What is a birth doula?

A doula, specifically a birth doula, is a trained labor and delivery assistant who helps pregnant women before, during, and immediately after childbirth. Doulas provide emotional support as well as help with other non-medical aspects of your care.

A doula can share guidance to help you make informed decisions about your birth options. And while they will never make any decisions on your behalf, a doula can also serve as a liaison between you and the rest of your birth team, communicating your birth plan and your wishes.

The word “doula” comes from an ancient Greek word meaning “woman who serves”. Today, women, men, and non-binary doulas continue to serve mothers during childbirth.

Estimates reveal that about 6 to 15% of mothers opt for a doula during labor. The choice often comes down to your personal preferences, your finances and whether or not you have other sources of support to be with you during the birth.

What is a postpartum doula?

Postpartum doulas differ from postpartum doulas in that they provide support after the birth, usually by visiting you at home to help with breastfeeding, preparing healthy meals, and more.

What does a doula do?

While it may seem like a birth doula doesn’t start helping you until after you go into labor, their services usually begin during pregnancy—so they can help you prepare for labor—and continue until labor and up to a few hours or days afterward.

Typically, a doula handles the following:

• It answers your questions about what to expect and eases your fears before giving birth
• Provides resources that can help you during and after pregnancy
• It helps you develop a birth plan and advocates for the type of birth you hope for
• It prepares your space and mind for the arrival of your baby
• Suggests different birthing positions during labor and helps you breathe through contractions by helping and providing words of encouragement and massage
• It explains what happens during childbirth
• Encourages you to communicate your wants and needs with your health care providers, including your obstetrician or midwife and your birth nurses
• It helps you immediately after giving birth, providing information on newborn care and breastfeeding guidelines

A postpartum doula can offer support in the first few weeks after giving birth, giving you information and guidance on how to care for, feed and bathe your baby. They will support you as you recover from birth and offer you information about care options for you and your baby. Postpartum doulas generally provide these services during the day, but you can also hire a nighttime postpartum doula to help care for your baby overnight so you can get extra rest.

It’s possible to hire one doula to help with both labor and postpartum, although it could be two separate people if you choose that route. One of the potential benefits of having the same doula is that they are aware of what happened during your birth as a first-hand witness, so they can better tailor their postpartum advice to you and your experience.

What is the difference between a midwife and a doula?

A midwife is a medical professional who can do almost anything an obstetrician can do, except perform a C-section, but a doula is not a medical professional.

Doulas do not have medical training, but there are professional training and certification programs for birth doulas and postpartum doulas through organizations including DONA International, Opens a new windowHOODOpens a new window (Professional Association for Childbirth and Postpartum), ICEAOpens a new window (International Association for Childbirth Education), i Childbirth InternationalOpens a new window. Community doulas – doulas who are funded by counties or private dollars to help mothers who may not be able to afford care – are trained through community doula training organizations.

Certification programs vary, but birth doulas typically attend workshops on doula work, childbirth, and breastfeeding. (Postpartum doulas have different coursework and requirements that focus on postpartum needs.) Aspiring doulas may have to write essays, provide doula services for several clients, and provide written recommendations before becoming certified.

Certification is not required for most doulas, and it is up to you whether you want your doula to have one. (Many doulas who aren’t certified by a specific entity are still able to provide excellent help and care.) It’s smart, however, to find out how many births your doula has attended—the more, the better—and to ask about your potential doula training. and experience.

What are the benefits of a doula?

It’s impossible to predict or control how labor and delivery will go: Will you bond with your nurse and will she have time for you? How will you react to pain? Will you be able to stick to your birth plan even if you end up having to be induced? Will you have a fast delivery or a long, drawn-out delivery? And if you have a partner who will be present at your birth, how will they hold up under the pressure?

Faced with these uncertainties, many women find great reassurance in having a doula by their side. Research has found that women who have continuous one-on-one support during labor tend to use less pain medication, have slightly shorter labors, and are less likely to have a C-section or forceps or vacuum-assisted delivery. In fact, if you’re serious about trying to have a natural, drug-free birth, a doula may be your best ally.

Women who have ongoing support are also more likely to report being satisfied with their birth experience. One theory is that mothers who have this support produce lower levels of stress hormones during labor than women who are left alone or with the help of inexperienced assistants.

How much does a doula cost?

A birth doula charges anywhere from a few hundred to a few thousand dollars for their services, depending on where you live—doulas tend to cost more in larger cities, for example. Some health insurance plans will cover some or all of the costs, and some doulas are willing to work on a sliding scale based on your ability to pay. Doula communities are usually free to the client. A few pioneering hospitals even provide doulas to patients who want them.

Some doulas charge by the hour, while most have a flat rate for their services. Also, some may offer you different packages, with only hospital support during the birth, or with more comprehensive support in the days and weeks before or after.

You can ask your doula if she provides text or call support during the early hours of labor, and if that’s an extra fee, as that time frame can last for days for some moms. This service can help you better understand what you’re feeling, get help timing your contractions and know when to go to hospital or seek medical help if you’re giving birth at home.

How do I know if I should hire a doula?

If you’re seeing a midwife in a low-volume hospital practice or planning to birth in a birth center or at home, you’re likely to have more continuous one-on-one support from your midwife. If you’re having a baby in hospital, it’s likely to be a different story – and hiring a doula can be a great way to make sure you have an experienced helper by your side during labor.

In a typical hospital setting, the laborer and some midwives do not stay in the room with you continuously during labor. Labor nurses often have to divide their time between several patients and may come and go according to shifts.

There are many reasons you may choose to hire a doula if you are able, such as:

• You are giving birth without a partner and want a support system in the room
• You prefer not to invite family into the room as your support system
• You are hoping for an unmedicated birth and want support with navigating pain
• Communicating with hospital staff is difficult or anxiety-provoking for you, especially if it involves asking for alternative options or explaining why the healthcare professional is recommending something. A birth doula can be your advocate.
• You want to be able to discuss the birth later with someone who witnessed it and can help you mentally examine and process what happened. This can be especially helpful if you have had a traumatic or difficult birth experience in the past.
• You want additional advocacy if you feel mistrust of medical systems
• You are a woman of color who believes that having a doula of color with you will help. There is a black maternal health crisis in the US, and research has shown that implicit bias can affect your care. The gift of a doula can help you learn how this affects your birth and can empower you to have a louder voice when it comes to your care.

How to find a doula

Organizations like DONA InternationalOpens a new window, HOODOpens a new windowand the National Association of Black DoulasOpens a new window can help you find a reputable doula near you through the referral locator on their website, and you can always ask your birthing instructor, midwife, obstetrician, or family and friends for their recommendations.

If you’re looking for a doula, plan to start interviewing them early, in the second trimester, as you book them months in advance. If you find a doula who seems full around your appointment, ask to be added to their waiting list, as the needs of their other clients can change at any time. However, you may not realize you want a doula until later in your pregnancy; if that’s the case, don’t be afraid to try to find one anyway, even if you’re already in your third trimester.

It’s not a bad idea to interview several doulas before deciding which one you would like to hire. Since your birth doula will be with you during one of the biggest moments of your life, it’s especially important that you feel comfortable and that your relationship is in harmony.

Read more:

Video: What is a doula?

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