To doula or not to doula?

I’m going to start by saying I am a doula, and I have had a doula attend both of my births.  

Doulas can be wonderful assets for mamas in pregnancy, labor, and postpartum.  Study after study has shown the benefits of doulas.  And honestly, having someone in your corner during such a transformative and powerful event is so important.

But here’s my “but” about doulas – we’re not everything.  You don’t NEED a doula to have a great birth.  No doula can give you what you already have – your innate power and understanding of how to birth your baby.  Doulas also can’t truly protect you from the broken maternity care system.  Real talk – if you’re relying on a doula to be the wall between you and a provider or birth setting, you likely need to reevaluate those choices.

Ok, but what is a doula and what do they do?

Think of a doula as the emotional support part of your birth team.  They also can provide physical support in the midst of labor. A doula is usually with mama continuously throughout labor.

Typically when people speak of a doula, they’re talking about the hands on physical and emotional labor support.  They can suggest positions to make labor more comfortable or more effective, provide comfort measures, and give all the emotional support and words of comfort mama may need.

While a midwife or OB typically provide the medical mind, a doula can assist in making mama feel safe and comfortable. 

While a very important and probably the most common role of a doula, it’s not the only thing doulas do!

Many doulas offer other services or may focus on something else entirely (hi, that’s what I do because I can’t be on call with my own littles at home!!).  

Some other roles and spaces you might see doulas in include childbirth education, postpartum care, abortion or miscarriage support, or even in non-birthy spaces like an end of life doula.

The history of doulas

With its origin from an ancient Greek word meaning “servant-woman,” the concept of village women attending one another’s births is not a new concept.  While the word comes from Greek, women supporting each other in the birth space is documented in ancient stone carvings and statues.

Our modern concept of a doula came with the reemergence of the unmedicated, low-intervention birth community in the 1960s.  

The formalization of “professional training” (something we’ll get into a little later) is a relatively new phenomenon, the most popular DONA – Doulas of North America – training coming into existence in only 30 years ago.

Who should hire a doula?

The easy answer is simply anyone who wants one!

Mamas are often told of populations that just NEED a doula, but at the end of the day, it’s another body in the birth space.  Every person beyond mama in the birth space is an intervention, each bringing their own energy, fears, and biases into the space.

Each person in that space needs to be carefully considered, and it’s not a decision to be taken lightly when inviting someone to be there.

Benefits of Hiring a doula   

Hiring a doula has many benefits during labor, but they also have many benefits in the pre and postnatal times, too.

Before birth, a doula may be able to help with building a birth plan, helping mama learn her options and provide helpful resources to guide research into those options.  A doula can also help with postpartum planning and lining up resources like a lactation consultant or pelvic floor therapist that you may need after birth!

During birth, continuous labor support like a doula has been shown to improve outcomes for mamas and babies in birth.  

Faster labors, increased chances of a vaginal birth/decreased c-section rates, fewer instrument- assisted births, shorter pushing stage, fewer medical interventions along the way, more satisfying birth experiences, improved breastfeeding success, and reduced rates of postpartum depression have all been studied benefits of having a doula with you in labor.

Another benefit of hiring a doula some mamas find over having a friend or family member for support can is the emotional tie – a doula is not tied to you emotionally the way a family member or friend may be.  Someone close to you may struggle seeing you in your most vulnerable moments – like in transition when you scream “I can’t do this anymore” – and encourage an intervention in the moment whereas a doula may be more able to say “you are doing this” and encourage you onward in your labor.  

While not medical in training, doulas tend to be very educated in physiological birth and can bring both their book knowledge and practical experience of witnessing other births to your labor. 

A partner may be a great emotional support, but birth is a transformation that hits both mama and dad.  To expect dad to be able to support mama as he’s transforming too is unfair and ultimately impractical.  A doula can also help dad in the birth space as he’s witnessing, processing, and reveling in his partner’s power.

 I want one! How do I pick a Doula?

Interview a lot, and go with your gut!

Similarly to finding any member of your birth team, ultimately, you want someone who respects you as the authority in your birth space and who will add to your birth experience.  

There are no “licensed” doulas, and while there are “certified” doulas, all that means is that she has paid money to some organization to be able to call herself that.  Some organizations come with rules and limitations on how a doula can be in a birth space, so it’s important to be aware if you’re planning to hire a certified doula what her governing body may require of her.  

This list may change based on your birth goals (and you can start figuring that out with my freebie), but here are a few questions you may want to ask of a potential doula:

  1. Why did you become a doula?
  2. How many births have you attended? Can I talk to some of your previous clients?
  3. What is your opinion of homebirth? Have you witnessed a truly physiological, uninterrupted birth?
  4.  What does working with you look like? What do you do with clients before and after birth?
  5. How do you support mamas postpartum