Doula

Since ancient times, women have been accompanied during pregnancy and childbirth by more experienced women to help them better manage this new stage in their lives. Over time the role of the doula disappeared or diminished because as time evolved, childbirth moved from the home to the hospital.

The role of the doula consists mostly of emotional assistance, even though they can also provide physical help. They don’t have clinical responsibilities, so they can’t be seen as a midwife, as they carry out the needed health functions of childbirth.

Some countries in Europe regulate this profession, and their services are even included in the social security system.

The doula in pregnancy

Although most people know that doulas accompany the birth, the services they offer can be from pregnancy. They can provide perinatal accompaniment and fundamental information, as well as helping with exercises.

At this stage the emotional support is usually focused on preparing the mother mentally for childbirth, talking about her fears and explaining how things work so that she can make informed decisions. The main idea is that in this way each woman chooses how she wants to live her pregnancy and birth.

The doula in childbirth

The role of the doula during labor is to ensure that the mother has a humanized and painless birth. They accompany you from the beginning of labor and are attentive to act so that the memory of the birth is a good one.

In addition to the accompaniment, doulas help you interpret the medical explanations of your gynecologist or midwife, offer suggestions, and help mothers to move or change position during labor to help the baby to be born better. Many use aromatherapy or massage to help reduce pain.

Some doulas are also trained as lactation consultants, helping mothers get off to a good start breastfeeding and supporting them in having skin-to-skin contact with their baby. It is important to mention and remember that a doula cannot and should not tell you what to do, they are only there to support.

The postpartum doula

In the postpartum stage, doulas help during the mothers’ recovery, with activities such as washing the baby’s clothes, washing the dishes or helping to cook some food so that the mothers can rest and recover.

Their emotional accompaniment continues since it is in those first months with the baby when the most difficult or heavy part of becoming a mother appears. They must be attentive to signs that may indicate some kind of depression or anxiety, and provide emotional support.

The work of a doula is not only limited to supporting the mother, they also help the father or grandparents feel part of the whole process of the arrival of a baby, solving their doubts and explaining the role of each one.

Why are doulas back in the market?

Basically, it is due to a crisis of maternal mortality in which low-income houses are at risk of poor birth outcomes. According to the U.S NHeLP’s Doula Medicaid Project, these services are in stages of consideration, planning and implementation in 17 States:

● Six states (Oregon, Minnesota, New Jersey, Florida, Maryland, and now Virginia) currently reimburse for doula services in Medicaid.
● Six states (California, Washington D.C., Illinois, Indiana, Nevada, & Rhode Island) plan to get CMS approval to implement doula coverage in Medicaid in 2022 and 2023
● Five states (Arizona, Connecticut, Georgia, Louisiana, and Washington) are considering a Medicaid doula program in Medicaid.
Statistics of how doula services are impacting maternal health

A study published by The Journal of Perinatal Education Vol 22 Issue 1, states that “studies that examine the relationship between birthing mothers and their doulas report consistently positive experiences. Newton et al, for example, found among a sample of Latina women giving birth at a Boston hospital that mothers supported by doulas were more likely to breastfeed their newborns and to delay first infant formula feed.”

“Similarly, Nommsen-Rivers, Mastergeorge, Hansen, Cullum, and Dewey reported that in comparison to a group of women receiving standard care, a doula-paired group of women experienced significantly shorter periods of labor, less instances of instrument-assisted birth. In a study of 2,174 expectant mothers receiving doula services compared with a sample of 9,297 receiving standard care, Mottl-Santiago and associates also found higher rates of breastfeeding and early initiation rates among the doula-supported mothers.”

Why should people now hire a doula even if they are having a hospital birth?

In those countries or communities where women give birth in hospitals, health centers, maternity homes, or in their own homes with convenient emergency services, ongoing support is usually provided by women who serve as midwives, licensed midwives, doulas, or even traditional birth attendants.

Doulas carry out the mission to reassure and ensure, with their expertise and service, the best possible experience on the road to motherhood.

During pregnancy, doulas provide pertinent information, help clarify the role of the couple in labor and reduce the fear of physical pain, share non-medical techniques to mitigate pain, and facilitate logistical issues as basic as telling expectant mothers what their suitcase should contain when they leave for the hospital. During labor and delivery, they provide emotional support with their constant presence and words of encouragement, as well as concrete information about what is happening and what will happen next.

They also physically soothe mothers with massage techniques, and warm baths, indicating more comfortable positions and encouraging mobility. After birth, they often facilitate bonding between parents and newborns, assist in the initiation of breastfeeding and offer recommendations and practical advice for the care of the baby once at home. Their role, therefore, can have significant effects in contributing to a healthy birth, without replacing other elements that ensure safe delivery.

As your doula, my job is to take on the unnecessary stressful load of navigating the healthcare system on your own while being pregnant. I will meet with you on a regular basis throughout your pregnancy to hear your concerns, to review with you all information provided by medical and birth providers, to answer any questions that you may have or to direct you to the right resources to find your answers. I will also establish a communication line with your obstetrician or midwife to coordinate your care upon request, and to be present at your birth.

If I have to explain my role as your doula in one sentence, I would say that I will be your friend and advocate holding your hands throughout your pregnancy and postpartum periods.

Book your complementary Meet & Greet today:

https://calendly.com/makayahealth/doula-services-package

References:

https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2022/06/06/more-states-adding-medicaid-benefit-for-doula-serviceshttps://ccf.georgetown.edu/2022/06/02/doula-services-in-medicaid-state-progress-in-2022/https://healthlaw.org/doulamedicaidproject/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/

https://www.istockphoto.com/photos/doula