Sunday, September 24, 2000
Doulas provide physical, emotional support for mother-to-be and family during labor

By Yolanda Johnny Taylor
The Macon Telegraph

It looks like a punch line to a bad joke.

The very pregnant woman squats atop a gigantic blue exercise ball. She nervously tries to maintain her balance while the plastic ball underneath her tentatively sways.

But there is a method to the madness.

The woman is learning techniques to make childbirth faster and easier on her body.

"Squatting helps with dilation (the expansion of the cervix to make room for the baby's delivery)," said Amy Solen, a childbirth educator who will be helping the woman - 22-year-old Tomika Jones - through her delivery.

"When we are in the squatting position, our body is in one of the most comfortable positions to push."

But there's more to it than just that.

Solen is teaching Jones some of the trade secrets she has learned as a doula, a trained female birth assistant who provides physical and emotional support during labor.

"For single parents and young people, especially teen-agers, doulas are a good idea, because they give you that extra support," said Jones, who is expected to go into labor Sept. 27. "I'm not nervous at all."

A doula (pronounced doo-lah) provides medical education and nonmedical care before, during and/or after childbirth, according to the client's wishes. The women - usually mothers themselves - also coach the would-be mothers through pain-dulling techniques and movements, and support the new mothers during labor with soothing words and foot, back and hand massages.

For Jones' mother, Carol Adams, using a doula has helped her prepare her daughter for labor, as well as taught her a few things about childbirth.

"I'm getting a little mad," the mother of two adult children said with mock seriousness after watching Solen teach Jones new childbirth techniques.

"They didn't have any of this when I was in labor. You were in a room almost by yourself. I didn't have anyone massaging my feet or showing me how to sit to make it go faster."

Doulas, unlike midwives, do not deliver babies or perform medical tasks. Instead, doulas concentrate on helping the mother and family through the delivery process and help convey the families' wishes to the medical staff.

"Sometimes, even if the mother wants to do it naturally, she will feel pressured into having an epidural (a drug used to deaden pain below the waist)," Solen said. "I help make sure the mother's wishes are heard."

To be a doula, organizations such as Doulas of North America and Childbirth and Postpartum Professional Association provide training classes and certification to women who meet the groups' criteria.

The fees for a doula vary from $400 to $1,500 depending on where you live. The fees may also depend on the doula's experience, training, and whether they are certified. Clients are urged to ask a doula about fees and deposit requirements.

"It can be expensive, but it depends on where your priorities are," Solen said. "People spend thousands of dollars on weddings and cars. Why not spend half of that on your baby?"

Having doulas in the delivery room helped reduce Tammy Hankinson's anxiety about having her daughter, Vanessa Hope, in a hospital where she didn't know anyone.

"Kelly and Holly (her doulas) had been with me the whole nine months," she said. "It was comforting to have faces you know there."

The doulas also helped relieve some of the pressure on Hankinson's husband, David.

"I think he appreciated having them there," the mother of two said with a knowing chuckle. "I knew he wanted to help, but sometimes once birth begins, you lose sight of checking on the mother's breathing and want to just see the baby get out there."

Research has shown women who use doulas have a 50 percent reduction in Caesarean sections, 25 percent shorter length in labor, a 60 percent reduction in the need for epidural anesthesia and an increased success at breast-feeding.

"I teach women to do what their bodies are telling them to do anyway," Solen said.

Doulas have long been a fixture in Africa and in some European countries, but they are becoming more popular in the United States.

"We have a significant increase in doulas in the last five years," said Christi Ridd, DONA's administrative director.

The nonprofit organization has grown from 700 members in 1995 to close to 3,300 members in 1999. Ridd said she attributed the increase to women demanding more support and wanting an advocate in the birth place.

But the boom hasn't really hit Macon yet.

"Macon's so unique compared to other cities in Georgia," said Debbie Liipfert of the Beginnings childbirth and lactation service program at The Medical Center of Central Georgia. "Atlanta has a lot of doulas, and Columbus does. It just hasn't caught on here yet."

Liipfert, who has worked with doulas before, said certified doulas help reduce the amount of pressure on the mother and the mother's family. Doulas take over as the birthing and breathing coaches and allow families to enjoy the birth.

"We're expecting too much of the mother's loved ones," she said. "We should let people be in the roles they are comfortable in. Maybe they don't want to be in the delivery room but feel like they have to be."

In addition to helping in the delivery room, doulas can help once new mothers return home.

Postpartum doulas help new mothers adjust to their first few days at home, doing everything from teaching the new mother how to breast-feed to cleaning the house to doing grocery shopping.

The role of a postpartum doula is to make the transition from hospital to home as smooth as possible, Solen said.

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