One Labor-Intensive Job

(2 of 3)
The role of a labor doula varies depending on the needs and desires of the parents. For some people, the support of a doula is more important after the actual labor. Ruth Callahan of New York City owns Doula Care, a service that provides postpartum home services, including help with breast-feeding, new-baby and new-mother care. The doulas might even run errands or baby-sit siblings. "I was much more interested in the transition into motherhood--teaching them about breast-feeding and helping them gather their confidence," says Callahan. Doulas tend to specialize in either labor or postpartum work but rarely do both.

Training and certification for both types of doulas are available through various organizations (see box), though there is some debate among the doulas themselves over the need for certification. "Some people feel very strongly that being certified isn't what makes you a good doula," says Lijah Friedman, a DONA-certified doula based in Brooklyn, N.Y. "It's creating a political and selective situation in the doula world." Most doulas think that while training and certification don't guarantee quality services, the knowledge can't hurt. Says Guralnick: "Your heart and hands are the most important. If someone's not certified, they're not necessarily less qualified."

Debra and Ash Suri, a Manhattan couple in their early 30s, are expecting their first child at the end of this month. After reading several childbirth books and attending a Lamaze class, Debra decided she wanted to have a doula present at her baby's birth. She interviewed several women and chose Guralnick. "I really wanted to go with a doula, because Barbara has so much knowledge and experience, and I find it very comforting to have somebody there with us from the beginning to the end, to be able to answer our questions," says Debra.

Individual doulas follow their own routines, and Guralnick includes two pre-natal visits with a couple to get acquainted and go over options. In a meeting in the Suris' apartment--Ash's first with the doula --Guralnick provides the couple with documents and reviews topics like pain medication and various interventions that can be used during labor and delivery. Debra sits on the massive 75-in. ball to get accustomed to how it feels. (Women in labor often find the ball more comfortable than a chair.) She guides them through massage techniques and positions that ease labor pain, demonstrating for Ash what he might be called upon to do on the big day, and shows them a birth-and-labor video, which serves as a springboard for questions.

"I thought you were here to do my job," says Ash with a laugh. His comment raises a pressing issue: If a doula is providing all this physical and emotional support for the woman, what's Dad supposed to do? While Ash is relieved that Guralnick will be there, many birth fathers feel a bit wary and even threatened by the news that their wives want special help from another nonmedical person. Good doulas make fathers feel more involved and more useful at a stressful time.