What is a doula?
A doula understands that birth is a transformational experience for everybody involved. During pregnancy and the postpartum period, she provides information to the parents so they can make the best possible decisions for themselves and their babies. We assist you in finding your vision of birth and sticking to it. We can be your sounding board whilst you are navigating a complex medical system in a mostly foreign country. We facilitate communication between the laboring woman, her partner and her clinical care providers. During labour, we offer emotional support to both parents, we are "mothering the mother”, and suggest comfort measures (positioning, massage etc) to ease labour. And we will continue to be there for you long after birth, protecting your memory of the birth experience. A doula does NOT support the mother in a medical role – that is the job of the midwife or doctor.
How is a doula trained?
A certified doula receives professional training in the physiology of birth and the emotional needs of a woman in labor. Again, this is not medical training – doulas are trained in professional birth support. Whilst I am currently working on my certification, I do by no means think that only certified birth attendants are good attendants. The ability to just BE with a birthing mother and her family is something that can’t be trained.
Why should I have a doula?
Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, many women wish for consistent, continuous reassurance, comfort, encouragement and respect. Numerous clinical studies have found that a doula’s presence at birth tends to result in shorter labors with fewer complications, fewer interventions and reduced rates of caesarean sections as well as increased rates of breastfeeding. Add to this the fact that your are most probably birthing in a foreign country, an unfamiliar medical system and without the immediate support of you family and friends, the question really turns into “why shouldn’t I have a doula”.
But what about the Dad?
Many partners are a little nervous about being birth partners, but just as uneasy about a doula trying to take their place. Being a birth partner is a tough job. It is an important part of a doula’s role, to help your partner to build confidence and to be as involved in the birth experience as he feels comfortable. Sometimes a doula does nothing at all, whilst dad steps it up and does a fantastic job at supporting his woman! And sometimes a couple decides that his place is not in the birthing room, which is just as fine. But for most partners it means that we work together. Second time parents often mention how much easier it was to work together in the presence of a doula as compared to the first birth where they where on their own.
But what will my OB/the midwifes think?
Many obstetricians and midwives are very supportive of doulas. Many doctors at international hospitals are familiar with us and are working with us regularly. Some even recommend that you hire a doula. The same applies for most L&D nurses at these hospitals. There is the occasional obstetrician who is uncomfortable with having a doula present, just as certain hospitals do not allow fathers in the birthing room. If you would like to have a doula’s support and your doctor refuses, take a pause and think.
I can’t have a doula, I am planning an epidural/c-section.
My job as a doula is to help YOU achieve the birth that YOU want. Birthing is about empowering women and their partner with factual evidence to do what they believe is best for themselves, their babies, and their families. Your decisions are just that: YOUR decisions. I can give you information that you may need to make decisions, give you options that you didn't realize you had, and/or remind you of your original birth plan when labor gets intense, but ultimately my job is to support what YOU want and support all of your choices along the way. Doulas accompany women into all birthing situations, including high-risk pregnancies/births, inductions, medicated births, and even planned cesareans. More than half of women who have cesareans say that they felt "frightened" and 34% say they felt "helpless." My job is to help you feel safe and secure. There are specific techniques that can reduce additional interventions and/or complications no matter what your birth plan includes! Many women mistakenly believe that because they're not planning an unmedicated birth, they don't have any options. You always have options.
So how do I find my doula?
It can be tempting to go with the first doula you meet (because they’re all pretty special) but I do recommend speaking to several doulas, as every doula is unique and has something different to offer. It’s important that you and your partner both meet the doula, you both need to feel assured and comfortable around her if you’re going to share such a special, vulnerable moment with her. And no, a doula will not be hurt if you tell her that you have found someone else you click with really well… If you are looking for a full list of doulas that are available around your birth month, contact me and I will feed your request into our Doulas of Bangkok network. Or come to our mothly chat at "Choices in Childbirth" (see resources).