What is a doula and how does she help?

What is it about Sunday night? Are our bodies pre-programmed after years of schooling to go into automatic anxiety mode?

This Sunday, my moment of didn’t-do-my-homework anxiety came courtesy of a blast from my academic past.

In my Masters year, I wrote a thesis titled “Women Supporting Women: The Role of Doula’s in South African Birth Stories”. It was a qualitative research study in which I interviewed doulas and their clients to explore this relationship and demonstrate its relevance for modern psychology.

My big failing (oh there are so many) is that I never published this research. It was a good study. The findings were really interesting but I never bloody published. In terms of academic success I would self-diagnose myself with a serious case of failure to launch.

After presenting my research at Cape Town Midwifery and Birth Conference last year, I was implored by the ladies of the doula community to please publish my results and yet over a year later I still haven’t.

This thought took me down a bit of a shame cycle on Sunday night but then I realised that it’s not too late. I have this platform and I should use it, if not for anything else, as a way of vanquishing my own demons. So today I am going to share my findings with you. This is the most condensed version I could manage, as I know you don’t want to read 25000 words. Perhaps this will motivate me to write an actual academic paper one day.

Here’s to failures!

Introduction

I was introduced to the work of doulas by my mother and her neighbour at the time, Ruth Ehrhardt. I was fascinated by how they spoke of support being the primary tool of doulas or birth companions as they are sometimes known. I started to investigate further and discovered a huge body of scientific literature describing the medical benefits of doulas. My research was intended to explore the relational aspects of the role.

Birth

Birth is connected to and must be considered within a cultural and historical context. Historically, birth was an event in which women took centre stage. This was seen cross-culturally and around the world, in both industrialized and non-industrialized countries.

Since the beginning of the 20th century, the site of childbirth has moved from the home to the hospital setting resulting in a drastic increase in obstetric interventions such as analgesia and foetal monitoring.

The natural childbirth movement of the 1960s, aided by feminist voices, helped to bring another perspective. Since the late 1970s medical researchers have taken an interest in the benefits of having someone providing continuous support to a woman in labour.

Although an ancient role, this woman is commonly known as a doula today.

What is a doula?

Doula is a Greek term that roughly translates as a “woman who helps other women”. The role is technically defined as a woman who provides “continuous physical, emotional, and informational support to the mother before, during and after childbirth”.

A doula is not trained to provide medical or clinical care or assistance. A doula does not replace the role of the midwife or obstetrical nurse but instead offers a range of physical, emotional and social support.

Doulas in South Africa

One of the first studies done on labour support was conducted in Johannesburg in the early nineties. Currently, doulas can obtain certification through the organization WOMBS (Women Offering Mothers Best Support) in the Western Cape and DOSA (Doulas of South Africa) based in Johannesburg.

Their service includes a pre-birth visit, support throughout labour and birth and at least one post-natal visit.

Benefits of doula support

The benefits of doula support has been well documented over the last 30 years with over 16 randomised controlled trials (RCTs), at least two meta-analyses and a Cochrane library spanning over a decade of reviews.

Medical benefits:

  • Shortened duration of labour
  • Reduction in caesarean births
  • Reduced need for medical interventions such as forceps, fetal monitoring and oxytocin stimulation, epidural analgesia and other pain relief
  • Better breastfeeding outcomes

High obstetric intervention has been found to contribute to women’s experience of birth as traumatic, which can sometimes lead to symptoms of post-traumatic stress disorder. In particular emergency caesareans and intrusive obstetric interventions such as forceps, vacuum extraction as well as the use of analgesia are found to be the most related with trauma symptoms.

Research shows that women having an emergency caesarean section are at greater risk (six times) of developing postnatal depression. Mothers who undergo these invasive medical procedures and experience their birth as unpleasant may have feelings of low self-esteem and depression, impacting their relationship with their new infant.

These medical procedures, while establishing a remarkable decrease in infant mortality, are used due to the assumption that birth is a pathologic condition which must be treated, undermining the women’s body and her autonomy and diminishing her confidence.

Psychological benefits

  • More positive birth experience
  • Greater sense of control
  • Lower anxiety and depression
  • More affectionate mother-infant interaction
  • Greater maternal responsiveness and competence
  • NB for mother-infant bonding and attachment
  • “Has far-reaching and powerful psychological consequences”
  • Long-lasting effects on self-worth

The research shows that Mothers who received doula support reported having a more positive birth experience, felt a greater sense of control over their births, reported coping better, and had lower anxiety and depression scores. Doula support results in more affectionate mother-infant interaction, as well as greater maternal responsiveness and competence.

Mothers spent more time with their newborns, reported finding motherhood easy and their babies less fussy. Mothers who received doula care also commented that they felt more attuned to their babies and felt they sensed their needs better than mothers who had not received support.

This is very important for mother-infant bonding and attachment and “has far-reaching and powerful psychological consequences” (Hofmeyr et al., 1991, p. 762) for both mother and child. A woman’s experience of her birth has very important and long-lasting effects on her self-worth as a mother and a woman.

Aims

The broad aim was to investigate the nature of doula support, both what doulas do but also what is helpful and supportive about what they do.

I wanted to describe and explore the role of doulas in South Africa with specific interest in:

  1. The participants’ subjective notions of the ‘relationship’ that is formed between doula and client(s).
  2. The reasons for why and how this relationship is so helpful

Methods

I conducted a qualitative study. My sample included 8 qualified doulas, 1 trainee doula, 1 doula trainer, and 6 mothers and fathers who received doula care (3 women, 3 men). All particpants lived in Cape Town. Data collection involved open-ended, semi-structured interviews. Initially each participant was asked “what is/was your experience with doula care?” or “what is your experience of being a doula?” The data was then analysed using thematic analysis.

Results/Themes

Theme 1: The structural elements of doula support

  • the doula’s time and availability
  • suggestions and help
  • planning

These include the elements of doula support that ‘structure’ or ‘sculpt’ the relationship between doula and client(s) such as the doula’s time and availability, her ability to make suggestions and help plan the birth with parents and the doula’s help in planning, both before and during birth.

“…the other thing is she’s there the whole time. You know, the nurses, they’re in and out. She’s there, you’ve got a problem and she’s there, that was great…”

Theme 2: Professional qualities of doula support

  • Expertise and experience
  • Knowledge and training
  • Neutrality and objectivity
  • Insight and preparedness
  • Educating about medical and hospital procedures
  • Translating medical jargon

The professionalism of doula support entails the expertise and experience doulas bring to birth; their knowledge and training; as well as their identity as a neutral and objective third-party. The doula’s neutrality and objectivity offers her client unbiased and sound professional support. Having someone who is able to pass on their knowledge and experience is highly supportive

One of the other ways a doula’s knowledge and experience is found to be supportive results from her insight into the process of birth and her level of preparedness. Her role entails educating the mother and father about the medical and hospital procedures, as well as translating medical jargon used by medical practitioners.

“…why it was so good was because she kind of gave you insight into what was happening, what was going to happen…”

Theme three: The relationship

  • The special qualities of the doula
  • Doula as integral and life-saving element
  • ‘Just being there’
  • Reassurance for fathers
  • Recognition and nurturing of couple’s bond
  • Communication – what is said (and the doula’s words of encouragement)
  • Physical comfort
  • Creating a connection (eye contact & touch)
  • Trustworthy and humane
  • Express care and concern
  • Doulas promote, encourage and affirm celebration of birth
  • Feminine qualities
  • Unique and special connection
  • Sharing in a significant life event
  • Guide into the Unknown
  • Trust

Doulas come across as being incredibly special and unique women who really enjoy and take pride in their work. Not a single participant had a negative or even neutral comment to make about their experiences of doulas. Participants described doulas in terms of being an integral and life-saving element that they felt they wouldn’t have coped without.

The doula ‘just being there’ provides assistance to the mother and father. The presence of the doula is also reassuring for fathers, as they seem to benefit from having a companion to share the experience with.

Fathers need to be supported as well, and that it is very important to consider his needs and how best to support and empower him through the process. The doula’s role needs to involve recognition and nurturing of the couple’s bond. By acknowledging and allowing the couple to stay connected, the labouring woman is supported by both her partner and her doula, while the man still feels he has a role to play and thus their union as a couple and as expecting parents is nurtured and supported too.

One of the most vital ingredients in any helpful relationship is communication. Participants made frequent mention of the way in which the doula’s words of encouragement or the things she said helped. Doulas seem to know the right thing to say at the right time, which helps the mother to feel assured and relieved.

Doulas refer to their words of encouragement as offering mothers positive reinforcement, which relaxes them and helps them to believe in themselves.

Doulas provide physical comfort to labouring women. Some of the things that doulas do to help make the labouring woman more comfortable include massage and touch, helping the woman into different positions, breathing techniques, and helping her to eat and go to the toilet.

Another more subtle aspect of doula support is understood by doulas as creating a connection with the mother, which is often done through eye contact or gentle touch. This is considered helpful in that it provides the mother with reassurance of the doula’s presence.

Doulas were contrasted to medical staff in that they were viewed as more trustworthy and humane. The ways in which the doula communicates with her clients expresses care and concern. Doulas do not patholologize pregnany and birth but actually celebrate birth, which encourages and affirms.

There was reference made to the benefit of the doula’s feminine qualities. The usefulness of women being able to tap into their feminine power and strength through the support of another woman. There is a unique and special connection that is formed between women and that this connection aids and facilitates a successful and positive birth experience.

When describing their experiences of doula support, participants referred to the relationship between doula and client as special and unique due to the particular kind of sharing that goes on during birth. The doula participants also communicated their recognition that birth is a particularly important and momentous event in a woman’s life.

One of the resounding and most acknowledged aspect of the relationship that is helpful and meaningful, as communicated by participants, is the notion of trust. It is through trust that the doula is able to act as a guide to the unknown and it is through trust that she is able to connect with the women she supports.

Conclusion

There is in fact a very close fit between what the participants put forth as the most notable aspects of doula support and what is articulated in the literature.

Some interesting insights into the more subtle and complex features of the doula/client relationship were established.

These findings help to position the work of doulas within its socio-historical context.

Birth is a highly significant event in a woman’s life. Not only is it a physical journey, an experience nobody can truly prepare you for; but it is an emotional and spiritual journey as well.

The particular hormones that are at play combine to place women in an altered state of consciousness, one that is essential yet not completely understood by modern medicine. And through this radical experience, the labouring woman is transformed.

There is clearly something unique about birth that engenders female bonding, where women require the strength, support and wisdom of other more experienced women.

IMG_8410

Showing 31 comments
  • minecraft

    Can I simply just say what a relief to find an individual who
    actually understands what they are discussing online.
    You certainly know how to bring an issue to light and make it important.
    More people must look at this and understand this side
    of your story. It’s surprising you’re not more popular given that you surely possess
    the gift.

  • 韓國膠原蛋白提拉線,在韓國又稱作FTL(Fine Thread Lifting細線埋入拉提術)」,可達到最新趨勢V臉回春效果。它是運用獲得韓國食品藥品管理局KFDA最高安全等級認證的可吸收縫線PDO (polydioxanone)的Fine Thread(細螺紋) 埋入皮膚真皮層裡作用,利用異物反應原理,促進皮膚真皮膠原的增生、刺激局部微循環、從而提拉皮膚和肌肉,增強皮膚彈性,達到提升、除皺,美白、嫩膚等多重回春效果。

  • 一般網店

    客製網頁開發

  • 防曬霜

    賦予絲質柔滑,奢華的細膩質感和無與倫比的通透感,令妝容增添喜悅。

  • 腹部

    去除老廢角質,打造更乾淨的肌膚,並清潔堵塞的毛孔。

  • Link exchange is nothing else except it is simply placing the other person’s blog link on your page
    at suitable place and other person will also do similar in support of you.

  • NEAUVIA,歐洲血統透明質酸,目前遍布於全世界56個國家,行政總部在瑞士,卻是源自於意大利的品牌。採用21世紀先進的技術,提取出前所未有的高純度透明質酸,迅速的在全球攻占市場,卓越的品質,領先的技術和平民的價位,已經逐漸的出現在大眾的視線裡,被越來越的人使用。NEAUVIA以系列分女性專用和男性專用,大中小分子以及唇部專用和私處專用,其中私處專用己經在國內一些比較大的整形機構普遍使用。素材提取無與倫比的純淨,運用嶄新PEG鏈結技術-更安全

  • POND`S 旁氏 【無瑕透白系列】深層去斑透白精華霜(三重滾珠設計) Anti Spot whitening serum的商品介紹 UrCosme (@cosme TAIWAN) 商品資訊 POND`S 旁氏,無瑕透白系列,深層去斑透白精華霜(三重滾珠設計) Anti Spot whitening serum

  • 您是否曾經渴望尋找一個適合自己需求的靈活樓宇按揭計劃?歐力士是您最好的選擇。我們提供多樣化的按揭計劃,包括住宅、商用、工業物業。我們的專業團隊會應 …

  • BEING spa 【依芙蘿拉系列】水漾花妍純植香氛護手霜 BLOOMING FLOWERS的商品介紹 BEING spa,依芙蘿拉系列,水漾花妍純植香氛護手霜 BLOOMING FLOWERS

  • Thanks in support of sharing such a fastidious idea, piece of writing is
    pleasant, thats why i have read it entirely

  • Silent Seduction is definitely not A Game. This is an intense framework that will enable you to allure a woman totally without anything besides 3 basic contacting traps. These mysteries will give you extraordinary measures of power over a woman’s feelings and wants, so please utilize this dependably and morally. – https://bit.ly/2P60PZT

  • HOLIKA HOLIKA 【臉部保養系列】極緻修護超保濕乳液的商品介紹 HOLIKA HOLIKA,臉部保養系列,極緻修護超保濕乳液

  • Wonderful blog! I found it while searching on Yahoo News.
    Do you have any suggestions on how to get listed in Yahoo News?
    I’ve been trying for a while but I never seem to get there!
    Thank you

  • you’re truly a good webmaster. The website loading velocity is amazing.
    It kind of feels that you’re doing any unique trick.
    In addition, The contents are masterpiece.
    you’ve done a wonderful task on this subject!

  • Attractive element of content. I simply stumbled
    upon your blog and in accession capital to assert that I get in fact loved account your weblog posts.
    Any way I’ll be subscribing to your augment or even I fulfillment you access consistently fast.

  • I’m not sure where you are getting your information, but great topic.
    I needs to spend some time learning more or understanding more.
    Thanks for excellent information I was looking for this info for my mission.

  • FG韓星 能請來GD、吳赫合作!她是韓國「音源榜女王」IU李知恩 – FG生活風格 – FashionGuide 華人時尚專業評鑑 (圖片來源/IG@dlwlrma、,Twitter@Chojungseok,(@jojeol))IU這次新曲邀請到BIGBANG隊長G-Dragon跟hyukoh樂團的吳赫,一起合作推出2首歌曲,其中與GD合作的《Palette》唱出IU自己25歲了解自我的心情,廣受大韓國網…,

  • Descargar facebook
    Thanks for sharing your info. I truly appreciate your efforts and I am waiting for your next post thanks once again. Descargar facebook

  • quest bars cheap

    Attractive portion of content. I just stumbled upon your website and in accession capital to claim that I acquire in fact enjoyed account your blog posts.
    Any way I’ll be subscribing in your augment or even I success you get right
    of entry to consistently quickly.

  • FAN’S VIEW: Arsene Wenger needs to make Arsenal more appealing than Manchester City and Barcelona. He needs to make Arsenal the home Hector Bellerin can’t leave. Arsene Wenger needs to make Arsenal a trophy-winning powerhouse to keep Hector Bellerin away from Barcelona

  • quest bars

    Hello! Do you know if they make any plugins to
    assist with SEO? I’m trying to get my blog to rank for some targeted keywords
    but I’m not seeing very good results. If you know of any please share.
    Kudos!

  • Quest Bars

    Attractive section of content. I just stumbled upon your web site and
    in accession capital to assert that I get actually
    enjoyed account your blog posts. Any way I will be subscribing to your feeds and even I achievement you access
    consistently rapidly.

  • Hello there! This is my first visit to your blog! We are a collection of volunteers and starting a new project in a community in the same
    niche. Your blog provided us valuable information to work on. You have done
    a marvellous job!

  • Sling TV

    This information is invaluable. Where can I find out more?

  • With havin so much content and articles do you
    ever run into any issues of plagorism or copyright violation? My website has a lot of unique
    content I’ve either written myself or outsourced but it seems a lot
    of it is popping it up all over the web without my agreement.
    Do you know any solutions to help stop content from being stolen? I’d truly appreciate it.

  • Hello are using WordPress for your blog platform? I’m new to the blog world but I’m trying to get started and
    create my own. Do you need any html coding knowledge to make your own blog?
    Any help would be greatly appreciated!

  • Good day! I simply wish to offer you a big thumbs up for your excellent information you’ve got here on this post.
    I will be coming back to your website for more soon.

  • Ole Gunnar Solskjaer has left Cardiff City by mutual consent, bringing an end to a hugely underwhelming eight-month spell at the club for the Norwegian. The final straw was losing 1-0 to Middlesbrough. Ole Gunnar Solskjaer leaves Cardiff by mutual consent after disastrous eight-month reign

  • Hey very cool website!! Guy .. Beautiful .. Superb ..
    I’ll bookmark your web site and take the feeds additionally?
    I am glad to seek out numerous helpful information right here within the publish, we’d like develop more techniques on this regard, thank you for sharing.
    . . . . .

  • Sannypealf

    Nice posts! 🙂
    ___
    Sanny

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Not readable? Change text. captcha txt

Start typing and press Enter to search