Doulas - today's midwife

During an excruciating labor that stretched into 23 hours, Cherie Hodges was thankful she had a doula by her side.

Her doula — who served as a labor coach, support system and advocate for Hodges — helped keep her calm during the experience. She coached Hodges, a first-time mother, on breathing techniques and birthing positions. She helped Hodges make decisions when the pain was too unbearable for her to think straight.

And then, after the baby was born, the doula coached her on breast-feeding and coping with new motherhood.

In short, Hodges’ doula helped her navigate the stresses of pregnancy and childbirth, she said.

“The doula was just a tremendous help,” said Hodges, whose daughter, Loretta, is now 9 months old. “She helped give me a sense of calm and purpose. … She supported and guided me through the whole process.”

More Valley women are discovering the benefits of calling on a doula — a person trained in childbirth education, breathing and supportive techniques who provides emotional support to the mother. The word “doula” means “woman’s servant” in ancient Greek, according to DONA International, an organization that certifies doulas.

Doulas aren’t licensed by the state, but some are certified by DONA and most complete several hours of classes on childbirth, including the Lamaze method, as well as on relaxation techniques and breast-feeding. Doulas aren’t licensed to perform medical exams or run tests.

Hoping to show results

“The biggest duty of the doula is to support the mother in labor,” said Noelia Galvan, coordinator of the Rio Grande Valley Doula Program. The new program will offer free doula services to 100 women who are patients at the region’s community health centers, such as Su Clinica Familiar in Harlingen and Nuestra Clinica del Valle in Pharr.

The doula pilot program is funded by a grant from the U.S. Department of Health and Human Services. The program’s organizers hope to show that doula services improve the mental health of expectant women and new mothers.

“There’s a lot of need in the Valley for women who are pregnant to have this kind of support,” said Gloria Casas, manager of the Healthy Start program, an outreach effort that targets mothers at risk of complications.

The program is offered through Valley Primary Care Network, a coalition of four community health centers. The network is helping to launch the program, along with Holy Family Birth Center in Weslaco, Migrant Health Promotion and South Texas Behavioral Health Center, among others.

“Hopefully we can show (results) and expand it,” Casas said.

Doulas-in-training

Fifteen women — some of them social workers, some retired nurses, many mothers themselves — are currently undergoing training to participate in the program. When the organizers advertised the workshop, the response was overwhelming, Casas said — more than 60 women called, wanting to sign up for training.

The doulas-in-training said they wanted an opportunity to help pregnant women and be health advocates for them.

“When I attended the training, I was really impressed at how much one person can help (a pregnant woman),” said Amy Gonzales, an AmeriCorps volunteer at Holy Family Birth Center who is training to be a doula. “The help you’re giving is going to have an impact.”

A few studies have suggested that a doula’s presence can reduce the need for pain-relieving medications and epidurals and lead to shorter labors. A new study from the Boston

University School of Medicine also found that women who had doulas in childbirth were less likely to have C-sections and more likely to breast-feed their babies.

“It’s something that’s going to affect the outcome from the very beginning,” said Maria De Hoyos, a mother of five who is undergoing doula training. De Hoyos had a doula for her fifth childbirth and it helped ease the process, she said.

“I was much calmer,” De Hoyos said. “I had support … and I felt the difference firsthand.”

Doulas also can urge women to seek prenatal care. That’s the reason for Migrant Health Promotion’s program, which offers doula services to immigrant women at risk of complications.

That program’s doulas drive women to doctor appointments, provide education on pregnancy and childbirth and coach them on breast-feeding, said Lizette Pacheco, program coordinator.

“It’s our job to find resources for them,” Pacheco said.

Doulas in delivery rooms

Many doulas encourage women to write a “birth plan” outlining their preferences for the birth, such as the use of pain medication and techniques to use to ease labor pains.

The birth plan isn’t meant to replace a doctor’s orders but helps the woman remember and advocate for her preferences, organizers of the doula pilot program said.

Some doctors are supportive of having doulas in the delivery room, while others are not, said Galvan, the coordinator of the Valley program.

An article in American Family Physician, the journal of the American Academy of Family Physicians, suggests that women in labor could benefit from doulas because their presence can cut down on pain-medicine use.

“If we worked together, it would be wonderful for the mother,” Galvan said. “Doulas build a personal relationship with the client, which a doctor doesn’t always have much time to do. … We’re a support to (the doctor).”

There’s also something special about women supporting one another in pregnancy and childbirth, Galvan said.

“It’s empowering,” she said. “It’s the way it used to be, women helping each other, and that link has been broken as society has changed.”

New mother Hodges is glad she had a doula’s support.

“They help you stay healthy throughout your pregnancy,” she said.

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Melissa McEver covers health and environment issues for Valley Freedom Newspapers. She is based in Harlingen and you can reach her at (956) 430-6252.

Find a Doula:

Valley Primary Care Network - (956) 425-6200

Holy Family Birth Center - (956) 969-2538

What is a doula?

A doula provides emotional and physical support for expectant mothers, offering educational materials on childbirth, education on relaxation and pain-relieving techniques, coaching during labor and breast-feeding assistance. Doulas are not state licensed, but some are certified by DONA International or other associations and therefore have pledged to work under a code of ethics and specific practice guidelines. Doulas are not licensed to perform medical exams or tests and should not replace your primary healthcare provider.

Source: DONA International