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Neonatologist says Doulas help deliveries Assistants give comfort, support to women undergoing childbirth By SUSAN JAY A nationally known neonatologist and researcher is calling for a revolution in labor and birthing care. "By the year 2000 no woman should ever be alone or without a trained woman in delivery," said Dr. Marshal Klaus, who is based in the San Francisco Bay area. If Klaus had his way, every woman in labor would have a Doula by her side, he told local doctors, nurses, midwives and Doulas at this week's Perinatal Lecture Series, sponsored by Asante Health Systems. The word Doula is a Spanish term for a woman trained in the physical and emotional aspects of childbirth. She stays with an expectant mother throughout labor and delivery. She is not a midwife. Many midwives, however, often act as Doulas, if they are present the entire time of labor and birth. Klaus said a group of studies have shown that the presence of a Doula can substantially reduce the length of labor, the chances that a Caesarean section will be performed and the use of pain medication. Klaus is an expert in treating high-risk and premature infants. For the past several years he has researched the effectiveness of Doulas around the world. Klaus said Doulas encourage, praise, reassure and touch women in labor. They inform women about options, advocate for them, and always make sure the woman is in control. "The woman adds something special that we still don't fully understand," Klaus said. Women in Jackson County are using Doulas more and more, and local and state legislators are working on a proposed bill for voluntary licensing of Doulas. La Clinica del Valle, a local health center that treats many Hispanic patients, provides Doulas for many of its Spanish-speaking pregnant patients. Ashland Community Hospital also works with Doulas, often to help its Hispanic patients. Kelly Precie, the Doula coordinator for the Ashland hospital, trains and certifies Doulas with her Doulas Make a Difference business. The Jackson County Vital Links program has eight Doulas who assist drug- and alcohol-dependent pregnant teenagers before and during birth. Klaus said results from seven randomized studies showed that women who had Doulas present during labor and birth had a 50 percent lower rate of Caesarean sections than those who did not. Those women also used pain medications 30 to 40 percent less than women who did not have a Doula, and the length of their labor decreased by 25 percent. In one of the studies, women who received an epidural block for pain and women who had a Doula reported similar pain levels. Those who had neither reported high levels of pain. "Somehow the Doula is giving pain relief," Klaus said. Lee Harker, a neonatologist at Rogue Valley Medical Center, said that while Kraus' research was "striking," and a lower C-section rate is always significant, much more study would have to be done to persuade hospitals and health plans to formally support a Doula program. While Klaus doesn't have a scientific explanation for the research outcomes for Doulas, Precie has her own opinion of why Doulas are so effective. They never leave the expectant woman during labor, she said. They provide a sense of security that can actually relax the mother, which helps reduce tension in the muscles active during labor and delivery, making the process easier. Most Doulas are hired privately and charge a sliding-scale fee of $100 to $300. Some Doulas, like Precie, also offer private childbirth classes and help women create a childbirth plan. Mail Tribune Copyright � The Mail Tribune 1998, Medford, Oregon USA