A doula is a person pregnant women hire to give them guidance and support during pregnancy, childbirth, and the postpartum period. Most doulas are women, although there are a few men in the profession as well. They typically begin their work a few months before a woman’s delivery date.
They are commonly thought of as birth coaches to help women through the difficult childbirth experience and the aftermath.
Support Where Needed
Doulas give emotional, informational, and even physical support to women, but they can also help the entire family with the rigors of pregnancy, childbirth, and adjusting to their new lives.
Although doulas don’t usually have formal obstetric training, they are often certified — some of the classes they take can take up to a year to finish. Some people mistakenly believe that doulas are only used for home births, but they can also be used in the hospital setting.
The Benefits of Doulas
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Doulas can have a positive impact on the women who use them as part of their birth plan. Many of the studies done about the benefits of doulas show they can lead to safer and healthier births.
Plus, women sometimes feel better about their overall experience of becoming a mom when they have the support of a doula.
Some studies have shown there is a 28-percent decrease in the risk of Cesarean section when doulas are used. The largest effects recorded were as high as 39-percent (1).
Hiring a doula also appears to lead to shorter labor, which is something no woman would argue with.
It also can cut down on the amount of anesthesia used and how long it is used for.
With doulas, there are fewer births where forceps or vacuums are needed to assist with deliveries.
Babies have higher APGAR scores when doulas are involved. APGAR tests measure heart rate, respiration, muscle tone, reflex response, and color.
Women leave their birthing experience with more positive memories and a better feeling than they often do without doulas.
Women who use doulas tend to be as much as 60 percent less likely to ask for an epidural(2).
Those who enlist the help of a doula can be as much as 40 percent less likely to need Pitocin to start labor or speed it up. Pitocin is a synthetic form of oxytocin, which has been known to cause injuries in babies through oxygen deprivation (3).
Doulas can also help women cut down on the use of pain medications of any kind.
No matter what, childbirth isn’t going to feel like a day at the spa, but the hands-on methods employed by a doula can hit just the right muscles and spasms to help relax you as much as possible.
The fee for a doula varies greatly, depending upon experience levels, services provided, and even the location you live in. Bigger cities are typically more expensive for hiring doulas, just as they are more expensive for a lot of things.
If you catch a rural doula who doesn’t have much experience and is trying to get a client base, you may be able to find one for as little as $300, but you should be prepared to hear fees up to $2,500 (4).
Can a Doula Be Covered by Insurance?
Usually, doulas aren’t covered by insurance plans because they are seen as a non-medical aid for childbirth. But some insurance plans do cover doulas or at least a portion of their services. Sometimes you can pay the doula and get a detailed receipt to send to your insurance company for reimbursement. Your best bet is contacting your insurance company to find out — it doesn’t hurt to ask.
Doula Frequently Asked Questions
What Training/Certification Do Doulas Need?
Doulas don’t need to be certified. But if you’re looking to hire one, it’s a good idea to choose one who has been certified. Certification programs will vary, depending upon which organization is backing the doula.
Finding a certified doula will give you more confidence that a doula understands their role and how to best help you.
What Are the Different Types of Doulas?
There are three types of doulas — antepartum, birth doulas, and postpartum doulas (5).
Let’s look at what each one can bring to the table.
Antepartum doulas: This type is able to give you prenatal services, including information you’ll need before childbirth. They might help with prenatal massage, breathing techniques, and ways to relax. They can help you make meals, which is great if you are on bedrest, and they can give you moral support. They are especially helpful if you are having a high-risk pregnancy or uncertainties that are causing stress and anxiety.
Birth doulas: As the name implies, these doulas can give you support during childbirth — the support will be both for you and your partner. They’ll help with relaxation methods and coax you into different positions that may help with the pain. In addition to physical and emotional support, they can help you get the hang of breastfeeding during your hospital stay. Birth doulas usually will meet with you a few times before birth as well.
Postpartum doulas: These doulas will help you with your postpartum needs, including breastfeeding questions and getting some much-needed sleep. If you’re suffering from postpartum sadness, it will be good to have her around too.
Just because there are different types of doulas, it doesn’t mean your doula won’t offer more than one type of service. She can be a birth doula who also gives postpartum care, although it will likely cost more if she is offering both services.
What About the Father’s Role when Using a Doula?
A doula isn’t meant to replace a father’s role — whether it is in the prenatal period, the delivery room, or in the week following delivery. The doula will work hard to include your partner as much as he wants to. And if you have a partner who isn’t too interested in being there throughout the process, your doula can help fill in the cracks so you have all the support you need.
Many fathers appreciate having a doula to help with childbirth. It takes some of the pressure off of them when they’re unsure what they should be doing to help their partner. And they’ll be relieved their partner has someone on her side who knows exactly what needs to be done.
What Can’t Doulas Do?
While doulas can perform a lot of duties to help support a woman through this challenging but exciting time of her life, there are some things she can’t do.
Doulas shouldn’t give you medical advice. If a sticky situation comes up during delivery that requires you to make a medical decision, your doula shouldn’t offer any advice about it (6). They don’t have the medical training to make decisions like that when it comes to your health, so you and your partner, along with your medical doctor, will be responsible for any decisions.
Unlike midwives, they can’t give medications to you either — they aren’t allowed to administer them because they don’t have the medical training (7).
Can a Doula Deliver a Baby?
A doula is not allowed to deliver a baby. They also can’t do other medical procedures like checking on your cervix dilation, breaking your water, or checking the strength and rate of your baby’s heartbeat.
What Does a Doula Do During Birth
For physical support, doulas can offer women ideas as to different positions and relaxation techniques they can try in the later stages of pregnancy and delivery to find some relief from the constant discomfort and pain they’ll be facing.
They also can give hands-on relief by using methods like gentle touches, counter pressure, and by instructing moms-to-be about their breathing techniques. They can also show a woman’s partner how to be there emotionally and physically during birth and the postpartum period.
Emotionally, your doula will act like a cheerleader of sorts by letting you know you can do this and that you’re doing fine.
What Does a Doula Do After Birth?
Postpartum doulas help moms with all the tasks they need to do with their new baby but don’t always feel up to doing.
A doula can help for the first couple of days or may be employed for weeks until the mom feels like she has a handle on what she has to do and has recovered enough to do it by herself. They can help with things like making your meals or snacks, caring for your baby, helping with breastfeeding techniques, and helping you manage your emotions which can sometimes be all over the map as you shed those pregnancy hormones.
If you have other children, she can also help take care of them and help them bond with the new baby. And a postpartum doula can do some light housekeeping so your house doesn’t fall apart as you recover and you can spend more time with your baby. If you have many children and taking care of them after delivery is your biggest challenge there is what is called a sibling doula who can take care of all your children’s needs.
Can a Doula Help With Breastfeeding?
Doulas can help with breastfeeding in many ways. First of all, she can give you information about breastfeeding and its benefits, which may help you decide to feed your baby with breast milk instead of formula.
They can help you understand what a proper latch looks like, find comfortable positions that will help you pursue breastfeeding, and teach you how to tell if your baby is drinking enough milk. They might help set up breastfeeding areas throughout your house, so you’ll have what you need no matter which room you’re breastfeeding in.
Your doula will also stress the importance of eating frequent snacks and drinking enough water to help your body adjust to the rigors of breastfeeding. She will also be able to address any concerns you have and give you the reassurance that while breastfeeding isn’t always easy, it is beneficial. Studies show that women who have a doula for support experience higher rates of lactogenesis or production of breast milk in the first 72 hours after birth.
Dr. Njoud Jweihan is a medical doctor in Atlanta, Georgia with a passion for primary care and women’s health. She has over nine years of medical education and training experience. She also enjoys cooking, traveling and is excited to welcome her first child this summer!