- A doula is a non-medical specialist who can offer you and your partner support and guidance before, during, and after giving birth.
- Doulas can offer constant support during the birthing process whereas nurses and doctors may be in and out to attend to other patients.
- While doulas aren’t necessary, researchers have found that women who have continuous support during labour are more likely to have a vaginal delivery and less likely to need pain medications.
- This article was medically reviewed by Olivia P. Myrick, MD, who is a clinical assistant professor with the Department of Obstetrics and Gynecology at NYU Langone.
- Visit Insider’s homepage for more stories.
Typically called a birth doula, a doula is a non-medical specialist who provides physical and emotional support during labour and childbirth.
Although most women do not have a birth doula – only 6% of Americans surveyed in 2013 did – several studies have shown that having continuous support during labour, such as that from a doula, can improve outcomes. Here’s what you need to know.
The difference between a doula and a midwife
Unlike a midwife, a doula is not a medical professional who can provide medical advice or care.
Midwives are more similar to obstetricians, in that they are licensed registered nurses. Many of them work alongside doctors in hospitals and are professionally trained in birthing babies.
Doulas are more involved with a single patient’s birthing experience, not the mechanics of birthing itself. They focus on planning for the mother’s comfort during the birthing experience through methods of stress-relief and mental preparation. Doulas often have just one patient at a time, so their focus and attention aren’t divided.
The training a doula receives to become certified can vary, but generally, it’s through an agency such as DONA International. During this training, a doula may be required to attend several births, receive positive evaluations from mothers-to-be, and attend a multi-day training program.
What a doula does before labour (antepartum doula)
If you are on bed rest or have a high-risk pregnancy, a doula can help before labour in ways that are specific to your needs.
This may mean attending prenatal visits with you and your doctor, offering emotional support, or helping you with small tasks around the house if you are on bed rest.
What a doula does during labour
Many doulas are able to come to your home in the early stages of labour, and they can be quite reliable in determining when you may be transitioning into active labour and when to go to the hospital.
If women are planning to go through the birthing process without an epidural, doulas are helpful in managing pain through alternative techniques like breathing techniques and different labour positions. Even if you decide to have an epidural during the process, doulas can still coach you when it is time to push and during the delivery itself.
“When we’re providing continuous labour support for the mum, we can get the mums to relax,” says Hodges.
Doulas can also offer an extra voice in the room to make sure your desires are being heard and met as well as provide explanations for any changes or unexpected situations during labour.
Finally, some doulas offer to take photos of the special moments just after delivery if photography is allowed in the room.
What a doula does after labour (postpartum doula)
Having a doula after labour can be helpful to you and your family, especially if you had a cesarean delivery or other complications during childbirth. A doula can help in a variety of ways, such as running errands, preparing meals, providing breastfeeding support, light housekeeping, caring for your other children, or helping take care of your newborn baby.
The length of time you choose to have a doula, and how often they visit after labour usually ranges from a few days to a few weeks and can include night services. Not every doula offers these benefits, so it is important to clarify this before hiring.
Science-backed benefits of a doula
What researchers have found is that, compared with women who did not have continuous support during labour, women who did were more likely to have a vaginal delivery that did not require medical instruments, such as forceps, to assist, less likely to have a cesarean, and less likely to need pain medications.
These women also spent less time in labour, were more likely to be satisfied with the birth experience, and were less likely to have a baby with an unfavourable 5-minute Apgar score, which is a test given 5 minutes after birth to evaluate the baby’s health.
A 2013 study in the Journal of Perinatal Education also found that women who had doulas were less likely to have a complication during labour and were more likely to breastfeed than women who did not have doulas.
For a more comprehensive list of scientific studies about doulas, check out this overview from ScienceDirect, an online database of scientific and medical research.
How to know if a doula is right for you
Before hiring a doula, you and your partner should have a serious conversation about how comfortable you feel having another, non-medical person with you in the delivery room. After all, giving birth is a very private, emotional time that you may not want to share except with each other.
You should also know that a doula is not necessary for giving birth. Nurses and doctors are trained to help you through the birthing process, beginning to end. However, what a doula offers that nurses and doctors can’t is continuous company and support. Nurses and doctors have other patients to attend to and therefore will likely be in and out of the delivery room, unlike a doula who can stay by your side 24/7.
Like you, doulas have their own philosophy about what is and isn’t good for you pre- and post-birth. And if what you want doesn’t align with what your doula thinks is best, then it can cause conflict and be more stressful than helpful. That’s why “the main thing to look for is compatibility,” Hodges says.
For example, if you want to deliver without medication but are open to using medication if the pain is too much to bear, you may not want to choose a doula who is against using medication during birth.
You will typically meet with a doula a few times before the birth to discuss a birth plan and ask questions. This is important because the better rapport you have, the better understanding the doula has of your personality and what your needs and desires are for your birth.
How much does a doula cost
The cost of a doula varies and likely depends on where you live. Hodges says for Allegheny County, which is the area in Pennsylvania that she serves, a doula may cost anywhere between $US600 and $US2000.
Hodges says that health insurance companies may cover doula services – you just need to call and ask. You can find a doula by searching the database from DONA International or by asking your provider for recommendations.
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