What is A Doula? Is having a doula worth it?
Updated: Mar 4
The most common question people ask when someone suggests hiring a doula is: “what is a doula?” This is often followed by asking: “do we need one?" Many expectant parents wonder if hiring a doula is worth the cost. When making the decision, it is important to fully understand what a doula can offer. If you are trying to decide whether or not doula care is right for you, you've come to the right place. We will review what a birth doula does and the reason why doula support might be right for you.
DISCLAIMER: I am a doula. Of course, this article is written with that perspective in mind. I have objectively laid out the evidence and added reasons why doula support might not be a good fit for you.
What is a doula and what do doulas do?
A birth doula is a non-medical support person who is trained to support people throughout labor and birth. Doulas specialize in one-on-one care, comfort measures, physical support, emotional support, partner involvement, as well as information sharing.
Physical Support & Comfort Measures
Physical support from a doula helps you feel a sense of control, confidence, and comfort during labor. The types of physical support and comfort measures often include:
Soothing touch like massage, counterpressure, and acupressure
Assisting with water therapy like getting into a shower or bath at an optimal time
Helping create an environment conducive to a calm birthing experience
Supporting with movement and positioning
Applying warm or cold therapy
Labor and birth are equal parts emotional and physical. Doulas offer a sense of reassurance and care making you feel nurtured. Doulas are most concerned with your emotional health and ensuring you have an empowering and positive birth experience. The types of emotional support doulas offer include continuous presence, praise, encouragement, reassurance, accepting your wishes, debriefing the birthing experience, and listening with empathy.
Information overload during pregnancy can trigger anxiety. Doulas can help distill important information for their clients. Informational support helps avoid the overwhelm by Googling or researching information independently. Doulas can help:
guide you through the stages of labor so you know what to expect
suggest techniques to support labor and comfort
support you in locating evidence-based information
help the partner understand what might be going on
explain what to expect from medical procedures before they occur
An important element of doula support is advocacy. What makes doulas different from medical providers, besides the non-medical nature of their role, is that their sole objective is to support the birthing person’s interests and desires. Medical staff ultimately serve the hospital and are obligated to follow hospital policy, even if this is not in the best interest of the birthing person. Advocacy support includes:
encouraging you and your partner to ask questions about their medical care and verbalize your preferences
helping amplify your voice if you are being dismissed
teaching positive communication techniques
helping facilitate communication between expectant parents and providers
pointing out your preferences if the provider is beginning a procedure that is not aligned with your preferences or has not gotten consent
supporting you to ask the right questions so that you can make an informed decision
Reasons to hire a doula
The benefits of doula care are proven to be effective.
The benefits of doula support are backed by a large body of scientific evidence. It is proven that the birthing outcomes for birthing people who have continuous support during labor and birth are significantly improved compared to those who do not.
Doula support shows a 39% decreased risk of cesarean and a 15% increase in spontaneous vaginal birth. Support from a doula is also associated with shorter labor, higher satisfaction with the birth experience, and better outcomes for the baby.
Doulas are effective because they become a buffer to the hospital's harsh and sometimes sterile feeling environments of the hospital. Their companionship boosts a birthing person’s self-esteem. In fact, doulas are considered a form of pain relief. Birthing people with a doula feel less pain when getting continuous support and often avoid the use of epidural anesthesia as well as common medical interventions like Pitocin augmentation and continuous fetal monitoring.
To better understand how doula care makes such a positive impact, I love the conceptual model created
by Evidence-Based Birth.
Doulas can help reduce stress and anxiety.
A study conducted in Iran in 2017 showed that first-time birthing people with doula support have less anxiety and lower average pain during labor compared to birthing people without a doula. The combination of informational, physical, and emotional support help you to feel grounded and calm throughout pregnancy and birth.
Doulas offer continuous one-on-one support throughout labor and birth. When birthing in the hospital the doctor will likely only visit when the baby is crowning or if complications arise. Nursing staff will check in on the birthing person periodically but do not offer continual support. Continual support during labor is a key factor in decreasing the use of medications for pain relief and increasing satisfaction with the birthing experience. Many doulas also offer support before you go to your place of birth.
Partner Involvement & Support for Your Partner
Another key role of a doula is helping your partner know what to expect and how to best support you during labor and birth. Doulas can help coach partners on comfort measures and emotional support techniques that are best in each stage of labor. Whether this is your first or fifth child, doulas can help partners feel more involved, empowered, and calm throughout labor and birth. Having your partner fully involved can also make you feel more nurtured and supported throughout labor. Remember, you're not the only one who will benefit from emotional support.
Connecting with Local Providers & Resources
Doulas can offer recommendations to trusted providers in your area like pelvic floor therapists, lactation consultants, acupuncturists, chiropractors, midwives, OBs, and pediatricians. It can be overwhelming trying to find care providers in your area and doula support can help ease this burden. Depending on your needs during pregnancy and postpartum a doula can help you determine what providers might be able to assist you with whatever challenges you are facing.
Once In A Lifetime Experience
Giving birth is a once-in-a-lifetime experience. Whether you plan to have one or multiple babies, you will only give birth to your child once. This is a life-changing moment that you can never repeat again. As a doula who has supported many people in their second births, doula care makes a huge difference. My clients note the difference doula care has made for them in having a memorable and empowering birth experience.
Reasons Doula Support Might NOT Be A Good Fit For You
I am a doula so, of course, I am an advocate for doula support. After seeing many different births in many different settings I have witnessed the benefits firsthand. That being said, there are some people who might fare better without doula care.
You simply don't want anyone else in your birth space.
You hope to cut down on the people present and don't want to have anyone else present. Note that if this is the reason you might consider virtual doula support. You could use this as a "phone a friend" option that can help your partner feel better prepared if they don't know how to support you.
You view birth as a medical event
Remember, doulas cannot give medical advice, they can provide evidence-based information to help you make informed decisions. If you view birth as inherently medical in nature you will likely only want to seek support from medical professionals.
You want to ONLY get information from the Doctor.
Some people don't want more information and simply want to put all of their confidence in their medical providers. If this is you, you probably won't get the most out of doula care. Doulas do not work against doctors, however, they might present some advocacy skills and evidence-based information that are uncomfortable for you if you don't have an interest in questioning medical professionals. It takes 15-20 years for evidence-based practices to make their way into hospitals.
You are not open to changing your view on birth
Birth is so much more than what we are told by society. We grow up learning birth is gross, painful, and scary. If you are not interested in learning about the true power of your body and how birth can actually be a transformational experience, doula support is likely not a good fit for you.
Ready to Hire A Doula?
It is important to find a doula who is a good fit for you. Take some time doing your research and set up a consult call with the doula(s) you are interested in working with. Ask about their experience, specializations, and service details.
I provide virtual doula support worldwide and in-person doula support in the Massachusetts area. You can learn more about my doula services HERE.
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Meet the Author
Clara O'Rourke (she hers),
Holistic Doula & Childbirth Educator.
I am a researcher turned total birth nerd with a passion for supporting people birth in their full power! I guide people through their pregnancy, labor, and postpartum journey by helping them overcome fear or anxiety about birth, providing evidence-based information so they can make informed decisions, and making sure they have everything they need to birth with confidence. Birth is sacred and it should be treated that way. I am committed to providing support for birth and beyond, regardless of a person's background, sexual orientation, gender identity or expression, or relationship status. También ofrezco mis servicios en español. I wish you and your growing family the brightest of beginnings!