“You’re a what?” This is the usual response when people ask what I do. It seems the hierarchy of well-known birth professionals is OB-GYN (Obstetrician-Gynecologist) at the top, CNM (Certified Nurse Midwife), then somewhere amongst the various birth terms you’ll find doula. In fact, while typing this my spell check is flabbergasted by the word, trying to get me to change it to an actual word. Tisk tisk, spell check.
So what exactly is a doula?
A doula is a non-medical professional who provides informational support prenatally, physical and emotional support during labor and birth, and usually a post partum visit to go over the birth and give any additional resources or breastfeeding assistance if needed.
Let’s break this down a bit more.
Most doulas attend intense training workshops to learn the phases and stages of birth, mental and physical sensations the laboring mother is experiencing, and what comfort measures/positions/words are appropriate to best guide her through the birthing experience with the most comfort. Some doulas are certified while others aren’t and there are various doula organizations with their own requirements in order to obtain certification. Along with the formal training, doulas are constantly learning and expanding their knowledge base as new research is released. The experience of attending births comes with an abundance of insight that can only be learned on the job. We really do learn something new at each birth that we can carry to the next.
With the overwhelming amount of information pregnant families have to learn, a doula will help them navigate their way through the most important parts of it such as:
- Explaining the pros and cons of procedures/interventions
- Assisting with the birth preferences sheet which will outline your wishes for labor and subsequent baby care procedures (this is a must for hospital settings)
- Educating and empowering the mother to help ease any fears or concerns about the birth process
- Recommend resources for prenatal care such as chiropractors, childbirth educators, acupuncturists, yoga instructors, lactation consultants, massage therapists, etc.
- Review various comfort measures both physical and mental to expand your ”labor toolkit”
A doula is not there to run the show or take over the role of the birth partner. They are your advocate to help you fulfill the kind of birth you desire. They work alongside you, your partner, and all other support persons as a team, your birth team, to support you along the transformative journey of birth.
Do I need a doula if I have a midwife?
You know that answer is YES! Although midwives do provide more nurturing, hands-on care than an OB, they are still responsible for checking heart tones, temperature, recording various labor events and of course catching (or assisted catching) your baby. Some midwives do perform doula tasks but generally they need to be running on all cylinders executing their own duties to ensure a safe and healthy mom and baby without being completely exhausted. That’s where a doula comes in. Your doula will be with you from the moment you say you need them even if you are still in very early labor and stay with you continuously until the birth. Midwives usually come in during active labor around 4-6 centimeters dilation and by this point it’s best to already have a rhythm established to help you cope with labor especially if you want a narcotic free birth.
Do I need a doula for a hospital birth?
Absolutely. The doctors working in hospitals use a medical model of care which regards a laboring woman as a patient that needs help birthing her baby rather than allowing the body to work naturally and to only intervene on an as-needed basis. Since the use of interventions is quite high, your doula will be by your side to explain the pros and cons of suggested augmentations so you can make an informed decision on your own as opposed to letting your doctor decide for you. Your doula will be familiar with the hospitals policies/doctors/nurses and be able to guide you every step of the way with full confidence. Doulas work with the staff to support you. If an epidural is in your birth plan, you will need to be able to effectively manage your contractions until the anesthesiologist is available to come to you. Also, sometimes epidurals work on only half of the body or not at all so if that situation happens to you, your doula will be able to help you through it.
Did you know there are different kinds of doulas?
You can think of a doula as your tour guide through the child bearing phase of life. There are Fertility Doulas who will help those who are trying to conceive but finding it challenging. Birth Doulas are the most common which embody everything we’ve covered thus far. Postpartum Doulas are available to help the transition of a new baby into the parents life offering breastfeeding support, newborn care, physical and emotional recovery from birth, bonding, and any other type of guidance you need from birth to several weeks postpartum, depending on whatever schedule the family needs. For those who suffer a pregnancy loss of any kind, a Bereavement Doula can soothe and support the grieving family. These doulas are one of a kind as they do not accept money for their services (unless donations are given). There really IS a doula for EVERYONE interested in having a child and there are studies that can confirm the benefits of doula care.
Let’s look at the research.
When you hire a doula you are hiring someone who is there to advocate for you, who is able to turn off their inner dialogue to be present for you, to comfort you, and to hold the sacred space for you. This is a necessity during these life moments. These are people you will always remember playing a pivotal role in your experience so it is recommended to interview a few doulas before choosing the one who will be the best fit for you and your partner.
I urge you to read the full Cochrane Review that was summarized for the Health Benefits infographic above: Continuous Support for Women During Childbirth.
If you want to find doulas in your area you can use several websites such as: