The Big Essay

Down to the wire, I'm getting all my papers and documents in order to send in to DONA after my final birth, which is coming SOON!!! I co-hosted a shower for Chrissy this past Saturday, which was so fun and made me realize how soon her baby is coming!! We'll have our final prenatal meeting within the next week or so, and then we wait... I CAN'T WAIT!!! I'm so excited that my final certification birth will be for one of my best friends--I know she's going to do great!

So I started and finished my big essay today, which will be handed in with a plethora of other documents. Here is it:

The Purpose and Value of Labor Support

A. The benefits of labor support to the mother and her family

For the laboring mother, the advantages of having a doula are great. The mother feels more comfortable with her labor knowing that a kind and knowledgeable woman is constantly by her side. She is able to relax more freely and let go of fear, which decreases pain and speeds up labor. Statistics also show that having a doula present can decrease complications, such as the need for oxytocin and cesarean section.1 In one study, having a doula present showed an 11% decrease in the use of oxytocin and a 10% decrease in cesarean sections.2 Doulas can also greatly benefit the mother’s partner. Though he may love his partner dearly and want to support her as best he can, he has never been through anything like this and may not know what to say or do to help her best. When the couple chooses to have a doula, “the pressure on the father is decreased and he can participate at his own comfort level.”3 And astonishingly, having a doula even has benefits for the baby. In one study, 51% of babies whose mothers had a doula were breastfeeding at 4-6 weeks, as opposed to only 29% of babies whose mothers did not have a doula.4 Furthermore, significantly fewer mothers suffered from post-partum depression, and more reported a positive birth experience in the weeks following their baby’s birth.4 It is very clear that doulas are extremely helpful for not only mothers, but also for their partners and their babies.

B. The purpose behind providing labor support

The birth of her baby is arguably one of the most memorable and life-altering days of each woman’s life. Throughout history, women in labor have without question been supported by other women throughout the journey of childbirth.5 Sadly, the normalcy of this natural and beautiful support system has disappeared from the highly sterile and cold environments of American hospitals. The doula recognizes the need for women to be supported emotionally and physically during labor, and her goal is to provide this support to any woman who desires it. She also understands the need for families to experience intimate connection on the day of their baby’s birth, and her services empower them to have that connection.6

C. The doula’s responsibilities

The doula’s primary responsibility is for her client. She must do everything in her power to ensure that her client has all the support possible, and everything she needs for the most satisfying birth, according to that mom’s expressed desires. As a professional, she also has certain responsibilities she must abide by. She must possess a strong work ethic and sense of commitment to each client. For instance, she should return calls promptly, be committed to sticking to pre-arranged meeting times, and make every effort to assist the mother during the prenatal weeks, labor, and the first few weeks following the baby’s birth. She should have a respectful and courteous attitude toward her colleagues and her clients, and should respect each client’s privacy. She must also remain up-to-date with new developments in her field by continuing education, actively networking with others, and being involved in related organizations. Her fees must be fair, and she should strive to offer discounted or volunteer services when possible.7

D. The doula’s role

The role of a doula is very special and unique because of the intimate nature of the birth process. She offers a minimum of one prenatal meeting, though usually more, to get to know her clients, establish rapport, educate them on the birthing process, and to learn what she would like her birth to be like. During labor, she is with the mother at all times (except for short bathroom or food breaks), providing any support the parents need. This could be giving a massage, counter-pressure, hot/cold compresses, or instructing the partner on how to do these things. She provides reassurance that her body knows what to do, and encourages the mother to trust in the process. She could help with visualization or relaxation techniques that have been discussed at a prenatal meeting, or facilitate the spontaneous coping methods the mother may begin. The doula does not perform any medical tasks, but may guide the mother to ask questions or speak up to her care providers. She provides “support, information, and mediation or negotiation.”8

1. Table 1 in DONA’s Position Paper
2. Klaus ’86, Table 1, in DONA’s Position Paper
3. DONA’s Position Paper, page 2
4. Hofmeyr ’91 & Wolman ’93, Table 1, in DONA’s Position Paper
5. DONA’s Position Paper, page 1
6. DONA’s Position Paper, page 1
7. DONA’s Code of Ethics
8. DONA’s Standards of Practice