- The Washington Times - Sunday, May 27, 2001

Once upon a time, a woman giving birth was surrounded and encouraged by her extended family. Modern times, however, have meant mothers-to-be no longer live close to their own mothers and grandmothers. Most births occur in a hospital, attended by a physician and an often-nervous partner.

That´s why some women hire doulas to encourage and comfort them during labor and delivery.

A doula, which comes from the Greek word that means "women´s servant," is a trained labor companion who offers the mother support during delivery and the postpartum term. A doula provides no clinical or medical services but may do whatever else the patient requests, be it to give a back rub, provide breast-feeding support or distract older children.

"We provide comfort measures and act as an advocate between the mom and the hospital staff," says Kristie Ridd-Young, administrative director of Doulas of North America (DONA), a 3,200-member organization that trains and certifies doulas.

"Often, these responsibilities are a lot for the dads to handle," she says. "We have found that some dads are actually more involved if a doula is present for guidance."

A relaxed mother can mean a smaller chance of such complications or interventions during a birth as the use of forceps and medications, Ms. Ridd-Young says.

A 1998 study of 361 women that was published in the journal Pediatric Research reported that rates of Caesarean sections in induced labors dropped from 64 percent to 20 percent if a doula was present. The study was conducted by Susan Landry, a professor of pediatrics at the University of Texas at Houston,

"When women are happy and relaxed, labor goes faster and happier," says Wendy Sewell, a DONA-certified doula who serves clients in Northern Virginia. "Long ago, when women went into labor, they had friends, neighbors and relatives there to make them happy. A doula provides some of that role.

"A doula also eases some of the personal responsibility for nurses," Ms. Sewell says. "Nurses just can´t provide that sort of support. They have too many patients and paperwork. With a doula, nurses can monitor more than one woman at a time. It is a plus for everyone concerned."

Cindy Belsky, a Chantilly mother of four, used Ms. Sewell and a midwife during her last two deliveries at Fair Oaks Hospital.

"Having a doula let Charlie, my husband, just be a dad rather than being my caretaker," Mrs. Belsky says. "Even though I was having my third child, Charlie didn´t always know exactly what to do. When he knew I was being taken care of so I could relax, he was actually able to step in and participate more."

Mrs. Belsky enjoyed the experience so much that she is studying to become a certified doula. To be certified by DONA, doulas must study materials at home, undergo a three-day training session and observe three births, after which they will be evaluated by the mother, nurse and doctor, midwife or both.

A doula´s services typically cost between $295 and $895, depending on geographic location, Ms. Ridd-Young says. That price generally includes two prenatal visits to help the mother practice relaxation techniques and to discuss what sort of duties the mother may want the doula to perform during labor; the doula´s presence at the labor and delivery; and two postpartum visits to check on the mother´s well-being.

Doula services usually are not reimbursed by insurance.

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