doula versus birth companion

The word doula is a direct translation of an Ancient Greek word meaning female slave of a woman, gifted to her postpartum. You and I will work together to ensure your birth unfolds as you envisioned. I provide continuous companionship through active labor to give you the emotional and physical support you need.

In most cases, birth is a safe, natural event that does not need medical intervention. You evolved to do this! For centuries, women and birthing people accompanied their beloveds in labor and provided assistance through touch, breath techniques, song and prayer, food, and their simple presence. The camaraderie of those who knew what to expect was a balm unto itself. Having someone to assist with doula care is clinically proven to reduce pain and anxiety, shorten labor, nearly halve the cesarean section and synthetic oxytocin use rates, and reduce the need for pain medication by a third. (Please note pain medication is different from pain management – my personal mantra was pain not suffering, and once it crossed the line I’d take any and all assistance I could get.) Studies have also shown doula care, with its continuous, one-to-one care, lowers reports of pain 24 hours postpartum, increases the rate of nursing (while fed is best, human milk offers unique advantages), increased parental emotional health postpartum, and a generally more favorable view of one’s child as more attractive, clever, special, and easy than other babies.

For those whose births do benefit from medical interventions, for whatever reason, a birth companion can assist with understanding and unpacking the options to ensure informed consent. There is a magic and science to pregnancy and labor, and it’s all complicated and exciting and often confusing for the one living in a body with such rapid changes. You take only 40 weeks to grow another living, human being, and then in a matter of hours make them separate and unattached. It’s enough to give anyone whiplash. Add in the stressors of balancing what’s right for you and your child’s physical health with what’s best for your emotional and mental health, cultural practices, and your own or familial expectations, and it’s difficult to take a moment in labor to focus on the benefits and drawbacks of any particular option. A birth companion stays with you, continuously and one-to-one, and can help remind you of your previously stated wishes and sort through what the options mean.

After the birth, a birth companion is still available but the main act is done. The birth companion withdraws, remaining available and always phone-able – you don’t have to worry about waking someone up in the middle of the night, that’s what they’re there for – but allowing the family to settle in to a new existence with a new member. The family can set up or not set up their home as makes sense for them, accept or not accept visitors to assist or admire the baby, and learn how they want to arrange familial duties. The birth companion checks in once or twice in person but gives the space and room for the family to develop their own traditions and choose which familial and cultural traditions they want to continue.

All this is comparable and identical to what is currently called a doula or doula care. However, as Western societies approach a greater understanding of gender, I believe the term is outdated. It is better to focus on the act being undertaken by a person, regardless of their gender, not supporting roles that lock people into unconscious ideas and expectations of gender. As your birth companion, you and I will work together to make the safe, healthy, happy birth you deserve happen, with only the gender roles and expectations you choose to have.

Information from The Doula Book, 3rd ed., by Klaus MD, Kennell MD, and Klaus MFT, LMSW.

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