New parents have no doubt about doulas Assistance: The concept of the outside coach and supporter for new moms and dads has undergone a rebirth.

March 30, 1998|By Sarah Pekkanen | Sarah Pekkanen,SUN STAFF

Holly Schmidt will never forget the new father who tucked in his wife and infant daughter for an afternoon nap, then walked into the middle of his kitchen and burst into tears.

"I can't handle this," he sobbed. "I don't know what I'm doing." He was too embarrassed to tell his wife that he didn't even know how to hold their new baby.

Schmidt sprang into action. "I'll teach you," she promised.

During the next few days, whenever his wife slept, Schmidt secretly coached the father in diapering techniques, demonstrated how to bathe a newborn and taught him to cradle his daughter close instead of balancing her out on his forearms.

Schmidt is the type of person every new parent fantasizes about: While other visitors coo at the baby, she specializes in coddling moms and dads. Whatever they need -- be it a home-cooked casserole, lessons in the art of burping or a sympathetic ear upon which to unload mother-in-law complaints -- she delivers.

Schmidt is what is known as a doula, a Greek term that roughly translated means a woman who mothers a new mother. She is one of a growing number of Baltimore professionals stepping into a role traditionally held by close friends and relatives.

Doulas help ease the physical stresses triggered by a birth, stresses that can be aggravated by increasingly short hospital stays. They also fill the emotional void that results when new mothers don't have a nurturing network of family and friends close by.

In addition to postpartum doulas like Schmidt, women called birth doulas help ease women through labor. "I'm a really interactive doula -- I climb in bed with them sometimes and put pressure here and there: head, back, feet, hands," said Gwen Peters, a Columbia resident.

While doulas have long been a health-care fixture in some Scandinavian countries -- where insurance routinely covers their fees -- the concept didn't begin catching on in the United States until the mid-1980s, said Alice Gilgoff of the National Association of Post-Partum Care Services in Bronxville, N.Y.

It's difficult to gauge the precise number of doulas working in this country, since many operate on a word-of-mouth, free-lance basis and aren't required to register with a national clearinghouse. But Doulas of North America (DONA), which certifies birth doulas and puts them in touch with pregnant women, boasts 2,500 members. In Maryland alone, some 160 women have undergone birth doula training from DONA's Maryland coordinator, Michele Oseroff.

One reason doulas have spread to Baltimore is that the region is home to a relatively large population of Orthodox Jews, a faith that prohibits men from touching their wives during labor, Oseroff said. In such cases, a husband can offer verbal support while a birth doula squeezes hands and dispenses back rubs.

"Being a [birth] doula is like having a one-night stand with someone," Peters observed. "You get totally emotionally involved with them, then you may have just one contact after the birth."

The relatively brief encounters have produced some striking results: A Texas study published in the Journal of the American Medical Association in 1991 showed that mothers with birth doulas enjoyed shorter labors and needed 50 percent fewer Caesarean operations.

The health-care community is taking notice. Last month, Helix Health became the first health-care system in Baltimore to offer doulas to pregnant patients at three of its affiliated hospitals: Union Memorial Hospital, Harbor Hospital Center and Baltimore County's Franklin Square Hospital Center. The cost to parents is roughly the same as free-lance doulas charge: $200 per birth, or, for postpartum care, $200 per 12 hours. Among the doulas in Helix's roster are Schmidt and Peters, who also continue to free-lance.

For postpartum doulas, job descriptions are fluid. Some wrap Christmas presents. Others drop older children off at soccer practice. One doula even helped a new mother who had decided to renovate her kitchen at a curious time select the color for her new walls. (They settled on "bok choy.")

Frequently, however, new mothers need emotional support more desperately than they need a tidied-up living room.

"A lot of women need to talk about their labor and delivery," said Wendy Holbrook, a doula from Columbia. "Sometimes when women talk about labor, someone tries to one-up them: 'Well, I was in labor for 42 hours and I had three epidurals.' "

In Baltimore, it seems, women are eager to provide that sympathetic ear. More than 300 applicants -- none of whom were men -- responded to Helix's advertisement seeking doulas (33 were eventually chosen). Although some doulas are nurses, Oseroff didn't seek out medical experts: What she really wanted was women who were exceptionally caring. Helix's training included role-plays and discussions of topics like home safety for babies.

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