Monday, June 6, 2011
Doulas in Jeddah
We’ve all probably heard of Midwives and know what their function is, but have you ever heard of “Doulas?” I recently learned about Doulas from Alicia Ali and Dayle Valenzuela, two young women who provide Doula services in Jeddah. They were kind enough to answer my questions.
Susie: Exactly what is a Doula and what does a Doula do?
Dayle: A Doula is a trained child birth professional. She is usally a mother herself, and offers her services to help aid women before, during, and after childbirth. A Doula is there to offer information to the mother prenatally, and help her figure out what kind of birth she wants. The Doula usually assists the mother at the onset of labor, and accompanies her wherever she chooses to birth. Doulas are trained in recognizing the needs of a laboring woman, and provide emotional and physical support to her.
Alicia: Most often the word Doula is referring to the birth Doula, or labor support companion, but there is also the antepartum Doula and the postpartum Doula. Most Doula and client relationships begin a few months before the baby is due. During this time, they establish a relationship that gives the mother complete freedom to ask questions, express fears and concerns, and take an active role in creating a birth plan. Most Doulas make themselves available to the mother by phone to answer questions or explain any developments that may arise in pregnancy.
Doulas do not provide any type of medical care. However, they are knowledgeable in the medical aspect of labor and delivery so they can help their clients get a better understanding of procedures and complications that may arise in late pregnancy or during delivery. During delivery, Doulas are in constant, close proximity to the mother at all times. They can provide comfort with pain relief techniques, such as breathing, relaxing, massage and laboring positions. Doulas also encourage participation from the partner and offer reassurance. A Doula acts as an advocate for the mother, encouraging her in her desires for her birth. The goal of a Doula is to help the mother have a positive and safe birth experience, whether the mother wants an un-medicated birth or is having a planned cesarean birth.
Susie: Are there different kinds of Doulas?
Dayle: Yes. The two main types of Doulas are birth and postpartum Doulas. A birth Doula attends the mother during her labor, whereas a post partum Doula assists the mother after childbirth.
Alicia: Antepartum Doulas provide help and support to a mom who has been put on bed rest or is experiencing a high risk-pregnancy.
Postpartum Doulas are there to support you in your first weeks of being a mom. They provide informational support about feeding and caring for the baby. They provide physical support by cleaning, cooking meals and filling in when mom needs a break, and they provide emotional support by encouraging a mom during those times when she feels overwhelmed.
Labour Doulas are trained women who will stay with you throughout labor and birth.
A Doula also provides emotional support, physical comfort measures, an objective viewpoint and assistance in getting the information she needs to help the mother make empowered decisions throughout her pregnancy.
Susie: How long have you been a Doula and what interested you in becoming one?
Alicia: I have been practising as a Doula for 10 years, including 7 years of post training and 3 years of pre-training. My interest began after my second child. I was fortunate to have a Doula for all three of my children, yet after delivering my second child, I was asked by my brother to ‘be there for support’ for his first baby. At that time, I had just delivered 3weeks prior and could not refuse. It was a success and the couple highly valued my presence. This triggered my personal interest to take professional doula training. Finally during my third pregnancy when I was 7 months pregnant, an opportunity came up for training in Canada.
Dayle: I've been a Doula for over a year and half now. The main reason I chose to become a Doula is due to my own childbirth experiences. I experienced a very difficult labor and delivery with my first child. The type of birth I got was not at all what I was planning, and I greatly regretted not choosing to hire a Doula. I was determined after that to help other mothers avoid some of the things that made my birth and pospartum experience difficult. With my second pregnancy I hired a Doula, and it made a huge difference! I had completely natural birth, and it was honestly the best day of my life.
Susie: What type of training does a Doula have?
Dayle: A Doula is usually trained by an overseeing organization. I was trained in Phoenix, AZ, by a Midwife to be a Birth Trust Doula. There are several organizations that a Doula can choose from.
Alicia: Workshops are mainly conducted by Doula Trainers. Workshops styles vary; some can be done over a couple of days. CAPPA and DONA are popular Doula certifying bodies. Each organization has their own minimal requirements as far as training is concerned. This may be found on their respective websites.
Susie: What are some of the benefits of hiring a Doula?
Dayle: Studies have shown time and again that Doula-attended births have lower incidence of harmful interventions such as episiotomies, vacuum extractions, c-sections, forceps delivery, and the list goes on. Mothers who chose to hire a Doula have also reported increased satisfaction in their childbirth experience.
Alicia: In all the above studies, the Doulas used soothing words, touch and encouragement. They explained the procedures as they occurred and translated medical terms into laymen's terms. The results of the studies were as follows:
• Reduced the overall cesarean rate by 50%
• Reduced the length of labor by 25%
• Reduced oxytocin use by 40%
• Reduced the use of pain medication by 30%
• Reduced forceps deliveries by 40%
• Reduced requests for epidural pain medication by 60%
• Reduced incidences of maternal fever
• Reduced the number of days newborns spent in NICU (neo-natal infant care unit)
• Reduced the amount of septic workups performed on newborns
• Resulted in higher rates of breastfeeding
• Resulted in more positive maternal assessments of maternal confidence
• Resulted in more positive maternal assessments of maternal and newborn health
• Resulted in decreased rates of postpartum depression
Klaus and Kennel speculate that the mere presence of a Doula had a beneficial effect on the emotional state of the mother, resulting in a decrease in catecholamines (adrenaline). This relaxed state allows uterine contractions to be more effective and reduces the occurrence of compromised uterine blood flow.
Susie: How do Doulas differ from Midwives?
Alicia: Doulas are non-clinical whereas Midwives are clinically qualified.
Dayle: Often times Midwives are busy making notes on the mother’s chart, checking the mother for dilation, her blood pressure, listening to fetal heart tones, etc. Doulas are not involved in any of these tasks, which allows the Doula to only focus on the mothers needs. Having a Doula as part of your birth team ensures that no matter what takes place during labor and delivery the mother always has the emotional and physical support she needs to cope.
Susie: For what period of time are Doulas' services generally required?
Alicia: Prenatal period and Postnatal (a few weeks) are popular choices for mothers and families.
Dayle: I encourage mothers to contact me early in their pregnancies. This allows us to get to know each other, as birth is a very intimate experience. However most mothers do not begin looking for a Doula until they are in their third trimester, and that's fine too. Once the mother has chosen to hire me, I'm there for her until after she delivers. I usually have one follow up visit with the mother around 2 weeks postpartum to help answer any questions the mother may be having and to provide resources.
Susie: How do fathers generally feel about the presence of Doulas?
Dayle: Overall the response from fathers is overwhelmingly positive! For those fathers who choose to take an active role in helping his wife cope with labor, I usually take a back seat role, offering suggestions to the father on how he can support his wife, and giving him a break when needed. For those fathers who are squeamish about childbirth or do not wish to participate for cultural reasons, they are usually relieved to know that their wife is being well cared for and looked after.
Alicia: Doulas lessen the stress of fathers during birth. A big stress for many partners is feeling they need to support the mother during the birth and advocate for her, while at the same time, the father has as many emotional needs and worries as the mother has. Also, the hospital environment can be intimidating itself, with nurses walking in and out, and the doctor usually not being around to answer many questions. Fathers end up with a positive experience and a feeling of being there to support his wife during birth thus strengthening the bond between the couple. It is common for dads to ‘chicken out’ as they feel too much stress on them and the couple ends up opting for a mother or sister to be present during the mother’s delivery, thus leaving the father to be totally out of the picture.
Susie: What other services do you offer?
Alicia: A unique part of the services is I offer through Your True Nature is a Complete online Birth Education Course. This is an amazing and truly empowering self paced course with unique content ranging from natural birth techniques, breathing, natural healing, prenatal yoga, etc. In the Kingdom, we lack prenatal education options through hospitals, and have a shortage of trained instructors, thus, this is an ideal solution for many. This e-course is practical for internet savvy mothers who lack access to classes, support and information such as books or are living in remote areas. There are a total of 7 Modules. More information is available at: http://yourtruenature1.wordpress.com/courses-and-education/Doula-services/distance-support-Doula-service/
Dayle: I've just started a new Facebook group caled "Caring Moms of Saudi Arabia" for mothers who can network with one another to help each other through difficult times. The idea for this group came to me when I heard from a friend who had recently given birth and was struggling to care for her three small kids all by herself. She needs a caring Mom to come bring her a few meals and to help out with her kids so she can take a nap. Most expat mothers in KSA don't have their family close by to help out and are very isolated. This way we can be a support system for each other, both physically and emotionally and fill that void.
Susie: Where can women find out more information about your services and how can they contact you?
Dayle: My website is - http://jeddahdoula.webs.com/
And my Email is - email@example.com
Alicia: Here’s my website - http://ytnature.com/
and here’s my Email - firstname.lastname@example.org
Susie: Thank you both so much for taking the time to answer these questions. It’s been enlightening.
Thanks also to my friend Kacy, who gave me permission to use these beautiful photos of her handsome baby boy Mazen for this special post.