What is a Doula?

What IS a DOULA? A frequently asked question, a service with heart and compassionate presence.

The word "doula" which comes from ancient Greek refers to a woman who personally serves another woman.  Women have been serving other women in childbirth for centuries and have proven that another woman’s presence and support has positive effects on the labor process.  Today “Doula” refers to a woman as well as a few males, trained and experienced in childbirth.

My husband/partner is my left hand and my doula is my right. - from Doulas Making a Difference

Numerous clinical studies have found that a doulas presence at birth:

• tends to result in shorter labors, length reduced by 25%
• increases positive feelings and higher degree of control over their childbirth experience
• improves the mothers self image
• reduces the need for episiotomy
• reduces the need for oxytocin (a labor-inducing drug) by 40%
• reduces the need for forceps by 40% or vacuum extraction
• reduces the mother’s request for pain medication by 30%
• reduces requests for epidurals by 60 %
• increases initial breastfeeding rates 70%
• reduces cesarean rate by 50%
• reduces complications

Research shows parents who receive support will:

• Feel their babies are healthier
• Feel their relationship with their husband/partner was improved
• Feel more secure and cared for
• Feel more successful in adapting to new family dynamics
• Have greater success with breastfeeding
• Have greater self-confidence
• Have less postpartum depression
• Have lower incidence of abuse

What is a doula?

A doula is a non-medical professional assistant in prenatal care, childbirth and during the postpartum period. The doulas role is to assist women in having a memorable and empowering birth experience.

There are three types of Doulas:

1. The Antepartum Doula provides help and support to the mother who has been put on bed rest or who is  experiencing a high risk pregnancy. They provide informational, emotional, physical and practical support to the family unit during the prenatal period.
2. The Labor Doula accompanies a woman in labor, mothering the mother, taking care of her physical, emotional and informational needs throughout childbirth. They are advocates and a listening ear for birthing mothers, as well as facilitators to her partner. A doula also provides support and suggestions for partners that can enhance their experiences of birth.
3. The Postpartum Doula continues valuable emotional  and informational support and guidance, helping a family make a smooth transition into new family dynamics. When a family goes home with a new baby, the Postpartum Doula supports every member of the family unit as a whole. During the postpartum period, a doulas guidance can empower and encourage new parents, inspiring self-confidence in parenting. Postpartum doulas are trained to offer families evidence-based information and support on infant feeding, emotional and physical recovery from childbirth, infant soothing and coping skills for new parents. They may also provide physical support with light housework, fix a meal and help incorporate an older child into this new experience

Some doulas are trained in more than one area and can provide services as more than one type of doula.

Women have complex needs during childbirth and the weeks that follow. They need individualized care based on their circumstances and preferences. Our doulas are educated to work within evidence-based standards of practice. The skills that they develop are medically proven to make a true difference in the experience of birth. A doulas attendance at a birth provides improved outcomes for mother and baby. Doulas do not perform clinical tasks such as heart rate checks, or vaginal exams but rather use massage, breathing, positioning, aromatherapy, reflexology, hypnotherapy, Healing Touch, Reiki, relaxation etc., to help labor progress as well as possible.

The Labor Doula joins a laboring woman either at her home or in hospital or birth center and remains with her until a few hours after the birth. In addition to emotional support, doulas work as advocates of their client’s wishes and may assist in communicating with medical staff to obtain information for the client to make informed decisions regarding medical procedures. Studies show that when doulas are present at birth, women have shorter labors, fewer medical interventions, fewer cesareans and healthier babies. Recent evidence also suggests that when a doula provides labor support, women are more satisfied with their experience and the mother-infant interaction is enhanced as long as two months after the birth. With doula support, fathers tend to stay more involved with their partner rather than pull away in times of stress. Today, a father's participation in birth preparation classes or his presence at prenatal visits and in the delivery suite is a familiar occurrence. Yet, we sometimes forget that the expectations of his role as a "labor coach" may be difficult to fulfill. Sometimes it is also culturally inappropriate for an expectant father to be so intimately involved in the process of labor and birth. The doula is not meant to sideline or replace the husband, the baby’s father, significant other or other friends or loved ones. Granted, their respective roles are similar the differences are crucial. The father or partner may be better able to provide continuous love and support but typically has little actual experience in dealing with the often-subtle forces of the labor process. Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation. Studies have shown that fathers usually participate more actively during labor with the presence of a doula than without one. A responsible doula supports and encourages the father in his support style rather than replaces him. The Labor Doula and the partner, in conjunction with the chosen caregivers form the perfect support team for the laboring mother.

After the birth many Labor Doulas will spend several hours assisting the new mother with beginning breastfeeding support and encouraging bonding  between the new baby and family members.
Community doulas play an important role for women at risk for complications, and those facing barriers to prenatal care. These doulas will combine the roles of labor support and postpartum doulas to offer continuous encouragement and reassurance to pregnant women with little social support. In order to form strong, trusting relationships in a social support network, it often benefits a pregnant teen to participate in both group discussions and receive individual attention. In this way, community doulas can encourage self-advocacy, teach parenting skills and motivate a teen to feel in control of her pregnancy. Goals also include informational support to teen mothers on preventing subsequent pregnancy and increasing the quality of the mother-infant bond directly after birth in order to increase the chances of secure mother-infant attachment throughout early childhood.

Read more about Doulas

• Mothering the Mother: How a Doula can help you have a shorter, easier and healthier Birth by Marshall H. Klaus, Phyllis H. Klaus, and John Kennell.
• The Doula Book by Marshall H. Klaus, John Kennell, and Phyllis H. Klaus.
• The Doula Advantage by Rachel Gurevich.
• The Birth Partner by Penny Simkin