Birth is not only about making babies.
Birth is about making strong competent, capable mothers who trust themselves and know their inner strength.
Barbara Katz Rothman
(Professor Sociology)
What is a Doula?
A Birth Doula:
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is sometimes referred to as a birth coach, labour support specialist or skilled birth companion.
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is a trained, non-medical professional birth companion
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is experienced and knowledgeable about all modes of childbirth in all settings
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supports only 1 birthing couple at a time
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continuously reassures and support the birthing couple with emotional care, physical comfort measures, information and advocacy and is in essence, a Birth Coach!
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uses physical comfort measures during labour, like massage, counter-pressure, gentle touch, movement, affirmations, relaxation & breathing techniques, music, involvement from your partner, aromatherapy, rebozo-techniques, acupressure, water, adjusting lighting to facilitate optimal birth hormones all within your own comfort zone
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understands the Rights of the birthing couple and may remind them about it.
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is up to date with universal Evidence Based Birth Practice so can inform the family of options
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understands that the dad also needs support in order to thrive in his important role as birth companion
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is chosen by the family before birth and understands their birth goals and wishes
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does not provide any medical care but respects the medical team wholeheartedly
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does not interfere with the role of the medical care providers but when well understood by them, complements their work
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is still quite unknown in Luxembourg, both among families and care providers
Please refer also to the video interview, "What is a doula?".
"Traditionally, expectant mothers have always gathered female support and companionship during the time of childbirth. The mother-to-be chose these confidantes carefully to uphold her birth instincts, support her intuition, hold her birth space and protect her ‘babymoon’."
- Why Doulas Matter, Maddie McMahon
"Women have complex needs during childbirth. In addition to the safety of modern obstetric care, and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualised care based on their circumstances and preferences. The role of the birth doula encompasses the non-clinical aspects of care during childbirth."
Doula
def: servant to women (greek)
A Postpartum (postnatal) Doula:
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is a professional support person trained to help not only the baby, but the family as well, in the days or months after birth
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may also offer support in the practical side of things: Laundry, dishes, housework, partner and sibling support, cooking, errands etc so the mother can recover, rest, bond and breastfeed.
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essentially, mothers the new mother, nurturing her so she can nurture her precious new baby.
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can reduce the incidence of perinatal mood disorders
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does not interfere with the role of the sages-femmes liberale/independent community midwives in Luxembourg that provides postnatal care* financed by the national health-system. These visits are shorter and also to solve specific problems e.g. feeding, monitoring baby's weight etc, mom's healing
*up to 10 days post-birth (if leaving hospital within 4 days of birth, otherwise 1 visit) or with a medical prescription
The way a woman gives birth has the potential to change how she feels about herself forever. The way she feels has consequences for how she mothers and cares for her baby, her relationships and society...
Doulas make a huge difference in the way families experience birth.
Debra Pascali-Bonaro
B.Ed., LCCE, PDT/BDT(DONA)
Benefits of having a Birth Doula?
The role of Doulas in Birth, is unequivocally supported by research. While Birth is ultimately a woman’s own journey to travel, Doulas are an invaluable help and should be a viable option to choose for all families!
"My husband (partner) is my left hand and my doula is my right." – from Doulas Making a Difference
In a culture where experts are sought after, in a country where 99,8% of women give birth in hospitals, with highly trained obstetricians assisted by nurse-midwives…where does a doula fit in?
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A Birth Doula has lots of tricks up her sleeve and is really a Birth-Fairy!
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She empowers a family to communicate their needs and perceptions and actualize their dream of a healthy, positive birth experience.
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She recognises that birth is something a family will remember all their lives and that each family's needs are individual
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She is independent from the medical care providers (obstetrician, midwife etc)
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She is independent from the hospital (therefore not limited to hospital policies)
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She is exclusively 100% dedicated to the birthing couple (she does not attend to any other clients at the same time).
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She is continuously by your side as long as you wish (she does not change shifts like medical care providers may)
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She provides support with tangible beneficial outcomes, more studied than any other intervention currently used in hospitals!
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She is recommended by the World Health Organisation, Baby-Friendly Hospital Initiative and the International Mother-Baby Childbirth Initiative (in fact, the recommendation is that care providers INFORM families of the option).
Over twenty-two scientific trials involving over 15,000 women, examining doula care demonstrate remarkably improved physical and psychological outcomes for both mother and baby. Birth Doulas have a positive impact on the well-being of the entire family.
The Evidence
for continuous labour support from a Birth Doula (in addition to the medical team)
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31% decrease in use of synthetic oxitocin. (the rate of artificial induction in Luxembourg is very high. Various studies here and here report on the risks associated. Famous obstetrician Michel Odent emphasises that we really do not yet know the long-term implications of this drug..) 7f
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28% decrease on the risk of having a surgical birth (C-section) 7f
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12% increase in likelihood of not needing instrumental assistance 7f
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9% decrease in the use of any medications for pain relief 7f
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14% decrease in the need to admit newborn to special care nursery 7f
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34% decrease in the risk of being dissatisfied with the birth experience 7f
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reduction in the duration of labor 7a
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baby is 4 times less likely to have a low birth weight 7a
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2 times less likely that mom or baby experience a birth complication 7e
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mom is significantly more likely to successfully initiate breastfeeding 7e
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less risk of baby born with low 5-min APGAR score 7a
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according to the World Health Organisation, improves quality of maternity care 7b
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reduces the need for obstetrical intervention due to the labor experience more holistically, individualised, compassionately and continuously supported
Known
Exclusive
Unbiased
Continuous
Professional
Independent
A great resource on the topic: www.evidencebasedbirth.com/the-evidence-for-doulas
the single most effective thing you can do to have a shorter and less painful labor, and minimize your risk of unneeded interventions is to hire a birth doula
What Birth Doulas do not do...
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Doulas are NOT medical professionals
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They do not perform clinical tasks such as vaginal exams or fetal heart monitoring
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They do not give medical advice or diagnose conditions
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They do not judge you for decisions that you make
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They do not let their personal values or biases get in the way of caring for you (for example, they do not pressure you into making any decisions just because that’s what they prefer)
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They do not take over the role of your husband or partner
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They do not deliver the baby
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They do not change shifts
I realised that I couldn’t offer the continuous emotional & physical support to each mother as I would have wanted, due to the fact that I have to monitor more than 1 labouring woman at a time. So it’s just fair that there is someone else doing that. As a nurse-midwife - we would love to be at each women’s bedside all the time but it’s not realistic between all the paper work, computer work, monitoring etc.
Nurse midwife from the film "Doulas, a documentary"
DIFFERENCE BETWEEN MIDWIFE & DOULA AT BIRTH
(in Luxembourg)
MIDWIFE
DOULA
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forms relationship with family prenatally
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chosen by the family
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does not change shifts - is continuously by your side in labor once called and as long as required after
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helps parents become better medical consumers, reminds them of their rights
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provides no clinical care
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exclusively dedicated to 1 birthing couple
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independent from the medical providers
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you can purposefully choose a doula that speaks your mother tongue
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allocated to the family upon arrival at the hospital
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no prior relationship with family
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adheres to shift roster - you may see 1-3 different midwives during your birth, more in the days after
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priority is hospital policies and obstetrician's personal preferences
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provides clinical care under direction of family's obstetrician
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attends several families at once as well as numerous administrative responsibilities
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may not be able to communicate in your mother tongue
Note: Due to inequality between the midwifery and obstetric profession in Luxembourg, midwives are sadly not trained and legally mandated to work autonomously in birth.
Note: should you opt for a home-birth, your midwife will not be bound by hospital policies etc and only attend to you, though a Birth Doula is still very complementary as the midwife is responsible for medical care.
#choice2haveadoula
"The realisation that a woman, experienced in childbirth, who is neither a member of hospital staff, nor part of the mother’s social circle, can have a tangible, positive effect on both the family's experience of childbirth and the outcomes of labour, 1st began to dawn in the 1970’s and 80’s through countless clinical trials.
* studies from a US neonatologist & pediatrician led to the founding of Doulas of North America (DONA) and DONA International.
* In the UK, well-known obstetrician, Michel Odent was instrumental in founding Doula UK in 2001.
* And so it continues...
* In 2016, the Luxmama Club & ParentPrep asbl launched the awareness campaign "Have a Choice 2 have a Doula" to bring the benefits of Birth Doulas to Luxembourg!
