May is International Doula Month and this month's Brilliant Activities for Birth Educators is all about how childbirth educators can incorporate a doula and the doula's skills at useful points during a childbirth class. You can access all the previous Brilliant Activities for Birth Educators posts by following this link here. Here are eight ideas on how a childbirth educator can integrate doulas and the concept of doula support into class time for a three way win, benefiting the doula, the childbirth educator and the families. The benefits of doula support have long been known (Hodnett, 2013) and in February of 2014, the American College of Obstetricians and Gynecologoists (ACOG) along with the Society for Maternal Fetal Medicine (SMFM) released a joint committee opinion that included doulas as an effective and underutilized tool for reducing the cesarean rate (Caughey, 2014).

"Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery. Given that there are no associated measurable harms, this resource is probably underutilized." - ACOG/SMFM

Invite Local Doulas to Your Childbirth Class as a Guest Speaker

Invite a local doula or two to come into your childbirth classes to share what a doula does and how they can help during pregnancy, birth and postpartum. Offer the doula(s) a few minutes prior to an appropriate topic (comfort measures? relaxation? birth positions?) to share how having a doula attend the birth can benefit families. If you cannot afford the few minutes during class, consider having them come for 15 minutes prior to class or right after class ends, to share the same information, while you are setting up or cleaning up.

Invite a Family Who Used a Doula to Share Their Birth Story

I like to invite previous class members who are willing to come back and share their birth and postpartum experiences with current class members. Consider inviting a familiy that chose to birth with the support of a birth doula or who used a postpartum doula in the days and weeks after the baby arrived. !0 or 15 minutes of class time can really provide a lot of benefits to your classes. They get to hear about a recent experience, see a brand new baby and learn how doulas supported the family.

Use a Doula as a Class Assistant

Consider inviting a local doula to assist you during your classes with set up and clean up and during class time. This will give the doula a chance to meet families who might be looking for birth or postpartum support. The families can learn more about how a doula can benefit them. If you do not need such consistent class support, why not invite some doulas to provide extra help during the specific class time when you cover comfort measures and practice positions. They can circulate with you to help families master the double hip squeeze, the lunge and other activities that promote progress and reduce discomfort. I always have a hard time checking in with a full class on an individual basis during these hands on learning sessions and a few experienced doulas can really make sure everyone gets personalized attention. If you are able, you can provide a small stipend for the help.

Doulas Can Support a Pregnant Person Who is Coming Alone

For a variety of reasons, a pregnant person might be attending a childbirth class without bringing a partner or other support person with them. They may attend class alone if they are a single parent, if your class time does not work for their partner, if their partner is deployed or working, or if other family members or friends are not available. You can invite a doula in to be a class partner for the pregnant person, so they have someone to practice with and support them during class time. Be sure to check in with the pregnant person first to be sure that this option is acceptable to them. Many people will appreciate the support during class of having someone focused just on them.

Provide a Doula Resource List

Offer your classes a resource list with links and information about where to find birth and pospartum doulas. Some helpful links might include DONA International, DoulaMatch.net (searchable database) and links to your local and state doula organizations. Be sure to include some potential questions families might want to use to screen and interview doulas. Don't forget resources for low income families who might be eligible for subsidized doula services from local hospitals, state or local agencies, doula nonprofits or other sources. Be careful to provide general resources rather than referrals to specific doulas so families can find the best fit.

Remember the Postpartum Doula

Doulas are not only for labor support. Having a postpartum doula support a family in the immediate days and weeks postpartum can help new parents with breastfeeding, emotional processing, baby care and learning to tend to a newborn, Postpartum doulas allow a family to get some rest, help with light housekeeping and meal prep and sibling care. When you talk about postpartum, breastfeeding and life with a newborn, postpartum doulas can be a part of that discussion.

Share the Lamaze International Labor Support Infographic

Lamaze has created a visually attractive and effective infographic that you can print and hang in your classroom or use during classroom discussions and activities. Provide this as a resource for the families you are working with by accessing the infographic here.

Healthy Birth Practice Three - Bring a Loved One, Friend or Doula for Continuous Support

Lamaze International's Third Healthy Birth Practice covers the benefits of a doula and includes references on the current research about doulas. This birth practice includes a short video that highlights the role of the doula. Consider showing this video in class or sharing with your students through email or social media.

Conclusion

Doulas are an important part of a safe and healthy birth. The evidence supports it. ACOG recognizes the value. Families deserve to receive doula information. Childbirth educators can incorporate doulas, share about doulas and provide resources and learning materials about doulas to families in their childbirth classes. May is International Doula Month, but doulas can be a part of every childbirth educator's toolbox all year round.

How do you share about doulas in your classes? What do you tell students and families? How do you like to teach about labor support to the families you work with? Share with us in the comments section.

References

Caughey, A. B., Cahill, A. G., Guise, J. M., Rouse, D. J., & American College of Obstetricians and Gynecologists. (2014). Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology, 210(3), 179-193.

Hodnett, E. D., Gates, S., Hofmeyr, G. J., Sakala, C., & Weston, J. (2013). Continuous support for women during childbirth. Cochrane Database Syst Rev, 7(7).

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