While hospitals and birthing centers have different approaches to childbirth, both settings can benefit from the addition of doula care. In hospitals, where OB-GYNs and other medical professionals closely monitor contractions and can administer pain medication (including epidurals), a doula can work alongside the team to provide continuous support and guidance. Birthing centers are only appropriate for low-risk pregnancies, given they don’t perform continuous fetal monitoring, nor provide epidurals, instead using non-medicated options to relieve pain. In both cases, doulas can offer invaluable assistance and reassurance. Let’s explore how doula care can complement traditional maternity care in both hospital and birthing center settings. Research shows doula care leads to improved physical and psychological outcomes for the mother and the baby.
The Role of Doulas in Medical Settings
In both hospitals and birthing centers, doulas play a vital role in supporting mothers and their families during labor and delivery. Here’s a breakdown of their responsibilities:
- Comfort and Support: Doulas provide emotional and physical support to the mother, helping her to relax and feel empowered.
- Advocacy: Doulas can advocate for the mother’s wishes and preferences, ensuring that her birth plan is respected.
- Communication: Doulas can help bridge the communication gap between the mother and the medical team, ensuring that everyone is on the same page.
Collaborative Models of Care: Success Stories
Several hospitals and birthing centers have embraced the benefits of doula care by integrating doula programs into their services.
- New York Presbyterian Brooklyn Methodist Hospital: This hospital launched a doula program in 2020, offering free doula support to parents. The program’s success led to its expansion to include both birth doulas and postpartum doulas.
- Urban Midwife Associates: Based at Boston University Medical Center, this practice developed the Birth Sisters model in 1999. Doulas from local ethnic communities were trained to provide culturally sensitive support to pregnant women. They were trained by DONA International trainers and the hospital’s midwife practice. As many as 40% of the hospital’s birthing mothers received Birth Sisters services in 2007. Since then, focus has shifted to socially high-risk mothers, and services begin at 24 weeks of pregnancy. The program has shown positive outcomes, including a reduction in cesarean sections and increased breastfeeding rates.
Bridging the Communication Gap
Doulas play a crucial role in facilitating communication between birthing parents and medical staff. By providing information and advocating for the mother’s wishes, doulas help to ensure that everyone is on the same page.
- Information Broker: Doulas can help the mother understand medical information and make informed decisions.
- Advocate: Doulas can advocate for the mother’s preferences, ensuring that her birth plan is respected.
- Support: Doulas can provide emotional support and encouragement, helping the mother to feel empowered and confident.
Navigating Challenges: Building Positive Relationships
When working in a hospital setting, doulas may encounter challenges due to the medical model’s emphasis on intervention. It’s important for doulas to provide mothers with the information they need to make informed decisions, even if things don’t go according to their original birth plan. However, it’s encouraging to see that organizations like the American College of Obstetrics and Gynecology (ACOG) have endorsed the use of birth doulas, and many healthcare providers are becoming more open to their role.Â
When interviewing potential doulas, be sure to ask how they would navigate any friction they might encounter with hospital staff. Their approach to these situations can significantly impact the overall atmosphere in the room and your birth experience. For example, would they prefer to have a private conversation with the doctor or involve you in the discussion?
One experienced doula offers advice on how to foster positive relationships between doulas and the hospital staff:
- Respect Medical Expertise: Acknowledge the medical team’s expertise and encourage the mother to ask questions and seek their opinions.
- Approach with Curiosity: Show humility and curiosity, appreciating the different perspectives that healthcare providers bring to the table.
- Build Trust: Foster mutual respect and trust between the doula and the medical team. This benefits everyone involved, especially the mother.
Conclusion
Collaborative birth care models, which integrate doula support into hospital and birthing center settings, have demonstrated positive outcomes for both mothers and babies. By emphasizing a less interventive approach and focusing on the overall well-being of the birthing person, these models can lead to improved perinatal outcomes and deeper satisfaction of individual birth experiences.
As more hospitals and birthing centers adopt or adapt to doula care, we can look forward to a future where mothers and babies receive the comprehensive support they deserve. The benefits of collaborative care are clear, and it’s exciting to see this approach gaining momentum.Â
