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Working with a Doula | Image Courtesy of Rebekah Vos via Unsplash
Working with a Doula | Image Courtesy of Rebekah Vos via Unsplash

Are You Thinking of Working with a Doula?

Here are some of the benefits

Being a pelvic floor physical therapist, I work with pregnant and postpartum women almost daily. Not having birthed any children yet and currently pregnant, I was curious about the doula process both professionally and personally. So, I attended a wonderful birth doula training program and learned a ton about what working with a doula is all about.

What is a birthing doula?

A doula serves as an activist for women who are birthing. They provide continuous physical, emotional and informational support to the mother and family prior to, during, and immediately after birth. The doula’s ultimate goal is to advocate for and elevate the mother’s voice. Hospital staff, labor & delivery nurses, family members, and obstetricians/gynecologists are not able to provide in this role because they have other obligations, like focusing on the mother's and baby’s medical health and wellness. The doula’s extra support is focused on the mother’s needs and allows for a safe space for birth to occur, increasing the likelihood of an overall, satisfying birth experience. 

Benefits of working with a doula:

Authors of a systematic review that included 15,000 women within 21 randomized controlled trials concluded that having a doula has clinically meaningful benefits for women and infants; furthermore, there are no known associated adverse effects or harm. The authors encouraged that all women should have support throughout labor and birth. 

In comparison with those who did not have continuous labor/birth support, those with doula support had the following benefits:

  • shorter labors 
  • less likely to have a pitocin supplementation 
  • less likely to have epidurals 
  • less likely to have forceps or other assisted devices during the second stage of labor
  • decreased rate of cesarean section births 
  • giving birth to a baby with a higher apgar score 5 minutes after

Most importantly, improves the woman's satisfaction about the birth itself!

Working with a doula:

Once you have interviewed for the right doula for you, there are usually 2-3 prenatal visits to connect with your birthing doula to discuss various things such as:

  • the intended place of birth
  • your vision for your birth
  • things that you know that can provide a sense of calmness (such as aromatherapy, lighting, sounds)
  • your priorities/desires for the need for interventions during your birth (pitocin, epidural, etc.)
  • education about labor itself including the pre-labor, labor progression, how to time contractions, when to transfer to the intended location of birth
  • breathing practices
  • help you develop a birth plan

During labor, a doula may: 

  • provide comfort measures: reminding you on breathing techniques, aromatherapy, emotional support, massages for relaxation & pain relief, recommending different positions to promote comfort, and more
  • advice on questions to ask of caregiver on certain topics
  • reminding client to ask caregiver questions on procedures different from her wishes
  • requesting help if birthing partner or baby appear to be under distress
  • help with woman’s partner to allow for improved birth satisfaction (makes sure partner’s basic needs are met to help set up success for helping the woman)

Doulas are a wonderful addition to your birth team to help improve the miraculous experience of birth, especially if you are someone that would like to have the least amount of intervention. If you have any further questions about working with a doula, DONA is a great resource to get more information. For more pregnancy related blog posts, click here.

**COVID-19 Note: Due to COVID-19, at this time, there are some hospitals that are only allowing doulas that are certified to be in the birthing rooms. Here’s a quick link to find certified doulas in your area.

 

References:

  1. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth [PDF]. Cochrane Database Syst Rev 2017, Issue 7.  DOI: 10.1002/14651858.CD003766.pub6.   
  2. Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol 2002; 186(5) S160-172.
  3. Simkin, P. Position Paper: The Birth Doula’s Role in Maternity Care (PDF) DONA 2012. 

What Our Patients Have to Say

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Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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