A doula is a trained support specialist who provides continuous physical, emotional, and informational support to the mother before, during, and after childbirth. 98.6% of births in the U.S. take place in hospitals, and nearly all of them require some kind of medical intervention. However, doula-supported deliveries are linked to shorter labor, decreased need for medications, fewer c-sections, higher rates of breastfeeding initiation, less anxiety, and less postpartum depression (Klaus et al., 2012; Martin et al., 2015).
Doula Types
There are a few different types of doulas:
- Birth doulas support during pregnancy, labor, and childbirth.
- Postpartum doulas assist families in the weeks following the baby's birth.
- Fertility doulas aid in the conception process, particularly for families facing challenges in getting pregnant.
Many doulas provide comprehensive services, known as full-spectrum doula care, allowing you to work with one doula throughout the entire journey.
What does a doula offer?
Consider a doula as a valuable ally for you and your partner throughout the entire journey of pregnancy, labor, childbirth, and the postpartum period. A doula can offer a range of support encompassing physical, emotional, and informational aspects:
- Increased coping methods: Your doula can recommend strategies to alleviate the stress and discomfort associated with labor. This may involve teaching breathing techniques, assisting in finding comfortable positions during contractions, or providing soothing measures like aromatherapy and foot massages.
- Reduced interventions: Research indicates that the presence of doulas can lower the likelihood of assisted vaginal delivery and decrease the probability of a cesarean birth. Even if a cesarean becomes necessary, a doula can offer ongoing support and reassurance. Some doulas may even accompany you to the operating room, if desired, instead of a partner or another support person.
- Objective guidance: Doulas are trained to guide you toward evidence-based resources, enabling you to make informed decisions throughout your pregnancy and childbirth journey. They assist in formulating a birth plan by prompting consideration of important questions. For instance, preferences regarding immediate skin-to-skin contact after birth or decisions related to banking umbilical cord blood.
- Advocacy: During labor, your doula can advocate for your birth plan, ensuring your preferences are communicated effectively to the healthcare team. In unforeseen circumstances, when new decisions must be made, your doula can assist you in navigating these choices.
- Improved communication: Doulas facilitate clear communication in complex situations, reminding medical professionals to explain terms and ensuring you are consistently aware of the proceedings.
- Focused attention: As doctors and nurses cannot be present in the room at all times, having a doula ensures continuous support, contributing to a relaxed and calm atmosphere.
- Postpartum assistance: Some doulas extend their services up to eight weeks post-delivery, providing support for recovery, breastfeeding, and managing sleep schedules.
Doulas vs. midwives: What's the difference?
Some people think a doula and a midwife are the same thing, but their educational backgrounds and duties differ.
Scope of Practice:
- Doula: A doula is a non-medical professional who provides emotional, physical, and informational support to a pregnant woman before, during, and after childbirth. Doulas focus on the well-being and comfort of the mother, offering encouragement, comfort measures, and advocacy.
- Midwife: A midwife is a trained healthcare professional with medical expertise in providing prenatal care, attending childbirth, and offering postpartum care. Midwives can provide a range of medical services, including conducting physical exams, ordering tests, and assisting with the delivery process. They can also handle routine gynecological care.
Medical Training:
- Doula: Doulas do not have medical training and do not perform medical tasks. They are there to provide emotional and physical support, help with pain management techniques, and facilitate communication between the mother and medical professionals.
- Midwife: Midwives are trained healthcare professionals who have received formal education in midwifery. Depending on the region and the type of midwife, their training may vary from a certified nurse-midwife (CNM) with nursing and midwifery education to a direct-entry midwife with education solely in midwifery.
Responsibility During Birth:
- Doula: Doulas primarily focus on providing continuous emotional and physical support to the laboring woman. They do not deliver babies or provide medical interventions.
- Midwife: Midwives are trained to manage the entire childbirth process. They can deliver babies, provide medical interventions such as administering medication or suturing, and handle complications that may arise during labor.
Location of Services:
- Doula: Doulas typically provide support wherever the birthing person chooses to give birth, whether it's at home, in a birthing center, or in a hospital. They are not limited to a specific setting.
- Midwife: Midwives can work in various settings, including hospitals, birthing centers, and homes. However, their scope of practice and ability to attend births in different locations may depend on local regulations and the type of midwife.
Is a Birth Doula for me?
If you are considering the possibility of seeking additional assistance and guidance during childbirth, having the services of a doula could prove to be a beneficial decision. Opting for a doula is particularly beneficial if you are committed to a specific birthing plan, as the doula can act as your advocate, providing support when you find it challenging to assert your preferences.
Doulas have training to offer assistance in various types of childbirth scenarios. While families aiming for "natural births" (meaning without medication) may be more inclined to hire a doula, it's important to note that doulas are available to support you regardless of your choices regarding pain medication and other aspects of the labor process.
If you're not the type to want someone cheering you on every step of the way — and you don't feel the need to have extra support in the delivery room outside of your medical team and your support partner — then you may not want or need a doula.
Is a Postpartum Doula for me?
A postpartum doula focuses on the well-being of both the postpartum mother and the newborn. Their primary goal is to help the postpartum parent in physical and emotional recovery while also providing guidance on essential baby care tasks such as bathing, diapering, swaddling, sleeping, and breastfeeding.
Many postpartum doulas hold certifications as lactation counselors, enabling them to address common breastfeeding challenges, including latching techniques. They offer advice and instill confidence in caring for the baby while remaining vigilant for signs of postpartum depression.
When considering the possibility of working with a postpartum doula, it is recommended to ask about the specific certifications of your potential doula candidates. This is crucial because some doulas are trained solely for birth support, some exclusively for postpartum support, and others possess expertise in both pre- and post-birth assistance.
How much does a doula cost?
The cost of hiring a doula can vary significantly based on factors such as location, experience, and the range of services offered. On average, doula services in the United States can range from $800 to $2,500 or more. This fee typically covers prenatal visits, continuous labor support, postpartum follow-up, and educational resources. In some cases, doulas may offer additional services such as childbirth education classes or lactation consulting, which can contribute to a higher fee.
Fortunately, concerns about the affordability of a doula may be mitigated by exploring potential reimbursement options. While doula services are often considered out-of-pocket expenses, there is a silver lining—certain health insurance providers cover the costs associated with doula care. Additionally, some states have included doula services in their Medicaid plans, and others are contemplating similar legislative initiatives.
To explore financial assistance options, be sure to contact your health insurance provider directly. Ask about their policies regarding coverage for labor support, childbirth education, and lactation support services. Moreover, investigate the possibility of utilizing health care flexible spending accounts (FSA) or health savings accounts (HSA), if available, to contribute towards the expenses associated with hiring a doula. This proactive approach can help individuals and families navigate potential financial challenges and make informed decisions about accessing valuable doula support during the childbirth experience.
While the cost of hiring a doula may be an out-of-pocket expense for expectant parents, the potential benefits, such as increased emotional support, improved birth outcomes, and enhanced overall satisfaction with the childbirth experience, are often considered invaluable. It's important for individuals and families to carefully consider their budget, preferences, and the specific services offered by a doula when evaluating the associated costs.
How can I find a doula near me?
Starting your search for a doula early in the pregnancy, aiming to secure their services by approximately week 20, is highly recommended. Due to the high demand from repeat clients and referrals, experienced doulas tend to get booked quickly. Nonetheless, it is still possible to hire a doula even close to the due date.
The most effective method for finding a doula is through recommendations from those you trust. Consult with your healthcare provider, as well as friends and family, to gather suggestions. You can find a complete step-by-step guideline here.
Interviewing at least three doulas is recommended. Trust your instincts and choose someone with whom you feel a connection. Since a doula will be present during a profoundly personal experience, establishing a strong emotional bond is crucial.