A birthing "Doula", the Greek word for "woman helping woman", helps a mother through labor by giving emotional support, encouragement, and information.

Many people are of the opinion that a doula is an "extra" in the birth team, that she is a nice touch, but not necessary. However, a doula is a valuable member of the team who fulfills a unique role during the labor. No other member of the team comes to the mother in early active labor and stays until mom and baby are comfortable and nursing. Midwives come close, but their focus is on the clinical aspect of the labor and birth. Doulas get the unique privilege of focusing on nurturing the mother and her family and/or other support people. Our job is very straightforward: comfort the mother and her family, and be a source of encouragement and information. The job doesn't get clouded with clinical tasks.

It is interesting that pregnant mothers, even very well educated and informed mothers, will often make great birth plans, and then walk into the hospital and forget everything theyÕve learned and behave helplessly. They often speak of feeling intimidated and frightened. Their partners, with the thought of the safety and health of the mother and child coupled with the fear they frequently feel at being helpless to relieve the pain of labor, often don't provide the support they need to refuse unnecessary treatments and procedures that they knew they didn't want before they arrived at the hospital.

Women who want to use deep abdominal breathing will often allow their staff to coach them into using shallow chest breathing. Women who want to birth in their own position will often allow the staff to turn them to the lithotomy position, even though they know the hazards of it. Women who want a natural birth will give in to the pressure that they feel their doctor is placing on them to induce when their due date approaches and there is no sign of spontaneous labor. The list goes on.

That's where the doula comes in. She can be the bridge between a woman's desires for birth and the reality with which she is presented. Prenatally, when a client talks to her doula about pressure to induce, they can discuss the ramifications of inducing and not inducing. They can discuss the pros and cons of common procedures and the doula can be the sounding board for the mother so she can clarify what it is that she wants from her birth experience.

Once labor begins, she can be the support for the family who chooses to do things that may not be supported by the staff. She can be the stabilizer when another family member, such as a grandparent-to-be, is upset with them for not making decisions with which they agree. She can be the person who is there to hold the hand of a mother who's labor has not gone according to plan and is now having to make changes in her mental image of birth. She can be the one who helps the mother who is frightened of labor, and had no intention of natural birth, to breathe calmly until pain medication can be obtained. The doula provides continuity of care by working and bonding with the family prenatally, helping them through their labor and birth, and then post-natally visiting the family to see that all is well.

We may well someday discover that the doula is the first line of defense against post-partum depression. Helping a woman feel empowered to make her own decisions during her pregnancy and birth, helping her to not be put in a position where she feels like a victim, and enabling her to process her birth afterward may go a long way with many women who hope to avoid postpartum depression. Likewise, she may be the first line of defense against child abuse when it is caused by a weak mother/child bond. When she is free to hold her child in the sensitive few hours after birth and is assisted with breastfeeding problems, as many doulas do, the bond between the mother and child is made stronger so that hurting that child would be like hurting her own soul.

Doula care not only improves the experience of childbirth for the family, they help to provide the right start to a better future for the family. Every woman, every family, deserves a doula.

Alison Haasch, childbirth educator trained at The American Academy of Husband-Coached Childbirth, is now an independent childbirth educator, a DONA trained doula, and a breastfeeding counselor. She is the mother of two.