Don't Put It All on Dad: Why Laboring Women Need a Doula

Normally, pain is a sign that something is wrong, or out of the norm.  A woman experiences sudden chest pain and severe shortness of breath.  Something is wrong.  Another woman trips and falls.  She catches herself with her hand on the ground in front of her.  A intense pain in her wrist tells her something is wrong.

A woman goes into labor.  As it progresses, she no longer feels a tightening in her abdomen -- she feels pain with the contraction.  Something is NOT wrong.  Pain is an indication that labor is progressing. However, in many cases, labor and birth does not have to hurt as much as can.

The amount of pain a woman feels during labor and at the time of birth is based on many factors:  position and size of the baby; the woman's own position at the time; fear and anxiety; uncomfortable procedures; restriction in movement and comfort options; lack of loving companionship;  lack of empathetic care; length of labor; hunger; the use of pain relief medications; and so on.

Again, for many women, birth does not have to hurt as much as it can.  When women are free to move around, have knowledgeable labor support, experience loving support from the baby's father and other family and friends,  uses comfort measures including massage, aroma therapy, warm water baths or showers, peaceful environment, and more, the pain is typically not as intense.  Labor is usually shorter than it would have been otherwise, and outcomes are better.  There is less need for Pitocin (which causes very painful contractions), amniotomy (artificially breaking the "bag of water"), and operative deliveries like forceps, vacuum extraction, and C-section -- all of which carries increased health risks -- some very serious -- to the mother and baby.

Dr. Robert Bradley was a physician who developed one of the three most popular approaches to childbirth in the last century.  He believed relaxation was the key to dealing with the discomfort of labor. He also felt husbands (as was typically the case at that point of our history as a country) played an important role in providing physical and emotional support for laboring women.   Dr. Bradley was on a good track, but not quite on the right one.

You see, is was women, and not husbands, who took the role of labor support for thousands of years.  Fathers provided emotional support, if they were part of the birth at all.  Fathers sometimes became midwives in "emergency" birth (which really was birth that was going very well in most cases).

While loving husbands bring some security and support to women during birth, they only begin to bring the nurturing care women can bring.  Also, men typically are way out of their comfort zone, no matter how many classes they have attended -- especially with a first birth experience.  The stress on them can be enormous, making the experience less enjoyable. 

Yes, I hear you.  "If I am not enjoying it, then he shouldn't enjoy it either!".  But wouldn't you want to have a birth experience in which your support team increased your confidence in your ability to give birth?  Wouldn't you want an labor which is not a painful as what many women experience in a fully medicalized approach?  Wouldn't you want an experience that, when it was over, you rejoiced in it instead of being traumatized or left feeling unfulfilled?

A man who has no background with birth, other than a childbirth and a breastfeeding class, does not have, in most cases, the confidence required to serve as a advocate for the mother in all situations. 

"What if I'm wrong?"  "Do I remember this correctly?"  "Is this a unique situation?"  "Will I be putting her in danger if I stand up for her birth plan in this instance?"  "The doctor is saying this;  he is supposed to know.  Who am I to question?"  These and other questions can quickly come to the Dad's mind and affect his ability to support the mother's choices.

A doula, however, is very aware of the research, of the scare tactics, and of the options.  When pressure is put on the mother to accept an intervention when it's necessity is truly in question, a doula can educate the parents about the situation and options.  She can offer alternatives.  She can suggest how to word answers or questions when communicating with a care provider.  She imparts the confidence and knowledge and skills required to avoid unnecessary interventions which can lead to undesired outcomes.

As a result of the Fall of Man, recorded in Genesis 3, women across the globe and over millennia have suffered oppression, abuse, and pain in childbirth.  Still, God has  provided ways to minimize the pain and optimize the experience.  (By the way, the oppression and abuse women have endured since that time was NOT the original plan.  One day, a world will exist where women will enjoy the intended position of respect --see "The Big Picture" page if you want to know more). 

As we understand the natural, God designed,  process more and more, and as we support that process, the rate of complications, and even the amount of pain can be lessened significantly in most cases.

 

Enter the doula.  A doula understands the principles which promote natural childbirth in ways more comfortable to the mother.  This professional birth companion is a knowledgeable, supportive, and caring resource for both mom and dad.  She does not take dad's place.  She takes stress off of the dad so he can participate with more confidence and less worry.

She provides a wealth of knowledge and expertise to facilitate the normal progress of labor and to decrease the amount of pain the mother would have otherwise.  She helps women cope with labor.  She supports the mother's right to objective, complete information.  She will fight to the death for the mother's right to make informed decisions.  She does not direct how the labor will be handled, she provides the information and tools and support so the mother can make these decision and benefit from natural pain control/coping methods.

I love my husband and I know he loves me.  He endured three childbirth classes and three labors.  Doulas were not available at the time in my area.  Now that I understand and appreciate what doulas offer, I wish we could have had one.  He would have enjoyed these three special experiences much more.  His memories of them would be more precious.  As for me, I have no doubt I would not be dealing with health issues from interventions I could likely have avoided if there had been today's doula supporting me.

Even though I was not blessed to have a doula, I have been blessed to serve as one for some of my class members and for one of my daughters in law over the years.  After my first grandchild was born, my son said, "Mom, you are really good at this!  You should think about doing this for a living."  I had to laugh at this because I had been making part of my living over the years as a childbirth educator, lactation consultant, and on occasion, as a doula.  He was ready "to do it again".  He was just enjoying the "high" of witnessing the birth of his first child and forgot the years he lived with childbirth charts in his closet, or his mom counseling with pregnant and new mothers over the phone and at the stores.  

With this birth, he participated as much as he was able, with loving caresses and slow dancing.  He had hurt his back and was not able to do many of the counter pressure techniques, etc.  This is another benefit to having a doula.  If dad has an injury or health issue, the doula can assume more of the "heavy" support.  My son's exuberance was just a confirmation of how the services of a doula enhances the experience for the mother AND the father.

Some women think that the L & D nurse can serve as a doula.  Unfortunately, this does not work like many women anticipate.  L & D nurses have many obligation beyond providing comfort measures for their patients.  They often have to step away to attend to a myriad of responsibilities.  A doula is WITH the mother at all times, stepping away only for brief, necessary breaks.  All certified doulas have the necessary skils and knowledge to promote normal birth.  Not all L&D nurses are trained this way.  Many only know medical management with a few comfort technques. The nurse can assist only as time allows, even if she does have doula training.

So, if you are pregnant, or planning on having a baby, one of the most important things on your list is not all the designer baby gear which will get little use, but a doula.  Below are some ideas on how to afford one.

If you still are not certain, think about the financial costs related to having a C-section, both in the hospital and while you are recovering.  Your co-pay will be higher with most insurance companies, and will offset most, if not all of the services of a doula.  Decreasing the risk of a C-section by having a doula makes financial sense.

There are other costs to mom's and baby's health which can occur with side effects of many unnecessary medical interventions.  Having a doula to help protect health outcomes for mom and baby makes health sense.   Enhancing the birth experience for mom and dad makes total sense.
 

Consider locating "birth circles" in you area.  Visit them while you are pregnant.  Listen to the birth stories.  You will learn so much about  how to avoid common problems.  You will also learn how to increase the likelihood of a safe and positive experience.  Doulas are good resources for locating birth circles.

With a doula, you will have someone there to advocate for your birth plan, and to help you during that first, extremely important breastfeeding.

To read about the research evidence related to doulas, click  here:   http://evidencebasedbirth.com/the-evidence-for-doulas/

Please listen to this old, and hopefully "birth wise", woman who has been there, done that, seen that, studied that, experienced that, and who has "that" as part of her life's work:  find a doula.  You will not regret it.   To locate a doula in your area, click http://dona.org/

Note:  In a recent Comfort Measures class, a mom who had taken the childbirth class told me she now had a doula.  Dad's big smile and nod of his head told me he was relieved.  They had practiced a wide variety of positions, massages, and counter pressure techniques in the class.  They will be going through labor "together", but with the knowledgeable support of a doula.