I think every laboring women needs a doula. And here's why...
1) Doulas are nothing new.
A lot of people, when they first hear about doulas, think... oh, that's new. But it's not at all. For thousands and thousands of years women have been supported by other women during childbirth. We watched an awesome film at our training called "The Timeless Way" which showed the history of childbirth starting with ancient artifacts and moving to more modern depictions. I was struck how the very same image was represented through sculpture, wall carvings, pottery, and art over and over and over again. It is the "classic birth triad"--an upright laboring woman supported from behind by another woman, with a midwife in front ready to catch the baby. It has only been in the last century that this "classic birth triad" has all but disappeared. Doulas are not new. Modern obstetric practice is what has strayed (very far, I might add) from the time-tested norm.
2) Women need a "buffer" (i.e. Hospitals and drugs mess with birth).
Don't get me wrong. I am so grateful we have hospitals and drugs to handle birth complications (which do happen!). But, really, when used excessively (as they are) they mess with birth big time. The hospital with its policies (no food or drink, IVs, restriction to bed, bright artificial lighting, time constraints, flat on back or semi-recumbent positions for pushing, etc.) is really the least ideal place to facilitate the birth process. And pretty much any and all of the drugs hospitals introduce into the process screw up birth's carefully orchestrated hormonal responses, often leading to the need for further interventions to counter-act the drugs' side effects. So... here's my point... because 99% of American women give birth in hospitals (80-90% of those with drugs), there is a dire need for a buffer of sorts--something or someone to help women and babies come out of the modern birth machine as unscathed as possible. Doulas can be (and are being) just that buffer. And, I should add, sometimes epidurals just don't work (or only work on one half of a woman's body). Plus you still have to get through early labor (0-4 cm) before most doctors/hospitals will allow you to get an epidural. For some women, even early labor is killer. So it's a good idea to have someone present who is trained to help you cope with labor pain (even if you plan to get an epidural)!
3) Birth is women's work.
We put a lot of pressure on dads (particularly first-time dads) to be the sole support for their wives in labor. The fact of the matter is that it's overwhelming to many of them. They are often at a loss when faced with their own difficulty in seeing their wife's pain while simultaneously trying to help support her through that pain. A study comparing first-time fathers' and experienced doulas' participation in birth showed that males touched their laboring partner only 20% of the time while doulas touched them 95% of the time. They also spent less time with the women and were close to them less than the doulas (Bertsch et al. 1990). I absolutely believe that a husbands' presence can be vital. I would never want to give birth without Ax by my side. But I also believe that the assistance of wise, experienced women is also vital for laboring women. As much as a husband's support is wanted and needed, he is a man and can't ever understand what his wife is experiencing. Experienced women offer a different and much-needed emotional support. Doulas are also trained to assist fathers, giving them suggestions for ways to help their wives when they are unsure how (or are reluctant) to step in and help. My first "doula" did this beautifully.
4) Doulas are proven to improve outcomes for mothers and babies.
Study after study has shown that doulas have a profoundly positive impact on birth outcomes. Check out these numbers (from one of my doula training handouts):
When all the studies are calculated together, the presence of a doula reduces:Who wouldn't welcome those amazing benefits?! As my doula trainer so aptly pointed out, if a doula were a machine, every hospital would have three of them.
* Cesarean sections by 50% (!)
* Length of labor by 25%
* Oxytocin [Pitocin] use by 40%
* Pain medication [opiates] use by 30%
* Forceps deliveries by 40%
* Requests for epidurals by 60%
* Decreased maternal fever
* Decreased newborn admissions to NICU
* Decreased sepsis workups on newborns
* Decreased infant health problems
Long term benefits:
* Increased mother/infant bonding
* Decreased postpartum depression
* Increased success in breastfeeding
I'm not telling you all this to drum-up business for myself. Even if I was looking for clients, I wouldn't be charging anyone. I'm telling you this because I am (excessively) passionate about helping women have wonderful, satisfying birth experiences. Doulas can work wonders, but I don't think most women are aware of just how much difference a skilled doula can make. I just had to spread the word!
As for me... I've got two fabulous births under my belt, and I'm a trained doula myself, but I am still going to have TWO doulas (and two midwives) at my next birth. I am thrilled that we will be surrounded by supportive, experienced women as we bring our first son into this world. I feel confident that their loving presence will make this our best birth yet.
P.S. If you'd like to hire a doula but can't afford one, have no fear! There are always doulas willing to volunteer their services. It's a generally universal doula belief that all women should have access to doulas regardless of ability to pay.