What Does a Doula Do(ula)?

I’ve been asked this numerous numerous times. What does a doula do? Why do I need a doula? What can a doula do that my husband or mom or best friend or sister can’t? I plan on an epidural anyway, doulas are only for unmedicated homebirths.

There’s a lot to unpack here, but I’ll do my best.

Think about childbirth before the medical revolution in this country. Before everyone went to the hospital to give birth, where and how did women birth? First of all, families were immersed in life-giving from young ages. If you had little brothers or sisters, you more than likely watched them come into the world. If you didn’t, you undoubtedly had a cousin or friend who you watched give birth at some point in your life. You already knew the power, the innate intricacies of childbirth, because it was done at home, with healers or doctors, and only in extreme cases ended in a hospital stay (if there was even a hospital close enough). So when it came time for a woman to have a baby, she was already well versed in what it looked like and smelled like and sounded like. We are well-separated from birth nowadays. Until I gave birth I had no clue what birth looked like. I read birth stories ravenously, but had no real idea of how it looked and felt.

So for me, becoming a birth doula and working in this way reignites this option for parents. I am a trained companion, not a healthcare professional, who supports my clients through their labors and births. The role of a doula is to complement healthcare professionals. Medicalized birth in modern society has made birth very one-sided and sterile. A birth doula’s role is to bring the family element back into the room so that a birthing family can have a well-rounded experience. We are there to help our clients cope, to hold hands with them, educate them on their options and make sure they feel like they have a voice in the process. This is a life-altering experience they are going through. An analogy I like is this: while you might go on an overseas trip alone without having any clue how to get through it, you would most likely have a better time if you had a guide. A doula is a well-trained guide. ​

A birth doula’s role is to bring the family element back into the room so that a birthing family can have a well-rounded experience.”

So let’s start with what a doula does. Let’s start at the beginning. A doula meets with you in your pregnancy and starts giving you information so you can educate yourself on the process of labor and childbirth and postpartum. We have so many resources and have honed our referral lists and contacts in this aspect of life.

I remember being very overwhelmed with questions when I first became pregnant. Who should I see for chiropractic care? Where should I order my breastpump? Are there support groups? How many stretch marks are normal? Oh my gosh, how much nausea could possibly be normal? Which prenatal vitamin is best? These are all questions I’ve been asked and been able to help with. Our job as doulas is to have these resources ready to go for you to help you navigate your pregnancy.

​I like to meet with clients at least twice in their pregnancy to help answer some questions and get my families thinking about what they would like their birth to look like and how I can help support them to achieve that goal. Once we have signed a contract and the final payment is made, I go on call for my clients. This is generally 2 weeks before their due date. On call means they have their own (very loud) ringtone on my phone, and my phone never goes on silent. I am available for whenever labor may start. Once labor begins, we determine when the family needs some extra support and I come help with labor. Depending on the person, this can be either at the client’s house or I meet them at their birthing place. From here on out, I stay with the family until baby comes. Once baby comes, I stay for an hour or two after the birth to make sure everyone is feeling okay, and then I leave the family inpeace to digest what they just went through. I text or call over the next few days, and at 2 weeks postpartum I come by for a home visit to check in on the family and our client/doula relationship is over. But I run a support group for parents in the area, and luckily I get to talk to and see my clients and members of the community there. It is lovely to go from working for someone to being their friend and watching their baby grow.

Why do I need a doula? There’s a few reasons. Here is an article I like to refer to when talking about doula care and why it’s beneficial:

https://evidencebasedbirth.com/the-evidence-for-doulas/

They have done many many studies that have shown that having a doula can lead to better outcomes in a labor and birth situation. There are absolutely no negative consequences in any study for continuous labor support with a doula.

​I truly can not write anything more comprehensive or helpful than Evidence Based Birth, so I would highly recommend you at least skim through that article. I am quoting directly from that page here but it lays out the very basic reasons hiring a doula is beneficial:

“Of all the ways birth outcomes could be improved, continuous labor support seems like one of the most important and basic needs for birthing people. Providing labor support to birthing people is both risk-free and highly effective. Evidence shows that continuous support can decrease the risk of Cesarean, the use of medications for pain relief, and the risk of a low five minute Apgar score. Labor support also increases satisfaction and the chance of a spontaneous vaginal birth. Continuous support may also shorten labor and decrease the use of Pitocin. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that with some outcomes, doulas have a stronger effect than other types of support persons. As such, doulas should be viewed by both parents and providers as a valuable, evidence-based member of the birth care team.”

So, following from that, I’d like to answer the next question I laid out: What can a doula do that my husband or mom or best friend or sister can’t? And this one is quite simple, really. We can be objective. While we are emotionally engaged and invested in you as a person, we are not related to you or connected as strongly as a friend or family member. It allows us some neutrality when it comes to communication as well as strength even when seeing you uncomfortable or vulnerable. A friend or family member may also not be familiar with the emotional intensity, or the sensory experience that come with the birthing process. This may hinder them from being able to provide their undivided attention. There is also the fact that we are professionally educated on the risks, benefits, and implementation of birthing routines and interventions as well as helpful techniques for birth positioning and comfort measures. In other words, this is our job. We do this all the time. It is a magical job that we do not take on lightly, but it is still work for us. We have seen it before. We don’t care if you poop on the table. We know how to calm you down or squeeze your hips in the right way, or where exactly to put a cold cloth to help with your back pain. We have dedicated our lives to this art, and we are dedicated to helping you.

The last point I set out in the opening paragraph is something I’ve heard a lot and I’d like to comment on it. For a reminder, this is what I wrote: I plan on an epidural anyway, doulas are only for unmedicated homebirths.

Doulas are for everyone.

Let me say that again.

Doulas are for EVERY. ONE.

We are trained to help with any situation. You want an epidural? Bet. Let’s get you on that peanut ball and keep things rolling and get you some ice chips. You want an elective cesarean? Awesome, I have some great suggestions for how to get through that first poop and I know the hospitals in the area that will allow a clear drape and immediate skin to skin. You want a waterbirth? That’s amazing, I know the place for you. We have the resources and the training to get your best birth. Even if everything goes completely sideways, we will be there to emotionally support you and make sure that your voice is heard.

So you’ve made the choice to have a doula, that’s great! How do you find one? There’s a few ways. I would start with a google search. See if you like anybody that shows up in the search and set up a consultation. Ask your friends. Odds are someone has had an experience with doulas. But here’s the biggest tip I have: interview a few doulas. Check in with a couple of us. Make sure that you vibe with the person who will be supporting you through your labor and childbirth. I promise I won’t be offended if you tell me you’re meeting a few doulas. I just want you to have the best experience, because it is such a paradigm shift in your life. Make sure your doula is trained and certified with a reputable agency, and ask them questions.

I hope this information was helpful. I plan to write something up about postpartum doula work and how that works soon. I’m always available for any other questions!