So, What's a Labor Assistant (Doula)?
What is a Labor Assistant/Doula?
A Labor Assistant, or a Birth Doula, is a woman who is trained to give physical and emotional support to laboring women and their partners. Labor Assistants may help the couple to stick to their birth plan (i.e.: helping the woman to stay active and/or relaxed during labor, and upright during birth…allowing for a more natural, less intervention filled labor and birth). She makes it statistically less likely that the birth she attends will end in the use of drugs, epidurals, or cesarean section. A Labor Assistant is NOT an OB or a midwife, and does not take on the responsibility of an OB or midwife, such as the physical act of catching the baby, or doing the things necessary to make sure mother and baby are stable like listening to heart tones and taking blood pressure. The Labor Assistant is present not to take the place of the birthing woman’s partner, but to support both the woman and her partner through the hard work of labor and birth.
How does a Labor Assistant provide this support?
She may break the partner if they need to eat, use the restroom, or physically rest tired muscles. She can offer new suggestions for relief from the surges/contractions if what the couple is doing no longer works or is not working at all. She can physically show the partner how to give the laboring woman relief with massage, firm and/or gentle touch, eye contact, relaxation techniques, and pain relief measures for times such as active labor and back labor. She reminds the mother to drink fluids and to regularly use the toilet, which keeps her hydrated and her contractions consistent. She listens to the couple’s needs, and helps them to remain relaxed and focused on the labor and birth.
A Labor Assistant is a great resource to tap if interventions become necessary. She can help the couple to understand their options so that they are able to make informed choices, and are able to understand the reasoning behind their caregiver’s use of these interventions. She is also useful as an advocate to the staff as to the content of the mother‘s birth plan. During the hard work and focus of labor and delivery, the mother and her partner are thinking about other things (getting past each contraction, and resting for the next one…), and may not have the concentration or energy to remind the caregiver/staff of their wishes (assuming a normal, healthy labor and birth).
The Labor Assistant helps the couple to remember that birth is a normal process, not an emergency. She understands the normal parameters of labor and birth, and helps the couple to remain calm, relaxed, and focused during this sometimes disorienting process.
What is the scope of care provided by the Labor Assistant to her clients?
An ALACE trained Labor Assistant provides a continuity of care, prenatally through the postpartum period. She meets with the mother (and her partner) before the birth to become aware of the mother’s expectations for the birth. This includes going over or helping to formulate the mother’s birth plan. This also includes the mother’s expectations for the parameters of the relationship between the Labor Assistant and the mother, the Labor Assistant and the partner, and the Labor Assistant and the rest of the birth team (caregiver and staff). This is also a time for the couple and the Labor Assistant to get to know each other and become comfortable with one another. It is a time for the Labor Assistant to get to know what the mothers preferences are beforehand as far as scents, massage oil/cornstarch, support styles during labor and birth. The Labor Assistant will try to help the couple to ensure that they are prepared for after the birth of the baby. This is not necessarily to be sure that they are prepared with things, but with support for after the birth. She will help them to formulate a plan to provide them with meals, household help, and care for the mother-baby unit, so that the only work that must be done by the new family after the birth is to recover and bond.
The Labor Assistant then attends the mother during labor and birth. Once the contractions become enough work that simple distraction isn’t enough to occupy the mother’s mind away from them (when she can no longer "do life"), the Labor Assistant is called. The Labor Assistant will stay until after the placenta is birthed, the breastfeeding relationship has been established (assuming a normal healthy outcome), and the family is recovering from the work of the labor and birth.
Later, the Labor Assistant will make a post-partum visit. She will review the labor and birth with the family, helping to process the milestone. She will provide breastfeeding support, and assess the mother’s well being. She will try to help the couple be sure that the mother-baby unit is being supported in such a way that the work of recovery and bonding is being facilitated.
What I provide as part of my Labor Assistant package:
Two prenatal visits. One visit will cover a “getting to know you” session, paperwork, and formulating or going over the birth plan, as well as relaxation preferences for labor and delivery. The next visit will include some post partum prep work…going over meal plans, expectations of housekeeping support, and basic mother-baby unit support.
Labor and birth support. You should call me when labor begins. We will then keep in contact, and when you can no longer go about your daily routine without pausing to consciously relax through the contractions (and recover from and prepare for them), I will attend you. I will remain with you through the delivery of the placenta, through establishment of the breastfeeding relationship, and until you are settled in your room as a family, recovering from the work of labor and birth.
Post partum visit. I will visit you one time to be sure that the mother is recovering well emotionally. We will discuss the birth, and your feelings about it. I will also provide breastfeeding support at this meeting. I was a La Leche League Leader for seven years and now run an independent breastfeeding support group. I also have thousands of contact hours of hands on support and education in breastfeeding support services and troubleshooting. If you are interested, I will also provide you with area Breastfeeding Support meeting days, times, and locations, as well as the name and phone numbers of area leaders. This is so that you can continue to receive (free) quality breastfeeding support in your community.