DISCOVER DOULAS // A passion for pregnancy

For many pregnant women, each day can bring new questions.

I'm feeling dizzy. What should I do?

What is causing this cramping?

Is it safe to have sex in my third trimester?

For Brandy Fishman, it was itchy feet.

"I had read about itchy palms," she recalled, "but feet?"

So Fishman, 29, picked up her phone and called her doula, Suzanne Falk. Her advice: rub calamine lotion on her soles.

Falk is a doula who assists women through pregnancy, childbirth and sometimes nursing.

For a one-time average fee of $400, she acts as the experienced friend who is available at any moment but who is emotionally distant enough to calmly deal with the unexpected twists and turns of daunting labor.

Doulas are popping up everywhere, including South Tampa, where the majority of Falk's clients are working women.

"I'm there to hold their hands, to answer their questions," said Falk of Beach Park, who has been a doula for 3{ years. "It's the best thing I have ever done."

Doulas are not necessarily medical doctors, midwives or nurses. They're mainly women who have a passion for the pregnancy and birthing process.

That's what led Dee Pullen to become a doula. Pullen, the president and founder of the Tampa Bay Doula Association, is the mother of two children _ ages 9 and 11. She said she would become a surrogate mother if she could, but she's 45.

"I loved them," Pullen said of her pregnancies. "I do miss them."

Pullen, who has assisted in almost 100 births, estimated there are about 50 to 60 doulas in the Tampa Bay area.

The need exists because expectant moms often need someone to listen to their concerns without judging them or dismissing them, Pullen said.

Doulas are on call around the clock. They'll even accompany their moms-to-be to doctor's appointments.

"It's all about the client," said Pullen, who once spent an entire Saturday with a pregnant mom leafing through medical books and photocopying passages to back up a birth plan for the woman's obstetrician. "We're like a concerned, older friend who has a lot of experience and is willing to sit down and pay attention to your concerns and help you find answers."

A lot of people have never heard the term "doula." It's understandable, considering the word has only been in some dictionaries for two years.

Ann Grauer, president-elect of Doulas of North America, said it wasn't easy moving "doula" into mainstream vernacular.

While "bling-bling" breezed right in, "doula" took eight years. It involved a lot of letter-writing, said Grauer, who was part of the process.

Grauer remembers seeing the word for the first time. She was standing in a Barnes & Noble in Wisconsin, flipping through an American Heritage Dictionary and there it was: Doula, a woman who assists another woman during labor and provides support to her, the infant and the family after childbirth

"I whooped a nice big holler," said Grauer, who lives outside Milwaukee. "My children were excited, but a wee bit embarrassed."

The word "doula" dates back about 3,000 years to ancient Greece.

"The doula was the most honored servant in the Greek household," Grauer said. "A wise woman of birth, she was the one who all the people in the house would turn to when it came time to birth."

Grauer, a charter member of the 11-year-old organization, said doulas have always been around. They just now have a term for it.

"They were the friend who everybody called whenever someone had a baby," she said. "They just didn't have a name for what they were doing."

Doulas have risen in popularity like a baby boom.

In 1994, DONA had 750 members. Eight years later, membership has swelled to 4,500 people worldwide.

Doulas can be certified by a number of organizations, including DONA, the largest doula group.

To become certified by DONA, a person must complete a required reading list, attend a series of childbirth classes as a nonpregnant person, participate in training workshops, attend births, write essays about their experiences and be evaluated by clients.

"It's not an overly involved process to become certified," Grauer said. "It's a meaningful process."

Doulas can't be found in the phone book. They're located mainly through word-of-mouth or through doctor's offices. Those registered with DONA are listed through its Web site at www.DONA.org. They typically take on two to five clients a month.

Falk, a mother of two and former dental hygienist, chose babies over teeth because she found it more rewarding.

"I think that it's a real honor and privilege for me to be allowed in the room at such an intimate time," said Falk, who by choice does not assist in home births. "I really think in my own little way that I make it better for them."

Doulas in no way replace dads or overshadow their roles in the birthing process, said Grauer. They add to the experience.

"You just feel so clueless your first time around," said Christy Atlas, mother to 4{-year-old Lexie. "When we got into the labor room, she was fabulous to have. Your mother is kind of emotional and your husband doesn't know what to do."

When Fishman, the mom with itchy feet, visited a friend and her newborn in the hospital, the first thing the new dad told Fishman's husband was "get a doula."

Fishman, of Sunset Park, breezed through her pregnancy and got the most use out of Falk during her 10 hours of labor.

"She's like a liaison between you and the nurses," Fishman said. "When it was time to worry, she went and got the nurse, whereas my husband would have gotten up and screamed."

When Fishman wanted a blanket, they didn't have to buzz for the nurses. Falk knew where they were kept and retrieved one herself.

Fishman considers her husband the ultimate control freak but found him relinquishing many duties to Falk.

Jeffrey Fishman was so impressed with the doula that he wants one in the room when their family expands.

"She just made the whole experience a lot more comfortable," he said.

Jeffrey Fishman leaned on Falk as much as his wife did.

"You've got all these pieces of equipment in the room and they make all this noise," he said. "What's a good noise and a bad noise? I'm not an expert. She's basically your advocate."

Brandy Fishman, who quit her job as a benefits administrator to stay home with Jacob, now 10{ months, still marvels at her birthing experience.

"There's no way my husband would have made it through the delivery without a doula," she said. "This is the most amazing thing you can do for yourself."

_ Dong-Phuong Nguyen can be reached at 226-3403 or nguyen@sptimes.com.

Q&A: All about doulas

Doulas are available day or night to offer advice and support to women during their pregnancies. Here are some common questions asked of doulas and their responses.

Q: I'm feeling dizzy. What should I do?

A: Often, drinking water and lying down can help. A common cause of dizziness is dehydration.

Q: Is it safe to have sex in my third trimester?

A: Unless there is a medical reason, it should be safe to have sex.Q: I think I'm in labor.

Q: I think I'm in labor. When should I go to the hospital?

A: If you feel the need to go, do so.

Q: Should I ask for an epidural during labor?

A: Doulas work with you in writing a birth plan. If the birth plan says "no epidural" but during labor you request one, they will educate and support you.

Note: Doulas stress that they do not dispense medical advice. They urge their clients to call their doctors.

For more information, go to www.DONA.org