What is a Doula?
A birth doula is a non-medical professional birth worker that you hire to be with you during labor and delivery. They help labor progress more comfortably, increase your feelings of safety, and help your partner be more involved. The term doula comes from the Greek word meaning woman, caregiver or servant.
Doulas provide physical support, emotional support, and informational support.
Doulas know birth well. They have seen birth unfold first-hand many times and so are specially equipped to walk with you on your journey.
Birth doulas are trained to assist during labor. Most have one or more certifications or training that give them special knowledge in the birth room. They have a ‘bag of tricks’ they use to help you during the experience. They can help you find the best position to labor in, explain the birth process, suggest certain movements or exercises to bring baby down or for pain relief, give massages, work with essential oils, and much more. Birth doulas are really good at helping create birth plans and many offer childbirth education classes to help prepare you for the birth you are seeking.
Doulas are present! One of the best parts about having a doula is that she stays with you, providing continuous support during labor. Your nurse and provider will be in and out of the room attending to their other duties. A doula is beholden to no one except you and she stays by your side no matter how long it takes to support you during labor. According to the American College of Obstetricians and Gynecologists (ACOG “evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor.”
Postpartum doulas provide post-birth support in the first days and weeks after your new baby arrives. Many birth doulas will include 1 postpartum visit as part of their services. Postpartum doulas provide practical and educational support to help with mother-baby bonding, infant feeding and newborn care, emotional and physical recovery from your birth, and techniques for soothing your baby. Postpartum doulas may also help with the baby’s laundry, the dishes or prepare a healthy meal for you.
An antepartum doula works to support and assist women who are on bed rest or those with a high risk-pregnancy. Her job is to help get the pregnant mother as close to her full-term due date as possible so she may deliver a healthy full-term baby. Similar to postpartum doulas, antepartum doulas provide care in a woman’s home. They may support the mother by helping with light house cleaning, prepare meals, go grocery shopping, run errands and more.
Doulas can be trained in more than one area and are able to serve as more than one type of doula. The information in this article is primarily about birth doulas.
What is the Difference Between a Doula and a Midwife?
A Midwife is a health care provider. Though Midwives practice the Midwifery Model of Care (as opposed to the Medical Model of Care practiced by most OB’s), they are still responsible for your medical situation. It’s the Midwife’s job to keep an eye on your labor progress, your vital signs, and baby’s tolerance to labor.
A Midwife will be the one watching for and handling issues if they arise. Your doula’s job is to help you manage the intensity of labor.
The Midwife is charged with issues of safety; your doula, with issues of comfort.
Many Midwives also act in a doula-like capacity in labor. A Midwife is more likely than an OB to rub your back, ask how you’re feeling, and suggest position changes. But she is not a doula because her first priority is to your safety. You can learn about Choosing a Care Provider here.
Do I Need A Doula if I Have a Midwife?
Everyone deserves a doula. As we discussed above, a Midwife is more likely than an ob/gyn to consider your comfort. But a vast majority of Midwives do not stay by your side or have your comfort as their primary concern. A doula does.
No matter what kind of birth you are planning, a doula can make it better, easier and more joyful. Drug-free, natural birth with a Midwife is a great place to have a doula because she can help with comfort measures and navigate the intensity of the experience. Even a pre-labor cesarean benefits from a doula—someone to stay with you by the table if your partner goes to the baby.
The one situation that does not call for doula support is if you’re an experienced birther and you would really not benefit from an extra presence. Otherwise, a doula can help tremendously.
What Kind of Things Does a Doula Do?
Most relationships with a doula start in pregnancy. You find someone you feel good about and meet once or twice for prenatal visits. During this time she will give you her tips for labor and you’ll talk about your birth plan, including what you envision everyone’s roles on your birth team being.
In labor, a doula does many, many things all tailored to the needs of her client and the labor. Some use the rebozo a lot, some use plenty of encouraging speech, some are trained massage therapists. Doulas are people, so their practice styles vary.
A Doula Might:
- Help you stay calm
- Run errands for you
- Answer your questions
- Explain your options
- Suggest changes in position
- Support you physically
- Hold your hand
- Give unbiased support
- Help you labor longer at home
- Take photos
- Make sure you stay hydrated and fed
- Share tricks to help progress, even with an epidural
- Explain what is happening, even if no one else does
- Help you write your birth plan
- Help you breathe optimally
- Share in the emotion
- Help start breastfeeding
How Much Does a Doula Cost?
The cost varies a lot. Sometimes there are new doulas looking for experience, nursing students or staff doulas that you can use for free. Some high-demand luxury doulas charge thousands of dollars.
What doulas charge also depends on where you live. In smaller towns, it can be as low as $400 and in big cities, the average is closer to $1000. Many offer payment plans.
What are the Benefits of Having a Doula?
The benefits of a qualified doula cannot be enumerated, as they will vary as widely as the doulas and the people who hire them. Here are some common perks:
- You pick the certified doula who is right for you and she shows up—no on-call lottery
- She stays with you through shift changes, overnight, and into the next day if necessary
- She helps your partner be more involved
- You’re likely to experience an easier, more physiologically natural birth (see below)
- She can help you navigate hospital procedures, rules, and events
- Prenatal assistance with questions, choosing a medical care provider, and community resources
- Increase in confidence and positive thinking about birth and yourself
- Access to a lending library of books and labor tools
- You are less likely to have a c-section. A 39% decrease in cesarean birth has been shown with doula support!
Is There Any Research About the Benefits of Doulas in Labor?
Research shows that, with the continuous support of a doula present in labor, you’re more likely to:
- Feel less pain
- Have a vaginal birth
- Avoid epidural pain medication, if you want to
- Labor under your own power, without augmentation
- Have a shorter labor (by an average of 41 minutes)
- Deliver without forceps or vacuum
- Have a baby with a high Apgar score
- Have a more positive childbirth experience
- Be satisfied with your birth experience
Are There Any Disadvantages of Doulas?
Doulas are great but as Dr. Elizabeth often reminds expecting moms “Doulas are not magic wands”. Hiring a doula will surely improve your odds of a vaginal birth and lower your risk of having C-section delivery. Choosing the right provider and place to have your baby is of utmost importance along with having a doula. Doulas can help advocate for you but your birth will often unfold based on how your provider and hospital/birth center practice. Doulas are often well-versed in knowing which providers may provide specific birth choices like waterbirth at a birth center or VBAC (Vaginal Birth After Cesarean). Honestly there is no real disadvantage to having a doula in the delivery room at your baby’s birth.
Can my Husband/Friend/Mom/Partner be My Doula?
In the olden days, we had lots of supportive female family members and friends to be with us in labor. Most of them were there for our comfort and would have seen plenty of birth before it. If you have someone in your life who can act as a labor support person, that may work just fine. It may also backfire because of their close association with you.
One of the benefits of a doula is that they aren’t emotionally tied up in your birth the same way your partner or mom is. They experience emotion, of course, and may even show it. But they are not paralyzed or confused by it the way someone who is part of your daily life may be.
This is one reason why you need a doula’s care, even in you have an awesome partner.
Especially if your partner is male, the doula will actually help them be more involved. The concept of men at birth is very, very new in the history of the world. Thousands of years of birth and only in the last 50 have we even thought about inviting the men we love into the room. They usually need some help being there.
Moms are a tricky one, too. If your mom or friend knows birth and your relationship is such that they make you feel awesome 99% of the time, they may be effective at continuous labor support.
Where Do I Find a Doula?
Ask your Midwife if she has any recommendations, but don’t stop there. Look for business cards around your birthing center or waiting room. Ask other moms in the area.
Tips for Hiring the Right Doula for You:
- Always interview more than one doula. They often have ‘meet-for-coffee’ visits where you can learn more about their practice and see if you are a good fit.
- The person you hire should make you and your partner feel very comfortable, positive, and relaxed. It doesn’t matter as much how many births she’s seen or what credentials she has. What really matters is that having her in the room will be a continuous physical, emotional, and informational support well worth your time and money.
Birth is a big deal! There is no bigger deal. You can’t have this birth to do again. Invest in certified doula care.
Send us an email for access to one of our preferred doulas in your area. Email us here
Disclaimer: Pregnancy by Design’s information is not a substitute for professional medical advice or treatment. Always ask your healthcare provider about any health concerns you may have.
ACOG (2019). Approaches to Limit Intervention During Labor and Birth. Number 766 (Replaces Committee Opinion No. 687, February 2017. Reaffirmed 2021). Retrieved from https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth.pdf
American Pregnancy Association (2017). Having a Doula: Is a Doula for Me? Retrieved from https://americanpregnancy.org/labor-and-birth/having-a-doula/.
Dona International (2018). Benefits of a Doula. Retrieved from https://www.dona.org/what-is-a-doula/benefits-of-a-doula/.
Evidence Based Birth (2017). Evidence on: Doulas. Retrieved from https://evidencebasedbirth.com/the-evidence-for-doulas/.
Free Video Guide on Creating Your Birth Plan!
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