Photo courtesy of The Doulagrapher
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What is a doula?
Doula is a Greek word meaning “servant”. We prefer the gentler translation of “Mothering the Mother”. Doulas love birth and babies and honor this time as an important rite of passage in a family’s life.
Birth doulas, or childbirth assistants, are trained professionals who serve the birthing woman and her partner. A doula supports women in achieving the birth they desire, whether at home, a birth center, or the hospital. She facilitates labor and birth by providing continuous physical and emotional support. She encourages informed consent for all decisions by offering objective, balanced information, and she respects whatever the family decides. In addition, a doula facilitates communication between the laboring woman, her partner, and their care provider.
Birth doulas, or childbirth assistants, are trained professionals who serve the birthing woman and her partner. A doula supports women in achieving the birth they desire, whether at home, a birth center, or the hospital. She facilitates labor and birth by providing continuous physical and emotional support. She encourages informed consent for all decisions by offering objective, balanced information, and she respects whatever the family decides. In addition, a doula facilitates communication between the laboring woman, her partner, and their care provider.
What are the benefits of hiring a doula?
Birth:
According to The Cochrane Review, hiring a doula to attend your birth means you are:
In addition, the presence of a doula:
Postpartum:
When a woman receives ample postpartum nurturing from a doula, she has:
According to The Cochrane Review, hiring a doula to attend your birth means you are:
- 26% less likely to give birth via cesarean section
- 41% less likely to give birth with vacuum extraction or forceps
- 28% less likely to use any pain medications
- 33% less likely to express dissatisfaction with your birth experience
In addition, the presence of a doula:
- reduces the need for labor augmentation with pitocin
- shortens overall length of labor
- enables partners to participate with confidence
- reduces the incidence of maternal fevers in labor
- decreases the incidence of postpartum depression
- increases successful breastfeeding
- lessens reports of pain at 24 hours postpartum
- enhances health of infants as measured 6 weeks postpartum
- improves a family’s satisfaction with the birth experience
- facilitates increased parental sensitivity and better infant bonding
Postpartum:
When a woman receives ample postpartum nurturing from a doula, she has:
- better sleep
- improved digestion
- greater milk supply
- a positive breastfeeding relationship with her baby
- reduced incidence of postpartum blues and depression
- less household stress and worry
- confidence and peace of mind
How does a birth doula serve me?
In the ancient tradition, a doula is a woman who provides wisdom and emotional support for her birthing sisters. She does this first by meeting with the expectant couple prenatally, in order to establish a comfortable relationship. She can help them explore their birth options and write an individualized birth plan. The doula may guide a couple in relaxation techniques or a labor rehearsal. She is available to answer questions and she will be on-call from late pregnancy until the birth. A doula offers to labor with the couple at their home even if they are planning to birth at the hospital or a birth center. Her experience is helpful in deciding when to travel to the birth location.
Doulas are not medical professionals and do not perform any clinical assessments. Rather, they serve as assistants to the mother. They are skilled at offering guidance for comfortable and effective laboring positions, helping mothers focus during contractions, and easing pain using a variety of non-pharmacological means. Doulas also improve the safety of birth by encouraging mothers’ basic biological needs for hydration, voiding, quiet, darkness, privacy, and warmth. A doula does not speak for a couple to their care provider. She instead facilitates their ability to self-advocate. She gently reminds them to voice their preferences, provides objective information about common procedures, and helps translate medical terminology.
Although nurses are experienced in dealing with a laboring woman's emotional and physical needs, they can seldom offer one-on-one support which lasts throughout the labor. Midwives may be able to offer more labor support, but they too have clinical duties to which they must attend. Continuous support from a doula gives parents the freedom to focus inward as they encounter the joys and possible challenges of their unique birth journey.
Following the birth, a doula remains with the couple and their baby to help initiate and establish breastfeeding. The time she stays varies from doula to doula and from birth to birth, but generally is 1-2 hours postpartum. Doulas will also establish a time to visit mom and baby postpartum, either in the hospital or at home. This visit is a chance for the doula to help the new mother process her labor and birth, and for all to admire the new baby.
In summary, a doula provides:
Doulas are not medical professionals and do not perform any clinical assessments. Rather, they serve as assistants to the mother. They are skilled at offering guidance for comfortable and effective laboring positions, helping mothers focus during contractions, and easing pain using a variety of non-pharmacological means. Doulas also improve the safety of birth by encouraging mothers’ basic biological needs for hydration, voiding, quiet, darkness, privacy, and warmth. A doula does not speak for a couple to their care provider. She instead facilitates their ability to self-advocate. She gently reminds them to voice their preferences, provides objective information about common procedures, and helps translate medical terminology.
Although nurses are experienced in dealing with a laboring woman's emotional and physical needs, they can seldom offer one-on-one support which lasts throughout the labor. Midwives may be able to offer more labor support, but they too have clinical duties to which they must attend. Continuous support from a doula gives parents the freedom to focus inward as they encounter the joys and possible challenges of their unique birth journey.
Following the birth, a doula remains with the couple and their baby to help initiate and establish breastfeeding. The time she stays varies from doula to doula and from birth to birth, but generally is 1-2 hours postpartum. Doulas will also establish a time to visit mom and baby postpartum, either in the hospital or at home. This visit is a chance for the doula to help the new mother process her labor and birth, and for all to admire the new baby.
In summary, a doula provides:
- late pregnancy advice & support as needed
- assistance in writing a birth plan
- 24-hour on-call availability
- continuous emotional and physical support during labor
- non-pharmacological pain relief measures
- positioning suggestions during labor and birth
- explanations of medical procedures
- support for the partner so that (s)he can love and encourage the laboring woman
- avoidance of unnecessary interventions
- help with initial breastfeeding
- other possibilities vary from doula to doula, including: reflexology, massage, aromatherapy, herbs, homeopathy, yoga, photography, birth music, mother blessing rituals, placenta encapsulation & more.
How does a postpartum doula serve me?
Postpartum doulas are dedicated to making this precious time one of ease and enjoyment. During the “fourth trimester”, both mother and baby are making tremendous and mostly invisible adjustments. The presence of a nonjudgmental, nurturing support person is vital to ease a smooth transition into motherhood. Doula services may include housekeeping, errands, childcare, meal preparation, lactation support, and education regarding common concerns of mother and baby. In addition, many postpartum doulas are also trained breastfeeding counselors.
Where can a birth doula serve me?
At Home - Whether you are planning a home birth or wanting to labor at home before being admitted to the hospital, your doula can be there to assist you. Labor tends to make the best progress wherever the mother is the most comfortable; for many women, this is in their own home. If you are choosing a home birth with a midwife, a doula complements your caregiver's role. Your doula provides continuous emotional/physical support, especially comforting you during those times when your midwife may be occupied with clinical assessments. During a prenatal visit with your doula, you can show her around your home so that she can familiarize herself with the setting and better serve you when it's time. In the event of an unanticipated transfer, your doula will go with your team to the hospital and continue to provide reassurance and support there. The continuity of a doula's presence will aide in adjusting to the change in plans and ease the transition from home to hospital. Even if your medical care must be managed by a doctor at the hospital, your doula care will not change.
At a Birth Center - During labor and delivery at a birth center, a doula provides the same support as during a home birth---she encourages, she listens, she offers her hands and heart to support you. As with a home birth, if you unexpectedly need to be or want to be admitted to a hospital, your doula goes with you. Having already gotten to know your preferences during labor, your doula can continue to support you in the manner that suits you best.
At a Hospital - During labor, your doula can give you information about proposed procedures (continuous fetal monitoring, artificial rupture of membranes, Pitocin augmentation) and help you take the time to thoroughly consider your options. Your doula can also remind you of your birth plan or goals, help you advocate for yourself and "soften" the clinical atmosphere of a hospital birth suite.
In the OR - If you are planning a C-section, your doula can help you orchestrate a "family centered" birth that honors your desires before, during and after surgery. In the event of an unplanned Cesarean section, your doula can help you to emotionally process the change of events and continue to make your birth an empowering experience. Some physicians allow doulas in the operating room, some do not, but nearly all doulas will stay at the hospital during surgery and resume supporting you as soon as possible during recovery. If your partner accompanies your new baby while you are still undergoing surgery or if complications separate you from your baby during the immediate postpartum period, your doula stays by your side. A doula's presence following a surgical birth can be invaluable when it comes to fostering positive memories of your birth, establishing breastfeeding and getting the best possible start to motherhood.
At a Birth Center - During labor and delivery at a birth center, a doula provides the same support as during a home birth---she encourages, she listens, she offers her hands and heart to support you. As with a home birth, if you unexpectedly need to be or want to be admitted to a hospital, your doula goes with you. Having already gotten to know your preferences during labor, your doula can continue to support you in the manner that suits you best.
At a Hospital - During labor, your doula can give you information about proposed procedures (continuous fetal monitoring, artificial rupture of membranes, Pitocin augmentation) and help you take the time to thoroughly consider your options. Your doula can also remind you of your birth plan or goals, help you advocate for yourself and "soften" the clinical atmosphere of a hospital birth suite.
In the OR - If you are planning a C-section, your doula can help you orchestrate a "family centered" birth that honors your desires before, during and after surgery. In the event of an unplanned Cesarean section, your doula can help you to emotionally process the change of events and continue to make your birth an empowering experience. Some physicians allow doulas in the operating room, some do not, but nearly all doulas will stay at the hospital during surgery and resume supporting you as soon as possible during recovery. If your partner accompanies your new baby while you are still undergoing surgery or if complications separate you from your baby during the immediate postpartum period, your doula stays by your side. A doula's presence following a surgical birth can be invaluable when it comes to fostering positive memories of your birth, establishing breastfeeding and getting the best possible start to motherhood.
Photo Courtesy of The Doulagrapher
Must I have a natural birth to work with a doula?
No! Doula care is valuable at each and every birth. A doula will support your birth choices completely and without judgment, even if you change birth plans mid-stream. Doulas believe strongly in informed decision making, so your doula will supply you with unbiased information if you need it. All birthing women are treated with love and respect.
How can a doula support a cesarean birth?
When you consider that one of the doula's primary jobs is to preserve positive memories of your birth, thus promoting higher self-esteem, it stands to reason that women undergoing a cesarean birth are especially in need of doulas. If you were to have a cesarean birth, your doula might be useful to you in many ways. First, if your cesarean was not planned—meaning that at some point during labor a surgical birth was recommended—your doula should be able to guide you in asking questions that will help you gather necessary information about the reasons your caregiver recommends a cesarean, the risks and benefits relative to your particular situation, and any alternatives you may have. Hopefully she will then facilitate your having time alone with your partner so you may process that information and come to a decision without feeling pressured. Couples who have had a chance to discuss a cesarean recommendation in this way are more likely to believe that they made an informed decision rather than an uninformed one and are, therefore, more likely to be satisfied with a surgical outcome. Other ways in which a doula might help with a cesarean section, planned or unplanned, include:
- During the pre-operative period, your doula can help explain procedures to you and help you get answers to any questions that you have, much like she would during a vaginal birth. Your doula can help you cope with painful procedures like the administration of an IV or the placement of spinal/epidural anesthesia for your surgery.
- Once inside the operating room, your doula will assist you in knowing what is happening by describing whatever you wish to know. Your doula will be at your side. She can take photos if you desire, particularly after the baby is born. She can remind the staff of any special requests you may have.
- If your baby needs to go to a warming table or the nursery, your husband can go with the baby, while your doula stays by your side. She can also act as a liaison between you and the staff so you remain appraised of your baby while you are separated. Many mothers feel frightened or alone during this time and having a doula by your side will help alleviate those emotions.
- During the postpartum period your doula can suggest post-operative comfort measures. She can assist you with any breastfeeding questions you may have, help you find the most comfortable positions for breastfeeding, or offer other special help you or baby might require.
If my partner is with me, why do I need a doula?
First-time parents often feel overwhelmed by the amount of new information they have learned in preparation for birth. Birth can be a powerful emotional journey for both parents. It is comforting to have a knowledgeable doula present who can answer questions in an objective, nonjudgmental manner.
For all couples, regardless of whether they have birthed before, there is tremendous benefit. A doula can create space for the woman’s partner to participate at her/his comfort level, reducing anxiety. Because doulas understand the normal processes of birth, they can reassure partners who may be perplexed by unusual birth behaviors. In addition, even prepared partners may be surprised at the intense work of assisting a laboring woman. A doula can “spell’ the partner when (s)he becomes tired, thus ensuring the mother has continuous support.
Studies show that partners participate more actively during labor when a doula is present. Rather than replacing a loving partner, a doula encourages the partner and enhances her/his ability to provide comfort.
For all couples, regardless of whether they have birthed before, there is tremendous benefit. A doula can create space for the woman’s partner to participate at her/his comfort level, reducing anxiety. Because doulas understand the normal processes of birth, they can reassure partners who may be perplexed by unusual birth behaviors. In addition, even prepared partners may be surprised at the intense work of assisting a laboring woman. A doula can “spell’ the partner when (s)he becomes tired, thus ensuring the mother has continuous support.
Studies show that partners participate more actively during labor when a doula is present. Rather than replacing a loving partner, a doula encourages the partner and enhances her/his ability to provide comfort.
What should I ask a prospective doula?
- What is your experience with birth/postpartum, both personally and professionally?
- What is your philosophy about birth/postpartum?
- Describe your doula training.
- Are you certified? By what organization(s)?
- When may we call you? May we call with questions and concerns?
- What are your fees? When is payment expected? What are your refund policies?
- May we request references from former clients?
- What is your experience in teaching breastfeeding techniques?
- What has been your most challenging situation as a doula, and how did you respond?
For birth doula:
- Do you provide prenatal and postpartum visits?
- What can I expect during these visits?
- What is your role in early labor? Active labor? Birth? Immediate postpartum?
- Do you provide labor support in our home?
- What comfort measures do you use for relaxation and pain relief?
- What kind of help do you offer to partners of laboring mothers?
- What types of births have you attended (Cesarean, epidural, intervention-free, VBAC, multiples, teen birth, etc.)?
- Have you ever worked with my midwife/physician?
- Are you on-call for more than one client at a time? If so, what are your back-up arrangements?
For postpartum doula:
- What types of services do you offer?
- How soon after birth do your services begin?
- When are you available?
- Are you currently certified in infant/child CPR?
What are typical financial arrangements?
Cost of services varies from doula to doula. In general…
Birth doulas request to be paid a deposit at the time of signing a contract; usually this represents a portion of the total fee. Some doulas wish to collect their entire fee prior to the birth, while others are content to receive prompt payment at the first postpartum visit.
Postpartum doulas charge by the hour and typically request to work a minimum of several hours per visit.
Please discuss payment plans with your doula of choice. We hope that you will select your doula based on an intuitive comfort level and personality match, rather than by financial considerations!
Birth doulas request to be paid a deposit at the time of signing a contract; usually this represents a portion of the total fee. Some doulas wish to collect their entire fee prior to the birth, while others are content to receive prompt payment at the first postpartum visit.
Postpartum doulas charge by the hour and typically request to work a minimum of several hours per visit.
Please discuss payment plans with your doula of choice. We hope that you will select your doula based on an intuitive comfort level and personality match, rather than by financial considerations!
