A Doula: To Help Another Woman

by Pam Jung

"A Doula helps a mother feel safe, confident and powerful."

It is a word that sounds a little strange to us: Doula.  In Greek it means a woman serving or helping another woman.  In our culture it has come to mean a person who helps a woman before, during and after she gives birth, most often in a hospital or birthing center.

We're lucky in Nevada County, CA to have living here a pioneer in the field, Janine Nugent.  This mother of two has done more than anyone else to make the title "doula", if not a household word, at least a respected name in the area of childbirth.  Herself one, she has witnessed more than 700 births.

"A Doula", Nugent says, "helps a mother feel safe, confident and powerful."  This is accomplished by lots of education and talk, and by being present before, during and after the birth.

Nugent walks us through those stages:

Prenatal - Around the 5th month of pregnancy, the doula meets with the mother and her partner for two to three sessions to discuss what they're learning in the childbirth class, questions they have, and address any fears that might be coming up.  "We show the women that birth isn't so scary," says Nugent, "by giving her a clear understanding of the birth process, and by teaching her how to relax in labor -- the key to having a positive birth experience - by doing some tension/release exercises, a little hypnotherapy, and listening to guided relaxation tapes.  I inform my clients that the pain of labor & birth is 'safe pain,' meaning it hurts, but it doesn't hurt you."

"We rehearse the do's and don'ts, and dispel myths, such as the one that says you don't eat while in labor."

"I also recommend enrolling in a prenatal yoga class. It's very beneficial." (Wild Mountain Yoga in Nevada City, offers such a class; call instructor Deborah Jordan at 530-265-4072).

During labor - The doula goes to the mother just as soon as her labor begins.  "We start working with her to relax before she really needs it, and we make sure she's eating the right foods (to keep her blood sugar up), drinking liquids, and resting."

The doula can remain in the home along with the midwife, or she can go to the hospital with the mother. Nugent feels it is in a hospital that a doula offers special value.  "Babies are an active part of this process, and they can't get into proper position if the mother is lying in one position in bed. We get her to walk, take showers, and move."

After birth - Once it is over, do mothers think it was worth it?  "Virtually every woman I've worked with over the past 23 years, no matter how difficult her labor and birth was, told me afterwards that it was all worth it.  They can labor hard for hours and work long and hard to push their babies into the world, but every mother feels she would do it all over again once she holds her daughter or son in her arms.  That moment of falling in love is sacred and profound, for both the mother and father.  We hold the space for this transition to occur."

For Nugent, the reward is part emotional, as in a recent birth when a mother, who had her first baby via cesarean, was able to have her second one vaginally, a process that was thought to be nearly impossible.  "The pride the mother had was incredible." 

Nugent received her training as a childbirth educator in 1981.  Her professional background was that of manager of medical clinics, and in 1986 was hired as the Director of The Birth Place, five miles from Stanford University Hospital in Palo Alto.  While there, she and another employee began the very first program for training doulas.  It was 18 months long, and it included being on call at the birthing center.  Nugent doubled there as a doula herself, until she left to have her second child and stay home for a while.  Her next step was to create the Peninsula Birth Connection, again in Palo Alto, which provided education, counseling, and referrals to health providers in the area.

Today in Nevada County, Nugent does doula support.  This means educating the community about the services and worth of doulas, making referrals to those women who are practicing, and establishing a good relationship with local hospitals.  "My focus is to be a bridge between the alternative and mainstream medical communities.  Each has wonderful things to offer.  Indeed, without mainstream medicine, a lot of our babies wouldn't survive."

Nugent also enjoys traveling all over the U.S. doing trainings.  One of these days you might even see her on Oprah (if the fates are kind), because she will stop at nothing in her campaign to further the cause of the doula.