What is a doula? I hear this question so often that I am more surprised to meet someone who knows what a doula is than to have someone ask me “what is a doula?”. To be honest, I didn’t really know much about doulas until I started training to become one!
During my second year of medical school I had the opportunity to take part in the Fir Square Interprofessional Student Doula Support Program as the community service learning option of my Doctor, Patient and Society (DPAS) course. The Fir Square Doula Program is funded by the Collaboration for Maternal and Newborn Health and brings together nursing, midwifery, and medical students once a week to participate in a doula class. In these classes we learned about various topics including the labour process, ways to increase comfort during labour, pregnant woman yoga, addictions and their impact on pregnancy, etc…and we had guest speakers from various organizations in Vancouver who work with pregnant women dealing with particularly challenging circumstances, such as:
- Oak Tree Clinic – specialized HIV/AIDS care for individuals including pregnant women
- Sheway – Pregnancy outreach program located in the inner city of Vancouver
- Fir Square – non-judgmental support for pregnant women with substance misuse at BC Women’s Hospital
Additionally, we were grouped into interdisciplinary teams of three and accepted clients as their doula. Specifically, our goal is to provide doula services free of charge to marginalized women who may be able to benefit from having a doula but cannot afford to pay for a doula.
According to DONA International:
“The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.”
What does a doula do?
Doulas can do anything! Well, just about anything. Doulas will meet with their clients throughout their pregnancy, see how they are doing and assist them with information gathering as needed. We also discuss birth expectations and arrangements surrounding our client’s birth so that we can get to know our clients and help advocate for them during the uncertainties and craziness of birth. We can guarantee our presence for women whose support people may not be able to attend the birth but at the same time we can stand to the side or even leave the room when many support people unexpectedly show up and the woman is in great hands. During the labour process we can whip out our toolbox of comfort measures to encourage our client to try different positions and movements to provide pain relief. We can also help our client make phone calls, get juice or water, assist them in the shower, make sure to bring the music they picked out, etc… When the pushing begins we can be the person standing at the head of the bed encouraging our client to breathe and push but if her partner is doing a fantastic job, we will readily step aside. We can even be the person holding the camera up in the air while hiding out in the washroom (to stay out of the way of all the health care providers that come in) to help capture pictures of the baby as he/she comes out (trust me, it’s actually lots of fun!). Basically, doulas are there to support our clients with the non-medical aspects of their birth throughout the labour and delivery period.
Who needs a doula?
Basically, anyone! In my limited experience, the most common reason why a woman would like to have a doula is if she her support people cannot guarantee that they can attend their birth. Either their home is very far away from the hospital or they have other children that their partner needs to stay home and care for. A doula provides women with a familiar face during their labour and delivery. While women do not usually know exactly which health care professional will be at their birth, they will usually know the doula who will be present. A doula can provide comfort as someone who already understands the woman’s needs and can help them find ways to improve their birthing experience according to the woman’s preferences. Women who have partners who have never been at a birth or feel anxious in the setting may also find that they can benefit from having a doula who may be able to support both the woman and her support people. And to top it off, research has shown that doulas make a positive difference for the woman and her baby!
Why become a doula?
As a doula, I have had the most rewarding experiences that I can recall. It’s an incredible privilege when women open up their lives to me at a vulnerable, stressful, exciting, but also extremely personal time of their lives. I have had the opportunity to share laughter with a woman who had a very smooth pregnancy and birth and also the opportunity to be a shoulder to cry on for a woman who faced numerous challenges during her pregnancy, birth, and post-partum periods. I have also had the opportunity to support a woman who battled addiction and poverty and I have developed immense respect for her as she fought through her challenges to become the mother that her baby needed. I cannot even properly describe how moved I was when a mother who had limited and precious time alone with her baby requested for me to feed her baby and so that I could share that intimate moment with her. Although I have had only a very small taste of what it is like to be a doula, I am unreservedly certain that it is one of the most memorable and worthwhile experiences to be had.
Erica Chhoa, WHRI Summer Student