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A Doula Delivery

Doula. It's a weird word, one that you may not have heard -- yet. These birthing assistants are used in only a small percentage of deliveries, but the trend of hiring a doula (the Greek term for "female helper") is growing. And with good reason: A spate of studies has shown that childbirth with a doula can shorten labor time, significantly reduce the use of pain medication, and cut the need for cesareans by half. Thanks to these findings, the number of certified doulas in the U.S. has surged during the past two decades. "The fact that doulas were satirized on Frasier [Daphne and Niles hired, then fired, a doula during one episode] said that we had arrived," notes Ann Grauer, immediate past president of DONA (Doulas of North America) International and a birth doula for 16 years.

Doulas are not medically trained -- they don't deliver babies, replace a doctor or a midwife, or play the role of a nurse. Rather, a doula is there to comfort the mom-to-be -- to relax, reassure, and guide her. "A lot of women doubt themselves during childbirth," says Carolyn Ogren, of Middleton, Massachusetts, a doula for 37 years. "A doula's job is to soothe a woman's fears and to help her through labor." And unlike doctors, nurses, and midwives, who often have their hands full attending several patients at once, doulas can provide continuous care to a woman throughout her labor.

In addition to offering constant emotional support, a doula is trained to provide pain relief through such methods as massage, breathing techniques, and water therapy. "My doula was a tiny woman, but so strong," says Kristine Talbott, a Laguna Niguel, California, mom of two. "She massaged my back during contractions while my husband talked me through them. I ended up not needing any pain medicine at all."

A study published in Obstetrics & Gynecology found that women who used doulas were not only significantly less likely to have an epidural but much more inclined to rate their birth experience as good. "I used a doula for my second baby," says Erica Browne Grivas, of Glastonbury, Connecticut. "I felt so excited to be able to deliver without medication that it made me forget all the difficulties I'd had with my first birth."

To decide whether you should use a doula, first discuss with your husband how he feels about having another person around at this intimate time. "If spouses think they won't be able to handle labor well, they might want to consider a doula," says Lisa Masterson, MD, an obstetrician at the Cedars-Sinai Medical Center, in Los Angeles, who works regularly with doulas. "When my daughter was born, my partner was there, but he didn't know what to do," says Angela Ferin, a mom from Brooklyn and a doula for five years. "The nurses were busy, and I needed some emotional support. I realized after the fact, 'Wow, that was hard.' Not only did I use a doula with my second child, but I became one as well."

If your partner wants to be involved during your labor, a doula can show him massage techniques and reassure him that everything's all right. If he doesn't think birth will be his time to shine, then the doula will take over, freeing him to encourage and comfort you.

Although most doulas serve as birthing assistants, some are available to offer advice on breastfeeding and other newborn-related concerns after your baby arrives. Some will even do light housekeeping and run errands. "When a mom comes home from the hospital, I provide emotional support and help her establish a routine," says Ferin, who also does postpartum work. "I'll bring her soup, do her laundry, help her nurse, and recommend a lactation consultant if necessary." In fact, one of the most important things postpartum doulas offer is resources, such as names of pediatricians and information about La Leche League meetings.

This is your miracle time, and a doula is there to make sure you have the birth experience you desire. "She has the luxury of focusing only on what Mom wants," says Grauer.

Start by checking with your local hospital -- some have in-house doula programs, though it's likely that you'll need to hire one privately. Get recommendations from the teacher of your childbirth classes, your ob-gyn, or a pediatrician's office. A doula's set fee can be as low as $250 or as high as $1,500. Most insurance companies don't cover the cost.

You can also contact one of the major doula organizations: DONA International (dona.org), International Childbirth Education Association (icea.org), or the Association of Labor Assistants & Childbirth Educators (alace.org).

Once you've identified several potential doulas, call to see whether they're available around your due date and to get a sense of your compatibility. "The right personality is important," says Masterson. "Spend time with the doula beforehand to make sure you click."

When you meet, ask about her training and birthing experiences, her fees and refund policies, whether she works with other doulas for emergency backup, and what sort of interaction she likes to have with clients before the birth. Some prefer regular meetings; others just want phone updates after each obstetrician appointment. It's also a good idea to get references.

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Copyright ? 2006. Reprinted with permission from the February 2006 issue of Parents magazine.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.