What is a doula?
Throughout human history, and still in many cultures today, birthing women have received support from other women. The word doula is relatively new in Sweden, but it comes from an ancient Greek word meaning approximately “nurturing woman.” In the United States, it has long been common to have a doula present at both hospital and home births, and in Sweden, the practice is becoming increasingly common. It seems that the more medicalized birth becomes, the greater the need for the continuous support a doula can provide.
A doula can be incredibly valuable for both couples and single parents. At some hospitals, midwives are able to offer continuous support, but this depends on factors such as the time of day you arrive, how many women are already in labor, and how many midwives are working on the unit. Midwives often have many responsibilities and may not have the time to provide continuous emotional and practical support, which can be experienced as difficult or even distressing by the birthing woman.
A doula’s unique role is to protect and support the emotional experience of giving birth by:
Supporting and strengthening the woman and, when applicable, her partner, before the birth.
Helping to create a birth plan.
Supporting conditions that encourage the release of oxytocin, which can benefit the progress of labor and contribute to natural pain relief.
Providing massage and other forms of physical support.
Suggesting different movements and positions that may help facilitate labor.
Guiding and supporting the partner.
Remaining present and supportive if complications arise.
Helping communicate the woman’s needs and wishes to the maternity staff.
Meeting with the family after the birth to help process and reflect on the experience, if needed.
A doula can visit you at home before the birth to talk about your fears, expectations, and individual needs. During labor, she stays with you continuously from sometime during the early stages of labor until after the placenta has been delivered. She also comes for a follow-up conversation when you are ready to talk about and process your birth experience.
At present, doulas in Sweden work privately and are not formally integrated into maternity care. Nevertheless, they are generally warmly welcomed by staff at maternity wards across the country. According to midwife Liisa Svensson, doulas do not threaten the role of midwives. Instead, having a doula present can be a valuable complement to maternity care. As Svensson explains, midwives often work under high workloads and do not always have the opportunity to stay with a birthing woman throughout her entire labor.
A doula supports the partner as well
A doula is not there to take over the partner’s role either. On the contrary, she can provide care, reassurance, and practical support to both parents. A doula, who has often experienced birth herself and has undergone specific doula training, can offer a different kind of guidance than a partner who has never given birth.
Having a doula can also give the partner the freedom to be fully present with the woman, without having to constantly keep track of what needs to be done and when. Instead, the partner can focus on being emotionally present and sharing the experience.
If you are considering having a doula, it can be helpful to interview several people to find the one who feels right for you and your partner. Trust your own instincts when making your choice. The chemistry between you is especially important during birth. You should feel completely safe, seen, and heard by the person you choose.
Below are listed the concrete effects a doula can have on a birth and for the expectant parents. Multiple studies show the same results.
A doula's presence and support during birth:
Tends to result in shorter births with fewer complications.
Reduces negative feelings about one's own birth.
Reduces the need for labor-inducing drip, vacuum extraction or forceps, and cesarean section.
Reduces the mother's need for pain relief and/or epidural.
Parents who receive support from a doula:
Feel safer and more cared for.
Start breastfeeding more quickly.
Have greater confidence in the parental role.
Have less risk of being affected by postpartum depression.
Have an easier time adjusting to the new family dynamic.
Source: DONA International and the Organization for Doulas and Birth Educators in Sweden (ODIS).
