by Rachel Lloyd, MCD
The year is 2020, and the pandemic is bearing down on us across the globe. As hospitals and medical workers struggle to keep the disease from spreading, women are suddenly forced to labor and birth without the support of partners, mothers, or friends. Elle Thomas was one of those women. She recounts being told by her obstetrician that she would not only be forced to give birth without her own mother at her side, but that her husband would also be prohibited from joining them in the delivery room. Because they had another young child at home, Elle’s husband could not commit to remaining inside the confines of the hospital during Elle’s stay, and therefore was told he would not be able to support his wife as she brought their new baby into the world. Luckily, the obstetrician had one option for Elle: a local Doula.
Though she did not know much about Doulas, she reached out to one in her community, and says she was met with great results. The Doula took every precaution to protect Elle while meeting with her before the birth. Elle recounts to me that she feels that having a Doula by her side was “almost worth” not having her husband or mother with her. The Doula spent several hours preparing her, going over her birth preferences, and educating her on choices she would likely need to make during and after labor and delivery. Then, when Elle’s water broke, the Doula met her at the hospital and stayed with her until the baby was a few hours old. Elle explains that although she’d had a typical vaginal birth with her first child, she felt the experience with her second one flowed more smoothly and offered her more autonomy — even in the midst of a global pandemic — thanks to the education and advocacy the Doula provided her.
While Elle’s story is just one of many women whose labor plans were derailed for one reason or another, research does show us that having a Doula offers many benefits. In a study conducted by the National Institutes of Health, women who utilized Doulas as part of their birth support were 52.9% less likely to need a c-section, and their odds of developing postpartum depression or anxiety were reduced by 57.5%. In the United States, where the maternal mortality rate is 23.8 deaths per 100,000 live births (a relatively high statistic compared to other places in the world), having a Doula could truly mean the difference between life and death.
A Doula’s role in the birthing process can become even more crucial for women of color, whose maternal mortality rate is 2.6 times higher than that of white women, according to the National Institutes of Health. Their reporting states that for women of color who had a Doula present for their birth, labor was quicker, APGAR scores were higher, and c-section rates declined. For these women, as well as women living below the poverty line, a Doula could truly be a lifeline as well as a welcomed source of information, support, and pain relief during an emotionally and physically taxing moment in their lives.
Although Doulas are not trained as medical professionals, they are trained. As such, a qualified Doula will likely know far more about the birthing process than a first-time parent, making them uniquely qualified to understand the process and guide not just the birthing mother, but also her partner. With many first-time parents, the partner is experiencing many new things as well and may be unprepared to handle their loved one’s emotional or physical needs during birth. For example, one birth I attended escalated quickly from prodromal contractions to regular and consistently painful contractions. While the father was packing the car and arranging things to leave for the hospital, I was able to stay with the mother and provide emotional support to her during contractions. Through the use of hip squeezes and counter pressure, I was also able to successfully decrease her pain.
During the drive to the hospital, her contractions became even more painful and close together. As the father drove, I was able to sit in the back with the mother and continue counter pressure to help her through the contractions. Once at the hospital, the parents became overwhelmed with the myriad of questions and decisions necessary. I offered explanations of procedures, reminded the mother that she could ask her providers questions, and reiterated the birth preferences she and her partner had made clear to me beforehand. Even with her husband, mother, and many medical professionals present, the mother later thanked me and voiced that my support had been instrumental, as I was able to provide emotional strength in moments when her partner or mother had become distracted or anxious.
Elle’s story, as well as that of my own client, are just two of thousands concerning women who have utilized Doula care to help make their labor and delivery go more smoothly. Many hospitals are now revising their policies to include Doulas more effectively and exempt them from limits on the number of support persons a birthing mother can have. A nurse recently commented to me, “I love Doulas. They make my life so much easier because they’re able to help me with little things, and they can call us if mom needs something or is having a problem.” Provided a Doula remains professional and courteous, most hospital workers appreciate having them on hand and react kindly when they see a Doula enter the birthing space.
While the number of birthing mothers who use Doulas is still relatively low, that number is increasing over time, especially as more awareness of birth workers and their role becomes public. As someone who has attended five births as a Doula, and who has also heard many stories from friends and family who did not have Doulas available to them, there seems to be a clear contrast between the confidence, support, and positive experiences often reported by families who utilize Doula care and the uncertainty or distress that can arise without that support.