Doulas consider the spirituality of birth

The comfort of another woman at the births of her three children was invaluable to Rina Grossman, so much so that the young mother decided that helping other women give birth was her calling.

Grossman, 29, is a birthing doula — a woman who provides emotional, physical and informational support to women when they need it the most. Doulas, also called “labor specialists” or “birth assistants” serve as advocates, labor coaches and information sources for the mother and her partner.

Often, doulas meet with the parents in the second or third trimester to get acquainted and perhaps help them prepare for birth. At the birth, they usually work with the birth team but remain focused on the mother, her partner and their needs. She may also provide information about birth options.

Studies have shown that women assisted by doulas have less need for drugs or epidurals. Doulas mother the mothers at a time they need it the most.

Grossman, who chose to have her children at home, recalls her own labors.

“My doula saved me,” Grossman said. “I had back labor and she knew what to do.”

The word “doula” comes from the Greek and literally means a woman servant. Since the beginning of time, women have helped other women give birth; it only changed at the beginning of the 20th century, when hospital births became the norm, said Grossman.

 “Hospital nurses cannot be with the woman for the entire labor,” Grossman said. “That is the job of the doula.”

Doulas participate in hospital and home births. Doulas are not required to be midwives — they do not take the mother’s blood pressure or check for dilation. Rather, they do what they can to provide comfort and support — from monitoring the temperature of the room to massaging the laboring mother to facilitating communication with medical personnel.

Sometimes that involves hard physical work. At a recent birth Grossman massaged the mother and walked with her during her labor. “It can be exhausting,” she said.

Grossman is part of a small but committed cadre of women trained to do the job. The Chronicle spoke with three local Jewish women who all work to help parents prepare for birth and guide them through the process.

“Scariest times”

Grossman expects to be certified by Doulas of North America, an organization formed in 1992, after she attends her third birth later this month. She attended classes in New York.

Training consists of reading, 16 hours of workshop and evaluations after participating in three births. The doula must also write accounts of the experience.

Leah Robbins, a mother of nine who has assisted at many births, is now completing her doula training.

“The birth experience is something I’m familiar with,” Robbins said with a laugh. “When I was younger, we used to go with our friends and help each other out. I didn’t know about doulas, but that’s what I was doing.”

The first woman Robbins helped who was outside her circle of friends was in a difficult relationship and she was unsure if the baby’s father would be present. Her mother had died and she had no one else to call on.

“Birth is an exhilarating experience,” Robbins said. “But it’s also scary. The doula is there to offer support and comfort at the scariest times.”

Robbins described the role of the doula as relatively passive in a hospital birth: If the mother wants medication or an epidural, the doula helps her communicate that to the medical staff.

Louise Rachel, an instructor of the Bradley Method of Natural Childbirth since 1986, became a doula in response to requests from women in her classes. She completed her doula training in 2002.

Typically, Rachel said she meets with the parents-to-be a couple of times before the birth if they have not attended her childbirth classes.

Rachel said she has only assisted in hospital births but would be thrilled to help at a homebirth.

One part of the doula’s job in the hospital is to be a communication bridge between the mother and the medical staff. Sometimes that means reassuring women that they have options, Rachel said.

She recalled a time when a nurse came in to do a regular cervical check.

“The mother looked at me and said ‘do I have to?’” Rachel told her, “That may help with their charting but it won’t get the baby out quicker.”


Find a doula — The Association of Labor Assistants and Childbirth Educators — Childbirth and Pospartum Professional Association — C.A.R.E. Network — Doulas of North America — Doula Network — The International Childbirth Education Association 



Shifra and Puah

For observant Jewish women, doulas are especially important, Robbins said.

Jewish law limits when a husband can touch his wife during the birth process and has modesty requirements.

“My husband would step behind a curtain at the time of the delivery,” Robbins said. “Having a doula present does not push a husband out. It enhances and helps that relationship.”

Jewish law also played a role in Sophie Fox’s decision to have a midwife present in June for the birth of her third child. Her husband, a holistic practitioner, was an active participant in the birth but stepped aside at the end for religious reasons.

“There’s a certain comfort that one can’t get from one’s husband,” said Fox. “It’s something another woman can understand.”

Grossman, a friend of Fox’s, sent her a birth bag — a bag containing relaxing CDs, a reference book, candles, energy drinks and other helpful tidbits. Robbins was also present during the labor and delivery.

The degree that faith and prayer play a role in the process depends on the parents — the doulas all said they are not there to impose their beliefs. Still, the women say the process is religious for them.

For Robbins, Jewish doulas are the symbolic daughters of Shifra and Puah, courageous midwives from the Passover story whose fortitude played a role in the Israelites’ liberation.

Being present when two of her daughters gave birth was especially powerful for Robbins.

“When you are in the room during a delivery, you feel there a power beyond that of the woman,” she said. “You feel like you are in the presence of God.”

Doulas’ fees range from approximately $300 to $1,000. In some cases, a portion of the expense is paid by hospitals. Post-delivery doulas, women who teach and support young mothers in the so-called fourth trimester, are also available.

Marie Rohde is a Milwaukee-based freelance writer.