Doulas are going mainstream. These experienced labor assistants provide the emotional and physical support that women and their partners need through the birth process, as well as pre- and postnatal. 
We spoke with Phyllis H. Klaus, MFT, LMSW, one of the authors of “The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth” (3rd edition), about why more moms should consider inviting a doula into their labor and delivery experience.
Many moms know what a midwife is, but a doula is somewhat of a lesser-known labor aid. Exactly how does a doula provide support during labor?
A doula leads a woman during pregnancy, helping her feel more positive about going into labor and teaching her all kinds of pain control methods. The doula helps plan the things that the parents might do to support the labor, and stays with the mother through the whole process of birth. Studies have shown enormous results with a doula.
Tell us more about these studies — what difference are doulas making in labor success?
The length of labor is lessened with a doula versus no doula. There’s a 2-hour difference. The use of pitocin to augment labor is greatly lessened also. And why does this matter? It matters because woman feel more empowered when they are able to birth with their own body function. If you can avoid intervention, there will be less effect on you and your baby in the postpartum period.
What methods does a doula use help a mom manage her pain during labor?
The woman is taught how to move into different positions and how to work with equipment like a birth ball, which is like a great big physical therapy ball. The doula also shows mom how to relax into a contraction. She might show how the partner can hold the mother leaning against the wall. This helps the woman loosen her leg muscles until the whole area starts to relax. The more the mother is relaxed, the more the body relaxes and allows labor to continue in a normal way. Massage is also an important skill to teach the partner. One study has shown that 10 to 20 minutes of massage on different parts of the body has been shown to reduce labor length and pain a great deal.
You mention in your book that another tool a doula may use in labor is hypnobirth. Can you share more about this method?
Hypnosis is just a natural state of mind. A lot of people are frightened by the word hypnosis, like somebody waves a watch in front of your face and you’ll quack like a duck. It’s nothing like that. It’s a natural state of moving in a kind of reverie or meditative state, which many people do naturally, in prayer for example. Visualization is very common today in many methods for many reasons. But when you’re using it for birth, it’s very beautiful because the body actually responds and it becomes a way that women can help themselves with inner focus and concentration.
How can a woman prepare herself during pregnancy for a doula-assisted birth?Â
One of our goals in the book is to help the mother choose a doula. We want her to interview a few people, not just one, and find out where the doulas are in her community. The mother will get a sense of who she feels she will fit with or be comfortable with. If the first person she talks to doesn’t feel right, she should certainly interview more. Every doula should also have a backup person that the mom interviews so she feels comfortable if, for example, her doula is involved in another birth.
What if you can’t afford a doula? Are there skills a mom or a relative can learn to help her with the labor?
A mother could chose a volunteer such as her own mother or sister or aunt, or anyone she trusts a great deal, who could be taught by a trained doula. The doula will teach the volunteer some of the skills for helping the mother during labor.
Sometimes in childbirth preparation classes, a couple could maybe ask a doula to train them in that setting, but this is a new concept and it’s new in our book. We wanted to find a way that a doula could work with a couple for 4 hours of training during pregnancy, and then she lets them go. They are now on their own to learn. They have a hand-out. They have practicing to do. They have some of the methods to practice – massage and so on. We’re hoping that this will be a new movement.
How can a doula help moms after the birth?
So many of our mothers today, whether single or with partners, are very much alone after the birth. They’re in the hospital a day or two and then are sent home. Doulas provide postpartum support to women by coming in and tending to her, and also helping her with breastfeeding issues. Women who have this kind of support feel better about the baby and they feel closer to the baby and they feel more confident. And they also get the nurturing sort of tender care that they need in a very vulnerable period.
Many times birth does have some disappointments. A lot of women feel bad about things after birth, that they didn’t do it as they had planned. it’s terribly important for all caregivers to validate them on their hard work, and how well they did, and how super they are, that they can be proud of themselves, and what a great baby they have. A doula can help process the experience with the couple or the mom and really help her feed her inner strength and talk about how it really was, even with some difficult moments.
