Well, at least I hope it will be. And, I suspect it will – I mean, at least as cool as being in a lot of pain for several hours can be.

With my first labor and birth experience, I did not have a doula. I planned a natural hospital birth with a midwife. I ended up with a semi-induction (Cervidil was used; Pitocin was not), constant external fetal monitoring thanks to the Cervidil and a supine position, doctor-attended delivery because the midwife was out of town. Granted, my first birth did not turn out as planned, but I still got the unmedicated experience for which I hoped.

This time around, I am employing a doula to help me have a birth experience that is closer to my wishes. I am also super lucky that I live in an area where midwives are plentiful. There are four who catch babies at the hospital where I will deliver and another team of midwives at the neighboring hospital.

My doula is certified through DONA International, the world’s premier doula association. It is an “international, non-profit organization of doulas that strives to have every doula trained and educated to provide the highest quality standards for birth and/or postpartum support to birthing women and their families,” according to its website. The site also provides a feature that allows users to search for doulas in their communities.

So, what exactly is a doula? First, know that there are two kinds – birth doulas and postpartum doulas. Some doulas serve in both capacities, while others choose only one area. The following information is pulled directly from DONA’s website.

A Birth Doula

  • Recognizes birth as a key experience the mother will remember all her life (emphasis mine)
  • Understands the physiology of birth and the emotional needs of a woman in labor
  • Assists the woman in preparing for and carrying out her plans for birth
  • Stays with the woman throughout the labor
  • Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decisions
  • Facilitates communication between the laboring woman, her partner and her clinical care providers
  • Perceives her role as nurturing and protecting the woman’s memory of the birth experience
  • Allows the woman’s partner to participate at his/her comfort level

A Postpartum Doula

  • Offers education, companionship and nonjudgmental support during the postpartum fourth trimester
  • Assists with newborn care, family adjustment, meal preparation and light household tidying
  • Offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary

I am working with a birth doula only, so the remainder of this post will focus on that role. It is important to note that a doula does not provide medical care, such as monitoring blood pressure or checking the cervix. These are tasks performed by nurses, midwives and/or doctors. A doula offers emotional, verbal guidance and physical support through massage and other pain management techniques, such as hip squeezing. One of the reasons I am looking forward to having a doula is because I know she can suggest various positions for both labor and the pushing process.

I would also like to point out that having a doula does not decrease the role of the birthing woman’s husband. In fact, I see my doula as someone who will encourage both me and my husband. During my labor with Elliot, I hit what is referred to in natural birth as “the wall.” I reached the point when I said I couldn’t labor without pain medication anymore. I told my husband I had changed my mind and that I wanted an epidural. He quickly told the nurse, who called an anesthesiologist. (I never got the epidural because it was the middle of the night, and the anesthesiologist arrived just as I was deemed “complete.”)

I am not faulting my husband at all in this situation; he was simply doing what I asked because he loves me. Family members find it difficult to see a woman they love in so much discomfort. A doula, however, does not have that deep emotional connection with the laboring woman. When the mother hits “the wall,” the doula responds, “You can do this. Look how far you’ve come. You’ll get to meet your baby soon.” The husband or other labor partner then finds it easier to follow suit and offer similar encouragement.

In addition, doulas have witnessed hundreds, sometimes thousands, of natural births. They are able to recall those experiences and use them as power and knowledge for the laboring woman.

DONA lists the following as advantages to having a doula.

Numerous clinical studies have found that a doula’s presence at birth:

  • Tends to result in shorter labors with fewer complications
  • Reduces negative feelings about one’s childbirth experience
  • Reduces the need for Pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
  • Reduces the mother’s request for pain medication and/or epidurals

Research shows parents who receive support can:

  • Feel more secure and cared for
  • Are more successful in adapting to new family dynamics
  • Have greater success with breastfeeding
  • Have greater self-confidence
  • Have less postpartum depression
  • Have lower incidence of abuse

I believe having a doula is just one component of achieving the natural birth I desire. There are many other elements – a detailed, yet succinct birth plan; a healthcare provider who supports labor that is not induced or augmented, does not put time limits on laboring or pushing and catches babies in any position imaginable; a hospital that is fairly accustomed to natural births, offers hydrotherapy and birthing balls and encourages immediate skin-to-skin contact following birth; and a supportive, loving husband who is an integral part of the entire labor, delivery and postpartum experience.