To Be a Doula

Photo courtesy of moke076 via Flickr Creative Commons
Photo courtesy of moke076 via Flickr Creative Commons

by denise bolds, MSW, CD(DONA).

So, you are a nanny. You are great with children, you think fast on your feet, you provide comfort, and you demonstrate enduring patience. Now your NannyFamily is expecting; a new addition is coming. Guess what, Nanny? You can be a doula too!

What is a doula? A doula originates from the Greek word for slave or servant. Women have been doulas in all cultures around the word for centuries. Fast forward to present day: a birth doula (there are other types of doulas) is a non-medical person who is a coach, companion, supporter, educator, and advocate assisting a woman, her partner, and the family in pregnancy, childbirth, and afterbirth. This support is both physical and emotional. A doula is not clinical; she does not perform examinations or administer any medications and she does not catch the baby as it is being born.

The benefit of having a doula is reduction of anxiety, increased maternal and fetal health, and a lower need for pain interventions. A doula also assists the mother with breastfeeding if she chooses to do so.  A doula can assist and support the new mother and her family for as long as needed.

Sounds like you? Can you be on call 24/7 knowing that labor can happen at any time?  Can you stand the sight of blood, vomit, and birth fluids? Can you coach a woman through labor that can last for hours? (My last birth took 41 hours). A doula is on her feet for hours at a time with little sleep or time to eat once the labor becomes intense. Are you comfortable in a hospital or birthing center environment? Are you assertive and confident? A doula learns many comforting techniques and comes prepared with her bag. You do not have to be a mother to become a doula!

Although doula training is not yet standardized, doulas undergo training and certification before they can practice their art. There are many training institutions to choose from based on individual needs and values (for example, DONA, ProDoula, Birth Arts International, International Center for Traditional Childbirth, and many more). In-person or online classes suit a variety of schedules and education needs. Training spans over several days, weeks, or months depending on how the course is set up and you will have to participate in births and complete the required reading in order to become certified. The training includes reproductive anatomy, stages of pregnancy, and birth comfort techniques: massage, acupressure, birthing positions, and breathing techniques. I personally use music, pillows, and a birthing ball in my comfort arsenal.  Many doulas also use rebozo, reiki, aromatherapy, and more. The mother and the family can also contribute to the comfort process.

Doulas work in groups or solo practices and can be found in hospitals, birthing centers, and homebirths. I have my own malpractice insurance because I own my business and this is a standard best practice to help protect you against a number of things that could go wrong. I interview my potential clients to assess their preferences and a confidentiality agreement is also signed as well as a contract itemizing services and fees. I also keep a record of her birth progress and at the completion of services, I write out an observation essay of the entire event and my actions and feelings, which helps to give me closure and is a learning tool for me. This document is not shared with the mom because you don’t want to have it alter her experience.

A post-partum (after the birth) doula helps the new mother and her family with the newborn in breastfeeding, light house cleaning, preparing meals, running small errands, and being a companion to the new mom as she adjusts to motherhood.

There are birth doulas, post-partum doulas, abortion doulas, hospice doulas, and perinatal bereavement doulas (fetal/infant death). The realm of the doula has expanded tremendously over the past ten years with articles in the New York Times, multiple medical journals, and television shows such as Family Guy and Tia and Tamara Mowery’s reality show, which featured a doula for one of the twins.

The medical arena is still not consistent in supporting birth doulas; a doula is to know her place in the birthing suite and of course there have been incidents in which the doula has crossed that line. I possess a medical social work background and was a trauma technologist for over 20 years, but I do not allow my previous careers to interfere with my work as a doula.

I also participate in groups that serve maternal health. This is my way of giving back and staying in touch with the issues in my community. I am also a member of several organizations for doulas, and I think any other future or current doula should be as well.

I love my job and I love empowering women and their families. No two births are alike! I think it’s awesome that there are so many nannies out there who aspire to become doulas. You can support the mother in her birth, you may also want to doula in the community where you nanny too and the flexibility is great; take on as many clients as your nanny work allows. Having you there means another familiar face of support as you continue to empower women and their families.