Baltimore's Child

Friends Make Great Doulas

Study Finds that Friends Make Effective Doulas
By Elizabeth Heubeck

Already worried about how you’ll get through labor, even if you’re nowhere near experiencing your first contraction?
You’re not alone. Countless women, particularly those who have never experienced labor before —or who have been through difficult labors before and worry that the next one will be just as challenging—feel the same way.
But there’s good news on this front. A recent study reveals that choosing a close committed friend to act as your lay doula during labor and delivery can help the experience go a lot more smoothly; it may even give your baby a head start.
The findings, published in a 2006 issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing, demonstrated that women who had the support of a female friend trained during two two-hour sessions as a lay doula benefited in several ways. Compared to women who did not receive this specialized support, they had shorter labors, increased dilation at the time of epidural and higher Apgar scores. (An Apgar score is the assessment of the newborn’s health.) They also had lower cesarean section rates compared to the hospitals’ general patient population.

A Friend Indeed
Lead study author Della Campbell, R.N., attributed the positive results to two key factors. For starters, knowing that the support of the doulas was a constant factor helped reduce the laboring women’s anxiety levels, explains Campbell, a research coordinator at the University of Medicine and Dentistry of New Jersey, School of Nursing.
“That constancy offered a totally secure feeling for the mom. Knowing that the doula wouldn’t leave her side, not even for a lunch or cigarette break, was very reassuring for the laboring women,” Campbell says.
That the mothers-to-be chose friends to be their doulas also played into the positive results.
“We didn’t have to spend any time getting people to feel comfortable with each other,” adds Campbell.
Typically, women who hire doulas meet them once or twice before the actual labor takes place. This in no way can replace the intimate bonds shared by women who have been friends for years.
“[During labor] they could look at their friend and listen to what she was saying, without even talking to her,” explains Campbell.
Although the study focused on the effects of a friend/doula as a support person during labor, it did not preclude the presence of others in the delivery room, such as partners or spouses, parents and other friends and family members. In fact, the study encouraged the presence of spouses and partners in the delivery room.
Also, fathers were invited to the doula sessions with the friends-in-training. Only a handful chose to participate, notes Campbell.
When it came to the actual labor and delivery, “We had to teach the doula not to make the male figure feel excluded,” Campbell says, adding that, in some instances, doulas were even tasked with helping the dad relax during the labor.
“We kind of thrust men into the labor rooms in the 1960s,” Campbell says, noting that some fathers remain uncomfortable being present in the delivery room.
While the study performed by Campbell and colleagues focused on low-income women, the take-away message applies to all women who desire constant support during labor and delivery, yet are not comfortable paying for the services of a doula—which can range from a few hundred dollars to thousands—or receiving support from someone they don’t know well.
The answer, according to this study, is to get a trusted friend to play that role.
“Ours is the only culture that doesn’t have women flocking around them during labor,” Campbell says. BC

Extra…
Doulas, Defined
The term “doula,” of Greek origin, means “woman’s servant.”
That’s not too far removed from the job description of doulas today. According to the organization Doulas of North America (DONA), the modern-day doula is “someone trained to provide physical, emotional and informational support to women and their partners during labor and birth.”
During labor, a doula may assist a woman with breathing and relaxation techniques and suggest positions that may bring greater comfort. She does not make any clinical decisions or perform clinical tasks, such as vaginal exams or fetal heart rate monitoring. Her most important task involves offering continuous, uninterrupted support throughout labor and delivery. Unlike nurses, who sometimes offer similar support but must leave when their work shifts are over, doulas remain with a laboring mother throughout the entire process, regardless of how long it lasts.
Some women even make arrangements to have postpartum doulas, who provide support to the new mother after the birth of her baby in a variety of ways, from making dinners to assisting her as she learns how to breastfeed.
While the idea of calling on a friend to become your lay doula is growing, classes to train for becoming a lay doula are still scarce in the Baltimore area. We suggest contacting the DONA organization for more information on finding training.
For more information call DONA, at 888-788-DONA, or visit the website www.DONA.org.
Elizabeth@BaltimoresChild.com