Doulas - How They Can Help You

Birth Doulas
You’ve just found out you’re pregnant. Congratulations! 

You’re now faced with many decisions about your pregnancy and birth journey; this can be very overwhelming. So, how can this process be made easier? 

A birth doula is a trained individual who provides one-on-one emotional, physical, and informational support to a birthing person through pregnancy, labour, and birth. They provide support at home, in birthing centres or hospitals, and maintain a constant presence with you through the entire labour process, from start to finish. The goal of a doula-assisted birth is to empower the birthing person to take control, decrease fear and anxiety, and ultimately leave them with a positive birth experience.

The Doula Role 

Typically, a birth doula meets with you one to two times during your pregnancy, depending on what stage you’re at when you first connect. During these meetings, you discuss how your pregnancy is progressing and a plethora of information about labour, birth, and postpartum. Together, you will develop a birth plan which encompasses all of the possible choices and outcomes that may come up during the birth. 

The birth doula will provide constant support during the labour process, in which they communicate regularly and stay by your side. They assist with pain and discomfort, keep you calm, help with your emotional needs, can guide a partner on how to support you, and facilitate communication and informed consent with medical providers. A birth doula does not provide any medical advice and does not replace an obstetrician (OB) or midwife. Rather, doulas complement their care.

In the postpartum period, your birth doula will follow up with you to ensure you are healing well, check in on your mood, and offer additional support. They may also be able to provide you with some breastfeeding support, depending on their experience and training. However, extensive breastfeeding support should be sought out through a lactation consultant. 

Note that a postpartum doula is a different type of doula; they provide help in the postpartum period and focus on catering to your household needs and infant care.

Training & Knowledge 

Certified doulas are trained individuals who have a strong knowledge of the birthing process, including the physiology of labour. Oftentimes, doulas seek out additional training and certifications to help offer you the best care they can.

Physiology Of Labour 

An incredibly important part of how a birth doula helps to improve the quality of your labour, particularly by decreasing discomfort, can be explained through the physiology of labour. 

First, let’s review the different states of the nervous system. There are two systems: The sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The sympathetic nervous system can be described as “fight or flight” mode, while the parasympathetic nervous system is described as the “rest and digest” mode.

When you are in an SNS state, it signals to the body that there is danger. The main hormones that take over are adrenaline and cortisol. When you are in this state, the blood flow is shunted to your muscles, heart, lungs, and brain to help fight whatever danger is near. Consequently, the blood moves away from your uterus and baby, resulting in lactic acid buildup, increased pain and cramping, and potential distress to the baby.

When you are in a PNS state, the body produces hormones such as oxytocin (i.e., your love, bonding, and birthing hormone) and endorphins. Blood will redirect to organs in your digestive and reproductive system (e.g., your uterus). This state tells you that you are safe and induces calmness. Oxytocin is the hormone that creates contractions and facilitates bonding and breastfeeding. Natural oxytocin reduces cortisol and relieves pain and discomfort as well. Additionally, endorphins as you probably know also reduce pain and induce a happier state of mind. At this point, you can likely tell which state is more favourable for labour.

On TV and in movies, most births are depicted in a way where the birthing person is screaming in intense pain, and overall, it seems like a very scary experience. Such expectations create fear and anxiety, which will put you in an SNS state; this prolongs labour, increases pain and discomfort, increases the need for medical interventions, and is associated with adverse birth/labour outcomes, including worse bonding and breastfeeding experiences.4 Other factors that induce an SNS state are the environment (e.g., harsh lighting, hospital sounds, various practitioners in and out), feeling overwhelmed or confused, and certain interventions and medical procedures during labour. 

You might be thinking about how to keep yourself in a PNS state with all that is happening during labour. Thankfully, birth doulas are trained in techniques that help induce this state and also revert you to a PNS state should stress increase. This is also why doulas educate their patients and develop a birth plan to decrease uncertainty, fear, and anxiety.

Choosing Your Doula 

Choosing a birth doula is a very personal decision, as they are with you through such an important and intimate time in your life.

Many birth doulas are licensed healthcare professionals such as naturopathic doctors, RMTs, chiropractors, and physiotherapists. The availability of these practitioners will depend entirely on the area you live in. Choosing the right practitioner will depend on what you are looking for most, and who you feel comfortable with. For example, do you want someone who will be able to provide more physical manipulations, pelvic floor care, or information about natural pregnancy support, nutrition, physical healing, breastfeeding, etc.?

Birth doulas make a great addition to your pregnancy team. Their role is to support you with whatever comes your way during labour, empower and advocate for you thereby improving your experience and creating fond memories of your labour and birth.

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