THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Sunday, July 10, 1994 TAG: 9407120518
SECTION: HAMPTON ROADS WOMAN PAGE: 06 EDITION: FINAL
TYPE: Cover story
SOURCE: BY DIANE TENNANT, STAFF WRITER
LENGTH: Long : 132 lines
IN HER ROLE as a doula, Larissa Blechman has bathed babies, comforted new mothers, done laundry and washed dishes, coached breast-feeding, dispensed infant care education and dealt with the postpartum blues. But the strangest thing a client ever asked her to do was wade into a goldfish pond.
The pond had to be tidied in time for a bris, a circumcision ceremony done on 8-day-old infants in the Jewish faith. Blechman slipped off her shoes and stepped in.
The task was in keeping with the Greek word doula (pronounced dool-ah), which means servant, but the professional niche doulas are carving for themselves is far different.
Doula services are springing up nationwide, offering two types of care: postpartum doulas provide education and emotional support to the new mother and family, and birth doulas give labor support and childbirth education.
``What I do is basically go in and care for moms and families after they have babies,'' Blechman said. ``There's all this attention on the pregnancy and all about labor and birth. There are all these books about parenting, but there's nothing about becoming a parent.
``It used to be that women got that from their mothers and their sisters and women around them. But now our society is different.''
So different, in fact, that women are willing to pay up to $35 an hour in some areas for someone to dispense care and advice, education and massages, hugs and reassurance. Along with that, doulas run errands, cook meals, watch for warning signs of infant or mom health problems, do light housekeeping and perform other tasks to let new moms recover and become comfortable in their role as parent.
Blechman charges $20 an hour. Her rate drops to $18 an hour for 30 or more hours of doula care.
Estimates are that from 800 to 1,000 birth doulas and 500 to 1,000 postpartum doulas work in the United States, with more being trained.
The concept of a doula is centuries old. But now, doulas are bringing their services into the health care mainstream.
Some hospitals contract with doula services so patients can be discharged at 12 or 24 hours after vaginal birth. Having a trained person to help the new baby and mom at home is less expensive than keeping them in the hospital, and also lessens the risk that either will be readmitted.
Some early-discharge programs provide home visits by registered nurses, for medical care, and doulas, for infant and maternal support.
Insurance reimbursement varies widely. Some doula services report that they have obtained reimbursement in cases where mothers were ordered by their doctors to stay in bed, where Caesarean sections were not healing properly, or for high-risk pregnancies.
Doulas have also testified before committees of the federal health-care reform task force, urging that doula care be included in standard health care for all women. The issue is not addressed in the Clinton administration's plan.
Blechman is the only doula in Hampton Roads certified through the National Association of Postpartum Care Services Inc. There is no government regulation of doulas, so NAPCS sets standards and application procedures for postpartum certification, and the Seattle-based Doulas of North America does the same for birth doulas.
Gerri Levrini, executive director of Mother's Matters Inc., a nursing care and doula service in Northern Virginia, heads the accreditation committee for NAPCS. She said the 30 doulas in her service follow guidelines of the American College of Obstetricians and Gynecologists, as well as the American Academy of Pediatrics to educate and care for clients.
``Now with an NAPCS accreditation and the standards being set, we hope we're really creating a role that is part of the maternity health-care team and actually extended into the home after the birth of the baby,'' Levrini said.
The term doula came into use about 15 years ago, in a book that examined the role of childbirth and postpartum helpers in other cultures.
``This country had no role that even came close to that role that they had in other countries,'' Levrini said. ``We were also struggling with the Supermom myth and the `I don't need any help and I don't even need my own mother' myth.
``Women are recognizing that they can't live up to this expectation of being the Superwoman or the Supermom. We're hoping that it (a doula service) is timely now, that there's more acceptance and recognition.''
Blechman began her doula service in April. She has had four clients so far, and hopes to expand her training into labor support and childbirth education as well.
``The women that I've worked with have all wanted eight hours a day for the first week or two - real intense help for the first - and then kind of slack off,'' she explained.
``Basically I do anything they need help with toward the goal of becoming a mother. I do a lot of help with breast-feeding.
``What these people are paying for is a relationship from me.''
Emily Dreyfus of Virginia Beach was looking for someone to help her after the birth of her first child, Samuel. The lactation consultant at her pediatrician's office told her about Blechman's doula service.
``I said, that's exactly what I've been looking for, that sounds great,'' Dreyfus recalled. ``It was just exactly what I wanted.''
Blechman helped with laundry, cleaning and cooking. She helped bathe the baby and gave Dreyfus tips on infant care.
``She was real helpful with advice about nursing and she was real supportive in terms of just support for me, too,'' Dreyfus said. ``I felt like it was so much more than a job to her. I felt like she really cared about the baby.''
``It's really a new industry in this country,'' Levrini said. ``In our area, I basically designed the program to address the early discharge as well as this being a transient area where families don't have their own extended family nearby. It does fill the gap of having family provide that support.
``We're looking at this becoming a trend in the future.'' ILLUSTRATION: D. KEVIN ELLIOTT/Staff color photos
Emily Dreyfus of Virginia Beach wanted someone to help her after the
birth of her first child, Samuel, and hired Larissa Blechman as a
doula.
Blechman cooks, does laundry and share information about infant
care.
``She was real helpful with advice about nursing and ...supportive
in terms of just support for me, too,'' says Dreyfus of Blechman.
Graphic\ TO LEARN MORE
For more information on birth doulas, contact Doulas of North
America, 1100 23rd Ave. E., Seattle, Wash. 98112, fax (206)
325-0472. For information on postpartum doulas, call the National
Association of Postpartum Care Services in Seattle at (206)
672-8011.
by CNB