Christine Twait spent the nine months of her first pregnancy carefully planning the kind of delivery she wanted: drug-free, unhurried, and surrounded by supportive people. Twait had chosen a nurse-midwife instead of an obstetrician to ensure she got the kind of hands-on attention she wanted, but when her water broke, all her preparation seemed to go with it.
“I was left alone for several hours with no one checking on me,” explains Twait, who lives in Woodbury. “I thought I’d get more personal care, but that wasn’t what happened. I felt very abandoned.” Eventually a nurse realized the baby was crowning, and in what Twait describes as “a big panic” the room filled with staff and her daughter Annaliese was born 11 minutes later.
Two years later when Twait became pregnant again she was determined to have a different experience, one she decided could best be provided by a doula. Taken from the Greek word for servant, a doula is a non-medical birthing assistant whose focus is giving physical and emotional support to moms during delivery. “I felt like what I needed was someone to support me without preempting my husband, someone who would make me feel empowered by the experience,” says Twait.
Luckily Twait’s hospital of choice for her second delivery, Woodwinds Health Campus in Woodbury, has a thriving doula program with more than 50 doulas on staff. Jeanette Schwartz, clinical director of maternity care at Woodwinds, says moms in the Twin Cities benefit from the country’s highest doula-to-mother ratio of anywhere in the country. Thanks to a large number of instructors locally, Schwartz says the Twin Cities currently has around 250 doulas at the ready.
“Doulas have become a lot more commonplace and around 20 percent of our mothers are using them,” Schwartz explains. “Many people associate doulas with unmedicated birth, but they are available no matter what your preferences are.”
Minnesota mothers are turning to doulas with good reason: Research has shown they aren’t just for peace of mind. A variety of studies concluded that moms who use birth companions are less likely to have operative vaginal delivery (including forceps and vacuums) or C-sections, and the duration of labor is statistically shorter.
“The benefits are huge!” says Schwartz. “Moms have higher satisfaction with their birth, postpartum depression rates are lower, and breastfeeding rates increase. There’s no risk to [having] a doula and all kinds of benefits.”
The state of Minnesota does not license doulas, but since 2007 the Department of Health has maintained a registry that lists doulas who have been certified through one of a number of private organizations (Doulas of North America and the International Childbirth Education Association are two). Despite the growing popularity of doulas, insurance coverage is rare; parents pay the $25–$45 hourly fee out of pocket or take advantage of volunteer doula services (Woodwinds offers a doula student free of charge, but if that student is busy with an earlier birth you’re out of luck).
A supportive presence
So just what happens with a doula in the room? Schwartz describes a comforting relationship that can include practices as intimate as massage, reflexology, and breathing techniques. Or, a doula can simply improve the atmosphere of the birthing room with music and essential oils. Doulas also support family members present in the room for the birth. “When doula evaluations come in it’s always the dads who give them the highest marks,” explains Schwartz. “They are frightened and don’t know what’s normal during a birth and the doula can look them in the eye and explain what’s happening so they can relax and even help with an acupressure massage or cheerleading.”
At Twait’s second birth her doula suggested different positions to try between contractions and guided Twait’s husband with massage tips (“My husband has a terrible intuitive sense of massage,” laughs Twait.) while also fielding an unusual request from Twait herself. “I was self-conscious about moaning, really opening up and making animal sounds, so I asked her to do it with me,” says Twait. “She said ‘Sure! I can do that.’ She wasn’t a rah-rah presence; she was gentle.”
Twait credits her doula with creating a more positive birth experience for her second pregnancy, an outcome Schwartz hopes will encourage other expectant mothers to explore the doula option. “Doulas are constantly with the mother,” says McPherson, “And that’s what we believe makes them so effective.”
Monica Wright is assistant editor of Minnesota Parent.
RESOURCES
Doulas of North America
DONA.org
Minnesota Birth Network
MinnesotaBirthNetwork.com
