Alone is Not Strongest
Throughout human history, until the 1900s and still in certain cultures, birthing women have always received support from other women. The word doula is relatively new in Sweden but is an old Greek word with the approximate meaning of "nurturing woman." In the USA, it has long been common to have a doula at both hospital and home births. In Sweden, it's becoming increasingly common. It seems that the more medicalized births become, the more the need for having a doula increases.
A doula can be incredibly important for both couples and single parents. At some hospitals, midwives can offer continuous support, but it depends on what time of day you arrive, how many birthing women they already have, and how many are working on the unit. Often midwives don't have time to be active support for the birthing woman, which many can experience as incredibly difficult.
The doula's unique role is to protect the emotional experience of giving birth by:
Supporting and strengthening the woman—and her potential partner—before the birth.
Helping to write a birth plan.
Actively ensuring that the woman has good oxytocin flow, which benefits the labor process and works as pain relief.
Giving massage.
Suggesting different movements or positions to facilitate the labor.
Guiding the partner.
Being present in case a complication should arise.
Acting as a voice toward the staff at the birth.
Meeting after the birth to help you process things if needed.
A doula can come to your home before the birth to talk about fears, expectations, and wishes; she is with you the entire time—from sometime during the beginning of labor until the placenta has come out—and comes for a closing conversation when you're ready to talk about how you experienced the birth.
So far, doulas in Sweden work privately and are not integrated into maternity care; however, they are usually warmly welcomed by staff at maternity wards around the country. According to midwife Liisa Svensson, doulas don't threaten the role of midwives but, on the contrary, can be a valuable complement to have a doula present in the delivery room, since, as she says, midwives often work under high workload and don't always have time to be with the birthing woman the entire time.
A doula is not there to take over the partner's role but can, on the contrary, give care and security to both parents. However, a doula—who has usually given birth herself and has doula training behind her—can guide in a different way than a partner who has never given birth themselves.
Having a doula also gives the partner the opportunity to be completely and fully present at the woman's side without having to keep track of what should be done and when.
If you want to have a doula, it can be wise to interview a few to find the one that suits you and your partner best. You should go with your own feeling when choosing a doula. The chemistry between people is particularly important during a birth. You should feel completely safe, seen, and heard by the person you choose.
From the book Gravid med kropp och själ (Pregnant with Body and Soul), by Maria Bengtsson and Victoria Häggblom (MiMa förlag, 2019).
