Doula services guide, support women through birth process

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They are a part of the birth process in many cultures of the world but are less well-known in the sophisticated medical environment of the United States. They are part prenatal educator, part labor coach, part exhorter. They are doulas, and doula services have been available since April 2000 at Success Naturally Yoga and Image Center.|ret||ret||tab|

The word doula (doo-lah) is Greek and means "women serving women." |ret||ret||tab|

"A doula gives emotional support and physical comfort during labor," said Ginny Ross, director of holistic prenatal services at Success Naturally. "The doula philosophy is also a belief that the birth of each baby has a long-lasting impact on the physical and mental health of the mother." |ret||ret||tab|

Ross is a certified doula and a certified doula trainer, and Success Naturally employs three other doulas, Peggy Gur-gens, Julie Ross and Phyllis Travis. Prenatal yoga classes and prenatal massage also are available at Success Naturally.|ret||ret||tab|

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Certification|ret||ret||tab|

Doula certification includes 30 hours of intensive training, attending at least three births and writing papers on doula issues. Ross received her certification through the Doulas of North America organization. |ret||ret||tab|

The relationship between a doula and an expectant mother begins long before the doctor says "push," according to Ross. "The doula does prenatal visits and answers questions about the birth process, and helps the mother understand the importance of relaxation," Ross said. "We also practice comfort measures and begin working with them on their breathing. We also work with their spouse or birth partner, helping to support them and deal with their fears about helping the mother through the birth process." |ret||ret||tab|

Doulas are present for the entire labor and delivery of the baby, and visit the new mother one and 10 days after delivery. "We don't leave for one single contraction," Ross said. "We also follow up after the delivery to provide information and referral services when necessary." |ret||ret||tab|

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The birth team'|ret||ret||tab|

While doulas are not doctors, they are an important part of the birth process for mother and baby. "We don't actually do anything clinically," Ross said. "Serving as a doula is not based on us making clinical decisions or recommendations. But we like to be considered part of the birth team. Once we're in the labor room, we don't interfere with that process." |ret||ret||tab|

Acceptance among physicians is an issue, but doulas are gaining ground in the Springfield area, Ross said. "It's becoming more accepted here," she said. "Doctors feel better once they see that we're there in a supporting role, not an interfering role." |ret||ret||tab|

Doctors might also be impressed with research that points to the positive obstetric benefits of doula support during labor and delivery, Ross said. "Research indicates that when a doula is present, labors are shorter, the likelihood of Cesarean section is lowered and fewer interventions (use of labor-augmenting drugs, episiotomy, forceps and vacuum delivery) are needed." |ret||ret||tab|

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Philosophy|ret||ret||tab|

The doula philosophy takes a no-guilt approach to all aspects of the birth process, including the use of pain-relieving drugs and necessary interventions. "All of those things (pain relief and interventions) are necessary in certain circumstances, but none should be considered routine," Ross said. "Our concern is that the mother deliver with her self-es-teem intact."|ret||ret||tab|

While having a doula present can make a birth easier physically and emotionally, doulas are invaluable when things begin to go awry in the delivery room, according to Ross. "When these situations present themselves, we offer emotional support and let the mother know that whatever we need to face, we're going to be there together and help her make those decisions," she said. "No matter how things go, we want her to have a sense of accomplishment and autonomy, and we want her to have choices and trust her body. We also want her to have a great memory." |ret||ret||tab|

Those memories can be the key to positive postpartum healing, Ross said. "The doula visits the day after the birth and lets the mother tell her birth story." |ret||ret||tab|

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Life-changing process|ret||ret||tab|

Recounting the life-changing process of giving birth soon after the event is very important psychologically and emotionally, according to Ross. "It's something that you never forget and it's important that you not hold it inside," she said. "But it's also important that any emotionally negative things that may have happened during the birth be replaced with positive things right away before it gets worse." This preserves the birth as a positive experience, she added. |ret||ret||tab|

Ross, along with the Doulas of Mid-America Foundation, believes that doula support is even more valuable to mothers in compromised financial and life situations. The foundation, via donations, is working to make doula services available to mothers who cannot afford to pay on their own, according to Ross. Success Naturally has provided doulas in 20 such cases with the help of the foundation. "We believe all moms deserve this kind of service, not just mothers who can afford it," she said. Medical insurance rarely reimburses for doula services, Ross said. |ret||ret||tab|

Mothers interested in learning about doula services available throughout the Ozarks can visit the Ozark Doulas Web site at www.ozarkdoulas.org.|ret||ret||tab|

Ross has attended 25 births in the past year and a half, which she considers a tremendous privilege and the ultimate expression of trust. "I'm also an RN and a health educator, but the most satisfying thing in the world is being a doula," she said. "The universe stops when those babies are born." [[In-content Ad]]