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What's a doula?
A birth doula is a trained labor coach who assists you during labor and delivery. She provides you with continuous emotional support, as well as assistance with other non-medical aspects of your care. She can provide guidance that will help you make informed decisions about birth options and resources. While she’ll never make any decisions on your behalf, a doula can also serve as a liaison and communicate your wishes with the rest of the birthing team.
You can also hire a postpartum doula to come to your home after the birth to help you settle in with your new baby.
What are the advantages of having a birth doula?
A doula helps you before labor and delivery by answering your questions about what to expect, easing your fears, helping you develop a birth plan, and generally getting you ready for the arrival of your baby.
During labor and delivery, a doula provides constant, knowledgeable support. She can make suggestions about positions during labor, help you with breathing through contractions, and provide massage. She can also answer questions you and your partner have about what's happening. (A birth doula can also assist you immediately after you give birth, providing information on newborn care and breastfeeding guidance.)
It's impossible to predict or control how labor and birth will go. Will you connect emotionally with your labor and delivery nurse, and will she have time for you? How will you react to the pain? Will you have a swift delivery or a long, drawn-out labor? How will your husband or partner hold up under the pressure?
Faced with these uncertainties, many women find enormous reassurance in having a doula by their side. Research has found that women who have continuous one-on-one support during labor tend to use pain medication less often, have slightly shorter labors, and are less likely to have a c-section or a forceps or vacuum-assisted delivery. In fact, if you're serious about trying to give birth without pain medication, a doula may be your best ally.
Women who have continuous support are also more likely to report being satisfied with their birth experience. One theory is that mothers who have continuous support produce lower levels of stress hormones during labor than women left alone or attended by inexperienced coaches.
If you’re seeing a midwife in a low-volume hospital practice or planning to give birth at a birth center or at home, you’re likely to have continuous one-on-one support from your midwife.
If you have your baby at a hospital, it's likely to be a different story – and hiring a doula may be the only way to make sure an experienced coach will be with you throughout labor.
In a typical hospital setting, doctors and some midwives don't stay in the room with you continuously during labor. Labor-and-delivery nurses often have to split their time among several patients, and they come and go according to their shifts.
Make sure your doula is prepared to work with your medical team and not contest routine hospital practices, such as taking vital signs.
What's it like to have support from a doula during labor?
Everyone's experience is different, of course, but here's one woman's story of a doula-assisted labor:
"Hiring a doula is like hiring somebody who's there just for you. When I went into labor, our doula met us at the hospital. Eighteen babies were born in the hospital that day, so our labor and delivery nurse was quite happy to have someone else there to provide emotional support and help make me more comfortable.
"Having the doula gave me enormous confidence, plus it took the pressure off my husband. He was able to relax and enjoy the experience. The doula showed him some acupressure techniques he wanted to try.
"She locked eyes with me and helped me breathe through my contractions, making suggestions about moving around and trying different pain management techniques. She could read my body signals perfectly, and knew when I was in transition (when I got sick, a pan magically materialized). She helped me remember to drink fluids and communicate my needs to the nurses.
"When it was time to push, the doula put warm washcloths on my perineum and locked eyes with me again, which was absolutely critical.
"I couldn't have done it without her. She made me fearless, and the lack of fear is what gets you through the pain without drugs. I had complete confidence in her. If I had been looking at my husband and saying, 'Help me through this,' it just wouldn't have been the same."
How much does a doula cost?
A birth doula charges several hundred to a couple thousand dollars for her services, depending on whether you live in a small town or a city. Some health insurance plans will cover part or all of the cost.
Some doulas are willing to work on a sliding scale based on your ability to pay. A few pioneering hospitals even provide doulas to laboring patients who want them.
What does a postpartum doula do?
A postpartum doula can offer you support in the baby’s first weeks, giving you information and guidance on how to care for, feed, and bathe your baby. She will help you as you heal from your birth, and offer you information on care option and resources for yourself as well as your baby. A postpartum doula may also help with household organization and chores, but not to the extent that a housekeeper or nanny might.
How do I find a doula?
If you're looking for a doula, try these resources:
- DONA International. The organization has a referral locator on its website. DONA International also gives referrals over the phone at (888) 788-3662.
- Visit the Childbirth and Postpartum Professional Association (CAPPA) website, or call (770) 965-9777.
Finally, you can ask your childbirth education instructor, midwife, doctor, or friends for a referral.
For a list of questions to ask potential doulas, see our doula interview sheet.