Blog | Monday, March 23, 2015

"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.

As 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, such as less use of epidural anesthesia, fewer C-sections, and improved infant mother bonding through 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 conjunction with the other end of life—death. A recent piece in the New York 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.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is Interim President of the University of Oklahoma-Tulsa. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.