A doula is knowledgeable about the birth process and very educated about the methods, but we don’t offer medical advice, or diagnose or perform medical procedures, whereas a midwife attends to the medical needs of the mother and her baby. There’s a myth that doulas only work with midwives, but we offer an independent service. As I like to say, doulas work from the waist up labour> and midwives work from the waist down.
A doula meets with an expectant couple a minimum of two times, helping them uncover what they desire for their birth experience. They explore different options for managing pain, and practise breathing techniques and positions for labour. During labour, the doula joins the mother when and where they’ve agreed; many women choose to labour at home for as long as possible, so the doula will come to the home, or she can meet them at the hospital. Once active labour begins, the doula is present until after the birth of the baby. Postpartum, they usually visit the family at home at least once to discuss the birth experience, and help with initial feedings, if asked.
There is a large range, mostly dependent upon location—you won’t find a lot of rural doulas—and the doula’s experience. A doula-in-training may charge only $100 to cover her expenses, while the fee could be around $2,000 for a more experienced doula.
The majority of maternity practices now have many doctors, and a mom may not have met the doctor who ends up delivering her baby, so the big draw is the continuity of care before, during and after the birth. Also, it’s so beneficial for a mother to start her journey into parenthood with the confidence that she can make informed decisions that are right for her and her family. My aim is to help women find their inner wisdom to make those decisions.
A doula supports both of them. She can keep a partner informed of what is happening during labour, what the medical language means, and assure him or her of what is “normal.” She encourages women and their partners to ask questions, and helps them form the language to do so, if needed. Partners are very comforted by my presence and I’m always reminding them to take care of their needs, too—to eat and rest—and make time to address practical matters, like phone calls to update family.
Some doulas offer both, and it’s ideal for the couple to have that continuity of care. Unfortunately, there aren’t enough postpartum doulas out there.
Try to have your doula in place by 28 weeks gestation so there’s enough time to build a relationship, explore birth options and get the info you need to make the best decisions for your care. This is also when the pregnancy becomes more of a reality, and when women tend to slow down and intuitively start putting things in place for their baby’s arrival.
A certified doula has attended an intensive workshop, a childbirth right preparation series, and three births where they were evaluated by the health care provider. DONA International (DONA.org) and the Childbirth and Postpartum Professional Association (CAPPA.net) are doula the main certifying organizations in Canada, and your local doulas will likely be members. Visit these websites to begin your search.
A version of this interview appeared in our Fall 2013 edition of Today's Parent Pregnancy with the headline, "Doulas, demystified," pp. 34-5.
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