Català

What does a doula service include?

It includes, as a minimum, two pre-natal meetings (generally within the third trimester), complete support from the onset of labour and right through to the end of the birth process, as well as two visits during the week following birth. A post-partum doula service includes several meeting at home, with a frequency and duration established by the mother’s needs and during the 15 days following birth approximately. This is a general rule, and flexible to be catered to the mother’s needs and her arrangement with her own doula.

Who substitutes the doula if an unforeseen event takes place during labour?

It is practically impossible to know the exact moment when labour will start. It is for this reason that doulas will arranged for a second doula to be on call as a preventative measure.

Does the Catalan Public Health Service recognise the figure of the doula?

At the present moment the figure of the doula is not recognised by the health system in Catalan Hospitals. Despite this, the role of the doula is becoming more popular and widespread and its acceptance will depend on every particular medical team. Different hospitals have different birth plans as well and some can strictly stick to its regulations.

During a Hospital birth, is the doula allowed to be with the woman? If I’m not allowed to have her, can I be made to choose between her of my partner?

The current system in Hospitals in Catalunya usually limits the number of people who can be with the mother to one, without specification to the relationship between them.

The flexibility on this rule varies depending on the Hospital, with some of them allowing only one person with the mother (in which case the mother has to choose who she wants by her side), and others accepting more than one person as long as the birth progresses without any complications.

It is important to know beforehand every Hospital’s birth protocol to plan accordingly. It is not advisable to add unnecessary stress at the last moment.
The doula´s role is not limited to the moment of birth, but includes the period before and after it. In the event of not being allowed to go into the delivery room, the doula can stay in the waiting room until the baby is born and continue accompanying the mother as long as she might require her to be there.

Recently (2007) the Conselleria de Salut de la Generalitat approved a new Protocolo de Atención Natural al Parto Normal (Natural Care Protocol for Physiological Birth), now in phase of implantation, and whose objective is to offer the necessary care conditions for a physiological birth when required by the mother. It is therefore expected that in such cases there might be room for changes regarding the number of people who can be with the mother during labour.

Is the presence of a doula allowed in a home birth or a Birth Centre?

In a home birth, it is the mother who decides how she wants her birth to be, except for those medical decisions that are the midwife’s or attending obstetrician’s competence. The presence of a doula is therefore the couple’s decision and one they should discuss beforehand with their attending midwife.
In a Birth Home or Centre, the doula is generally welcomed and accepted as part of the support system necessary for the mother. Some birth centres even have doulas as part of their team, or require their services on a regular basis.

I have a midwife. Do I also need a doula?

Midwife and doula fulfil different roles each with their own characteristics, which are not opposed or excluding, but complementing and never a substitute.

Up until not too long ago, a birth was a female event where a woman was accompanied by two o three women who helped her, supported her and assisted her when necessary. The most qualified and experienced woman was the midwife and the rest (generally family) fulfilled the role of doulas, giving emotional support, dealing with the practical tasks and assisting the midwife when required to do so.

Nowadays, the role of a doula begins with the onset of labour, slightly before the midwife starts to evaluate the birth process or intervene in any way that is not competence of the doula

I have a doula. Do I also need a midwife?

Absolutely. The midwife is always necessary for birth and the most experienced and qualified person to assist it.

What are the doula´s competences? Can she listen to the baby’s heartbeat or perform vaginal examinations?

The competences for a doula belonging to DoulasBarcelona are shown in this website (Do´s and Don´ts). They basically consist of continuous emotional support for the mother, during labour, the post-partum period and the puerperium. They are not qualified for medical checks of any kind (vaginal examinations, listening to the baby’s heartbeat, giving medicines, etc.), making a diagnosis, performing any physical intervention, giving medical advice, even when informed or qualified to do so.

Could my partner feel threaten by the presence of a doula during labour and birth or with her presence at home during the post-partum period?

It is certainly possible for the partner or the immediate family to not fully understand the need for this type of support, although in most cases those feelings briefly appear at the beginning and are overcome shortly, when it is palpable how a doula can facilitate matters.

However, it is important that all the decisions taken regarding birth and the post-partum are made by both partners in agreement, even though it is of paramount importance for the mother’s needs to be respected at all times.
The doula joins something as intimate as the process of childbirth and the fragile family balance following the days after the birth, and her loving and discreet accompaniment to the mother and to other members of the family tends to bring serenity, containment and confidence in all of them.

I am not going to have a physiological birth because I prefer a standard medicalized birth. Can I still have a doula?

Yes. The doula´s role is accompany the mother and fulfil her needs during birth, regardless of her choice of birth or her specific beliefs on motherhood.

If I know I will have a caesarean, is there much sense in having a doula?

Yes. The presence of a doula is not limited to a specific choice of birth, or the basis on which a choice is made, be it medical or personal reasons. A doula will accompany any women who needs her or wishes to have her in order to experience this event in the best possible way, both for her and her baby.