What is a Birth Doula? A Postpartum Doula?

Doula is a Greek word literally meaning “woman’s servant.” In regards to birth terminology, “doula” refers to a supportive companion (not a loved one) with an expectant woman. A birth doula performs one on one physical and emotional support during labor for the woman and her partner. She does not perform any clinical tasks; instead focuses on non-medical ways to comfort and support a woman during childbirth.  A doula understands and believes in the birth process and a woman’s ability to give birth. A doula helps a woman work through and with the pain of labor.  A doula can offer suggestions or alternatives for a laboring woman. She can help explain potential medical procedures and interventions if they arise.

A postpartum doula offers in-home education, assistance, reassurance, and emotional support to a new mother and her family. Postpartum doulas are not baby nurses, instead, they focus on the needs of the mother, as well as her family.  Postpartum doulas can help around the house, support the new mother so she can take care of herself (sleep/eat/shower), make suggestions to improve breastfeeding, sleep, or family transition. They can help parents learn “parenting skills” such as baby-wearing, soothing a newborn, balancing the needs of a new baby with the rest of life, etc. Doulas can make referrals to other professionals/resources as needed.

Why would I want a doula if my partner will be with me for the birth?

Many men want to take an active role in their partner’s childbirth education and in the labor and birth process, but most do not feel qualified to act as a labor authority. Fathers, too, need the support, guidance, and relief that a doula can bring to labor. The doula’s trust in the birth process and objectivity gained from her experience helps keep both parents calm and balanced during this emotional time. The doula’s knowledge and acceptance of pain as a normal part of the process can help some fathers cope while seeing their partners in pain. A doula can provide welcome relief for a father, who can then be more relaxed, loving, and emotionally available during the labor.

How are doulas trained?

Birth doula training emphasize quiet reassurance and enhancement of the laboring woman’s natural abilities. Training may include a series of childbirth education classes, educational seminars, birth observations with another trained doula, on the job training, and written tests or papers. Doulas receive training to be an advocate for laboring couples and to provide them with information on options so they can make informed choices. Postpartum doulas are specifically trained in breastfeeding and bottle feeding, newborn care, and typical postpartum adjustments, and how to assist families learn to care for their babies.

How does a doula really make a difference?

Results from various studies have all suggested that having a birth doula reduces the overall cesarean rate by 50%, Pitocin use by 40% and requests for epidurals by 60%. The use of a doula also showed a major reduction in the length of labor due to fewer stress hormones being produced in the laboring woman’s body. Similar studies have shown having a postpartum doula results in better breastfeeding success and fewer postpartum mood disorders.

What exactly does a doula do to provide support?

A doula’s role is to provide physical, emotional, and informational support to women and their partners during labor, birth and postpartum. The birth doula offers helpful advice on comfort measures such as breathing, relaxation, movement, massage and positioning. She also assists families to gather information about the course of their labor and their options. Doulas specialize in non-medical skills and do not perform clinical tasks. Doulas do not diagnose medical conditions, or offer medical advice. Most importantly, doulas do not make decisions for their clients; they do not project their own values and goals onto the laboring woman. The doula’s job is to help the woman have a safe and satisfying childbirth however the woman defines it. Similarly, postpartum doulas offer advice on breastfeeding, newborn care, self care, and parenting. Her job is to empower the family to feel confident in their ability to parent their own baby (or babies!)

Why would I need a birth doula if I am planning to have an epidural?

Giving birth is much more than a medical procedure. It is an emotional as well as a physical journey, and having a doula can assist with more than just pain. With or without pain medication, a woman benefits from the continuous support a doula offers.  Most care providers will not administer epidurals until a woman is in an active labor pattern and has dilated to at least 3 or 4 cm. The procedure itself can take some time, and pain relief is not usually immediate. Some women experience “incomplete” epidurals or “breakthrough” pain. Epidurals often cause mild side effects which are unpleasant, but not medically serious. A doula will stay by a woman’s side, helping her cope with side effects, and give a woman information about her options. In addition, while an epidural can relieve most of the physical pain, it does not affect a woman’s need for reassurance. Epidurals do not hold your hand, rub your shoulders, explain what is happening or help you make decisions. Epidurals cannot work as an advocate in helping a woman get what she needs from the hospital staff.

How do I choose a doula?

It is recommended to talk with several potential doulas by phone first, and assess if their philosophy matches your own. It is essential to find a doula who supports your goals and attitudes. Potential questions might be…

  • What do you think is the most important part of your job?
  • What are the main skills or abilities you offer?
  • How do you include my partner or family?
  • Why did you become a doula?

Practical questions might be…

  • What is your availability around my due date?
  • What is your background and training?
  • What is your back up situation?
  • What are your rates/ fees and what do they include?
  • Whom may I call as a reference?

Once you find a doula or two who meets all of your criteria, you will want to meet with her in person to make sure you feel completely comfortable in her presence. This prenatal interview will be the time for you to discuss the details of your goals, preferences, and concerns about the birth or postpartum. Your doula should be someone you feel completely comfortable with, someone who makes you and your partner feel relaxed and safe.

How does a doula really make a difference?
Results from different studies have all suggested that having a doula reduces the overall cesarean rate by 50%, Pitocin use by 40% and requests for epidurals by 60%. The use of a doula also showed a major reduction in the length of labor due to fewer stress hormones being produced in the laboring woman’s body.

The Doula Book © 2002; Klaus, Marshall, Klaus and Kennell.