By: Courtney Phillips
“There’s a secret in our culture,” said Natasha Baker, a certified lactation consultant, birth and postpartum doula, founder of Natasha Doula Birth Marks and mother of two in Fayetteville. “It’s not that birth is painful. It’s that women are strong.”
Natasha is one of a growing number of specially trained women in the U.S. to offer direct, one-on-one support to other women before, during, and after the birth of their baby. In Fayetteville, doulas play an especially critical role in many women’s lives whose husbands are deployed for the birth of their child.
DONA (Doulas of North America) International, a non-profit organization founded in 1992 for the education, support and recognition of doulas, has over 6,500 members in 50 countries. DONA’s code of ethics and standards of practice serve as a benchmark of care that most doulas provide in the United States.
More than the obvious emotional and mental benefits to a mother at the time of birth, research suggests that the presence of a doula can critically influence the outcome of a baby’s birth and early life. Twenty-one randomized studies involving more than 15,000 women were condensed and published by the Cochrane Review in 2011. The most marked findings include that the presence of a doula dramatically reduces the following: unnecessary cesarean rate by up to 50 percent, length of labor by 25 percent, requests for epidurals by 60 percent, Pitocin use by 40 percent and use of forceps by 40 percent.
A Birth Doula’s Role
Before a client’s baby is born, a doula educates a mother on proper birthing positions, comfort techniques and helps create an ideal birth plan. Natasha’s services begin with an at-home consultation with an expectant mother before the 35th week of pregnancy. “Traveling is part of my job. I understand that women in our area often have childcare constraints or a lack of transportation,” said Natasha.
While trained in non-medical physical and emotionally supportive techniques in pain management, many doulas are happy to support women who want medical pain relief during the birthing process. “We will always strive toward a client’s birth plan. If that includes an epidural, I’m fine with that. It’s an intimate part of their lives that they should treasure. I just want to have a positive impact,” said Natasha, who believes her key duties are to nurture and protect a woman’s memory of the birth experience.
When a woman goes into labor, a doula’s purpose is to provide emotional support, physical comfort measures and an objective viewpoint in what can become a high-stress and intimidating environment. “Pain is just one of the things that women are ‘scared’ of when having a baby. Birth shouldn’t be a scary thing. The power and intensity of your contractions cannot be stronger than you, because it is you,” said Natasha.
Generally, a doula is directly involved as soon as a client begins the earliest stages of labor and while they are capable of being a mother’s sole support and advocacy system in the birthing process, partner participation is welcomed and encouraged.
Stephanie Bielli, owner of Welcome Home Baby Lactation Services, LLC, offers a unique perspective as both a former nurse and now full-time lactation consultant. “Doulas play an important role for support for both sides of the spectrum as mothers may have a deployed spouse and family is too far away to be there. On the other hand, couples enjoy having a doula to lead them through the process, and demonstrate how to have an unmedicated and safe delivery,” said Stephanie, who has watched doula services come to the forefront of natural childbirth care over the course of her career.
Rebecca Steffens of Spring Lake, a mother of five and a client of Natasha’s, has given birth with and without anesthesia and with and without a doula’s support. “I was exposed to the idea of a doula through a documentary when I was carrying my fourth child. I knew I needed someone there. My family was far away and my husband was deployed. A friend recommended Natasha and I was very intrigued by the idea of having a woman there. A woman, especially one who has the training, would know better how to help you through it. She knew what to say and how to position me. If all women understood how much it can help, more would opt for one,” said Rebecca.
In her fifth pregnancy and delivery, Rebecca’s husband was present for the birth. She thought she would be able to replicate the techniques she learned with Natasha, but in the last phases of labor, she needed a doula for pain management. “If I have a sixth child, I will have a doula, again, even if my husband is there. I’ve had children without anesthesia and with it. The unmedicated birth with a doula was my best experience,” said Rebecca.
Immediately following a baby’s birth, most birth doulas stay, as needed, to facilitate a strong bond between the mother and child and to assist with the initiation of breastfeeding. In the days following a delivery, it may be a birth doula’s policy to check in on a family, but their role is significantly reduced.
For mothers who desire additional support after the birth of their baby, postpartum doulas provide an educated, experienced resource and non-judgmental support and companionship during the postpartum “fourth trimester.”
The same Cochrane Review research suggests that a postpartum doula’s involvement in a family’s transition can reduce the risk of mood disorders, postpartum depression and maternal exhaustion rates while increasing breastfeeding rates, maternal confidence and paternal satisfaction.
“My services really focus on making sure parents are taking care of themselves. It helps to normalize things. Whether I take the dogs out to play fetch, cook dinner, or keep the baby while a mom takes a shower, it’s about helping a family transition properly,” said Natasha, whose postpartum services vary from massage and aroma therapy to household chores and techniques to help colicky babies.
The national average price of a birth doula is $750. Depending on location, ala carte services and level of postpartum care, the average can increase to $1800. In addition to traditional support, many doulas provide unique services like belly casting, placenta encapsulation, lactation cookies, babywearing education and CPR classes. Most doulas are local, small business owners and will offer payment plans and gift certificates.
Operation Special Delivery
After the tragedies of September 11, 2001 and deployments that followed, many women were left to give birth alone. A doula in the New Jersey area sought to support them with her services. After operating in the New York/New Jersey area for several years, Operation Special Delivery extended its services nationwide to expectant mothers whose spouses will be deployed at the expected time of delivery, have been severely injured or lost their lives in the line of duty. If an expectant mother cannot afford the cost of a doula and she meets the criteria for selection, she will be provided a volunteer doula free of charge. Inquiries regarding Operation Special Delivery can be made at doulas.org.
Despite the unique need for doula services in our area, Natasha, a volunteer for Operation Special Delivery, notes that many women are unaware of the support a doula can provide before and after a baby is born. “It kills me to meet a mom who just gave birth and, when she learns what I do, she says, ‘Oh, I wish I would have had you!’ If I can be that support system for a mom, I feel as if I’ve had a chance to impact someone’s ideal birthing needs and experience,” said Natasha.