What is a Doula?
Doulas provide emotional and physical support to a woman and her partner during pregnancy, labor, birth and early postpartum period. They are called many things including: Childbirth Assistant, Labor Support Professional, Birth Assistant, Birth Companion, etc., but the description we like best is “walks with mother”.
Basically, your doula is there to ‘walk’ with you on your journey through pregnancy, childbirth and early mothering to help educate, support and validate the choices you make for your birth and family. In addition, your doula is also available to walk with you as a ‘mother’s helper’ when you need of help or support with your children at other times.
Why do I need a Doula?
According to “Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier and Healthier Birth”, by Kennell, Klaus, and Kennell (1993), having a doula can help reduce your risk of forceps assisted delivery and cesarean section, shorten the length of your labor and decrease requests for pain medications.
Women who have a doula attending them during their labor are:
26% less likely to give birth by cesarean section
41% less likely to give birth with vacuum extraction or forceps
28% less likely to use any pain medications and
33% less likely to be dissatisfied with or negatively rate their birth experience
(Hodnett and colleagues 2004)
Why use a Doula?
In order to have a positive birth experience, most women need continuous labor support. Although Obstetrical Nurses and Midwives are experienced in dealing with a laboring woman’s emotional and physical needs, they can seldom guarantee the support they provide will last throughout the labor – especially in hospital settings where shift changes, coffee breaks, heavy paperwork and busy nights regularly occur. Some OB nurses handle
up to six laboring couples at a time. Midwives may be able to offer more labor support, but they too have clinical duties to which they must attend.
The father or partner may be better able to provide continuous support but usually has little actual experience in dealing with the forces of labor. Even fathers who have had intensive preparation are often surprised that the amount of work involved is often more than enough for two people. Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation.
The laboring mother’s mother or mother-in-law, likewise may be better able to provide continuous support, but her own experiences and knowledge of birth are not always useful to the laboring mother, especially when the laboring mother’s ideals or expectations in childbirth differ from those of her mother or mother-in-law.
A professional doula can help bridge the communication gap between family members and help keep the mother focused on her birth and provide the emotional support to help the mother achieve the birth she wants. A doula can also act as a liaison between the laboring couple and their medical support team.
What is a Doula’s role?
Your doula can be as involved as you want her to be. Before hiring her, your doula will go over the services that she provides and discuss with you your expectations and desires for her role in your birth. It is important to remember that there are limitations to a doula’s role; for example: a doula does not speak for a couple, provide medical or clinical skills or act in any unprofessional manner. Most certifying organizations have Policies of Practice that each doula must follow. The Doulas of the Whole Mothering Center have chosen to certify through Doulas of North America (DONA) (see website link below).
A doula may provide:
- explanations of medical procedures
- emotional support
- advice during pregnancy
- exercise and physical suggestions to make pregnancy more comfortable
- help with preparation of a birth plan
- massage and other non-pharmacological pain relief measures
- positioning suggestions during labor and birth
- support for the labor partner so that they can love and encourage the laboring woman
- help in avoiding unnecessary interventions
- help with breastfeeding preparation and beginnings
- a written record of the birth
- many other services that vary from doula to doula
Will the Doula replace the father?
Some fathers or partners are concerned they may be sidelined or replaced by the Doula during labor. Although individual situations vary, and one should question a prospective doula about her philosophy. Generally the answer to this question is no – she will not replace him. Studies have shown that fathers usually participate more actively during labor in the presence of a Doula than without one. A responsible Doula supports and
encourages the father and enhances his support style rather than replaces him.
When should I hire a Birth Doula?
Retaining the services of a Doula is recommended at any point from the onset of pregnancy that still allows adequate time for the Doula to become a fully integrated member of the labor support team. Ideally, our feeling is that the earlier a Doula is retained, the more time there is to decide what role she will play in your process of becoming a mother.
When should I hire a Postpartum Doula?
Since your Postpartum Doula will be working closely with you and your family in your home, she should ideally be familiar with your family dynamic and the physical layout of your home so enough time should be allowed for all parties involved to be comfortable working closely together. We recommend retaining the services of a Postpartum Doula no later than four weeks before your due date. In some instances, your labor and postpartum
Doula will be the same person so that your relationship with her will already be well established for your postpartum period.
What training does a Doula receive?
There are several certifying organizations through which Doulas may receive part of their training. Additionally, an integral part of a Doula’s training is her own personal pregnancy, birth and mothering experience and the experience she has gained in assisting other mothers as a doula. While many doulas choose to seek certification through a recognized body, certification is not required by any organization or state in the US.
All of our Doulas are certified through or are working towards certification through the nationally recognized doula certification organization of their choice. They also bring with them their own experiences and the insights they’ve gained through working with countless mothers in various other programs and capacities in the Southeast Texas area. Doulas working with the Whole Mothering Center also undergo a period of hands-on
apprentice training with a more experienced Doula during the certification process.
You can find out more about Doula Training and Certification through these agencies:
How much does it cost to retain a Doula?
Doula services range in price from area to area and doula to doula. Some of this is based on the experience your doula has, some is based on the going rate in your area.
Birth Doula and Postpartum Doula packages begin at $575.00. We also offer an hourly rate for emergency and after-hours services for postpartum doula work and are happy to work with you on payment arrangements. For those who are experiencing financial hardship, we also offer a sliding scale of fees and are willing to barter for services (ask us for our wish list for ideas of services we’re willing to barter for). One reason we have chosen to offer this service is so that any mother who wishes to have the support of a Childbirth Doula or a Postpartum Doula will have the opportunity to have those services. Our goal is to help support mothers, and we don’t feel that a mother’s options should be based on her ability to pay.
I’ve heard some doctors don’t work with/hospitals have banned doulas.
Yes, that’s true – thankfully, that is not the case in our area. We have yet to come across a care provider in our area who is unwilling to work with a doula and have had positive experiences working with nurses and hospital staff with previous clients. We go out out of our way to form a professional and friendly working relationship with our client’s care providers and to communicate cooperatively and respectfully with each medical professional involved in your care. This works to facilitate a positive experience for you and for our future clients. We don’t believe that doctors or other medical providers are our or your enemy and we don’t treat them as such.
There are some hospitals that don’t ‘allow’ doulas; however, as the mother, you have the right to have whomever you want with you to support your labor. A hospital ‘ban’ on support person violates a mother’s choice and rights, and is unethical. We feel that such bans will surely be challenged.
You can read more about bans here:
- Another Doula Ban, Another Bad birth Plan from BirthingBeautifulIdeas.com
- TheUnnecesarean.com’s article on “flu season restrictions” that force a laboring mother to choose between her significant other or her support person.
Is your question missing from this list? If so, please email us and we will add it!