The Doula: A Hindrance to Family Bonding?


“Not only was it nice having someone familiar with the processes…in the thick of labor, I knew my wife felt so supported by Kim. It made all the difference, and I'm going to insist Kim be there for our next child.” ~Seth, on having a doula at his son's birth
I had a couple recently who expressed interest in having a doula, but were concerned that having another person there might take away from the intimacy of the experience. She said that they had been together for a long time, and had a very close relationship, and that was the one thing that made them a little bit hesitant about the whole doula thing.

I really do think that theirs is a totally valid and legitimate concern. Giving birth to your baby is one of the most memorable things you will ever do, and it's something that you will remember for the rest of your life! Having a doula there, or anyone else besides your partner, is truly a big decision that requires a lot of thought.

While in the end, it is totally up to you to decide, I thought I’d blog a little about my thoughts on the topic.

If you are giving birth in a hospital, there will likely be many professionals buzzing about you. Some you choose, like your doctor (who is usually only with you for a fraction of the time you are in labor), and others you don’t, like your nurses. A doula is a professional, just like a nurse or doctor, who will be there for your birth. The differences are that you choose who your doula will be, and that her sole purpose is to make sure you are okay. She doesn’t work for the hospital—she works for you.

As a doula, I encourage laboring moms to stay at home in early labor, where they can relax in a familiar environment and work with their partner to get into the rhythm of labor together. I ask that each mom calls me when she thinks she is in labor, so I can start making arrangements for my family and be there when she needs me, but I will not come until the mom feels like labor is getting more intense and could use some extra support and encouragement. So if the mom is having a “textbook” labor, there will be plenty of time at home with just her and her partner.

When I do join the couple, at home or at the hospital, if they seem to be coping well and getting through the contractions just fine, I will gladly step back and let the dad continue supporting the laboring mom as he has been doing. I feel very strongly about not intruding on the bond that exists between the couple, and I strive to maintain a calm, peaceful, and reassuring presence throughout the labor and birth. Part of this is remaining calm and peaceful myself, and a big part of it is encouraging others in the room to respect the bond between the couple, and the intensity of the mother’s experience. I do this by speaking in a soft voice and encouraging the nurses to do the same, and asking the nurses to wait until the mom is not contracting to ask her questions or perform procedures when possible. This actually frees up the dad to give more of his attention to his lover, because he doesn’t have to worry about creating and sustaining that calm atmosphere, especially at a hospital birth.

If you are hoping for a natural, drug-free birth* in a hospital, I believe the role of a doula is vital. Sadly, most medical staff at the hospital are not very familiar with unmedicated birth, and don’t realize the importance of uninterrupted quiet and peacefulness so that the mother can maintain her focus to get through the contractions. When I was in active labor, I remember several times nurses bursting into the room, talking casually and loudly with one another and to me. It was a struggle to remain focused, to say the least. As I said earlier, Greg did a great job interacting with them—encouraging them to lower their voices and not to talk to me during contractions, but that did take his time and focus off of me. As a doula, one of my goals is to free up the dad to be available for the mom as much as possible.

Obviously, when labor is getting very intense and comfort measures or relaxation are not working as well as they did earlier, I will be available to offer new suggestions. I have been well-trained on a number of different positions and coping techniques. I can apply pressure in certain areas of the back that would feel especially good if she is having back labor, and I can show the dad how to do these techniques as well. It can actually be very exhausting to give constant pressure or massage if the mom needs it, so I can take turns with the dad, or we can work together to provide double the pressure.

There are countless benefits of having a doula, and I understand that a potential drawback could be having a "third wheel" along for the ride. I definitely respect couples who would prefer to work through the process of labor and birth alone. At the same time, though, I feel that I offer a level of service that would not detract from the most memorable day of their lives, but would enhance it.