The Importance of Doulas in Respectful Maternity Care  

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March 28, 2019

By Lucy Muthoni, midwife at eve’smama

For Doula Week, Lucy Muthoni, midwife at Nairobi's eve’smama, offers key insights on why doulas play a crucial role in the antenatal and postpartum process, and provides an overview of what a doula can do for you.

The term doula is a Greek word that refers to a woman servant (Rachel Gurevich, The Doula Advantage). 

Throughout world history, women supported women on their path through pregnancy, birth and especially after delivery. Over time, advancement in education and focus on careers has caused geographical separation which predisposes women to being alone or only with their spouses during childbirth.

This development led to the popularity of doulas.

Ina May Gaskin, also referred to as the “the mother of authentic midwifery” in America said, “If a woman doesn’t look like a goddess during labor, then someone isn’t treating her right.”

Allowing a woman to feel relaxed, encouraged, cared for, loved and appreciated is the best way to show respect to her during birth.

A doula is a non-medical person who assists a woman before, during, or after childbirth. Her main focus is on providing information, and emotional as well as physical support to the mum, her partner and her family. There are doulas that focus on the antenatal or postnatal period respectively, but there are also those that stay with the mothers throughout the entire process and support any kind of birth.

Doulas take a basic childbirth course during which they learn to care for pregnant women. They are certified by a training body, which qualifies them to take care of several mums at a time. Nonetheless, there are also doulas who carry this work out as a vocation and are not professionally trained.

How it works:

Ideally, mums should choose a doula by their third trimester of pregnancy. It is important to start creating a rapport with the doula as their support is quite intimate and personal.

Although most doulas are able to support any birth including caesarian sections and epidurals, there are still some that only assist natural (non-medicated, non-interventional) births.

This is why it is advisable to hire a doula through referral. On top of that, a mum should meet several doulas before making her final choice on the one she’s most comfortable with and who can best cater to her specific needs.

The doula will also meet the mum’s partner and members of the family that will be attending the birth.
She helps prepare the mum for labor and the birth process by sharing necessary information and advice. As most doulas have experience working with various doctors and hospitals they can provide useful insights on the process at hand. After meeting the doula, it is imperative that mums make sure that their hospital and/or doctor of choice is open to working with their prospective doula.

Why Hire a Doula:

According to various medical studies, having a doula at your birth

  • gives you a positive and memorable birth experience;

  • shortens the length of labor;

  • enables better coping;

  • reduces the requests for epidural anesthesia;

  • cuts cesarean-section rates in half;

  • promotes recovery;

  • improves breastfeeding and care of the baby by the mum;

  • has better outcomes for the baby.

What your doula does:

  • She helps you prepare physically, mentally and emotionally for the birth process.

  • She takes you through what to expect during labor and birth.

  • She allays your fears of birth by teaching you how to manage and cope with labor fears of birth by teaching you how to manage and cope with labor.

  • She helps you choose your birth preferences.

  • She is your cheer leader during labor and coaches you through the process.

  • She provides comfort and support.

  • She ensures you remain well-nourished and hydrated.

  • She communicates your preferences to the medical staff.

  • She helps explain what’s going on especially during medical interventions.

  • She ensures that your partner is keeping well and involves him in your care to the best of his ability and desire.

  • She ensures that you enjoy your first moments as a family.

  • Once you are home, she ensures that you all settle in well.

  • She will teach both of you how to care for your new baby.

  • She supports and encourages breastfeeding.

  • She ensures you are resting, keeping hydrated and well-nourished for your recovery.

  • She offers advice in regard to almost any kind of support needed.

What your doula will not do:

  • Have an opinion on how you give birth. She supports any kind of birth and therefore supports your choices.

  • Does not make any decisions for you but informs you adequately so you make an informed choice.

  • Does not provide any clinical care as she’s not medically trained.

A doula’s ultimate goal is to do everything within her scope of training to promote a positive birth experience for the mother and birth partner, and to help the family become comfortable with the new baby.