This month's Brilliant Activities for Birth Educators honors International Doula Month with an activity that reinforces Lamaze Healthy Birth Practice #3 - Bring a loved one, friend or doula for continuous support. Many professional organizations including the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have recognized the positive contribution that professional labor support offers to maternal-infant health outcomes in recent committee opinions they have published. Childbirth educators can share information with the families in their classes about the many evidence-based benefits of working with a doula as a member of the birth team through this fun activity! I have adapted this month's activity from an idea from my colleague, Teri Shilling. If you are interested in accessing previous Brilliant Activities for Birth Educators ideas, consider following this link to find many great activities for your childbirth classes.

A Do-What?

Many families starting their childbirth class having never heard of he word "doula" before, never mind understanding the role of the doula or appreciating the benefits of adding a doula to the birth team. Throughout my childbirth class series, I am constantly sharing how a partner can support a laboring person through the emotional and physical challenges of labor but a doula can sure help! I like to do this activity the second week of a seven-week series when we start to talk about the labor process. I like to be sure that everyone understands how a doula can support an entire family and refer back to the research on doulas frequently. Many families who might not have considered a doula prior to starting class now have their interest piqued and pursue the resources I have provided on how to find a doula for their upcoming birth.

When to do this activity

In general, I like to include this activity at our second class meeting, just before talking about the stages of labor. You could just as easily cover this when you talk about decisions to make ahead of time, or even during a labor rehearsal.

Time needed

This activity can adequately be conducted in approximately 15 minutes. Allow about five minutes for small group work and ten minutes for reporting back and large group discussion.

Materials

• Color image of a cesarean surgery
• Color image a healthy and robust newborn
• Color image an IV bag of Pitocin
• Color image both vacuum and forceps
• Color image of an epidural
• Color image of a radiant and happy person who just gave birth

I laminate all the sheets for longevity in my classroom.

How to conduct this activity

Divide the families into six small groups. Each group is given one of the laminated sheets. I share the evidence that we currently have about families who utilize doula services:

• Less likely to have cesareans
• Less likely to request pain medications
• Higher degree of parental satisfaction with the birth experience
• Less use of vacuum and forceps during second (pushing) stage
• Newborns with fewer NICU admissions
• Less need for labor augmentation such as Pitocin administration

I ask each group to discuss amongst themselves the reasons that they think doulas help with the specific topic that they have been given. How does a doula help reduce cesareans? Or increase satisfaction? In their small groups, the families brainstorm the things that a doula might do to impact their specific outcome and jot those actions down. For example, a doula might help with position changes to encourage labor to continue to progress and reduce the need for a cesarean. They elect a representative to speak for the group when we all come back together. This first part of the activity takes about five minutes.

We come back as a large group and each speaker shares their findings from their small groups. We discuss, share and elaborate on the role of the doula and how they help both the birthing person and the partner. Usually some families have already hired doulas, and a brief discussion about the process ensues. I conclude the activity by sharing resources- including a hiring guide and questions to ask, for parents interested in working with doulas, resources for finding doulas with DONA international and DoulaMatch.net

Family take-aways

This short activity is a great way to talk about both Lamaze's Third Healthy Birth Practice and allow families to discover how a doula can have a positive impact on their birth. It gives those who have hired a doula already an opportunity to share and allows those who haven't to consider whether including a doula on their birth team is the right choice for them. Regardless what they decide to do, all families leave this class more knowledgable on the role of a doula, the benefits for their labor and birth and how to go about finding a doula if they want one.

I appreciate the contribution that doulas make to maternal-infant health outcomes and would like to extend a hearty thank you to both birth and postpartum doulas for their caring and support for getting families started off on the right foot. How do you share information about doulas in your classes and with your patients and clients? Please share your ideas and thoughts in the comments section below.

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