Updated: Feb 1, 2021
What is a birth doula? What does a birth doula do? Why is a doula so beneficial? Do I need a doula if I have a midwife? What happens if I deliver in a hospital?
These are some of the most common questions I encounter as a doula. So, let's unpack them together.
What is a birth doula?
Doulas have been used to help women through pregnancy and labor for as long as women have been having babies. A doula is a certified birth professional that provides emotional, mental, physical, and educational support to pregnant, laboring, and postpartum mothers and their families.
What does a birth doula do?
It is a birth doula's goal to ensure the mother has the safe, informed birth that she wants and has a right to. Additionally, a birth doula will typically give you the tools to create a birth plan that is specific and right for your family. They also provide the pregnant mother with the support to be able to advocate for herself during labor. A doula does not an advocate for the mother, but the doula does provide all of the support so she, or a designated member of her birth team, feel empowered to advocate for the mother. This can be especially helpful when a woman is choosing to birth in a hospital where she may feel unfamiliar with members of her care team.
While it varies among doulas, they can also provide support through:
○ Comfort measures
○ Labor positions
○ Breathing techniques
○ Birth mantras and affirmations
○ Reiki healing
○ Placenta encapsulation
○ Ensuring you eat and drink
○ Advising on when to go to the hospital or birth center
Why is a doula so beneficial?
In a 2012 study evaluating the advantages of doula companionship to a laboring mother, it found that women who received continuous support from a doula have:
○ Decreased rates of the use of pain medication, an epidural, vacuum, or forceps
○ Decreased cesarean rates
○ Lower blood pressure during labor
○ Increased chance of a positive childbirth experience
○ Higher breastfeeding success rates
○ Greater levels of maternal self-esteem
In conclusion, doula are included in evidence-based birth and have been found to increase a woman's feelings of competence, perceptions of labor, confidence in adjusting to parenthood, and greater confidence in breastfeeding.
Do I need a doula if I have a midwife?
A midwife is a trained medical professional that provides medical care to the mother and baby before, during, and after childbirth. They are the ones that take your vitals, check on baby, monitor dilation, and deliver the baby. A midwife is able to provide family planning, prenatal, birthing, postpartum, women's health, and infant care, as well as provide gynecological exams and prescribe medications.
Whereas, a doula is a certified birth professional that provides emotional, mental, spiritual, and physical support through every step of the pregnancy, labor, and postpartum experience. A doula you call when you think you are in labor to guide you through each step, while a midwife you call once you are in active labor. It is encouraged that you contact your doula once your contractions begin, so you can work through comfort measures together and determine when she should come over to your house. Then you will both decide when it will be the best time to leave for the hospital or birth center or call the midwife to come to your home.
What happens if I deliver in a hospital?
Having a doula for a home or birth center birth is the same as having a hospital birth! You would still work together to create a specialized birth plan, ask her any questions you may have, and contact your doula when your labor begins. When you feel it is time to go to the hospital, your doula will accompany you.* Having a doula has been shown to lessen the need for intervention, increase a laboring mother's confidence, and increase the chance of a positive, healthy, empowering birth experience.
*Due to COVID-19, not all hospitals are currently allowing doulas at this time. Make sure to talk to your designated birth place about their requirements ahead of time. If this is the case, ask your doula about virtual services, so their presence can still be there to benefit you during labor.
Hodnett, E. D., S. Gates, et al. (2012). “Continuous support for women during childbirth.” Cochrane database of systematic reviews: CD003766. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175537>
Hofmeyr, G. J., V. C. Nikodem, et al. (1991). “Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding.” British journal of obstetrics and gynaecology 98(8): 756-764. <https://www.ncbi.nlm.nih.gov/pubmed/1911582>
Caton, D., M. P. Corry, et al. (2002). “The nature and management of labor pain: executive summary.” Am J Obstet Gynecol 186(5 Suppl Nature): S1-15. <https://www.ncbi.nlm.nih.gov/pubmed/12011869>