Women who opt for a doula ahead of their deliveries begin a relationship that will take them from early pregnancy through to the countdown to birth, and often into the postpartum phase. The doula's role in birth is to support the mother, advocate for her, and help the birth along. Some women birth with a doula at home, and others in a hospital setting; whereas an obstetrician provides check-ins at intervals, a doula is with you through the entire process.
Providing hands-on support or just affirmative words, doulas are an integral part of childbirth, say the women who have enlisted their services. Although everyone involved in a birth is focused on the end-goal of a healthy baby, doulas are keenly attuned to the needs of laboring women, and pick up on tiny cues from their clients that may otherwise have gone unnoticed. Their skillset is similarly tailored to the mother, as she goes through one of the most profound transitions of her life, physically and emotionally.
"At the onset of labor... at that point, we’re in constant communication, checking in on an hourly basis to see what the progression might look like. This can be over the course of a few hours, sometimes a few days depending on the length of the labor. We’re usually the first line of contact before people contact their doctors.
A lot of the sensations can be amplified by nervousness or fear.
"At that point, we will communicate with the client to see sort of, as the labor progresses, when they would like to have the physical support. By the 5 to 7 minutes [between contractions] mark, we’re usually with the couple by then or the mother giving support because at that point, the contractions are just really more intense for a mom. Especially the first time, as things happen, they’re happening in a way that you’re feeling for the first time, so a lot of the sensations can be amplified by nervousness or fear. When the doula shows up, there’s hands-on support in the form of comfort measures, sometimes there are herbs administered to move things along, other times it’s just using the contraptions in the house as well as what we bring in our doula bag to move things along.
"There comes a point where the contractions get to a pattern where it indicates we should probably go to the place of birth, if it’s not at the home.
"We stay with her as a constant presence of support. Before they move you into a room [in the hospital], they’ll do an internal vaginal exam at which point they’ll determine how far along you are in dilation and centimeters.
"Once admitted, the mom gets into the room... and it’s just really hanging out, laboring, using the birth ball or water, any of the techniques that are available to us to keep a mom as comfortable as possible to move things along. One of the things I like to do is administer an enema and that helps to really get things moving, and will help open up the bottom half of the body, including the cervix.
"When it’s time to push, it’s all hands on deck. The doula is really hands-on with helping the mother maintain the position she wants to be in to deliver her baby, keeping her in a calm headspace, giving her water and ice chips and a cold cloth to cool her off. Also giving her words of encouragement and affirmation, breathing deeply with her, doing all types of things to keep the comfort going. [We’re also] making the room comfortable, maybe having low lighting or diffuser and things to make the room smell good.
"We never call it a birth plan. [We call it] birth preferences because we know lots of things change. One of the stressful things is when everything’s going smoothly and then suddenly we’re on the course towards surgical delivery. That can pose stress, obviously, for the client and we have to adjust and help them wrap their head around. It calls on the doula to be an emotional support for that client.
Our role is to gently and easily slip away.
"Pushing for everybody can take different lengths of time. Sometimes it’s like a baby’s out in three pushes, but normal is like within a two-hour timeframe of pushing for many first-time moms. Once the baby is born, the doula will stay for the first hour of life at least just to make sure that breastfeeding has been established, the mom is comfortable. Our role is to gently and easily slip away.
"Every single birth is different, and each time is almost like the first time. Each time is super miraculous and amazing, really because you see this mother undergo this transform and that in and of itself is really powerful."
This interview has been edited for clarity.
You’ll never forget the birth of your child, but what does everyone else who was there remember? Find out with more from Romper’s look at birth, Stork’s Eye View.