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Mother's helper Doulas make birth better for some Bay Area moms
Oakland Tribune, Apr 2, 2006 by Candace Murphy, STAFF WRITER
IT WASN'T UNTIL Erica Kain was a day past her due date that she decided she was woefully unprepared for the birth of her baby.
There she was, driving down Highway 24 alongside her sister, who'd just arrived in town to lend a hand for the big day, when the realization struck.
"We were talking in the car, and it occurred to me that my sister had no real experience with birth. Whatsoever," says Kain. "My nervous sister was nowhere near the energy I needed in that birth room. I needed someone who'd been through a birth before. Someone who had experience."
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To say that Kain pulled the car to a screeching halt, "Starsky and Hutch" style, isn't too far from the truth. And after she parked, she marched, as quickly as the extra 50 pounds on her body and the baby in it would allow, into Lafayette's Nurture Center.
Kain wanted a birth doula. And she wanted one right away.
"It just occurred to me right then," says Kain, 34, "that a birth doula would be the right thing to have."
Doulas are quite possibly the quintessential Bay Area birthing accoutrement: They bear an exotic name that sounds somewhat granola- esque. They often use meditative and holistic techniques. And a portion of the hard-core medical community can't stand them.
Talk about hitting all the requirements for a liberal-loving, left-coast population.
"Doulas are more popular than they've ever been, and probably more popular here than anyplace else," says Betsy Appell, 38, a Berkeley doula who's been practicing for four years and is booking up to six months in advance. "I can't say why. All I can say is that the doula is for the woman, not so much the baby. The more relaxed the woman, the easier the birth."
Named after the Greek word for slave, doulas are, basically, personal assistants for expectant parents that come in two flavors. Birth doulas sit by the mother's side during delivery, helping her through labor by massaging her back or suggesting alternate positions, making an increasingly medical world just a bit more personal. Post-partum doulas care for the mother at home after the baby is born, taking on a role a grandmother might, making our increasingly fragmented families seem just a bit more whole.
Qualifications vary
How doulas work varies as much as their fee schedules, which range from $250 to $1,400. Some doulas, like Appell, who lived for a time in a Buddhist monastery, have extensive Zen training and are certified. Others have no certification but have attended hundreds of births and have clients swear on their children's lives by them.
Don't confuse a doula with a midwife. A doula's focus is the emotional and physical well-being of the mother. A midwife's concern is the health and well-being of the fetus, in addition to the mother.
"Being a doula is more about being than doing," says Sharon Craig, 23, who used to be a doula in the Bay Area but is now a certified clinical midwife in Kabul, Afghanistan. "It amazed me how, after births, women would lavish me with all sorts of comments like 'I could never have done it without you,' when I felt I wasn't really doing much. But the main thing for women in labor is for them to have someone who is focused entirely and solely on them. They know that their doula will not leave them."
It's not all just earthy, touchy-feely hocus-pocus either. Statistics assembled by DONA International (formerly known as Doulas of North America), an organization that trains and certifies doulas, give pause. According to studies in North America, Europe and Africa, women cared for during labor by a birth doula, compared to those receiving "usual care," were 26 percent less likely to have Caesarean sections; were 41 percent less likely to give birth with a vacuum extractor or forceps; were 28 percent less likely to use any "drugs," such as an analgesic or anesthesia; and were 33 percent less likely to be dissatisfied or negatively rate their birth experience.
Those stats are key because doulas are traditionally hired by women seeking natural childbirths. After all, that's what swayed Kain toward getting a doula, even as late as one day after her due date.
"I didn't decide I wanted to commit to natural childbirth until that day in the car. But we were in no way prepared," says Kain. "Yes, we'd gone to a women's center for classes about childbirth, but they were just not that useful. At one point they had (my husband) hold an ice cube in his hand and said, 'That's what a contraction is like.' He didn't get it. He just held it in his hand until it melted. That was the extent of our preparation."
When Kain remembered a friend of hers in San Diego had gone through natural childbirth twice using a doula, she hired one immediately. That doula ended up being Deanna Jesus, who was working part-time inside Lafayette's Nurture Center the day Kain's car came screeching to a halt out front.
"She ended up coaching me through the final part of my labor," says Kain. "The second my eyes laid on her, wham! I knew we were going to be OK and get through it. I never lost that faith."
