How Doulas Enhance the Birth Experience
Doula is the Greek word for a woman experienced in childbirth who helps a woman in childbirth. She comes with high praise from Dr John H. Kennell, professor and pediatrician at Case Western Reserve University, Cleveland, Ohio.
“A doula alone is more beneficial than having the father as the sole source of emotional support” according to his findings presented at the annual meeting of the American Association for the Advancement of Science. When both doula and father are present, the doula provides reassurance to him as well.
Based on a combined analysis of six trials— in which women were randomly assigned to a doula or not the rate of cesarean deliveries decreases by 50% when births are attended by doulas, Dr. Kennell said. The use of forceps decreases by 40%, requests for epidural analgesia by 60%, the need for pain medication by 30%, the use of oxvtocin to hasten delivery by 40%, and labor duration by 25%.
“If doulas were a medication or a device, I expect there would be a stampede” to use them, Dr. Kennell said. “Just because having a doula present makes good common sense does not decrease its importance.”
Studies show that the father-to-be provides support to 80% of laboring women in the United States. To study whether the father eliminates the benefits of a doula, 555 healthy women were randomly assigned to be attended by the baby’s father and a doula or only by the father. Among women assisted only by a male partner, 22.5% required cesarean delivery, Dr. Kennell said, compared with only 14.2% of those assisted by the father and the doula.
Moreover, doula-supported mothers bond more quickly to their new baby, 2.9 days versus 9.8 days for non-doula mothers and spend less time away from them. They are also more likely to rate their baby as ‘better than average’, Dr. Kennell said.
North American hospital births are notoriously long and painful. Worldwide an average first time birth takes five hours but 24 hour marathons of birthing agony are not uncommon in Canada and USA. An experienced doula knows the ideal environment for giving birth is similar to the mood set for love making, where the principal figures feel safe, uninhibited, relaxed, and excited. Darkness, music, couple encouraged smooching and privacy are part of the doula’s birthing kit. She runs interference between hospital staff who would switch on the suture lights, take blood pressure readings and demand recitation of health card numbers in the name of efficiency, all the while derailing the birth passion.
Dr. Kennell noted that the role of doula has existed for centuries, as women have historically given birth at home surrounded by caring female family members. He also observed that in several animal species, including the elephant, whale, dolphin, bat and cow, a female remains close by the laboring mother-to-be, which may provide animal models for study of the doula effect.
The most important history in a doula’s resume is her own birth experience. If her own baby was born easily and gently in an atmosphere of joy she will be better equipped emotionally to help empower laboring women, than if she endured painful contractions and faced birth by cesarean section.
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