Pregnancy feels like a rollercoaster, and you might be looking for someone to help you strap in and enjoy the ride. You have likely heard the word “doula” tossed around in mommy groups, but do you really need one?
Are you curious about what they actually do and how they fit into your birth plan?
In this article, we will break down exactly what a doula is, how they support you, the evidence-based benefits of hiring one, and the real costs involved.
What Is a Doula?
A doula is a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth. Think of them as a knowledgeable birth companion who does not leave your side.
While doctors and midwives focus on the clinical safety of the baby and mother, a doula focuses entirely on the mother’s comfort and emotional well-being. They typically begin building a relationship with you a few months before your due date.
Support Where Needed
Although doulas do not have medical degrees, they are educated in the physiology of birth. Many go through rigorous certification programs that take up to a year or more to complete. While often associated with home births, doulas are valuable assets in hospital settings and birth centers as well.
The Benefits of Doulas
Bringing a doula into your birth team is not just about having someone to hold your hand; the statistics back it up. Research consistently shows that doula support leads to safer, healthier, and more satisfying birth experiences.
Here is what the evidence says about having continuous support:
- Lower C-section rates: Studies indicate a 28 to 39 percent decrease in the risk of Cesarean sections when doulas are present (1).
- Shorter labor: Continuous support can shorten the duration of labor, which is a massive win for any laboring mom.
- Less pain medication: Women with doulas often request less pain medication and rely less on anesthesia.
- Fewer interventions: There is a significant reduction in the use of forceps or vacuum extraction during delivery.
- Healthier babies: Newborns tend to have higher APGAR scores (a test measuring heart rate, respiration, muscle tone, reflexes, and color) when a doula is involved.
- Better mental health: Women report more positive memories of their birth and generally feel more satisfied with the experience.
- Reduced epidural requests: Mothers supported by doulas are up to 60 percent less likely to request an epidural (2).
- Less Pitocin use: You may be up to 40 percent less likely to need Pitocin to induce or speed up labor. Pitocin is a synthetic oxytocin that can sometimes cause fetal distress (3).
- Effective pain management: Doulas use hands-on methods like hip squeezes, counter-pressure, and massage to target specific muscles and provide relief during contractions.
How Much Does a Doula Cost?
Doula fees vary wildly based on location, experience, and the specific package you choose. As with housing and groceries, services in major metropolitan areas will cost significantly more than in rural towns.
If you find a doula in training who needs to attend births for certification, you might pay as little as $300 to $500. However, for an experienced professional, you should expect to pay anywhere from $800 to over $2,500 (4).
Some doulas offer sliding scales based on income, so it is always worth asking.
Can a Doula Be Covered by Insurance?
Traditionally, insurance plans have not covered doulas because they are considered non-medical support. However, this is changing. Some forward-thinking insurance providers now cover a portion of doula services. Even if yours does not, you may be able to pay using your HSA (Health Savings Account) or FSA (Flexible Spending Account) funds. Always call your provider to check your specific benefits.
Doula Frequently Asked Questions
What Training/Certification Do Doulas Need?
Doulas are not legally required to be certified to practice, but hiring a certified professional is highly recommended. Certification organizations (like DONA International or CAPPA) require rigorous training, including childbirth education, breastfeeding support, and attending live births.
Finding a certified doula gives you peace of mind that they adhere to a code of ethics and standards of practice.
What Are the Different Types of Doulas?
While many people think only of birth support, there are actually three main types of doulas to support you through different stages: antepartum, birth, and postpartum (5).
Here is a breakdown of what they do:
- Antepartum doulas: These professionals support you during the pregnancy itself. If you are on bed rest or dealing with a high-risk pregnancy, they provide help with meal prep, household organization, and emotional support to reduce anxiety.
- Birth doulas: This is the most common type. They join you during labor to provide physical comfort measures, emotional encouragement, and advocacy. They stay until the baby is born and everyone is settled.
- Postpartum doulas: These experts step in after the baby arrives. They help with breastfeeding, newborn care, light housekeeping, and ensuring the mother gets enough rest and nutrition.
Many doulas are cross-trained and can offer packages that include both birth and postpartum services.
What About the Father’s Role When Using a Doula?
A doula does not replace the father or partner; she enhances his role. The doula takes the pressure off your partner so they can focus on loving and supporting you emotionally without worrying about remembering breathing techniques or medical jargon.
If your partner needs a bathroom break or a quick nap during a long labor, the doula ensures you are never left alone. Most partners report feeling more relieved and involved when a doula is present to guide them.
What Can’t Doulas Do?
Doulas are non-medical support persons. This means there are strict boundaries on what they can and cannot do.
They cannot give medical advice, diagnose conditions, or perform clinical tasks (6). If a medical decision needs to be made, a doula will help you ask the right questions to your doctor, but the decision remains yours. They also cannot administer medication or catch the baby (7).
Can a Doula Deliver a Baby?
No, a doula cannot deliver a baby. They also do not perform vaginal exams, check fetal heart rates, or break your water. Those are medical tasks reserved for your OB-GYN or midwife.
What Does a Doula Do During Birth?
During labor, a doula is a constant presence. Physically, they suggest position changes to progress labor, apply counter-pressure to ease back labor, and guide you through breathing techniques.
Emotionally, they are your personal cheerleader. They remind you of your strength when you feel like giving up and help maintain a calm atmosphere in the room. They also facilitate communication between you and the medical staff to ensure your voice is heard.
What Does a Doula Do After Birth?
Immediately after birth, a birth doula usually stays for one to two hours to help with initial bonding and the first latch if you are breastfeeding.
If you hire a postpartum doula, their work is just beginning. They visit your home in the days or weeks following birth to help you recover. They might hold the baby so you can shower, prepare nutritious snacks, assist with older siblings, or simply listen as you process your birth story.
Can a Doula Help With Breastfeeding?
Yes, most doulas have training in lactation support. They can help you establish a good latch, find comfortable nursing positions, and recognize hunger cues.
While they can handle common challenges, they are trained to refer you to an International Board Certified Lactation Consultant (IBCLC) if you encounter complex issues. Studies show that having doula support increases the likelihood of successful breastfeeding initiation.
Why Is It Called Doula?
The word “doula” comes from ancient Greek, meaning “a woman who serves.” It perfectly describes their role: serving the mother through the transformative journey of childbirth.
How Often Should You Meet With Your Doula?
Typically, you will meet with your birth doula two or three times before the delivery. These prenatal visits are used to discuss your birth preferences, fears, and comfort measures. After the birth, most doulas offer one follow-up visit to check on you and the baby.
Do Doulas Reduce Maternal Mortality?
Yes, evidence suggests that doulas contribute to lower maternal mortality rates. By advocating for the mother and reducing the need for high-risk interventions like C-sections, doulas help improve overall safety outcomes for both mother and child.
How Long Should a Doula Stay After Birth?
A birth doula typically remains with you for 1 to 2 hours postpartum. Their goal is to ensure you are stable, fed, and comfortable, and that breastfeeding (if chosen) has been initiated successfully before they leave you to rest.
What Is the Difference Between an OB-GYN, Midwife, and Doula?
An OB-GYN is a surgeon and doctor trained to handle high-risk pregnancies and perform C-sections. A midwife is a medical professional who provides holistic care for low-risk pregnancies and delivers babies.
A doula is a non-medical support person. They do not deliver babies or perform medical tasks; they provide the physical and emotional support necessary to help you through the process.
Are There Virtual Doulas?
Yes, virtual doulas have become increasingly popular. They provide prenatal education, birth planning assistance, and emotional support via video calls, text, and email. While they cannot offer physical hands-on support during labor, they can still guide you and your partner through coaching and advocacy from a distance.
