What Does a Doula Do?

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A do-WHAT? If you know what a doula is, you may think that they are angels-in-disguise, or you may think they are obnoxious know-it-alls. If you don’t know what a doula is, you may wonder if she delivers babies or performs voodoo.

In actuality, none of these are true! But if you don’t know yet, don’t worry- at first I knew nothing of doulas either. My first pregnancy got me hooked on all things birth and babies and it was after having a fantastic first birth experience with a well-equipped, knowledgeable, and compassionate birth team that I decided to pursue becoming a doula. But more on why I became a doula later. (That’s for another post!) Let’s address some of the most common FAQs about doula-ship.

veritybirth2My midwife acting as a doula during the birth of our second baby. Many thanks to Emily of Sweet Moments Photography for this shot!

What is a doula?

“Doula” is the Greek word for “servant,” and the term has recently come to be associated with a trained assistant who serves a mother before, during, and after birth.

  • Before birth, the doula discusses various birth options and procedures with expectant families, and helps them obtain the necessary information to make informed decisions. She helps parents work through fears, concerns, hopes, and desires for their births. She can also help to create a birth plan and provides childbirth preparation for the big day. Note that this preparation is not meant to be a substitution for a full childbirth education course.
  • During labor and birth, the doula provides continuous emotional support and physical comfort means to the mother. She helps the mother’s other support persons to be involved as much as they are comfortable. She can, when needed, act as a liaison between parents and staff in order to help protect the parents’ birth plan. She provides guidance and information during labor if any new options or twists and turns arise. She is always available to complete whatever tasks are needed to be done- no job is too demanding or too insignificant.
  • After birth, the doula helps to promote early bonding with the newborn. She helps the mother to establish breastfeeding. She ensures that the couple is comfortable and that their needs are met before leaving the birth.
  • In the early postpartum period, the doula follows up with the parents to review the birth, help with breastfeeding and newborn care questions, and to refer the mom to any other resources that she might need.

What kind of support does a doula offer during labor?

During labor, a doula may use or show the mother and partner how to use: hydrotherapy, massage, counter-pressure, light touch, a birth ball, hot or cold compresses, movement and positioning, breathing techniques, vocalization, visualization, deep relaxation techniques, music, aromatherapy, and constant encouragement. She will help to encourage optimal fetal positioning, good progress, and maximum comfort for the mother. She provides guidance for working with a textbook labor as well as for dealing with the challenges of variations of “normal.” Ultimately, the mother writes the job description for the doula, and the doula remains alert and sensitive to what the family needs at any given time during labor.

What doesn’t a doula do?

A doula does not offer clinical advice, perform medical tasks, diagnose or prescribe treatment for any medical condition, speak for you or make decisions for you, project her own birthing values onto your situation, or take the place of the partner.

Are there any proven benefits of having a doula?

Yes! Several studies have been done to show the benefits of a doula. According to The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth (A Merloyd Lawrence Book), doula support in labor:

  • Reduces the cesarean rate by 45%
  • Reduces length of labor by 25%
  • Reduces use of oxytocin [pitocin] by 50%
  • Reduces use of pain medication by 31%
  • Reduces the need for forceps by 34%
  • Reduces the request for epidurals by 10-60%.

Less intervention means, in turn, less undesirable side effects and negative consequences for mother and baby, leaving both healthier and happier after labor.

The benefits of doula support don’t stop there, however. Studies have also shown that mothers who had doulas during their labors seem to have an overall smoother transition into motherhood, demonstrated by less anxiety, more affection towards their newborns, higher rates of breastfeeding, and other benefits. See this post on Long Term Benefits of Doula Support During Labor for more information.

What will my partner’s role be when we hire a doula?

Your partner can be involved as much or as little as he would like to be. The doula never replaces your partner; rather, she complements his role and encourages him to take part as he is comfortable. The doula can show the partner how to help the mother with various comfort means, she can act as a team with the partner in supporting the mother, she can back off and let the partner and mother do their thing on their own, or she can step in completely for the partner when he needs a break or if he is not at ease taking part in the birth. Your partner’s level of involvement is completely up to the two of you.

What birth settings does a doula attend?

Most doulas will happily attend whatever birth setting you are most comfortable in, be that home, hospital, birth center, or other setting.

Do doulas support women who want pain medication?

Yes. While many doulas are passionate about natural birth, we also feel privileged to serve a mother who chooses pain medication during labor. A doula’s goal should be to help you become informed about the pros and cons of each option available to you and then allow you to make your own decisions for your birth. If you choose pain medication, she will support your decision and provide guidance so you can maximize the benefits of the medication and work to minimize its negative side effects.

Do doulas attend cesarean births?

Doulas can support you through your cesarean as long as your birth place allows her presence during the surgery.

Do doulas take insurance?

Most insurance companies currently do not cover doulas. However, I frequently urge parents to contact their insurance companies and ask them to cover doula services. Show them the research that proves how a doula can minimize the chances of complications and procedures that carry much higher costs (such as a cesarean or extended hospital stays from complications, etc.). Insurance companies will only start listening after enough consumers start demanding changes in their services. If parents take their money elsewhere to an insurance company that will cover a doula, that speaks even louder.

My family can’t afford a doula, but we would really love to have one. Do doulas offer flexible payment options?

Many doulas are willing to offer a sliding-scale payment fee, reduced fees, barter arrangements, or even freebies if parents truly want a doula assisted birth but are unable to pay for one. Many times doulas-in-training offer reduced fees as well but can still offer invaluable services. This flexibility comes from our believe that women deserve the best birth possible, regardless of financial status.

These are some of the most common questions about a doula’s role, but if I didn’t address all of your questions, please feel free to ask and I will try to answer. Did you have a doula assisted birth? What did your doula do for you?


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