About Dads and Doulas
by Penny Simkin, P.T.
Myth 1 - If a woman has her partner, the doula becomes redundant.
- The doula may be the only person at the labor besides the partner who is there
solely for the emotional well-being of the woman. The nurse, the doctor, the
midwife have other priorities that compete with the emotional care of the woman:
for example, breaks, shift changes, clinical responsibilities, office hours and
hospital policies. The doula has few or no other priorities. She stays through
shift changes, and until after the baby is born. She is not just another stranger
with the couple. She has the woman's needs as her sole priority. In some cases,
the couple will bring several other friends or family members into labor with
them. Sometimes these people can be uncertain of how to help which leads to
confusion and actually adds to the woman's stress. The doula can direct and
coordinate the efforts of a group of people, giving them all some-thing useful
to do, so they work as a team on the woman's behalf.
Myth 2 - The doula "takes over", displacing the partner and interferes with
their intimate experience.
Reality - The doula can actually bring the couple closer. By making sure that
the partner's needs are met (food, drink, occasional back rubs, and
reassurance), the woman and partner can work more closely together. The doula
allows for the partner to participate at his own comfort level. Some partners
prefer to be there only to witness the birth of their child and to share this
experience with the woman they love. They may not want to play an active role
and do not want to be responsible for the woman's comfort and emotional
security. The doula can fill in and allow the partner to participate as he
wishes, without leaving the woman's needs unmet. When the partner chooses to be
the major source of emotional support, the doula can supplement his or her
efforts by running errands, making suggestions for comfort measures, and
offering words of reassurance and comfort. During a long tiring labor, she can
give the partner a break for a brief rest or change of scene. While the doula
probably knows more than the partner about birth, hospitals, and maternity care,
the partner knows more about the woman's personality, likes and dislikes, and
needs. Moreover, he loves the woman more than anyone else there. The combined
contributions of partner and doula, along with a competent, considerate and
caring staff gives the woman the best chance of an optimal outcome.
Myth 3 - The doula has her own beliefs about how the birth should go, and
imposes it on the woman or couple.
Reality - The doula's true agenda is to help ensure that the woman's or couple's
agenda is acknowledged and followed as much as possible. If the doula is
thoroughly familiar with the couple's wishes and their birth plan, she may
actually think more about it than the couple, especially when labor is intense
and things are happening rapidly. The doula can remind the staff or the couple
of some items on the birth plan that are forgotten, but which later might be
important. Sometimes if a birth plan is not followed, the couple later look back
with regret or disappointment. The doula helps with decision-making by asking
questions that will ensure that the right information is given to the woman or
couple so that they can make an informed decision. She may also suggest
alternatives for the couple to consider. She does not, however, make decisions
for the couple.
In summary, the doula helps make the birth experience to be as rewarding and
satisfying as possible. As one father said, "I heaved a big sigh of relief when
she (the doula) walked in. I hadn't realized how much pressure I had been
feeling. She not only calmed my wife, she calmed me down."
Penny Simkin, PT, is a physical therapist who has specialized
in childbirth education since 1968. Among her books are Pregnancy, Childbirth
and the Newborn: The Complete Guide, now in its third edition, The Birth
Partner: Everything You Need to Know to Help a Woman Through Childbirth,
Episiotomy and the Second Stage of Labor, and most recently,The Labor Progress
Handbook: Primary Interventions to Prevent and Treat Dystocia, with Ruth Ancheta.
She has written chapters for three major medical textbooks, and a series of
materials on pain medications and comfort measures for childbirth has recently
been published by Childbirth Graphics.
Currently, Ms. Simkin serves on several boards of consultants and editorial
boards, including the journal, Birth: Issues in Perinatal Care; the
International Childbirth Education Association; and the Seattle Midwifery
School, where she also teaches. She is a founder of the Pacific Association for
Labor Support (PALS), Doulas of North America (DONA), and trains doulas and
doula trainers. Her practice consists of childbirth education, birth counseling,
and labor support, combined with a busy schedule of conferences and workshops.
Copyright 1999 Penny Simkin.