When Jillian Hand Humphries was pregnant with her daughter (now 18 months) she wanted a doula to support her through labour and birth, but she was unable to find one. Then when complications during the birth left her feeling distraught and powerless, she decided to fill the gap. She become a doula to support other women through that challenging time.
She explains the role of a doula: "It is complete and utter support for the mother and her partner, and it is continuous, from beginning to end. You go in there when she needs you, when she goes into labour, and you stay by her side until an hour or two after the baby is born."
The word doula comes from the ancient Greek word for "woman's servant."
"The idea of other women supporting women who are in labour and birth has a very long history." Hand Humphries says, "In paintings of births you would see the woman giving birth, the midwife, and then there would be at least one other woman beside the mother, giving support. Doulas are there to be the woman beside the mother, supporting her."
Hand Humphries is the only doula practising in the province, although there is a midwife who does offer some doula services. But unlike midwives, who do medical monitoring and who divide their attention between the needs of the mother and the baby, doulas focus solely on the mother.
"A doula focuses on consistent and constant emotional, physical and informational support. They don't do anything medical, no vaginal exams, they don't take your blood pressure, they don't do fetal monitoring, they do nothing that really involves the baby."
Hand Humphries stresses that doulas do not consider themselves a replacement for any other member of the medical team. Instead, a doula complements the work of the medical professionals and, by providing constant emotional support, she helps the mother feel more in control of her birth experience.
"I think that within the medical model of birth, women are encouraged to consider the doctors and nurses as experts and they are kind of inadvertently taught to not trust their own body. Doulas help women still realize that they have power. They're giving birth, birth is not happening to them."
"I guess that's probably what draws me to it the most. That, for me, I felt powerless in my birth and I know that if I had has someone to help me kind of hold on to that power then I would have had a nicer, more satisfying memory of my birth experience."
Hand Humphries is completing her training with DONA International, the largest and oldest doula organization in the world, which offers a certification program that she feels will best prepare her to help pregnant and labouring women.
Her first stage in DONA certification was to complete a three-day course which included training in comfort measures, the process of birth and labour, how to provide support, how to help a mother follow her birth plan. This workshop, combined with a breastfeeding course, provided her with the background to practise as a doula while completing her certification.
The DONA certification requires her to complete further assigned reading and create a resource list, observe a childbirth education series, and attend three births (with positive evaluations).
Hand Humphries is currently a birth doula - which means she is trained to provide support during pregnancy, labour and birth - but she also plans to train as a postpartum doula. Postpartum doulas provide support for new mothers, helping them to adjust to motherhood, learn to breastfeed, establish routines with a new baby, and any other support the mother needs once her baby has arrived.
According to the website for DONA International, studies have shown that having a doula present during labour and birth has positive effects for both the mother and the baby.
"When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, have fewer caesareans and requests for medical intervention, and less postpartum depression," the site states.
"Studies have shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period."
The website also reports that clinical studies have also shown having the care of doula tends to result in shorter labours, fewer medical intervention (forceps, vacuum extraction etc), fewer caesarean births and less pain medication.
One of DONA's goals is to ensure that there is "a doula for every woman who wants one" and Hand Humphries shares that vision. She would like to see doulas become a routine part of prenatal care in this province.
"Overall, my hopes for Newfoundland, that we'd have enough doulas so that there'd be a doula for every woman who wants one but I'd also like for it to be commonplace that the first thing she would do is find her doctor and the second thing she would do, if she wanted a doula, was find one. "
Hand Humphries takes great satisfaction in her chosen work. "Doulas nurture and protect the woman's memory of her birth experience and I love that, I love the idea of protecting and nurturing that memory, making that the best memory for her that you possibly can."
For more information about her doula practice, contact Jillian Hand Humphries at email@example.com
For more information about DONA, visit http://www.dona.org.
Group wants medical and birth professionals co-ordinated
Kelly Monaghan, PhD candidate in community health at MUN's medicine faculty, and the co-ordinator of the community lobby group Friends of Midwifery, explains how giving birth affects a woman deeply.
"Giving birth is so much more than a physical process; it is a joyous experience for families that is laden with emotion and meaning. There are many accounts of elderly women who, whilst having great difficulty telling you what they had for breakfast, can recount vividly the details of each and every child birth experience - it is truly a moment of profound and unique significance."
For that reason, and many others, Monaghan and her group are lobbying for increased support for a birth professionals in this province. Newfoundland and Labrador has little in the way of co-ordinated labour support services, and Monaghan feels this puts women in this province at a disadvantage.
"This lies in sharp contrast to a strong doula movement in every other province in Canada and is extremely unfortunate, since doula support has been shown to afford many advantages including the reduction of procedural birth interventions and improved breastfeeding outcomes. Newfoundland and Labrador, in fact, holds the worst statistics in the country in both these regards and so stands the most to gain from the widespread availability of properly trained pool of labour support professionals."
Monaghan thinks there should more of a balance between emotional care and physical care during pregnancy and childbirth. Medical professionals would, of course, provide majority of the physical care while doulas could ensure that a woman's emotional needs were being met.
She would like to see this province join New Brunswick and P.E.I. in following the example set by doulas and medical professionals in Halifax. "Doula professionals have invested a lot of time building relationships with both the local health board and with the IWK Hospital more specifically. Indeed IWK actually provides funding towards the doula program. And now Nova Scotia is implementing publicly funded midwifery services."
She feels that changes in how pregnancy and childbirth are managed would have a wide-reaching effect on this province.
"An ideal system would empower women and partners in pregnancy and childbirth, recognizing intuitively that an empowered mother-to-be becomes an empowered parent and an empowered individual more generally. This has a profound impact on the building and sustainability of healthy communities."
Kelly Monaghan is co-ordinating The NL Doula Project in which 16 women will complete a doula training program (the same one that Jillian Hand Humphries completed) with DONA certified, Halifax-based instructor Hilary Marentette.