Birth Doula: Everything You Need To Know About This Birthing Angel

If you’re pregnant and hoping to have a natural childbirth, you may be wondering if you should have a doula attend your birth. Alongside your midwife or OB and your partner, a birth doula can be a vital addition to your birth team. Add in the best birthing classes, and you’re completely empowered.

What is a birth doula?

The word doula means “a woman who serves” in ancient Greek, and boy is that true! Doulas are trained professionals who give continuous physical (non-medical), emotional, and informational support to expectant, laboring, and postpartum mothers and families.

Throughout history, women have been giving birth with the support of other experienced women. Which is exactly what a doula is.

What does a doula do?

A birthing doula’s role is to help you have a positive and safe birth experience. During the months before birth, a doula can help you create a birth plan that’s right for you. During labor she will advocate for you and help the rest of your team follow your birth plan. This is especially wonderful if you need to or want to labor in the hospital where you’re unlikely to have a close relationship with your medical team.

A birth doula also helps with:

  • Breathing techniques
  • Relaxation techniques
  • Laboring positions
  • Massage for comfort
  • Making sure you eat and drink enough
  • Letting you know when it’s time to go to the hospital or birthing center (if necessary)

What are the benefits of having a doula?

Many studies have shown that the addition of a doula to a woman’s birth team can benefit the mother in numerous ways.

A Cochrane review updated in 2012 compiled data from 22 trials of 15,000 women whose birth experiences included women who had different kinds of continuous support during labor or none at all.

The results? Women who had continuous support, especially from a doula, were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, vacuum or forceps-assisted births, C-sections, or negative feelings about childbirth.

What is a birth doula? What does a doula do? How much do they cost? Can I have a doula if I deliver in a hospital? How is a doula different from a midwife?Other benefits include:

  • Increased chance of a positive childbirth experience
  • higher breastfeeding success rate
  • better maternal self esteem
  • lower blood pressure during labor
  • less pain experienced

If interventions are medically necessary, a doula can help support the mother emotionally so she can have a positive birth experience despite changes in her birth plan. She also can find ways to make it more natural in the midst of interventions.

How is a doula different from a midwife?

A midwife is a trained medical professional educated and trained in a clinical setting and certified (in the US) through MEAC (Midwifery Education Accreditation Council). She can typically provide family planning, infant care, women’s health care, prenatal, and birthing care as well as prescribe some medications and give yearly gynecological exams. In a birth, midwives typically stay with the mama once she’s in late/active labor or in transition and delivers the baby.

A doula, on the other hand, is with you from the onset. You can call or text her once your contractions start, and you two can determine when she should come over to your home to support you in early labor. Together, you will decide when it’s best to go to hospital, birthing center, or call your midwife to come to your home. Also, unlike a midwife, a doula is a childbirth professional that does not necessarily have medical training (though some do), but is trained in the physiological process of childbirth. Her scope of practice is limited to emotional, physical, and informational support, which means she is available to focus on mothering the mother instead of clinical tasks.

How do doulas and dads work together?

Doulas don’t take the place of partners during birth. Instead, they can work with your partner to give you support. Your doula can massage your back while you lean on your partner, or she can take his place when he needs to rest, eat, or use the bathroom.

Some families may choose to include a doula in their team so that dad isn’t the main birth coach. Doulas can be helpful during the pushing phase if dad plans to catch the baby. She can also provide a wealth of information based on her experience attending previous births, which can aid both mama and papa.

In short, your husband or partner knows you, and the doula knows birth. Together, that’s a dream team.

Can I have a doula if I deliver in a hospital?

Yep. In fact, a hospital labor and delivery may be the best time to have a doula at your side. A study found that laboring in a clinical setting (like a hospital) can undermine a woman’s confidence in her ability to give birth. It found that introducing continuous support, like that from a doula, can increase women’s confidence and therefore lessen the need for interventions and increase the chances of a natural, safe, and healthy birth experience.

Another bonus is that your doula works for you only, not your hospital or your provider. She will always have your (and baby’s) best interests at heart.

How much do birth doula services cost?

The cost of a doula can range from $300 to $800 or $1000 depending on where you live. Many doulas will set up a payment plan, or sliding scale for those who can’t afford it. Also, your insurance company may cover the cost (considered preventative care) since the presence of a doula can reduce your risk of a C-section.

Where can I find a birth doula?

Ask your midwife, friends, or family to recommend some doulas in your area. It’s a great idea to interview a few to find one who is just the right fit for you and your partner. Think about what “style” or personality type works best for you, especially when you’re in a stressful situation. Do you like the coach type? A gentle, laid back style? Pick a doula who resonates with YOU!

Here is a handy list of doula interview questions that you can bring to your interview.

After you hire her, she’ll probably do one or two prenatal visits to talk about your birth plan and provide tips for a successful birthing day. She’ll then go on call around your due date to be ready to come to you when you need her support during labor. She’ll stay for the duration of the birth until a couple hours postpartum and usually help out with establishing breastfeeding. Then you’ll have a postpartum visit with her within the first few weeks after the birth to recap the birth experience, talk about how your recovery is going, and answer questions you may have about breastfeeding and newborn care.

If you’re not having luck finding doula referrals, you can find one through any of these sites:

Here’s what other natural mamas have to say about working with a doula

I asked the mamas on my Facebook page if a doula supported their childbirth(s), in if they recommend working with a doula to other moms. Here are some of their responses.

  • I could not have survived my 50+ hours labor (30+ active in the hospital) without my wonderful doula by my side – And just as important, by my husband’s side! Both of us tell all of our expecting friends to consider hiring a doula. But it’s not one size fits all! I’m lucky to now call my doula a friend but you need someone with you who you are comfortable seeing ALL sides of you! – Donna Hoffman Cullinan
  • Best thing we ever did! She eased my pain with counter pressure and prayed over me when things got tough! She even took the best photo of when my daughter came out which makes me tear up every time I look at it! – Danielle Bosse
  • My doula was ahmazing! My husband was deployed. She put me in a position to get my big girl to move into a better position! My doula was a text away any time I had a question during and after pregnancy! She even sent me a video of how to get my daughter to get a better latch. She was worth every penny and more. She even captured my all time favorite picture. – Kathryn Wren
  • I was petrified of labour. Hiring a doula was the best decision we made. The support and encouragement for both me and my husband was amazing. She did not leave my side for a minute, and made me feel so safe. I would recommend a doula to all the pregnant ladies out there…especially those that are as terrified of labour as I was. I owe my doula Diane everything. “Thank you” doesn’t even come close to being enough. – Paulina Gumieniak
  • I had a wonderful doula that helped support me even after we realized a drug-free, natural birth wasn’t going to happen. After I found out my baby was not going to flip, my doula encouraged me, educated me, and supported me. She came to the hospital for my planned cesarean and helped me nurse my baby girl for the first time! She is still a source of wisdom and encouragement! – Sarah Beth Janes
  • I had a doula with both babies, and she made all the difference even when she was just helping me process where I was and listening. I had long periods of prodromal labor both times, and she gave me great advice along the way as well as helping me to relax and encouraging me. I ended up with an epidural both times, and she still used her knowledge to help me be comfortable and help me progress effectively (shoutout to the peanut ball!) and when I was afraid she affirmed my strength and helped me focus on meeting my baby. While I pushed she physically (I felt like I would dislocate her shoulder!), verbally, and emotionally supported me. She took pictures in those first minutes, and I’m sure I’ll treasure them forever. She was indispensable, and will be a forever friend. – Maegan Breakall
  • A doula is the first recommendation I give to pregnant friends. Hiring a doula for my hospital VBAC was absolutely key to my success. It took 9mos to convince my husband that she would be worth it. He didn’t want to spend the money AND he felt threatened by her. However, after meeting her, he finally realized that this meant he didn’t have to do all the research on techniques and yet he would still get all the credit for helping me through 30+ hrs of labor. Now he loves to tell dads “Dude, it’s worth every penny, because a doula makes YOU look good!” My doula was great at giving my husband the tools and the guidance to get me through what that I needed. I am now planning to become a doula. – Pamala Ergle Dunscombe
  • My doula was amazing! She stepped in when my husband couldn’t, and she helped with breast feeding, and checked on us after we brought our baby home. If it weren’t for her, I never would have had a natural birth. Let alone an amazing experience and now lifelong friend! – Lindsey Martin
  • We used a doula for our 2nd delivery. My first birth expierence was horrible, I was induced, poked 14 for an epidural, 30+ hr.s of labor and 30 min of pushing my son was stuck and I had to have a c-section. I found my doula who is well versed in Vbacs at 6 weeks pregnant and later switched to a group of midwives. She was incredible. She gave me the confidence that I would not be railroaded down the same path again and that my body was able to deliver a baby natarually. 2 completely natual vbacs later and anticiaption of a 3rd natual vbac birth before Thanksgiving I am so glad I made the choose to use a doula back then. I could have ran out of the hospital and screamed with joy after delivering my girls. – Nichole Davis
  • I always tell people if it weren’t for my doula I’d probably never had natural births! They’re worth the extra expense. – Kristen Cuffari

How about you?

Did a birth doula support you during your childbirth(s)? Would you recommend working with a doula to other mamas? Share with us in the comments below!

References

Raphael D. (1973). The tender gift: Breastfeeding. Englewood Cliffs, NJ: Prentice-Hall.

Hodnett, E. D., S. Gates, et al. (2012). “Continuous support for women during childbirth.” Cochrane database of systematic reviews: CD003766. <http://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. <http://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. <http://www.ncbi.nlm.nih.gov/pubmed/12011869>

“What Is The Difference Between A Midwife And A Doula? .” American Pregnancy Association. Web. 20 Mar. 2015. <http://www.americanpregnancy.org/pregnancyblog/2011/11/what-is-the-difference-between-a-midwife-and-a-doula/>.

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6 Comments

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  1. Would love to know which insurance companies are actually covering doulas as preventive care!

  2. Correction, Doulas in NYC/tri-state area cost at minimum $1,000. Experienced ones cost $1,500 – $3,500.

  3. LOL!! I am thinking of actually becoming a berth doula! I LOVE MASSAGING PEEPS! XD XD XD

    NE WAY, Yaaaa im gonna be a berth doula because then i will take the baby and recycle it bye

    • Lol I Love 2 See Kids Being Interested in The Mirecle Off Child Berthing, its really good.

      Yeah., Saffie

  4. My doula: a source of wisdom, comfort, reflection post-birth when I was grieving about my mama wound (see Mama Natural’s mama wound post), strength and assistance. I felt like I crushed her hand and knew I could if I had to. Michelle totally supported me and was my husband’s and my advocate so we could focus on the task at hand. She was my liaison between hospital staff and Steve and I. No matter how enlightened my dr. and hospital are/were, it still helped to have her there. At first, the cost was a concern for Steve as well. He wasn’t sure we needed it, especially having taken wonderful birthing classes. However, he was glad she was there, too and has since encouraged other people, men especially, to not worry about that part and just get a doula for their invaluable support.

    If had another baby I would definitely have a doula again by my side.

  5. I think doulas are great for moms who need them. As I mentioned on Facebook, I just don’t know what I would have one do. I birth in birthing centers so far, so I don’t have to worry about the unnecessary interventions. And during labor, I hate being touched or talked to. Even gentle or encouraging words or back rubs annoy me, because I have to be fully inside of myself to focus on getting through contractions. My past two labors have also been super easy. About a day of what feels like prodromal labor and then about half an hour of really intense labor. With my youngest, I had exactly four or five transition contractions after about 24 hours of wondering if I was actually in labor. My next youngest was much the same, only we were not prepared and he ended up “falling” out in the living room right after I’d called the midwife.

    I do think if I ever had to have a hospital birth, a doula would be a must. I’d need someone familiar with the system to advocate for me and help me keep the doctors and nurses off my back. lol. After our accidental homebirth, I was transported to the hospital, and even though I didn’t even deliver there, they were very in your face and it just wasn’t my favorite thing.

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