in all areas of their lives.

Evelyn Conrad of Your Birth Connection has 14 years experience as an independent childbirth educator and has been a doula for 18 years. She is certified in childbirth education and cofounder of the Maine Association of Independent Doulas, a nonprofit organization dedicated to furnishing support to its members and providing community education regarding the importance of doula-attended birth. May will be International Doula Month. For more information, call 945-9804.