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Constance Alexander: Before, during and after mothers give birth, doulas attend to their needs

Her tee-shirt says, “Do More of What Makes You Happy,” and the smile on Sarah Cunningham’s face as she describes her role as a doula makes it clear her calling gives her a sense of wonder and joy.

What is a doula? Ask Google and in .50 seconds, 3.7 million definitions pop up. The Greek root of the word translates into female helper or maidservant. More current usage defines doulas as women trained to provide advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth.

Before Cunningham began doula training almost twenty years ago, she thought she wanted to be a midwife. As her research progressed, she learned that midwifery leaned toward the medical aspects of birth.

Madonna and Child with the Young John the Baptist, Cosimo Rosselli, circa 1490 (Image from Wikimedia Commons)

“I wanted to focus on the woman as a whole,” Sarah recalled. “I was interested in how birth can be empowering to women.”

A doula seemed the best fit then and now. The way she sees it, even in 2022, the typical model of birth is more industrial than interpersonal.

“Sort of like – ”

She hesitates, appearing to search for the right word.

“Like a factory,” she finally says.

Her work with a client begins with the pre-natal conversation to determine some basics, such as who the mother wants present during the birth. Throughout the pregnancy, doulas support the mother in the choices she makes. With so many questions arising, the mother may harbor fears, doubts, and questions she has not necessarily shared with her doctor. She is likely, however, to talk more easily to the doula.

“A woman might tell me things like, ‘The doctor says I have to be induced, or I have to take bed rest,’” Sarah said.

The prospective mother may interpret statements like these as orders, but they may simply reflect the usual way that doctor does things. Sarah points out that the range of what is normal or ok varies widely.

To help the mother think through these issues, Sarah relies on a handy acronym, B.R.A.I.N.

What are the benefits of the procedure is the first question. R helps identify risks associated with whatever action has been suggested. A delves into alternatives to the recommendation. I, a secret ingredient, is Intuition, an essential tool.

“Intuition is important in the transition to motherhood,” Sarah declared. “The mother has to listen to something in her heart.”

N is another key question: What if we do nothing?

“We go back to that acronym throughout the process,” Sarah said. “It can help mothers open a conversation with the doctor.”

Constance Alexander is a columnist, award-winning poet and playwright, and President of INTEXCommunications in Murray. She can be reached at constancealexander@twc.com. Or visit www.constancealexander.com.

Sarah is careful to emphasize that it is outside the scope of a doula’s responsibility to intervene with the doctor on behalf of her client. “My role is to support the client and her choices,” she declared.

Doulas coach the father during labor and through the birth itself. Words may be helpful but eye contact and gestures are often more useful. A meaningful glance at the husband, for instance, may communicate that the time for joking is over. “Things are getting serious,” is the message.

With gentle coaching, the doula aims to make the couple a team. In short, the hope is that the two feel, “We’ve got this as a couple.”

“My goal,” Sarah declared, “is for him to experience the birth as a father, and to let both parents have their own experience.”

She admits that birth can be intense, even scary, so the value of doulas is that they know what is normal. A doula who has laid the groundwork and established a trusting relationship can reassure an anxious father and mother with two simple words: “It’s fine,”

After the birth, doulas remain in the delivery room for at least an hour. The way Sarah puts it, “I stay for the aftermath until the ‘babymoon’ starts.”

She uses the term as an equivalent of the honeymoon, but this new interlude is for the three of them, the family.

“They are settling into their life together,” Sarah said.

She follows up again before the mother leaves the hospital and gets together with the client at home too. A woman may need support regarding breastfeeding, exhaustion, depression, or a range of other concerns. “The hormones go crazy,” Sarah remarked. “A woman might feel weepy or sad.”

Some responses are typical, but frequency and intensity of issues make a difference, so communicating with the doula may provide a range of solutions, anywhere from crucial intervention to gentle encouragement.

“Breastfeeding success often determines post-partum health of the mother,” Sarah explains.

With a doula, a woman gets a head start on the lifelong role of motherhood. With doulas like Sarah Cunningham, they discover the miracle of motherhood and the formation of a new family.

Doulas are making a difference for families in Murray around the world. Additional information is available through DONA International.

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