What is a Doula?

by Rebecca on May 14, 2010

When I first became a doula in 2002, I heard this question a lot!

“What is a doula?”

Eight years later, I still hear this question, but not quite as often.  As more and more women are choosing to make their own choices for how they want their birth to be, doulas are more widely sought out to help support women in those choices.

The word doula is an ancient Greek word which means “a woman who serves”.  It has now come to refer to a trained and experienced professional who offers mothers continuous physical, emotional and informational support before, during and after birth. In other words, a doula is someone who knows how to mother the mother.

Every woman is different, and every birth is different, so there are countless ways a doula can help you.  Here are a few examples of ways that a doula might support  you during this pivotal event in your life:

You are pregnant and know the type of birth experience you would like, but you are not sure which care provider you should choose.  A doula is often acquainted with several care providers in the area and may be of assistance in helping you to know which providers are supportive of the type of birth you desire.

You are trying to choose a childbirth class.  You aren’t sure what the difference is between all the methods you’ve read about.  A doula can explain the main differences between various methods as well as help you to find a teacher for the class you choose to take.

You are full term and have been having some contractions, but you can’t really tell if you are in labor yet.  Your doula can discuss with you what is happening and help you to determine if labor has begun.

Labor is moving slowly and you want to speed things up.  Your doula will have several suggestions for you to help your labor to become more established.  If you’d like time alone with your husband or other support person, she can give you suggestions over the phone.  If you need someone experienced there with you to reassure you that everything is normal, your doula will come join you as soon as you would like her to.

You are in labor and are having a lot of discomfort in your lower back.  Your care provider thinks your baby may be in a posterior position.  Lucky you–you have a doula with you to apply counter-pressure to ease your back labor, put warm packs on your back, and help you to find the best positions to encourage your baby to rotate to an anterior position so that your back pain will ease and your labor will progress more quickly.

Your care provider thinks labor is not progressing quickly enough.  He/she would like you to have pitocin or an amniotomy (artificially breaking your amniotic sac) if things don’t speed up soon.  Your doula will be there with you to discuss the pros and cons of each option you are given, as well as to suggest some more natural methods of speeding up labor that you can try in the mean time.

Your husband really wants to support you during labor, but he has never seen a baby be born before except on tv.  He doesn’t really know what is normal.  He wants to help you, but he doesn’t want to see you in pain and he feels nervous about being the only person you can rely on.  A doula can help husbands or other support persons to be as involved (or uninvolved) as they (and you) wish.  Doulas take the pressure off of husbands and allow them to be there for you in whatever way you choose, without needing to know all the answers or trying to remember everything from your childbirth class.  A doula is a dad’s best friend in labor!

You have received an epidural, but it is only working on one side.  Since you have a doula with you, she will reassure you that this is normal and can help you to get in a position that will help the medicine to better circulate throughout your body.  She can also use massage, counter-pressure, visualization and other techniques to help you through the contractions you are feeling.

Your labor is moving very quickly and it is hard for you to stay on top of each contraction.  You have decided not to have medication, but you need some help to make it through.  Your doula will be right by your side, helping you through every contraction and giving you information about where you are in labor and what is happening right now.  When you are pushing your baby out, she can breathe along with you to help you not to push when your baby’s head is crowning.  Her calm demeanor will help you to stay calm and feel reassured that everything is all right.

Your doctor is suggesting that you have a cesarean section.  He has informed you that it is not an emergency, but if you are going to do it, he thinks you might as well do so soon.  You had not wanted a cesarean, but are very tired right now and not sure what to do.  Your doula will not tell you what you should do, but she will be someone who will listen to what you want and discuss with you the advantages and disadvantages of each choice so that you can make the decision that is right for you.  She may also offer some alternative suggestions that you can then discuss with your care provider.

You are very happy with the care provider you have chosen and end up with a great nurse when you get to the hospital, but you are so grateful to have a doula with you, because apart from your husband, she is the only person who will remain with you throughout every moment of your labor and birth.  Both your nurse and your midwife or doctor have several other patients that they must care for, and can only be with you for short periods of time.

During your cesarean section, you were so grateful to have a doula as well as your husband by your side.  When your baby was born and taken immediately to the nursery, you were very reassured that your husband was able to remain with your baby while your doula was able to remain with you throughout the end of the surgery.  She was also there to help you find the most comfortable position to begin breastfeeding after the surgery.

Breastfeeding is very important to you, but you have never done it before and are not quite sure how to begin.  Don’t worry, your doula likely has a lot of experience with breastfeeding and will remain with you after the birth to help you and your baby get off to a great start.

Your baby is a few days old and you have some breastfeeding questions.  Your doula will probably have several tips to help you, and if your doula can not answer those questions for you, she can refer you to lactation specialists who can.

You are planning a home birth with a caring, qualified midwife who will bring an assistant with her.  You know that they will provide continuous, compassionate support, but you are still grateful to have a doula who can focus completely on your comfort, while your midwife and her assistant focus on the well-being of you and your baby.

These are just a few examples of how a doula can help you.  What does a doula NOT do?

A doula is NOT a care provider (midwife or doctor).  She will not check your dilation, blood pressure, or your baby’s heartbeat.  She will not deliver your baby.  She will not tell you what to do.  She will not make judgments regarding your care provider’s advice.  She will not be responsible for the choices you make.  She will not judge you for the choices you make.  Her number one priority is to help you to have the positive birth experience that you are hoping for (your definition of positive!).

Several clinical studies have shown that having a doula present for your labor and birth:

~tends to result in shorter labors with fewer complications

~reduces a woman’s negative feelings about her birth experience

~reduces the need for pitocin, vacuum extractor, forceps, and cesarean delivery

~reduces the mother’s request for pain medication

~helps women feel more secure and well-cared for

~results in greater breastfeeding success

~reduces incidence of postpartum depression

~increases father’s confidence and satisfaction with the birth experience

~helps families get off to a more positive start

So why don’t you look into hiring a doula today?  Here are some places you can start looking:

DONA International

Utah Doula Association (Utah residents)

When hiring a doula, find out about her credentials and experience, but make sure to also get a feel for her personality.  Different women will feel more comfortable with different doulas.  Make sure that you feel excited to share this special day with the doula you have chosen.  She will be honored to share it with you.

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