Doulas Supplement Support For Mothers

By Nancy K. Crevier

Gloria Garvin’s license plate reads “doula,” a somewhat mystifying word to many who see her whizzing along Newtown streets. If it raises a question, that is fine with her — she is happy to explain what a doula is.

“A doula is a mother’s helper, from the Greek word meaning ‘a woman who serves.’ Doulas aid the mother through childbirth, looking to her physical and mental comfort,” she explained. “Imagine your best friend is going to come and make this birth better, that is a doula’s goal,” she said.

Ms Garvin, 71 years old, the mother of six herself, and a child care provider for 20 years, has been a hospital doula at Danbury Hospital since the program started in 1996. “I read an article that the hospital had received a grant and was going to start a program to assist mothers during childbirth. I thought, ‘If there is one thing I can do, I will help women to have a better birth,’” said Ms Garvin of her decision to become a doula 13 years ago.

Her own experiences with childbirth in the 1950s and 1960s were less than stellar. “You were alone, in a dark room, and even then I thought, ‘Why do they do this?’ I wanted someone to talk to. Even the exam was perfunctory and you didn’t always know what or why they were doing something,” she said. The actual childbirth experience was lost to women of that era, as most were given anesthetics, one of which had the side effect of erasing the birth memory. “I would have loved to remember it, good and bad. I would have loved to have had someone there for me,” Ms Garvin said.

She received certification from DONA, International, a nonprofit organization that supports doula training and education, after completing a three-day seminar, the presentation of accountability sheets from parents, nurses, and doctors about births at which she had attended, and a written exam. The women who completed training at that time became employees of Danbury Hospital. Continuing education each month keeps doulas up to date on current birth issues and new means of providing support for mothers-to-be. DONA certified doulas number more than 6,700 members worldwide, more than 5,500 of whom are in the United States.

Mothers choose a doula to be in attendance because family members can be too tied to the situation, said Ms Garvin, or may not always know what to do for the laboring mother. Having an outside person in attendance can ease any awkwardness for the mother-to-be. Where a woman would not want to express vulnerability to a friend or family member, said Ms Garvin, she can be open to asking a doula for help. “What people don’t realize is that for someone to be there who knows the birth process is to help better. Nurses on the maternity floor have so much to do with charting and other tasks, that they can’t attend to each patient 24/7. But a doula can,” she said.

A woman can also be assured that a doula is attentive to the privacy and dignity of the mother-to-be. “We are sensitive to mind what we hear and keep it to ourselves,” said Ms Garvin.

A doula offers nonmedical pain management techniques, from massage to simple adjustments to the mother’s position. Even pillow fluffing and changing the bed pad when the mother is out of the bed can make a difference in her comfort level, said Ms Garvin. Unlike a midwife, she does not do clinical procedures, such as exams, delivery, or suturing.

Soothing CDs and distraction through conversation are two other very simple means of comfort Ms Garvin offers in her position as doula, as well as providing the mother and family with information to help them better understand what is happening and why. A doula’s presence also allows other family members some respite during what can be a long process. Whether the labor and delivery takes one hour or 24 hours, the doula assigned to a patient stays with her. “We are only required to stay on for 24 hours,” Ms Garvin said, “but I don’t know any doula who doesn’t stay even if it takes longer. After 24 hours, you are family.”

Following the birth, a doula can help a new mother become comfortable with breast feeding, and with self-care procedures.

Providing mothers with a memory of childbirth that is as pleasant as possible is the main mission of a doula, and is a goal that Ms Garvin believes is essential to the well-being of the baby’s future, as well as that of the mother’s.

The program at Danbury Hospital has been effective, said Ms Garvin, with many parents telling her over the years that they chose that particular hospital because of its doula program. Doctors and nurses are appreciative of the work the doulas do, and supportive of the program.

What concerns Ms Garvin is the decrease in the number of doulas at Danbury Hospital. “The program at the hospital has not expanded in recent years. We need to strengthen the program and make it a community imperative,” Ms Garvin said.

Nearly 30 doulas were on staff when the program began. Now, only about eight doulas remain on staff, working a rotating schedule during which they are on call should a woman go into labor and request support.

The doula program is a viable program at Danbury Hospital, said Angel Fredricks, assistant to the coordinator of the program and a doula for six years. “It would be nice to have more doulas in the program, though, ” said Ms Fredricks. There are currently just enough doulas for the women who ask for one, but it can be difficult when there is a high birth rate at the hospital. While normally she averages four births a month, in July she cared for eight mothers during the birthing process. “If a patient is at the hospital for a long birth, we could be back on call with little time for recovery in between that birth and the next,” she said.

The hiring freeze is throughout the hospital and is not directed solely at the doula program, Ms Fredricks emphasized. Even with hiring at a standstill, though, she also encourages women to become certified doulas now. “There is training through local DONA trainers that is funded by a grant received by Danbury Hospital,” she said. By becoming a certified doula now, a woman can practice as a private doula, and be immediately available should she apply at the hospital once the freeze is lifted.

Both Ms Garvin and Ms Fredricks believe that the doula program is fulfilling for those who participate, but wanted to emphasize that the doula is not there to replace the birth partner, but to enhance the experience for the family. Doulas also are not there to make decisions for the patients, but to support decisions. “When we are done with the birth, the patients are so incredibly appreciative,” Ms Fredricks said. “That says it all. When somebody is so taken with what you have provided, you can’t beat that.”

Ms Garvin urges women to contact DONA, International at dona.org to find out how to become a doula. “You see such strength, such power in women when you assist at a birth. It’s just a pleasure,” said Ms Garvin. “I don’t know of any other job with such a huge amount of satisfaction. What other job has a miracle at the end?”