What exactly is a doula? While there are people who have heard of doulas, there are just as many who will ask me to repeat myself as if I was speaking a foreign language. In a way, they are right. The word doula comes from the Ancient Greek word doulē meaning “woman’s servant.” Although at the time it was more of a servant position, the name has come to mean something very special. In the past 20 years doulas and midwives have reemerged to become a very important part of the birth process for many women. In fact, currently the use of Doulas has more than tripled in the U.S., as parents have seen how beneficial it is to have a Doula be a support system, most especially during labor.
A doula is a labor assistant, hired to give continuous care to the pregnant woman and her partner before, during and after childbirth. She is not a doctor or a nurse or even a midwife. A midwife is a medically trained person who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery. The doula does not take the place of a nurse. One of the most important roles the doula has is to be there continuously throughout the labor and delivery. Nurses are certainly willing and able to be birth assistants, but, during most hospital births today, they are simply not able, due to work load and time constraints, to provide continuous 100% support.
The doula is also not there to take the place of the birth partner or husband. In fact, she is often hired to support and encourage both partners. The ability for the birth partner or coach to have a break is much appreciated by families choosing to have a doula. For example, if a woman is experiencing back labor, she often finds a great deal of relief from constant hand pressure to the hips and lower back. This is almost impossible to keep up for long periods of time, and is just one example of how helpful an extra pair of hands can be.
Mostly though, doulas are hired for their calm, experienced encouragement and support. Most women say that that was the best part of having a doula. One woman, from New Jersey, summed it up by saying:
“I felt loved, cared for, almost honored in my role as a birthing woman, it was fantastic.” Another woman, Christy said, “My husband was great, I couldn’t have done it without him, but just having another woman there made me feel much more confident.”
These are not unusual remarks. We are in a new time: this is the first generation of men who have even been invited in such numbers to the birthing room, much less being asked to have an active role. Women for centuries have always been the part of labor and birth. The outdated, “medically managed, no men in the room except for the Doctor model,” is happily a thing of the past. Having a woman present can have a tremendous effect on how mothers cope with their childbirth experience. There is something very powerful about being reminded of the women who have come before you and who have birthed their babies in the same way since time began. Having a doula present is in some way a reminder of this ancient ritual, and has been shown to have a very positive influence on the birthing mother.
In fact, statistics prove that having a doula can bring more than just comfort. In general, requests for epidurals are reduced, as are cesarean rates, analgesia use and forceps delivery. Across the board, the most significant findings show that women who had a doula reported that they had a more positive birth experience and were able to bond quickly with their babies.
A positive birth experience can greatly effect how a woman feels about herself and her baby. If she feels empowered, she will leave the experience more confident and secure in her new role. Moving into motherhood is one of the most important transitions a woman will ever experience. All along the way she has taken an active role in this process and the doula is hired to facilitate that process, not to lead it. An experienced doula knows that she is there to support the woman’s decisions whatever they may be. In the months before the birth the doula meets with the pregnant woman and family to go over the details and choices that the woman feels comfortable with. If she wants the doula to encourage her to have a medicine-free birth then that is what the doula will do. If the woman is not sure and thinks she might want the option of an epidural or other medicinal support, then the doula is there to help with that too. A doula is not a judge insisting on a “natural birth.” She is there to support, encourage and help ensure a positive birth. Most importantly, a doula should leave you with the empowered feeling that you did it. You birthed your baby and you are ready to take on the most important, amazing role of your life, motherhood.
Hiring a Doula
While there are no state licensing requirements for doulas, many have been trained by certifying organizations such as DONA, Childbirth International, and many others. Fees vary but are usually between $300 and $3,000.
Some important questions to ask potential doulas are:
- What is your training?
- Can you tell me a bit about your experience with childbirth and work as a doula?
- What is your philosophy about childbirth?
- What role do you intend to play in the birth room?
- At what point do you come to us? Do you meet us at home or at the hospital?
- Do you meet with us after the birth? What are you willing to do?
- Do you work with any other doulas in case you’re not available? May we meet with them?
- What is your fee?
Books that I have loved
Spiritual Midwifery, by Ina May Gaskin
After the Baby’s Birth: A Woman’s Way to Wellness, by Robin Lim
Some Additional Resources
DONA, International
Childbirth and Postpartum Professional Association (CAPPA)
BirthWorks, International
