What is a doula?
The word "doula" is from ancient Greek and means "a woman who serves." Doula is now used to refer to a trained birth professional who provides continuous physical, emotional and informational support to expectant mothers before, during and after birth. A birth doula provides this support prenatally, during labor, and for up to several hours following birth.
What does a birth doula do?
A birth doula provides continuous physical, emotional, and informational support to laboring women and their partners before, during, and just after childbirth. Specifically, a doula:
- assists with physical comfort measures
- assists with information and communication with the medical team
- provides emotional reassurance and support
- helps mom obtain the necessary information to make informed medical decisions
- helps the birth partner to be more involved and comfortable
- supports the mother and her decisions
What does a birth doula NOT do?
- A doula does not do anything medical, or provide medical advice.
- A doula does not make decisions for you. This is your birth, not your doula's.
- A doula does not speak to medical personnel for you. Instead, your doula helps foster better communication between you and your caregivers.
- A doula does not take the place of your birth partner. Your birth partner, whether it is the baby's father or a close relative or friend, brings something to your labor room that a doula cannot replicate: an intimate emotional relationship with you and love for you and your unborn baby.
Why choose doula care?
Among the many benefits of doula care, women cared for by a doula, as compared to women receiving usual care, are 26% less likely to have a cesarean, 41% less likely to require vacuum or forceps delivery, 28% less likely to request pain medication, and 33% less likely to be dissatisfied or negatively rate their birth experience (Klaus, Kennell & Klaus. (2002). The Doula Book. Cambridge: Addison-Wesley.). For the partner, the doula can help him or her stay more emotionally involved with the laboring mom rather than have to remember the entire childbirth class during labor.
Numerous clinical studies have found that a doula’s presence at birth:
- reduces maternal dissatisfaction with one’s birth experience
- increases positive maternal attitude about the baby
- reduces the need for interventions such as pitocin, forceps or vacuum extraction
- reduces the requests for pain medication and epidurals
- reduces the incidence of cesareans
- reduces the incidence of postpartum depression
- reduces the length of hospital stays for babies
- reduces the rate of NICU admissions
- results in higher breastfeeding success
- results in more affectionate mothers postpartum
The American College of Obstetricians and Gynecologists agrees, doulas are one of many ways to improve birth outcomes for both mother and baby.
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.
Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.
You can read more about the clinical evidence on doula support at Evidence Based Birth.
What is the difference between a doula and a midwife? A doula and a nurse? Why have both?
A doula provides non-medical emotional support and physical comfort to laboring women. Doulas do not assess or diagnose medical conditions. A midwife is a medical professional specializing in supporting women through healthy pregnancies and births. Likewise, an obstetric nurse is a medical professional, specializing in the support of laboring women. All professionals are able to provide emotional support during childbirth.
However your midwife and nurse may have multiple patients laboring at the same time, so they may be needed elsewhere during your labor. Your midwife and nurse will also have administrative responsibilities. Finally, in the event of a medical emergency, your midwife and nurse will need to act quickly to perform their medical duties, and will be unable to provide emotional support during the emergency. Having a doula present will ensure you have continuous emotional support even when your midwife and nurse are tending to their other responsibilities.
Won't it be uncomfortable to have a stranger at my birth?
By the time you're in labor, your doula will no longer be a stranger. You will often have at least 2 meetings with your doula to discuss your hopes for your birth, and her continuous presence during your labor will be a comfort. Your doula will likely be less of a stranger than the several nurses that you may see during your labor.
I'm planning on having an epidural/ induction/ Cesarean. Can I still have a doula?
Yes! ALL women can benefit from doula care during childbirth. The benefits of doula care include women reporting greater satisfaction with their birth, making more positive assessments of their babies, less postpartum depression, shorter hospital stays for baby, and easier breastfeeding, benefits that are all independent of the method by which you birth.
Choosing a Birth Doula
To find birth doulas in your area, ask your midwife or doctor, childbirth instructor, friends, coworkers, and your hospital or birth center for references. You can also search with doula certifying agencies, such as DONA International (http://www.dona.org/mothers/find_a_doula.php).
I found some doulas, now what?
Once you have identified doulas who you are interested in hiring, the following interview questions should help you determine which doula is the right one for you.
- What training have you had?
- Are you certified? If so, with what organization?
- Do you have one or more backup doulas for times when you are not available? May we meet her/them?
- What is your fee, what does it include and what are your refund policies?
- Tell me about your experience as a birth doula.
- What is your philosophy about birth and supporting women and their partners through labor?
- May we meet to discuss our birth plans and the role you will play in supporting me through birth?
- May we call you with questions or concerns before and after the birth?
- When do you try to join women in labor? Do you come to our home or meet us at the place of birth?
- Do you meet with us after the birth to review the labor and answer questions?