What is a Doula?

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Letter:  Dr. Kang and Dr. Power, my friend was talking about having a doula at her birth.  I have no idea what role a doula would play?  I worry my husband would find it weird having a stranger at the delivery....could you tell me more about Doulas? Alicia Power: Welcome to Growing Healthy, today are lucky enough to have Laura Warren from Vida Doulas on the show to tell us all about what a Doula is and what they can offer to your pregnancy, delivery and postpartum experience.    Just after this little reminder.  Alicia Power: Hello Laura, and thanks for joining us.  Why don’t you start off by telling us a little bit about yourself.   Laura: Hi Alicia, thank you for having me on your show. I've been a doula for almost 20 years. I'm also a childbirth educator and breastfeeding counselor, but most importantly, the mother of three amazing young women and grandmother of four incredible boys. Alicia Power: For people who don’t know what a Doula is can you give us a quick idea?  Laura:A 'birth' doula is a person trained to provide continuous physical, emotional and educational support to women before, during and immediately after labour; that's what I do. A birth doula meets with the clients once or twice before the birth to discuss options and wishes for their birth. The doula will join the couple at home or hospital when they need her. She will help with comfort measures and reassurance throughout.  She will remain with them throughout their labour and one to two hours after the birth, to assist with breastfeeding. Most doulas will do one to two post natal visits.By having a doula, the partner is able to participate at his comfort level and most, actually feel more confident to participate, knowing that there is someone experienced to offer suggestions. AP: Laura, we are trying to be evidence based in our podcasts.  Have there been many studies looking at the benefits of having a doula at your birth.   LW:  In 2010, Dr. Amy Gilliland did a study about effective labour support where she theorised that doulas are effective because of the attachment that clients form with their doulas. This attachment creates trust and helps in the release of Oxytocin which promotes labour contractions. In 2017, Bohren et al published and updated Cochrane  review on the use of labour support. Here, they found that overall, people who received continous labour support from a doula were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth,vacuum or forceps-assisted births and cesareans.  In my opinion though, the most important and effective role of the doula is to help a couple achieve the most positive birth experience possible, regardless of how they gave birth; and we do that by making sure that they exercise informed consent every step of the way, that they feel nurtured and that they are treated with utmost respect.  AP: Laura, is there formal training or a liscencing body for Doulas? Laura: Most doulas in Victoria do their training through DONA international which is the largest certifying organization. Clients hire a doula at different times. Most, do sometime during their second trimester, but I've been hired as soon as they find out that they are expecting, and I was once hired at ten days post dates (not that I recommend that ). My recommendation is that a couple start their search early on to make sure they get the doula they want Alicia Power: What is the cost of a doula? Are there any programs that you know of that may be able to help people out who can not afford a doula? Laura: The cost of a doula varies greatly, depending on level of experience. We'd like to think that there is a doula for everyone. Some doulas work on a sliding scale and other's (like my group) who charge the same fee, but are happy to arrange a payment plan if it makes it easier. Roughly, I would say that doula fees range between $400 and $1000 dollars. The local doula trainer, keeps a list of doulas interested in attending births to get experience. In order to access those doulas, the client must have a referral from their care provider and the cost is on a sliding scale. Alicia Power: You work as a Doula with Vida Doulas - can you tell us about why you formed a group as opposed to being doulas on your own?  Laura: We decided to form Vida doulas because we wanted to make sure that we had back ups who had similar levels of experience and commitment to the profession. We wanted to make sure our clients would receive the same level of care if their primary doula couldn't be with them. Vida is : Jay Duncan, Ashley Brilhante, Barb Fraumeni and I.  Besides being 'birth' doulas, Barb is also a post partum doula, I'm a breastfeeding counselor and Ashley has a birth pool rental business.  Alicia Power: What other services do you offer - I know you run a great prenatal course that I often recommend to my patients…  Laura: Yes! We appreciate all the support that Grow Health has shown VIda; thank you.Jay and I are childbirth educators with years of experience. When we started Vida, I created the 60/40 class which is a quaint, small group class that is 60% childbirth preparation and 40% newborn care. Jay teaches a similar version of this class for larger groups. We also offer private classes in the client's home and of course we offer breastfeeding consultations. http://www.doulasofvictoria.ca http://www.vidadoulas.ca/