Doula offers physical, emotional and informative support to pregnant women.

The pregnancy? from discovery to delivery? It is a very important phase in a woman's life. Is this a period that also requires special attention and care? care that extends even to the postpartum period.

Is it in this context that many women choose to hire a doula? which is, in short, the woman who gives the pregnant woman physical and emotional support before, during and after childbirth.

The World Health Organization (WHO) and the Ministry of Health in several countries (such as Brazil) recognize the doula profession and encourage doula support in childbirth.

The role of doula is, in short, to offer comfort, tranquility, encouragement, emotional and physical support and also information to the pregnant woman during this period of intense transformations she is experiencing.

There are, however, many doubts and confusions surrounding this important profession. Many women do not know, for example, what a doula does and what a doula cannot do. Below, Alaya Dullius de Souza, acupuncturist, doula and mother, clarifies the main questions on the subject.

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What is a doula?

According to Aláya, the doula is a female figure who fills the gap created in the hospital setting by the presence of one woman supporting another woman. Is doula's role to serve the woman in labor, does she provide informative support? Considering that knowledge and access to good information bring a safer and more conscious way to make choices - answering questions and helping prenatal women understand their desires and what to do to achieve them ?, he says.

During childbirth, Aláya adds, the doula gives physical and emotional support and is available to the pregnant woman whenever she needs it. “It's that friendly shoulder who understands the subject, who won't scare with stories or myths, who will welcome and explain, respect and embrace. While everyone is concerned about technical procedures and the baby, doula focuses on the mother ?, explains.

And being a trained professional, says Aláya, doula has a look used to childbirth. "Does it calm even present parents, as she acts as a guide step by step, embracing the woman's emotions, suggesting positions, serving her in whatever she needs?" be it a cold towel on the forehead to dry the sweat, reach for a glass of water, or massage during contractions, he says.

The doula is like a "personal birth trainer," Aláya compares. "She is there for the woman, and she deeply believes in the woman's strength, and gives her verbal strength to move on, even when everything seems difficult, and has strong arms to support the woman physically," he says. "It is someone who is there for what you need, but with a trained eye and attentive to the stages of labor," he adds.

What doula does X what she doesn't do

What a doula does:

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• Provides physical and emotional support, making it available to the pregnant woman whenever she needs it.
• Especially at the time of childbirth, she is present with the parturient, offering emotional support, encouragement and tranquility. It favors the maintenance of a pleasant, cozy environment, with silence and privacy.
• It suggests positions to make the parturient feel more comfortable, offers other measures of physical comfort, such as massage, relaxation, breathing techniques, baths.
• Provides information, explaining medical terms, hospital procedures, dispelling myths about childbirth, etc.
• Before childbirth, the doula guides the couple on what to expect from childbirth as well as postpartum. Helps the pregnant woman prepare physically and emotionally for these moments.
• The doula may still be present postpartum, assisting the mother in her contact with the newborn and regarding breastfeeding.

Aláya points out that the doula:

• Does not perform medical or nursing procedures such as touch examination, blood pressure measurement, checking the baby's heartbeat.
• It is not the role of doula to perform any technical procedure or to apply any type of medication.
• The doula also makes no decision for the parturient, but welcomes her wishes and encourages the woman in her choices, helping her to receive the information she needs to make conscious choices.
• The doula does not replace the parturient's escort of choice.

The advantages of having a doula to help the baby come

The doula offers physical, emotional and informative support to the pregnant woman.And according to Aláya, research has shown that doula's performance in childbirth can:

• Decrease cesarean section rates by 50%;
• Reduce by 20% the duration of labor;
• Reduce by 60% anesthesia requests;
• Reduce by 40% the use of oxytocin;
• Decrease the use of forceps by 40%.

"There's a phrase by John Kennell that says, 'If doula were a medicine, it would be unethical not to prescribe.' The presence of a doula in childbirth can make the experience more satisfactory for women ?, says Aláya.

Doula is not a midwife

This is a very common question among people: what are the differences between a doula and a midwife? A lot of people still confuse the functions.

However, they have extremely different roles. • The doula has no legal and technical responsibility in relation to childbirth. She does not give birth care, she is not necessarily a health professional ?, highlights Aláya.

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She assists and supports the woman in labor, giving physical and emotional support. Can we say who does? childbirth is the woman herself because it depends on her and happens in her body, while the midwife (whether she is a traditional midwife, an obstetrician, obstetrician or midwife) assists the childbirth (preserving the health of the mother and the baby), and doula assists the woman (providing everything she needs at the moment). While the team is busy monitoring mother and baby, evaluations and health care, is doula busy with the mother ?, explains Aláya.

The role of doula in humanized childbirth

Does doula play a fundamental role in humanized childbirth, which is, in short, a term that defines the return of human practices, from birth to the reception of the baby, and also in postpartum? That sees women as protagonists of her birth and her gestation in general, knowing that as a human she has her instincts and that childbirth is a physiological process and not something that always needs intervention.

Aláya points out that, before delivery, the doula guides the pregnant woman on what to expect, explains how labor happens, and prepares her for the details of this journey. ? Explain the procedures, assist in choosing the team, ask questions, such as a guide that gives a? Map? of the way, so that the pregnant woman can prepare her? backpack? and know where you will step ?, he says.

During childbirth, the doula is the person who will often? Guess? what the woman needs, adds Aláya. "She will seek to ensure your physical and emotional well-being, your thermal comfort, your nutrition and hydration, and especially support in positions, smiles in pain, words of encouragement, and will" translate. what is happening, functioning as an interface between the medical terms and the parturient ?, he says.

The doula will also make the place more cozy, Aláya emphasizes, or help the woman relax with breath and propose non-pharmacological measures to relieve pain, whether it be showering, postures or massages.

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"In the postpartum period, doula usually visits the family and assists in breastfeeding and first care of the baby," adds Aláya.

How to find a doula?

The best way to find a doula is by looking for support groups for humanized pregnancy and childbirth in your city, according to Aláya. They are usually groups coordinated by doulas, who know other doulas. Internet groups and some sites also gather the contact of some experienced or beginner doulas ?, he says.

Most people hire the doula by referral, the old word-of-mouth, Aláya adds.

Many doulas start acting on a voluntary basis to gain experience, either by helping friends or volunteering in public hospitals. Each doula will act in their own way and have their own packages. of care (visits and meetings before and after delivery, care in childbirth), the important thing is to find one with whom you have affinity and feel confidence, after all it will be there for you at a fundamental moment in your life ?, highlights Aláya .

Also according to the professional, the values ​​range from $ 500 to $ 2,000, depending on the region of the country, the experience of doula and what it adds in its service.

Who can become a doula?

Aláya points out that any woman with a deep desire to help other women, and complete confidence in the physiology of childbirth, that it is possible for women to give birth in a transformative way, can become a doula.

“To become a doula, it is important to understand that the pregnant woman is the protagonist of her birth, and we are only supportive willing to indulge in an action of deep care and affection, which may take a few hours, or many, that may require us to stay. awake all morning, get wet in the shower and be tested physically and emotionally ?, highlights Aláya.

A doula need not necessarily be an activist, but she must not accept inwardly the injustices and all the wrong and violent she sees in the prevailing obstetric system, Aláya points out. "Doula's commitment is to the woman, and only to her," he says.

The doula explains that there are courses of doulas in several Brazilian cities, and they give an initial preparation, but the woman should also try to study hard for herself, and seek to be always updating.

"In the end, doula is just a servant, but even for that you have to know how to serve well, and that includes respecting a woman's decisions even when they're not the ones you would make for yourself, and even knowing how to explain the facts yourself. when they can upset the pregnant woman, because what we want is to help women make their own choices consciously ?, concludes Aláya.

Statements from those who have already been assisted by doula

Cecilia Nassin, a 35-year-old lawyer, says she decided she wanted a doula for her first birth, early in her pregnancy, when she became more interested in natural childbirth. "I researched and had already exchanged emails with some doulas, but when I met one of them personally, I was sure of my choice?" Was she a great person? He says.

Cecilia says that she and doula spoke almost daily during pregnancy, either by telephone or by message, in addition to meetings (in person). “She was important in every phase, but especially in the“ finals, ”when I was feeling very anxious. But she calmed me too much? She says.

On the day of delivery, then, no comments? My doula helped me in every way, it was my 'safe haven'. She helped me to ensure that all my wishes were respected. I just have to thank her for having her by my side, and I have great memories of my pregnancy and also of my birth ?, says Cecilia.

Amanda Furlan, 32-year-old physical educator, says she has always been interested in doula's profession and had no doubt that she wanted to accompany one when she was having her baby. “My doula, who was actually already a friend of mine, was fundamental to me. Removed all my doubts, calmed me when necessary? It was lovely how much she understood the subject, how much it gave me tranquility. So much so that at the time of childbirth, I don't think I was very anxious, afraid. And she was there by my side all the time, was it very good?

Now you know more about the doula profession, you know what she can and cannot do, and especially how she can make a difference throughout pregnancy and especially at birth.

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