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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 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 J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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