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Thursday, September 29, 2005 | A young woman, clad in a hospital gown and visibly pregnant, walks slowly down the hall of the Birth Center at UCSD Medical Center. To her left is her husband. To her right is a woman she met only an hour ago, her volunteer doula, a member of the Hearts & Hands Volunteer Doula Program.
Suddenly the mother-to-be stops, turns to her husband and throws her arms around his neck, leaning into him and moaning softly as another contraction begins. Her doula gently rubs her lower back and whispers encouragement. “Great job, keep breathing just like that. Relax your shoulders, that’s good, relax your face, just let it go. Perfect. You’re doing great.” Gradually the pain subsides and the trio turns to continue their unhurried promenade down the hall.
“Doula” is a Greek word meaning “woman servant or handmaiden.” The role of a doula is to provide physical and emotional support to a woman during her labor. Doulas “hold the space” for women as they labor, keeping them grounded, offering comfort, and educating them and their loved ones about the birth process.
To help with relaxation and pain reduction, they employ techniques such as massage, aromatherapy, acupressure, position changes and music therapy. Numerous studies have shown that birth outcomes for mother and baby are enhanced by the presence of a doula; interventions such as Pitocin (a drug used to increase the strength and frequency of contractions), epidurals, forceps, and cesarean sections are reduced.
The Hearts & Hands Volunteer Doula Program at UCSD Medical Center in Hillcrest is the only program of its kind in San Diego County and one of the largest in the nation. Women wanting to become doulas must attend an eight-hour introductory training course and a tour of the birthing facilities. Novices are then paired with mentors, volunteers who have already attended births and can train new doulas.
Ann Fulcher is the Hearts & Hands program manager. She has been with the organization since its inception, and wrote the grant that now funds the program.
“Our mission is to provide a trained doula for any laboring woman who wants one. Our goal is to double the number of active doulas from a current roster of about 40.” They are also looking for diversity, hoping to find women representative of the many cultures in San Diego interested in becoming doulas to help women from within their own communities.
Jennifer Yeast is the community outreach and training coordinator for the program. Training for new doulas takes place every month.
“Sometimes women come to the class eager to sign up, not realizing what a time commitment this is,” Yeast said. “Once you agree to attend a woman’s labor and birth, you’re there until she delivers, no matter how long it takes.” Statistically, the average time volunteer doulas attend a laboring woman is 14 hours, but it can be shorter or longer.
Interested volunteer doulas also can receive training to work with specific populations of women. For instance, pregnant inmates at the Las Colinas Detention Facility are sometimes brought to the UCSD Medical Center to deliver their babies. Doulas must first attend an in-service at the jail in order to assist at these births. The prisoner is not allowed to have family members or friends present at the birth, so a doula can be especially comforting.
The UCSD Mother, Child & Adolescent HIV Program (MCAP) is a multidisciplinary team of HIV specialists who provide comprehensive prenatal care, along with social and mental health services, health education and peer advocacy. Women who are living with HIV/AIDS have specific medical needs during labor and the MCAP program teaches the doulas who will work with them about those special requirements.
Mayri Sagady-Leslie, CNM, MSN, current director of the UCSD Nurse Midwifery Service and the UCSD Birth Center, started the Hearts & Hands program at the urging of Linda Levy, head of Maternal Services at UCSD.
“Creating the volunteer doula program at UCSD Medical Center was a ‘win-win-win’ situation,” Sagady-Leslie said.
Women training to become professional doulas had a venue for attending births. Second, the assistance of a doula is helpful to the staff. If a nurse has several patients at once, it’s reassuring to know that the doula will be a continuous, one-on-one presence for the laboring woman. Third, and most importantly, the volunteer program is an opportunity for women who may not be financially able to hire a doula to have the benefit of one provided free of charge.
Women interested in becoming a volunteer doula with the Hearts & Hands program may call Ann Fulcher or Jennifer Yeast at (619) 543-6269.
Susan Humphrey is a freelance writer, volunteer doula and mother who lives in Lakeside.