What is a doula? A doula is a trained professional that provides emotional support, comfort measures, information and advocacy for the family. The doula’s purpose is to support women to have a safe and empowering birthing experience.
What does that look like? It’s sometimes hard to put the true value of a doula into words, but you will feel the value in the subtleties of the birthing day. It’s that we know intuitively how to support the ever changing needs of a woman through the course of her labor, from the loving encouragement to the sip of water to a firm touch to the need for a position change.
You might see your doula as a birth “project planner,” a coach, a mother figure, or an educator. Whatever the role, a doula is there for you and you alone, so let’s uncover what you need from your doula together.
When does a doula join a woman in labor? They normally ask that you call at the first hint of labor and stay in close contact throughout that period until you are ready for the doula to join. It is different for everyone but I recommend that a doula join you when you have noticed the shift into active labor. This is to ensure that you are in fact on the “Labor Train” and not experiencing prodromal labor. We also don’t want to inadvertently scare away your progress when it’s most sensitive in the early hours. That is the time to spend with your partner, relaxing and getting the oxytocin going. A good doula will however be in contact virtually with guidance and support before their physical arrival.
How do I choose the right doula? The most important thing is to feel a connection with your doula. This person is going to be holding space for you to moan, groan and transform, so you want to really like them. Ask yourself what you envision for your birth. Is there laughter? Is it spiritual and intentional? We all have similar “doula tools” and our differentiators are mostly how we interact with the world.
Does having a doula diminish my partner’s role? NO! The doula is not only there for mom, but there for the partner as well. The partner knows the mom and the doula knows birth, so their relationship is a collaboration in supporting mom in the best way. AND, the doula is there to normalize birth and offer support to the partner in times of stress.
I am pretty sure I want an epidural. Do I need a doula? An epidural can be a great tool for pain management. Keep in mind that there is still discomfort in early labor before the epidural is even an option. Additionally 1 in 10 epidurals do not work, so a doula is great insurance. Your doula can also help with things like effective positioning and pushing techniques that are specific to moms with epidurals.
What if my baby is born by cesarean? A doula can help your family understand the procedure and the options surrounding it (requesting that conversation is limited among the staff, whether arms can be free, is there a clear drape, etc.) A doula will remind everyone involved that birth is a deeply important experience, not simply a medical event.
What’s the difference between doula and midwife? Midwives are medical providers, trained and licensed to attend birth. They have the tools and expertise to ensure that baby and mama are safe. Doulas do not perform clinical tasks or exams and do not replace medical care providers. Our focus is the emotional health and physical comfort of the mother.
Why are some doulas certified and others not? The vast majority of doulas are trained by one of the many organizations (DONA, DTI, Cornerstone, etc). The basic doula training is typically a long weekend. After that, their is a certification process which includes reading, writing, CPR training, attending births, mentorship, etc. There is no one regulating body over doulas, so there is no one certification or license required for a doula to work. Some certifications require the doula to renew the certification annually. Many of the most experienced and skilled doulas allow their certification to lapse, as it’s an extra cost and generally unnecessary.
You may want a doula with up-to-date certification in the event that your insurance covers the fee and requires this. Outside of that, certification may not be important or reflective of a doula’s ability to support. Remember doulas are not medical providers, thus do not require regulation.
Outside of the basic doula training, there are other skills that a doula can be trained on like hypnosis, spinning babies, comforting touch, breastfeeding, newborn sleep, CPR, or newborn care. They may have certifications from these certifying bodies as they continue education.
What does a postpartum doula do? A postpartum doula is a support for the whole family in the immediate postpartum, so the mother may rest and recover from the birth. There is a range in tactical offerings here: cooking, cleaning, overnight care, laundry, massage, etc. But all doulas are trained to answer questions about healing and basic breastfeeding.
Can the postpartum doula babysit? Maybe! Many have boundaries around babysitting the newborn or older children. Some are happy to do this occasionally, while others do not include this in their service. This is a great question for the interview.
Why the range in rates? Postpartum doulas with more experience and additional education in lactation, traditional cooking, herbalism, massage, newborn care, infant sleep and bellybinding are usually closer to $50 and above per hour.
I want a night doula. Will they stay awake all night? Probably not. Many overnight doulas require a place for them to rest or sleep and will wake to support nighttime feeds and getting baby back to sleep. There may be some time dedicated to supportive tasks for the family, but if you want “awake care” you may have to search for this, and it’s usually a higher price tag. Daytime doulas tend to do more household tasks if this is important to you.