A profession of labor support has emerged over the last two decades. This role is called “doula” from the Greek word “doule”, meaning “maidservant”. The majority of labor doulas are women, though there are male labor doulas. Doulas provide non-clinical services. Doulas do not take the place of obstetricians or midwives, but round out the birth team by providing informational, emotional, and physical support to the pregnant woman and her family during pregnancy, birth, and the postpartum period. Doulas support births in homes, birth centers, and hospitals.
Doulas are not licensed or regulated by the state. There are many certifying bodies that train and guide doula practice. By hiring a certified doula, you know that you are hiring a trained professional with scope of practice guidelines and continuing education requirements.
Most labor doulas will meet with you twice prenatally to get to know you and to help you sort through birth options and your preferences. If you have a partner who will be involved with your birth, it is helpful if they are able to attend at least one of these meetings. Your doula does not replace your birth partner if he/she wants to be actively involved. She can guide your partner in ways to support you in labor, and your doula will also be able to support your partner. Prenatal support is not limited to these meetings. Your doula will remain in contact with you via phone, text, or email throughout your pregnancy to provide information, support, and to develop a relationship with you. By the time you give birth, she won’t feel like “another stranger in the room”. Many women say that by the time they gave birth, the presence of their doula is much like that of their best friend, but with the knowledge and skills to improve the birthing experience.
When you think you are in labor, your doula will meet you in your home or at your place of birth, depending on your contract agreement. A doula will not monitor your baby or check your cervix. She is educated in the emotional signposts of labor and is familiar with the sounds of active labor, and is able to provide support until you are ready to travel to your place of birth. During active labor she offers hands on comfort measures. She can suggest position changes to encourage better fetal positioning and descent. She will remind you of your birth preferences and encourage you towards that goal. She is not there to talk to the doctor for you. She is not there as a gatekeeper to fend off medical staff. She is not there as a birth advocate. Only you or your partner can make decisions. She can help you gather information on which to make those decisions. She will be there as a constant support no matter how those decisions might deviate from your original birth plan. She cannot guarantee the outcome of your birth, but studies have shown that the presence of a doula reduces interventions, can shorten labor, and improves satisfaction with the birth experience.
Doula support does not end with birth. She will remain with you until you are comfortable and have fed your baby. This is typically two hours. She will follow up frequently over the next two weeks to make sure you are adjusting well. In the event of concerns regarding you or baby, she will provide appropriate referrals. Between 4-6 weeks postpartum, she will visit you again to assess your current needs. She will help you process your birth experience and encourage you on your journey of parenthood. For more extensive postpartum support, postpartum doulas are available.
There are doulas to fit every personality and budget. Most doulas offer complimentary consultations so that you can interview several doulas before hiring one. Doulas combine their passion for birth and their compassion for women to help you have a satisfying birth experience. Hire a doula – when everyone else is focused on the monitors, she will be focused on you!