What is a Doula?

A doula is a trained birth professional who provides informational, physical and emotional support to women in childbirth and the fourth trimester.  A doula is educated in the physiology of birth and the emotional needs of a woman before, during and after delivery.  A doula is a specialist in newborn care and trained to provide effective support to a family that has just welcomed a new baby.  During this time a doula plays many roles - a teacher, a mentor, a friend, a cheerleader, a wise woman, an advocate, a baby whisperer, a listener, a godsend.


A doula is not a medical professional, however she fills some important gaps in maternity care.  While doctors, nurses and midwives may be attending other patients at any given time, a doula is dedicated solely to her client.  She provides continuous support – meaning that a doula does not leave a birthing mother’s side during labor, no matter what else is going on in the birthing room.  Doulas spend time getting to know clients before birth and have a thorough understanding of their birth preferences.  Doulas use this knowledge to facilitate communication amongst the birth team so that clients can make the best decisions for themselves and their babies.  A doula fills another critical gap in the weeks after the baby is born and before the mother's postpartum check-up.  A new mother’s body and emotions are going through huge changes during this time, and the professional support of a postpartum doula can lead to faster healing, less anxiety and improved breastfeeding outcomes.


Do I need a birth doula if my partner is going to support me in labor?

A doula does not in any way take the place of a birth partner.  If your partner plans to provide one-to-one, continuous support during labor, a doula can use her knowledge and experience to guide the partner.  A doula can step into that role when the partner needs to take a break, eat or get some rest, ensuring that you are never left alone.  Or a doula and the partner can work together, delivering comfort measures in tandem.  Oftentimes, four hands are better than two!


What if I want to have an epidural?

A doula does not judge anybody’s birth preferences, and if a client wants an epidural that is absolutely fine! A doula can help manage pain before the epidural takes effect and is ready to deliver comfort measures if the epidural wears off.  A doula can help a client who has had an epidural use positional change to facilitate progress and prevent fluid build up.  Doula care during an epidural can decrease the need for further interventions.


Do I need a postpartum doula if my mother is planning to help me after the birth?

If you have family or friends who want to help out after the birth of your baby, that's awesome.  It can be exhilarating but also exhausting and even stressful to have lots of people in and out of the house when you've just had a baby.  Sometimes you will hear well-meant but contradictory or outdated advice that just doesn’t feel right to you.  A postpartum doula uses up-to-date, evidence-based information to help you figure out how you want to parent.  Hiring a postpartum doula can free up friends and family so they can spend meaningful time with you and the baby, instead of trying to get everything done around the house.


How can I justify the cost of a doula? 

Hiring a doula can be expensive.  Ideally, insurers would recognize that doula care leads to better birth outcomes and lower medical costs and would cover this support as a basic component of maternity care.  Unfortunately we're not there yet, and in the meantime doulas need to make a living. When you take a close look at what a doula puts into each birth - in terms of time, education, travel, childcare for her own family, business overhead and (unquantifiable but very real) heart and soul - you see that most doulas barely break even attending births.  

To determine whether this expenditure is right for you, consider that giving birth is one of the most formative events in a person's life and that the memory of this event is going to be one of your deepest, most visceral memories.  Studies have shown that when a woman gives birth with the support of a doula, she tends to feel better about her birth experience - even when things don't go as planned. For an experience you are going to carry with you at the deepest level of your being, this is surely worth investing in.  It is rare to meet someone who doesn't think their doula was worth every penny.

If you really want a doula but don't think you can afford one, ask about a discount or the possibility of bartering services.  Some doulas are open to this.  


The amazing benefits of doula care

According to a 2012 Cochrane study by Hodnett et al., birthing women who have the continuous support of a doula experience:

  • 28% decrease in the risk of a cesarean
  • 31% decrease in the use of Pitocin
  • 14% decrease in the risk of newborn admission to the NICU
  • 12% increase in the likelihood of a spontaneous vaginal birth
  • 9% decrease in the use of any medications for pain relief
  • 34% decrease in feelings of dissatisfaction about the birth