The Doula Book
Written by Dr. Marshall Klaus, Dr. John Kennell, and Phyllis Klaus CSW
I happened upon this book while browsing the lending library of a local birth center a few weeks ago, it looked interesting so I borrowed the book to see what it was all about. I found that it is a very short and easy read (1-2 days is all), the layout of the book is easy to navigate, and the pictures are helpful in seeing what a laboring woman can look like with various types of support.
The topics covered in The Doula Book are:
1) The Need for Support in Labor
2) The Special Role of the Doula
3) Enhancing the Birth Experience
4) Reducing Discomfort, Pain, and Anxiety in Childbirth
5) Obstetric Benefits of Doula Support
6) Longer-Term Benefits of Doula Support
7) Birth with a Doula
8) A Father’s True Role
9) The Dublin Experience
10) Postpartum Care
Appendix A: The Training of a Doula
Appendix B: Relaxation, Visualization, and Self-Hypnosis Exercises
Appendix C: Characteristics of Randomized Clinical Trials of Labor Support
Appendix D: Resources
One thing that was unclear throughout this book is who is it written for? Who is the audience? Some parts seem to be directed towards moms, some towards father’s, and near the end it seems like it wouldn’t be helpful for parents, but it’s written more like an introduction to doula-ing a 101 type book. I didn’t like that it had an unclear audience as it can be a bit confusing.
Information for moms:
The authors of the book are trying to normalize various birth experiences, settings, behaviors, and needs that women can have. They talk about how fundamental birth experiences are, how they are transformative times in a woman’s life, that past experiences mold how women go into labor and view themselves, and how labor can have a big impact on a woman’s self-view that continues throughout her life. Because of the significance of the labor experience, it’s important to make decisions that are going to be best for you, to have individual care, and a birth team that meets your needs.
The authors site many studies that have been done across the world that show the unique benefits that having a doula present can have on labor outcomes, this is mostly described in chapter 5, but references are made through all of the chapters. The research studies show that doulas help shorten the length of labor by hours, decrease cesarean rates, epidurals, and medications for pain management, decrease the need for an induction or augmentation of labor, decrease overall cost of births (sometimes as much as thousands of dollars), and increase breastfeeding success.
To help mothers have a better understanding of how doulas can help them, there is an entire chapter (chapter 7) which explains what to expect when you hire a doula, some of the techniques used to help with physical discomfort and emotional support, things doulas can do in a hospital and homebirth setting, and in chapter 10 the authors review what postpartum support from a doula can look like. It’s a nice overview of a doulas role which is brought to life with examples and stories.
Information for dads:
Many fathers (or partners) have some hesitancy towards hiring a doula out of fear their role will be overshadowed by the doula, that they will miss out on the full birth experience, or that they will no longer be needed if a doula is there providing support. I often hear from women that they want a doula, but they “need to convince their husband that it’s a good idea first.” For any couple that finds themselves having these conversations, I highly recommend reading chapter 9 “A Father’s True Role” because it is written directly for fathers.
Sometimes there is a worry when hiring doulas of “I must not be good enough if she needs more support” which isn’t true at all! Studies have found that the support provided by doulas and fathers are actually very different, the roles may sound the same (be there to give support, comfort, and encouragement to the woman), but in practice the roles compliment, instead of overshadow. When fathers are at births without a doula present, we notice that they stand further away, are not in the room as often, provide less physical support, and talk less. But when fathers and doulas work as a team to support the laboring woman, we see that fathers feel more confident in their supportive role, they remain with the woman for longer periods of time with less breaks, provide more physical contact and intimate support, are more available emotionally, and they watch the monitors less. We believe fathers are able to provide better support with the help of a doula for two reasons:
1) They are able to learn from the doula and copy her behavior, and
2) They feel less pressure because they are no longer the sole person responsible for providing care and encouragement. When fathers are in the presence of someone more experienced in birth, they can relax more into their supportive role and be more emotionally available during that time.
Information for doulas:
It doesn’t really seem like the book is geared towards doulas until the last little bit, and then it’s written like an introduction guide to doulas, or a book you would be assigned to read in a “doula 101” college class. So for new doulas, or for women who are considering becoming a doula, this is a great book and I would recommend reading it before or during your doula training. I don’t think it’s as helpful for the more seasoned doulas out there because it does address a doulas role on a pretty basic level.
Topics such as doula training, general guidelines/scope of practice, assisting women through the different stages of labor, postpartum visits in hospitals and at home, and a few paragraphs on assisting women with a trauma background (definitely not enough on this specific topic to be considered a comprehensive overview though).
Overall, it’s a good read for early pregnancy, partners who are uncertain if they want a doula present or not, and women interested in becoming doulas.