Blush: What’s a doula? Why do I want one? – Guest Post by Tricia Surette

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Part 1: What’s a doula? Why do I want one?

Pregnant women often say that what matters most is the health of their baby or babies. Our society focuses heavily on the arrival of baby often to the detriment of the mother. One of my favourite quotes is, “the moment a child is born, the mother is also born,” and according to the internet it is attributed to Osho, a controversial figure. But the quote captures a truth about childbirth.

The woman is as integral to the process of birthing as the baby is, and her importance and her need for support is just as important as the health of the child. The act of labour is a symbiotic relationship between the woman’s body, mind, and soul working along with the movements of the newborn descending through her birth canal. The more we can allow that process to happen unhindered and for women to be free to listen to the intuition of their bodies, often the better the outcomes are for both the mother and child.

Here a doula holds a woman in early labour, providing support through the intense surges of her labour, as her body works to bring her baby earthside. Image taken by Nicky Rhea De Souza and shared here with permission.

Unfortunately, our highly medicalized birthing system in North America has forgotten the power of the female body – but this is starting to change.

Women are remembering, they are learning to trust themselves, and they are demanding more support. One of the forms that support might take is a doula.

“[A doula] is somebody who helps you see your strengths, helps plan, helps craft questions for your healthcare provider,” says Courtney Holmes, the family outreach and birth companion support worker at Mothercraft Ottawa. “They really help instill a sense of confidence and empowerment moving through the experience.”

Mothercraft Ottawa provides doula services to at-risk women in Ottawa. At-risk includes new immigrants and low-income mothers. The support the doulas provide those women is invaluable.

“How women feel about their labour and delivery is a huge marker for postpartum mental health issues afterwards,” says Holmes.

Pia Anderson, a local doula and Hypnobirthing teacher, has been a doula for over 14 years and has supported hundreds of women physically, emotionally, and informationally through their journeys of birthing their children.

Anderson tries to meet with each family at least three times prior to the birth. This helps build her relationship with the woman and her partner.

She is a big supporter of a birth plan, not because she expects everything will go according to the plan, but it gives a chance for the woman and her partner to explore their options and be aware of the different scenarios that might come up, as well as to explore questions they might want to bring up with their healthcare provider. It also gives them a chance to voice any fears or worries. Anything that can be addressed ahead of time or can be anticipated to come up during the birth, can help increase the chances of a positive birthing experience.

Anderson worries about the mothers who make a birth plan that they are too attached to.

Birth is not a predictable process and getting too entrenched into an idea of how it should go, ie. having your heart set on a “natural” birth (meaning no epidural, vaginal delivery, etc…) can set a woman up for disappointment if anything deviates from her vision. The birth plan is a great tool for educating yourself on what could happen and to help you be prepared for various outcomes, but it’s important that it’s viewed as a tool to help create an optimal birth in spite of anything that happens, and not a carved in stone agenda. Very few births go completely according to plan.

Melaina Landriault is a mother of three in Ottawa. Her first birth was a c-section as her daughter was full breach and stuck, but her two subsequent pregnancies were homebirths with doulas. Her second birth didn’t quite go as planned. It was supposed to be a hospital birth, but the hospital sent her home thinking she was still hours away from delivery. Her daughter had other ideas.

“I delivered her myself,” says Landriault. “[My doula] caught the baby!”

“We really believed what the doctor and midwife had told us and I’d never birthed before,” continued Landriault. “Then I remember pushing and [my doula] was like ‘Don’t push!’ and I was like, ‘I can’t stop this!’”

Landriault’s daughter was born in her living room with only her doula to support her. Her midwife arrived after the birth and an ambulance arrived to check everyone out as well.

This is not a typical scenario for a doula and most doulas will actively avoid a birth without any medical practitioners in attendance, but this one thankfully had a happy ending.

Unfortunately, if a doula attended a birth with no medical support and it didn’t have such a happy outcome, the doula could be open to a lawsuit with devastating results and charges could even be laid if the outcome is deemed the fault of the doula in any way.

Doulas are not medical practitioners and should never provide medical advice on your pregnancy or how you choose to birth. They can provide information to help you make a decision and will direct you back to your OB/GYN or midwife for answers, but they should never tell you how or how not to do something. The main goal of a doula is to support you in whatever choices you make and to help you achieve the best outcome for your birth so that everyone, including the mother, is healthy.

Stay tuned for Part 2 and Part 3 in two and four weeks respectively.

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