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What is a Doula and How Can They Make Your Birth Better?

Do you want labor to go as well as possible and to be able to look back on your birth experience with satisfaction? Then you might want to hire a doula.

husband and wife practicing labor with a doula

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Whether you’ve decided to give birth unmedicated or you’re planning on an epidural, you might be curious about hiring a doula. If you’re wondering, “What exactly is a doula?” or “How is a doula different from a midwife?” or “Why might I want to hire a doula?” this blog post is for you.

Put simply, a birth doula is a person, usually a woman, who supports women during labor in a non-medical way. They are an essential part of some women’s positive birth experiences.

Let’s dig in a little deeper and look at what a doula actually does and the benefits of hiring a doula, as well as some other important things to know.

What Does a Doula Do?

A doula provides support to parents during late pregnancy, labor and birth, and early postpartum. Her goal is 1) to help you and your husband or partner prepare physically and emotionally for birth, with an emphasis on education and 2) to help labor go as smoothly as possible for you.

A doula is not medically trained (more on that later) but rather is more like a friend to help you navigate the experience of giving birth.

She will likely come when active labor begins and will help both you and your husband know how to handle each challenge that labor brings.

Benefits of Hiring a Doula

To make it simple, let’s summarize what a doula does by looking at the three main benefits of hiring a doula. These benefits are 1) support and advice, 2) pain management, and 3) advocacy. 

Doulas Provide Support and Advice

Whether you give birth at home, at a birth center, or in a hospital, most of your laboring will be done at home. That most likely means that it’s only you and your husband or partner at home for most of your labor (which can be 24 hours or more!).

That is, it’ll be only the two of you if you don’t hire a doula.

Doulas are not there to take the place of a partner who wants to be involved. Rather, doulas act as a support to both mom and dad. Labor can be exhausting, physically and emotionally, so having another person there can be really helpful.

Doulas can help you know how to manage labor and give advice on different positions to try. They can be the calm in the storm reminding you that what you’re experiencing at any given point is normal. They can provide encouragement when you feel like giving up.

Doulas can also be a person who gets you what you need when you need it, whether that be a drink of water, a helping hand to get to the bathroom, or the chapstick from your nightstand.

These tasks may seem like a silly thing to hire someone for. But, in reality, what you’re paying for is the freedom for your husband to be with, comfort, and support you as only he can. If he is the only one there to get you food or whatever else you need, he won’t be available to sit with you through every contraction.

Doulas Help with Pain Management

One big thing that doulas do is assist in pain management, specifically for mamas who want an unmedicated birth. They utilize techniques such as counter pressure, massage, and guided relaxation to help mom cope with contractions.

They can help you know when warm water might be helpful and when a cold washcloth might feel good on your forehead. Many doulas often utilize things like reflexology and affirmations, too.

In addition to physical pain management, the emotional support doulas provide has actually been shown to be effective at reducing perceived pain for the laboring woman. Isn’t that neat?

Doulas are Advocates

In addition to helping women cope with labor, doulas are advocates. I like to think of a doula as someone that helps a woman stand up for herself and get the most out of the healthcare system that is supposed to be serving her.

Though a nurse may be helpful and kind, she is still an employee of the hospital and so has to follow certain policies and will have certain biases. A doula, on the other hand, is employed by you, so you are her primary concern.

During labor, especially in the hospital, a woman may feel pressured to do (or not do) certain things, whether that pressure is intended or not. For example, a doctor may recommend Pitocin or other interventions to a woman who intended to labor unmedicated.

A doula can help a woman feel confident in her decisions and make sure she feels enabled to express what she feels and what she wants and doesn’t want. In fact, just a doula’s presence alone may be enough to deter a doctor from offering unwanted interventions.

(As a note, most doulas adhere to the standard held by DONA (Doulas of North America), which states that advocacy is part of the doula’s role but “does not include the doula speaking instead of the client or making decisions for the client.”)

A doula may also be able to manage who comes in and out of the room, which helps to maintain the kind of environment a woman needs in order to be able to labor productively.

In the hospital, a doula can be a sort of translator, too. When doctors and nurses are talking in abbreviations and medical lingo, a doula can help you know what’s going on and make sure you understand your options.

Are Doulas Medical Professionals?

Doulas are not medical professionals. It is not within their scope and qualifications to give any sort of medical advice or diagnosis.

That said, doulas aren’t usually just flying by the seat of their pants.

Many doulas are trained and educated by organizations such as DONA (Doulas of North America). Doulas who choose to seek professional training usually have around 30 hours of classes and have experience attending at least a few births.

Some doulas are not professionally trained but rather provide support based on personal experience. This kind of doula may be hired or may be a family member or a friend.

Doula vs Midwife

Let’s be clear: a doula is not a midwife. A midwife provides medical care from conception to birth and through postpartum. They (usually) are certified and have extensive experience and education relating not only to labor but to all aspects of pregnancy, postpartum, and caring for a mom and baby. 

A doula provides supportive care, mostly during labor. Doulas do not have the training or authority to evaluate the health and vitals of you and your baby.

This is essential to understand. You may want to hire a doula, but your doula certainly needs to be in addition to another care provider. 

Meeting With Your Doula

If you hire a doula you will likely meet with her 1-4 times in the last few months of your pregnancy. These visits will be focused mostly on two things: getting to know each other and education.

Your doula might ask you how your pregnancy has been, how you’re feeling about the upcoming birth (including addressing any fears you may have), and what you’re hoping for when it comes to managing labor.

She’ll help you understand different coping methods and ways to handle the pain of labor. You’ll probably practice different labor positions and breathing techniques. She’ll help you understand what labor will be like and answer any (non-medical) questions you may have. 

Doulas may also make referrals to other professionals like chiropractors, lactation consultants, and pelvic floor therapists.

Some doulas also visit you after you have your baby. If you would like postpartum care from a doula, make sure to discuss that desire with any doulas you consider hiring.

How Much Does a Doula Cost?

Sometimes doula services will be covered by insurance, sometimes they will not. If you don’t have insurance or if your insurance won’t cover the cost of a doula, you can expect to pay anywhere from $1,000 to $4,000.

The cost will depend on where you live and how experienced your doula is.

It’s most common to pay a doula a flat fee for all of their services, but some may offer by-the-hour pricing.

If you’re worried about the cost but really want a doula, consider finding a doula who is still working toward her certification. She will likely be willing to attend your birth for a low fee or for free because she needs experience. 

Should You Hire a Doula?

So, should you hire a doula? Maybe!

The decision to hire a doula is unique to every woman. For some, a doula may be the key to the kind of birth experience they want. For others, a doula may make them more uncomfortable than anything, in which case it would be counterproductive to hire one. 

All I can share is what I did and why.

Why I Didn’t Hire a Doula

I think doulas are fantastic and I’m so glad they’re available for women who want their support.  This section is not meant to be antagonistic or negative. I just want to share my experience and perspective for those who may be in a similar situation.

My husband is the reason I didn’t hire a doula. He is incredible. He fully supported my choice to do a home birth and wanted to be right there with me through it all. His physical and emotional support was an essential foundation, but that wasn’t all he did. 

Together, we took a Bradley Childbirth class (which I recommend to everyone). The Bradley method is nicknamed “husband-coached childbirth” because of its focus on teaching the fathers about labor and exactly how to support their wife or partner through it.

The class taught my husband (and I) things like the basic physiology of labor and helpful tips like the emotional signposts of labor. But just as importantly, it also gave us the chance to talk about what we both expected labor to be like and how I felt he could best support me.

Because of that education and communication, when labor started, we both felt excited and prepared. We knew what to do and what not to do. I felt supported, physically and emotionally, and never wished I had anyone there but him.

What You Should Do

Clearly, what worked for me won’t work for every woman. And, who knows, maybe with a future birth I’ll decide I do want a doula!

So here’s my recommendation. It’s like my recommendation about every other choice related to birth:

Ask God.

Or, if you’re not one who prays, follow that gut feeling you know is right. Whatever that guiding force is for you, seek it out and follow what you feel you are directed to do. That’s the surest thing I can recommend. 

In the end, my hope for you is, as always, that you’ll have a wonderful birth experience that you can look back on with satisfaction and gratitude. The choice to hire a doula may play a big role in that.

Until next time,

Allison

READ MORE:

Why You Need a Support Person at Your Birth

Things You Can Refuse During Labor

What Makes Midwives and OBGYNs So Different

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