Doulas integral to Women's Hospital

The curving lobby of UNC Hospitals is a sheer face of windows, and on a bright day, the carpets are striped white from the sun.

Lois Ballen's office is on the fifth floor of the Women's Hospital, where the walls are painted soothing, matte colors, and the doorplates are gold and pink. From behind a set of locked, limited-access doors, she is the program manager of UNC BirthPartners, a volunteer, hospital-based doula program.

"A doula is a nonmedical care provider who offers emotional and physical comfort measures, along with helping families find information and finding a good position for birth," explained Debbie Young, director of publications for Doulas of North America.

Ballen, a registered nurse, has spent years seeing women come in for deliveries unaccompanied, unprepared or sometimes both.

"Women come in with the people they choose to help them, but they know nothing about birth - and labor can be scary," she said. Ballen says that most women bring family members who are no more comfortable or knowledgeable about birth than themselves.

"They see their loved one in pain or with weird behavior, and people freak out."

So far this year, 118 babies and their families have received a little extra help from BirthPartners' staff of volunteer doulas.

Young said doulas run the gamut of service, meeting patients prenatally, staying through the birth and working with mothers post-partum.

"It is the continuous care that makes the doulas work so well."

Most of the country's doulas are in private practice, but BirthPartners matches women with doulas when they arrive at the hospital in labor.

Ballen explained that women receive doula care in situations based on availability, risk or isolation during delivery.

Unlike the flurry of latex-gloved doctors and nurses checking vitals and measuring progress, the doula is focused solely on the woman in labor, answering her questions, helping her breathe and running interference with concerned family members.

Ballen said the benefits of having a doula aren't restricted to a calmer waiting room. "(Women who have doulas) use less pain medicine because they don't seem to need it," she remarked, grinning. Effects extend from a lowered risk of needing a Caesarean section to less post-partum depression, she said.

Ballen attributes the benefits to the hard work of doulas, whose job description calls for them to comfort and encourage women in labor. Doulas provide quality support with no agenda. "Whatever the woman wants, the doula will see what she can do to create that kind of situation."

BirthPartners' volunteer doulas are ordinary members of the community, retired nurses and graduate and undergraduate students who have undergone vigorous training: required reading, childbirth classes and 18 hours of doula training.

Junior Janaka Lagoo did just that and now signs on for the 12-hour commitment whenever she has the opportunity.

"When you do commit your time, it's a huge amount of time," she said. "You come in with a patient, and you want to be there for the whole delivery. It'll be six hours or 20 hours, you want to stay."

Since she finished her training at the end of her sophomore year, Lagoo has worked with nearly a dozen mothers and has fallen more and more in love with her work. "I really feel that doulas empower women in birthing situations to be able to voice their concerns," she said.

Nicole Fouche is a graduate student who is 33 weeks pregnant. At the moment, she is more concerned about getting help in the delivery room than getting her doctorate in biochemistry and biophysics.

"I think my decision (to get a doula) was based on the fact that I want a natural birth and that I'm pretty much doing it alone," Fouche said.

With no older parent figure to walk her through the birth, she's grateful for the company.

"I know that they're considered volunteers," Fouche said. "I know volunteers don't just have the expertise but also the enthusiasm, which also makes a difference because they're choosing to be there."

And Young says they've always been there.

"Doulas have always been around, but not with that formal name," she said. Young said that traditionally, there always has been an extra pair of hands at birth. "(She) may have been a mother or sister or wisewoman - it wasn't just a midwife, it was another woman there for comfort."

Young said that after birth began to be commonly practiced in hospitals, women lost that social and emotional connection.

"Women were taken and kept in fairly good isolation ... but what they didn't understand was that women were also being separated from their social net.

"Women only recently are starting to reclaim that."

Contact the Features Editor at features@unc.edu.