Doulas are great, right? You’ve heard that a friend used one and loved her birth. Maybe your doctor or midwife suggested that having a doula would be good for you, too. Even the most reputable medical authorities (here’s looking at you, ACOG!) recommend birthing with a doula to decrease your chances of having a cesarean birth. But what exactly is a doula, and what do they do?
If you’ve been looking online for information about doulas, you’ve likely seen a hundred versions of something like this:
A doula is a woman trained in the physiology and psychology of birth, and in the art of providing labor support to birthing mothers during pregnancy, the birth process, and immediate postpartum period. It has been well-researched and documented that women who birth with doulas have shorter labors, are far less likely to have a cesarean birth, are less likely to use pain medication during labor, and report being much happier with their births. Women who have birthed with doulas are typically more likely to describe their birth in positive terms, and feel more attached to their babies.
Ok, good. People who birth with doulas are happier and are likely to have fewer medical interventions. That’s great news. Doulas are non-clinical professional labor support prople who work as a team with you and your doctor or midwife. Doulas provide a wide range of services to families of all sorts, in a variety of birth situations. But the question remains – what is it, exactly, that a doula will do for you? Provide support for birth, yes, but what does that support look like? Here are ten answers that you might not find in the standard “doula blurb.”
We get to know you. Before your birthing time ever arrives, and even before you choose to make the doula/client relationship official, we meet face-to-face. If you are inviting someone into a setting as intimate and vulnerable as your birth space, it’s important to first make sure that your doula feels like a good fit for you. (Not sure what questions to ask? Find some suggestions here.) I want to know how you function and express yourself in your daily life, when you aren’t in labor, because that will help me gauge the intensity of what you are experiencing when you are laboring and working hard. I want to know what you’ve heard about your own birth, about your partner’s thoughts on what his or her role will look like, and all about your hopes and preferences for your birth. We’ll talk about what we can do as a team to help your wishes happen.
We help you decide what to pack for the hospital. Have you seen some of the “what to bring” lists on the internet? Some are five pages long! (What exactly will you need a rolling pin, a blindfold and a deck of playing cards for?) Others are more like, “maybe bring a toothbrush, but the hospital might provide that, too.” We talk through all of the options that are available at your hospital or birth center. (Do you really need to bring your own pads and newborn diapers? Do you need to bring your own birth ball, or will your hospital provide one? Your doula knows the answer!) We’ll talk about what you might want to pack for yourself, your partner, and your baby, and what I might bring with me or be able to make out of what the hospital has on hand. (Think of your doula as your personal Birth MacGyver!)
We talk a lot about pain relief. Are you intending to have an unmedicated birth? Are you already certain that an epidural is right for you? Or are you somewhere in between, and want support in making the best decision for yourself when the time comes? The more I know about your preferences and priorities, the better I can support you in making them happen. I will recommend classes, books, and other educational resources that are a good fit for you. We can practice laboring positions and coping techniques together to help you prepare. I want to know which ideas really appeal to you, and which ones are not of interest to you at all. (Are you a guided meditation/self-hypnosis sort, or is dancing/moaning/swearing more your thing?) This helps me know what to suggest when you are in labor, and eliminates the need to try to have a discussion about it between contractions.
We help you know what to expect in labor. Long before you are ever in labor, we talk through what the day of your birth might look like, step-by-step. We discuss when to call your midwife, and when to call me. We’ll talk about things like what to do if you think your water broke, how to know when it’s really labor, and how to know when it’s time go without getting to the hospital too early or too late.
We listen. Doulas are professional non-judgmental listeners. I want to know what you are feeling, what you are thinking, and what you are going through. Whether you need to talk through something you are worried about, share your excitement, or vent to someone who will understand that you are feeling tired and done when you still have a couple of weeks to go, your doula is only ever a phone call away. Reach out as much or as little as you need to.
We answer the embarrassing questions. Did your mother-in-law tell you that eating too many spicy foods in pregnancy will make your baby rashy, and you want to know if it’s true? Want to know if eating your placenta is really a thing? That’s what I’m here for. Doulas are walking “birth wikis.” If I don’t know the answer, I know who will, and I won’t hesitate to say “call your doctor” when it’s appropriate to do so. Nothing is too embarrassing, random, weird, or icky. Really, asking me questions about sex in pregnancy or about your mucus plug is way less gross than Googling it, I promise. (But about that mucus plug – maybe just hold off on sending me pictures of it unless I ask.)
We provide continuous labor support. No matter which doctor or midwife is on call, or how many people are in labor in your hospital at the same time, or whether shift change happens for the nurse a time or two during your labor, you can count on your doula to provide one-on-one support from the time you are admitted to your hospital until the time your baby is born. We’ll suggest position changes and comfort measures. We’ll rearrange the furniture and break out all the tools it takes to help your labor progress. We’ll get you in and out of the shower or tub, and remind you to breathe. We hold the vomit bowl, and keep the cold washcloths coming. We know where the extra towels and blankets and chux pads are hiding. We keep your water bottle filled and remind you to hydrate. We tell you, as many times as you need to hear it, that you are strong. You can do this. All is well. We talk through your choices as they arise, and help you have confidence in your decisions.
Support is for partners, too. A good doula combined with a supportive partner makes for a real Dream Team in labor. A doula never replaces the role of a loving partner or family member. We encourage partners to be involved and included to the fullest extent possible. I’ll also make sure that he or she stays nourished and rested, so that he has the strength and energy to support you.
We help you feel safe. Birthing with a doula in a hospital is a lot like traveling to another country and bringing your own interpreter. As a doula, I’m fluent in the language of normal birth, and in the language of “hospital.” I help you know what’s normal and what’s not, and provide encouragement and reassurance when you need it. I’m protective of your privacy and modesty, if that’s important to you. I make sure the door to your room stays closed when someone enters or leaves. I am mindful of each little detail that makes you feel more comfortable in doing whatever you need to do to get your baby born. I pay attention to what’s going on around you that might not be said out loud, and gently bring things to your attention as needed. I facilitate conversations with your care provider, explain what’s going on and keep you focused if something unexpected comes up. I support you in the process of asking the right questions to get the information you want in order to make your own best choices. I provide a calm presence to sustain you and your support people through what might be a mentally, physically and emotionally intense experience.
We help you adjust to new parenthood. Doula support doesn’t end when the baby is on the outside. We’re also trained to provide support with infant feeding, newborn care, postpartum self-care and early parenting. Some doulas are even available to provide in-home postpartum care for several hours at a time in the early weeks. Your doula is part of your village. Nobody needs to feel like she is alone as a new mom. Reach out – support is exactly what doulas are there for.
Now that you know more about exactly what doulas do, you are ready to take the next step. You can email me at firstname.lastname@example.org, or begin a search for a doula in your area by popping over to CAPPA’s website.
Best wishes, and happy birthing!