Demystifying Medicine One Month at a Time

Tag: doulas

“It’s their dying; not yours.”

Ever heard of a doula?

Doula is an ancient Greek word that translates as “woman who serves.” Specifically, it’s come to mean someone who serves as a birth attendant, a person trained in childbirth who acts in support of a birthing mother. A doula provides knowledge, comfort, and an extra pair of hands — whether it’s to provide nourishment or massage, or help a mother find a comfortable position.

doula1As you may imagine, the modern “doula movement” started as a reaction to over-medicalization of the birth process in the U.S. Too much hospital, too many medical interventions, too much ‘invasiveness’ of what should be a joyous and miraculous time in a family’s life. The ‘movement’ began in the early 1970s. The interesting thing about doulas is that they have achieved widespread acceptance from the skeptical medical profession — there’s strong science showing that labor attended by doulas results in better outcomes — e.g. less use of epidural anesthesia, fewer c-sections, and improved infant mother bonding (i.e. successful initiation of breastfeeding).

One of my mentors in medical school, Dr. John Kennell, was instrumental in doing the research that showed how doulas make a positive impact.

My wife and I were lucky to have the births of both of our children attended by doulas, one near Boston and one in Chicago. Both doulas even came to our home after birth to check in on us and see what we needed.

Recently I was surprised to see the term doula used in conjunciton with the other end of life — death. A recent piece in the NY Times business section, in the “Shortcuts” column, discussed the emergence of doulas helping those that are dying ease the process.

It’s quite logical, really. Most of us are afraid of death — the article chronicles a few for whom there was little in the way of family or friend support. A person experienced in listening, attending, and just being present is a wonderful gift to anyone, but especially someone who knows they will die soon.

Some of the doulas mentioned in the piece come from the hospice world, others from the birthing side of life who wish to use their skills elsewhere. The article gives details on the financial considerations if one were to hire a doula (it’s in the Business section, after all) — but trust me, no one is profiteering in this type of work. These are folks in it for the meaning.

RIP: JHK (1922-2013)

Dr. John Kennell was a lovely man. He had a gentle manner and a ready smile. Just being around him you knew he was smart and that he cared deeply for both his patients (the babies) and how they attached to their mothers.

John Kennell_photo2It seems hard to believe, but it took his scientific research to demonstrate that keeping newborns with their mothers and allowing them to bond fostered the best health outcomes. Only in a world that highly values technological and interventionist approaches would it be necessary to ‘prove’ something that seems so intuitive. His work led away from the practice of whisking newborns away from their mothers to incubators and nursery units.

I met Dr. Kennell two decades ago, when he taught me as a medical student. He seemed so wise that I took him up on his blanket invitation to join onto his research team. His later career was focused on demonstrating that doulas, birth attendants, lead to better labor and delivery outcomes (less reported pain, less need for c-section, fewer complications, etc.).

My job was to go to the hospital room of a laboring mother (who had consented to participate) and record observations about the labor (and those attending it–doulas and family members) in a time log. I didn’t last long as a birth researcher; it felt too intrusive to me to be in the midst of such a personal event.

Dr. Kennell won many awards for his work along with his partner, Dr. Marshall Klaus. I will always remember him fondly. His was an example of a life well-lived.

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