North Star Doulas work with hospitals


By Sue Cody


W2W doulas FBSupport for women during childbirth is always a personal choice, but there is growing evidence that emotional and educational support from doulas is helpful.

A 2014 study cited in the American Journal of Managed Care reports better outcomes and more positive experiences for mothers and babies if they have continual support through labor. There were more spontaneous vaginal births, fewer Caesarian sections, epidurals and other interventions. This led to enormous cost savings.

Doulas are trained professionals who provide emotional and informational support to women before, during and after childbirth. They do not offer medical advice or recommendations, and work alongside nurses, doctors, midwives and other caregivers. They discuss options and help women feel in control of their own experience.

North Star Doulas was created in Clatsop County to make doulas widely accessible, says Rebeckah Orton, one of the founders. Libby Silva and Faith Barrington are the other North Star doulas. The three represent the first state certified doulas in Clatsop County.

Doulas help prospective parents with prenatal and birth planning in their own home. “We don’t advocate any particular kind of birth,” says Orton. “We let people know their options, then support their decisions.” And they support the family postpartum.

Some people choose home births, some have planned Caesarian sections, others choose hospital births. Doulas offer support for whatever choice the parents make.

A birth doula accompanies a woman throughout her labor and delivery. Because women build a relationship with their doula, they are more likely to disclose feelings to her, says Silva. They can talk about food, how they are feeling or share difficulties.


Doulas work as a team with everyone present, including support for partners. Research shows that having someone besides a family or friend offering support during labor is most helpful. Doulas are not in the woman’s social circle. They offer a professional relationship that goes from beginning to end.


Silva says, “When women feel like they are in danger, with things happening to them, the doulas … can listen to their concerns and help them make an informed decision. Two minutes of discussion can help a woman gain back control and release the feeling that things are being done to her.”


“We offer a continuity of care,” says Silva. “If a home birth becomes complicated and we transfer to a hospital, we are still there. The continuity is not broken – and we are there postpartum.”


Supporting partners is important, too. Barrington says talking to fathers postpartum is important. A lot is expected of a dad who might have to do laundry, cooking, shopping and taking care of the mother. Doulas let them know it is OK to ask for support or to tell people not to visit.


Working with hospitals


North Star Doulas are building relationships with midwives, parents, care providers and hospitals. They have attended births at Columbia Memorial Hospital and report positive relationships with caregivers there.

“The nursing staff is stellar,” Orton says. “The providers know us. We offer emotional support…. We can calm a patient. We are patient advocates who meet with the doctors. We have found there is less need for anesthesia and epidurals.”


Barrington has been a doula at Providence Seaside Hospital and says her experience working with staff there has been very positive. “I am learning from them, and they are seeing what I do,” she says. “It’s a team effort.”


Stamp of Approval


The Oregon Legislature approved the payment of doulas in 2011. At $75 for two prenatal visits, attendance at birth and two postpartum visits, it was not much pay for the amount of time invested, says Orton.


Recently, the Columbia Pacific Coordinated Care Organization, which covers Medicaid patients in Clatsop County, approved payment of $350 to doulas for the same service. “The CCO is putting its stamp of approval on the uniformity of care,” says Orton.


Doula - Libby and Sylvia FBSome history


A traumatic birth experience led Barrington to seek help for healing herself. Now she is passionate about helping others to have positive birth experiences. She became a doula through DONA International, a leader in evidence-based doula training.


Similarly, Orton had a traumatic birth with her second child. The first birth was a positive experience, and the difference, she later discovered, was the support she had from her sister at the first birth. Her sister acted as a doula.


Orton had planned to become a nurse, but now she is a doula, studying to become a midwife.


Silva says she always had a positive attitude toward birth. “Women are awesome. Birth is cool, something to be revered.” She had her first doula training at the age of 18.


She says she watched women give birth in Uganda, where there is not a lot of fear around childbirth. Culturally, different experiences are accepted. There is no one to blame.


“My greatest joy is to see women come into their own power.”