Doulas are becoming a more well-known aspect of the birth team, but I was reminded the other day that there are still a lot of people who don’t know what a doula does. Let’s go over several questions you may have about the role, benefits, and science of having a doula. This is a long one, so grab your hot chocolate and come with me on this journey.
Labor is hard. It requires a lot of physical and mental fortitude. Having a baby is something our society has come back around to believing shouldn’t be done alone. Your likelihood of having the experience you are looking for increases dramatically with the physical, emotional, and educational support a doula provides.
DONA says a doula is
“a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.”
What does a birth doula do?
Ok. A definition is helpful and all, but you want more specifics, right? Many families don’t realize that the hospital staff are in the room for an estimated total of 2 hours (EveryMotherCounts.org). Medical staff come and go because they have other patients to care for. The beauty of a doula is continuous labor support. That means your doula stays with you throughout the duration of your labor, delivery, and even a few hours after you have the baby. A doula’s estimated average time with their client during labor and delivery is 18 hours. That doesn’t include the 2 hour prenatal visits and the 2 hour postpartum visit.
Preparation
During those prenatal visits with your doula, you’ll discuss your goals and dreams for the birth of your baby, a very special and precious event. Your doula will help you with your birth plan. The birth plan is a way to educate and learn about your options. It lets your birth team know what your goals are and is meant to prepare you for any scenario. The prenatal is also the time to practice some comfort measures. Go through your doula’s bag, pull out tools, and identify which ones you like and don’t like. Labor is a physically draining task, so your doula may recommend snacks rich in proteins and sugars to help keep your energy at the appropriate level.
Physical Support
When you’re uncomfortable, do you move? Do you try to find a new position to relieve the tension in a muscle and stretch it out? A doula helps you identify those positions that can help ease, or at least help you manage, the intensity of your contractions. Your doula will give you position ideas to help keep your labor progressing or to help slow your labor down. Many people find themselves holding their breath through contractions. Your doula will remind you to breathe. Your doula has very skilled hands and has been trained in massage techniques and pressure techniques which help manage contractions and ultimately reduce labor pain. A skilled doula can even help reposition your body to help a “malpositioned baby find its way through the pelvis and into the birthing parent’s arms.” (DONA)
Emotional Support
When you feel supported, you relax. When you feel supported, you feel happy with your experience. The continuous support of a doula helps you feel supported. Birthing your baby has a multitude of emotions that come with the experience. From joy, sadness, fear, excitement, pain, contentment, and many more, your doula will help guide you through. Your doula can create a space which allows you to birth your baby gently. A calm space that allows you to focus internally without worrying about what is happening around you; where you can just experience.
Educational Support
Have you heard the saying, “You don’t know what you don’t know.”? This is such a true statement. Although birth is quite a common occurrence, we are surprisingly limited in our knowledge and education of the event. A doula can help remedy that. Your doula will help you feel fully prepared for this major life event. Education is a big aspect of giving you resources to help you make the best decision about a medical procedure.
Partner Support
Your birth partner may be a spouse, friend, or other family member. And they are just as much a member of your birth team as your nurse, OB, midwife, or other medical personnel. Your doula will treat your partner as such by giving your birth partner tools during the prenatal to help you both learn your limits and how your birth partner can support you. Not to mention, labor can be as stressful for your birth partner so your doula will make sure your birth partner eats, drinks, rests, understands what is happening, and will help your birth partner participate in supporting you at the level they are comfortable.
Advocacy
Whether you’re someone who speaks up when you’re uncomfortable or not, our society has ingrained in us that the “doctor knows best.” It’s similar to the teacher-student or parent-child dynamic. The doctor is the knowledgeable individual in the room so we tend to bend to their wishes. Contrary to popular belief, the person having the baby is the one in control. You have the right to ask questions. You have the right to decline services, or ask for them. A lot of times its information that is lacking and a doula can help bridge that gap between professional and patient to get answers, helping you make informed decisions and feel good about those decisions.
What does a doula NOT do?
Since doulas are not trained medical professionals, it is not part of their scope to perform medical tasks such as checking your cervix, taking blood pressure, or giving you medication. A doula should not give you medical advice. Doulas can give you information and resources so you can make your own, informed, decisions.
What type of training do doulas receive?
Although there is no national certification requirement for doulas, many doulas choose to become certified. Organizations such as DONA International and Stillbirthday provide workshops, reading material, and other requirements before they certify their doulas. A certifying organization has Standards of Practice and Ethics their doulas must follow and continuing education requirements to maintain their certification status.
What are the benefits of having a doula?
Countless studies have been done gauging this very question. A doula can help reduce the likeliness of many medical interventions such as induction, breaking waters, pitocin, epidurals, and cesarean. Having a doula supporting you has been shown to shorten the length of labor. With easier, less medicated labor, a doula supporting the family has shown a decrease in newborns sent to the NICU. When a person birthing their baby feels in control and happy about their experience, they are less likely to develop postpartum depression, anxiety, psychosis, or other postpartum mood disorders. Through the support of a doula, the birth partner’s happiness in the birthing experience increases. With fewer interventions comes less cost for the family, so the support of a doula can save you money.
The postpartum support a doula can provide helps increase the likelihood of successful, long-term breastfeeding. Many people don’t know how to care for a newborn, a doula can help you transition into the new role you’re taking on. Having a newborn is hard. Healing from birthing that newborn is hard. Your postpartum doula can help ease the new stress and strains as you heal and learn your baby’s personality, likes, and dislikes.
Is a doula right for me?
YES. That’s the short, quick answer. Truly, every family will benefit by having a birth doula on their team. A doula can support not only an unmedicated birth but also someone who chooses to have an epidural and even cesarean deliveries. Doctors, midwives, and nurses are definitely a much-needed part of your birth team, and so are doulas. Your doula is available by phone, text, email, Facebook, or however you’ve set up your communication channel, pretty much 24/7. Your doula is someone you can talk to about the reservations you have, about your excitement, about your grief. Just remember, the doula you hire is for YOU and works for YOU. Your doula is unbiased support.
What does it look like to have a doula?
You can hire your doula as soon as you find out you’re pregnant. Shoot! Some people hire their doula while they’re still trying! Some hire their doula mid-way through their pregnancies, while others hire them closer to the end. It’s a personal decision or happenstance as to when you first heard the term doula. No matter when you hire your doula, you’ll be supported with information and emotional and physical support during your pregnancy, labor, and delivery.
How much does a doula cost?
Doulas usually run their own private businesses and make their own prices. In Kansas City, doula services can range from $600-$2500 depending on the training, experience, and services the doula provides. Some doulas offer secondary services such as photography, placenta encapsulation, belly binding, art, or other expertise. To see the services and package pricing Birth it Forward offers, visit our Birth Doula Services page. A doula may be an out-of-pocket expense, but their cost is usually a flat rate and can be paid with a payment plan. Some insurance companies will even cover the cost of a doula.
How do I hire a doula?
Are you ready to chat with us and see if we’re the right fit for you? We offer a free phone/Zoom consultation to get to know us, ask questions, and see if you want to move forward. You can visit our Doula Services page for information on our services and packages. If you’re ready to schedule a consultation you can fill out our Service Request Form or call at (816)-320-4800. Even better, if you’re ready to get your doula you can fill out our Intake Form!
Listen to the Podcast
Show Me the Evidence on Doulas
“Of all the ways we can find to give someone pain relief during child birth, providing a doula seems like one of the most important ways that we can manage pain. Doulas provide physical support, emotional support, information about child birth and advocacy, all of which can work together to decrease your pain”
Evidence Based Birth
“The evidence suggests that it is likely more than the emotional, physical, and informational support doulas give to women during the birthing process that accounts for the reduced need for clinical procedures during labor and birth, fewer birth complications, and more satisfying experiences during labor, birth and postpartum”
PMC
“A postpartum doula provides evidenced-based information on things such as infant feeding, emotional and physical recovery from birth, mother-baby bonding, infant soothing, and basic newborn care. Research shows that moms, dads, and babies have an easier time with this transition if a good support team is in place.”
American Pregnancy Association
The results of the study showed that doula’s presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula).
Case Study Preformed in Iran, 2017
“Continuous support from a person who is present solely to provide support, is not a member of the woman’s own network, is experienced in providing labour support, and has at least a modest amount of training (such as a doula), appears beneficial.”
Cochrane
“Doula” comes from a Greek term meaning “a woman who helps.” Although doulas are trained to assist expectant mothers through labor, delivery and beyond, they are not medical providers, as midwives are. Dona International, which calls itself the largest doula-certifying organization in the world, said doulas help mothers achieve “the healthiest, most satisfying experience possible”.
Washington Post
“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.”
ACOG
References
- Evidence Based Birth (EBB)
- Evidence on Doulas – https://evidencebasedbirth.com/the-evidence-for-doulas/
- Using a Doula for Pain Relief – https://evidencebasedbirth.com/using-a-doula-for-pain-relief/
- National Library of Medicine – Continuous Support for Women During Childbirth – https://pubmed.ncbi.nlm.nih.gov/23076901/
- National Library of Medicine – Articles about continuous support for women during childbirth – https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=23076901
- EveryMotherCounts.org – Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities – https://everymothercounts.org/wp-content/uploads/2019/03/Advancing-Birth-Justice-CBD-Models-as-Std-of-Care-3-25-19.pdf
- American College of Obstetricians and Gynecologists (ACOG) – Approaches to Limit Intervention During Labor and Birth – https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth
- Cochrane – Continuous support for women during childbirth – https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth
- PubMed.gov (PMC) – Comparison of the Effects of Using Physiological Methods and Accompanying a Doula in Deliveries on Nulliparous Women’s Anxiety and Pain: A Case Study in Iran – https://pubmed.ncbi.nlm.nih.gov/28961642/
- American Pregnancy Association – Postpartum Doula – https://americanpregnancy.org/healthy-pregnancy/planning/postpartum-doula-71046/
- PubMed.gov (PMC) – Impact of Doulas on Healthy Birth Outcomes – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/?fbclid=IwAR1bez_8ZQ2dBPTt5QXj4ise9w2FIqUkGb1kkUMC7NWwhNfyXl_BGPohnYk
- The Washington Post – Cities turn to doulas to give black babies a better chance at survival – https://www.washingtonpost.com/national/health-science/cities-turn-to-doulas-to-give-black-babies-a-better-chance-at-survival/2017/09/22/07420956-8363-11e7-ab27-1a21a8e006ab_story.html?fbclid=IwAR0Mw8lcOHbcco5GHaH7pmKPwNK3BgPFdpa_pmcOLT3WFlHd5x8l3QI60Q4
