Family Experiences That Arise From Pregnancy: The Role of a Doula - Term Paper Example

? Family Experiences That Arise From Pregnancy: The Role of a Doula Number Introduction Pregnancy is often a mixed bag for families in which they occur. It is an experience packed with growth, fulfillment, adjustments in gender roles, and challenges ((Bigner, 2010; Klaus, Kennel, & Klaus, 2012). It is a moment when the expectant couple faces up to their fears and prospects of their parenthood. Impending parenthood impacts psychological transformation in both partners, especially a few months to delivery. The challenge calls for the invitation of a doula to help the family in coping with the positive and negative psychological changes that arise from pregnancy. A doula will guide the couple on how to understand each other and take up new responsibilities in regard to safeguarding the welfare of the mother and the unborn child. In the recent past, there has been vigorous debate on the labor outcomes in expectant mothers accompanied by an assistant or doula and the results in mothers who were denied this additional help during labor (Bigner, 2010). In light of this uncertainty, Campbell, Lake, Falk, and Backstrand (2006) carried out a research study to determine the significance of a doula in providing continuous assistance to women in labor. The Original Research by Campbell et al According to Campbell et al (2006) the work of doula groups for women in labor may encompass emotional support, providing comfort, information and encouragement. These strategies may improve the physiologic condition of women in labor by guaranteeing them a sense of control of the situation they are in, thus helps to limit the necessity of obstetric options. The unwavering support was offered by inexperienced members of doula groups, people who were not hospital staff but had individual social ties to the women in labor. The doulas were then taken through a short training session, lasting for two hours in which they were enlightened on the basics of what women in labor needed most. According to Bigner (2010), women in labor who received continuous encouragement by the doulas were found to have a predilection of normal and spontaneous delivery; that is, they were able to give birth without caesarean intervention. Additionally, with doulas’ assistance, the women developed a tendency of refraining from painkillers. They demonstrated more satisfaction, and had fewer hours of labor. Their infants were likely to register higher scores on the five-minute Apgar scale. In general, the women experienced no adverse repercussions of labor and childbirth. In light of the positive role of doulas, Campbell et al (2006) affirmed that all mothers in labor should be granted unwavering support by doulas. Continuous advocacy from an individual, who is known to the mother in labor, who possesses the basic skills, appeared to be highly helpful in the birth parlors. Research review The main objective of the research was to evaluate labor outcomes in mothers who receive support from a team of doulas, on one hand and the results in women who were deprived of this extra advocacy service on another hand (Campbell et al 2010). The authors utilized a randomized controlled trial methodology to collect the relevant data. The research witnessed the participation of six hundred mothers. The participants had passed a clean bill of health in regard to normal delivery, when they were enlisted for the study. The women were asked to call a female relation or friend who was willing to play the role of their inexperienced support assistant. The members of the doula group were taken through a simple and short training session based on offering support to their respective clients. The outcome of the study was based on various respects including the type of childbirth, duration of labor, and the timing of analgesia and Apghar values in newborn babies. According to Campbell et al (2006), women who received doula service had shorter duration of labor. Additionally, they had easier delivery, which was prompted by more relaxation of the cervical muscles during epidural anesthesia and greater Apgar values at 1 and 5 minutes respectively. Despite the pivotal role played by the doula groups in the study, Campbell et al (2006) noted that the outcomes were too insignificant to offer any clues on the various areas of research including the type of analgesia or anesthesia or cesarean section. Problems in the original research There are several problems in the research, which may have compromised the outcomes, and rendered the statistics too insignificant to offer direction. The first problem lay in the selection of the participants. The selected doctors had no background training on the provision of support services to the women in labor. Their roles may have been blurred by their lack of experience in the provision of services. Additionally, the short training session may have been ineffective, or too shallow to equip the participants with the necessary skills for credible results (Klaus, Kennel, & Klaus, 2012). Therefore, in spite of professional health care providers having limited time to act as doulas, participants with a medical background would have made the difference. Secondly, owing to the unique needs of the women in labor, the identification of only one inexperienced layperson by a mother to assist her throughout the duration of labor may have presented challenges to the provision of appropriate advocacy services. Perhaps a combination of doulas with different capacities may have worked better to offer the women an all-round support they were in need of (Newman, & Newman, 2008). Bigner’s “Parent-Child Relations” (book) The researchers utilized the text appropriately in different respects (Bigner, 2010). Bigner (2012) properly utilized the text in providing a clear definition of doula; their selection process; and their roles in the life of an expectant mother. Bigner (2010) avers that the researchers at least attempted to put to rest the debate about the role of doulas. According to the authors, labor support persons, or doulas, are women who receive training on how to satisfy the laboring mother’s social needs. Doulas’ may provide advocacy services, propose new positions for a woman in labor, massage the woman’s body, run errands, or communicate with the mother’s family members. Typically, expectant mothers seek the services of a doula a few months to delivery (Bigner, 2010). In prenatal sessions, the pregnant woman often lets out her delivery preferences, her feelings about medications, and her reservations regarding childbirth. Campbell et al (2006) aver that a mother and a doula will also consider the appropriate kinds of social and emotional assistance and comfort strategies that may benefit the mother. The findings in the article and the book imply that it is appropriate for mothers to be allowed to hire a doula whom they are comfortable with (Bigner, 2010; Campbell et al (2006). This enhances efficiency and better service outcomes as compared with those ‘forced’ down on them by health care facilities. With a limited scope of work and professional independence, doulas fit well within the existing healthcare environment and processes. Doulas improve interaction between her client and the caregivers, and motivate them to take charge of their destiny by becoming more proactive in informed decision-making, especially on issues which are associated with their care. While doulas provide the much-needed encouragement to women in labor, it remains unclear whether laypersons acting as doulas can make any significant contributions to the existing care system (Bigner, 2010). The outcomes of the research contained negligible statistics; this lends credence to the critical theory of the caregivers as being ineffective and unresponsive to the emotional and physical needs of mothers and their infants. Quality of the research Campbell et al could have stated more about the quality of the research study on two main issues: first, they opted to leave out an assessment of the lay doulas in regard to their readiness to take up the new responsibilities or whether they were motivated and remained in the same condition throughout the study. By failing to vet the lay doulas to ascertain their abilities, the researchers may have compromised the outcome of the study in that respect. Secondly, the quality of the research may have been compromised by doulas that were uncooperative with the medical staff. Generally, doulas are non-medical persons who must take a subsidiary approach to the provision of care in favor of the medical staff at the health care facility (Klaus, Kennel, & Klaus, 2012). However, Campbell (2006) failed to provide a general assessment and results of how the doulas worked within these limits, and whether they cultivated relations with clinicians and executives, while avoiding cases of meddling. Conclusion The research was done in a scientific manner, however the participants and their mode of operation was unclear. This may have compromised the outcome. Although, it was appropriate to let the women in labor to select a lay doula, I would have asked the women in labor to select their respective doulas from among people with background in health or at least people with higher education. I would then have vetted them in order to establish whether they were ready for task ahead. In doing so, the difference in the outcomes would be more distinct. Generally, both Campbell et al (2006) and Bigner (2010) have established that doulas are indispensable in the life of women in labor. References Bigner, J. J. (2010). Parent-Child Relations (8th edition). Upper Saddle River, NJ: Merrill. Campbell, D.A., Lake, M.F., Falk, M., & Backstrand, J.R. (2006). A Randomized Control Trial of Continuous Support in Labor by a Lay Doula. Journal of Obstetric, Gynecologic, & Neonatal Nursing: Clinical Scholarship for the Care of Women, Childbearing Families, & Newborns, 35(4), 456-464. Klaus, M.H., Kennel, J.H, & Klaus, P.H (2012). The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth. New York: Da Capo Press. Moses, M.C., & Potter, R.H. (2008). The Use of Doulas for Inmates in Labor: Continuous Supportive Care with Positive Outcomes. Corrections Today, 70(3), 58-73. Newman, B.M., & Newman, P.R. (2008). Development Through Life: A Psychosocial Approach. New York: Cengage Learning. Read More