Do You Need a Doula?

A 'Lifesaver'

When she was pregnant with her first child, Rebecca Hart, a 29-year-old public-relations consultant in Jacksonville, Florida, needed a birthing coach. "My husband didn't want the pressure of being in charge," she says. So on the recommendation of several friends, Hart hired Brenda Csonka to be her doula.

Csonka proved to be a "lifesaver" during Hart's 42-hour labor. She went to Hart's home to help the mom-to-be breathe through her first contractions. When Hart's back labor became especially challenging, Hart, her husband, Todd, and Csonka all headed out, by arrangement, to a neighbor's swimming pool -- being in the water eased the pressure on Hart's back. Later, at the hospital, when Hart's labor stalled, her doctor said, "I can do a C-section, or you can keep trying." She elected to stay the course. "I felt so confident with Brenda there," Hart recalls. Soon after, she delivered a nine-pound boy -- with the benefit of very little pain medication. "I couldn't have done it without Brenda," she says.

What is a Doula?

A doula -- Greek for "woman caregiver" -- doesn't necessarily have medical training or make medical decisions, but she is familiar with the usual procedures involved in childbirth. She is part of your labor support team, which typically includes your partner, the doctor (or midwife), and a nurse (who may have her hands full tending to several patients). A doula's job isn't to deliver your baby but to give you her continuous attention, offering techniques to help ease the pain of labor.

She may encourage you to use a shower or whirlpool, for example. (Water is known as the "doula's epidural.") Other pain-relief methods include breathing techniques, walking, and using a birthing ball, a large rubber sphere that the mother sits on during labor to help relax the pelvic area.

Massage, another favored technique, helped Amy Anthony, a 27-year-old first-time mom from Anderson, Indiana, during her 20-hour labor. "My doula squeezed my hips together from the back with almost every contraction for two straight hours," she says. The doula also offered moral support to Anthony's husband. "The pain got pretty bad at times, and I was crying," she recalls. "Having our doula there helped him relax."

Considered "alternative" in the early 1980s, when the movement was in its infancy, doulas are now gaining acceptance within mainstream medicine. Several studies in major medical journals have found that a doula's constant help during childbirth can shorten labor and reduce the need for a cesarean or forceps delivery. And, according to a recent study published in Obstetrics & Gynecology, doula-assisted women are also more likely to forgo an epidural and to rate their birth experience as positive.

Marshall Klaus, M.D., an adjunct professor of pediatrics at the University of California, San Francisco, co-founded the doula movement after studying continuous support methods for laboring mothers. "We consistently saw that the more overall care a woman received during her labor, the greater her chances of an uncomplicated vaginal delivery," he says.