Birth is an overwhelming experience and the support you get from the hospital, while essential, is primarily medical. Those looking for an emotional and physical guide — a minute-by-minute coach for your birth — turn to doulas. There’s good reason. The American Pregnancy Association reports that having a doula on your birth team leads to a more positive childbirth experience, can cut the overall cesarean rate by 50 percent, the length of labor by 25 percent, the use of oxytocin by 40 percent, and requests for an epidural by 60 percent. So you think you want to get a doula. Here’s what you need to know.
Doulas are not medical professionals.
Although doulas have knowledge in many medical aspects of labor and delivery, a doula is not a doctor. Nor is a doula a midwife. Doulas do not deliver babies. A doula is a professional trained to provide informational, emotional, and physical support during childbirth. A doula advocates for the couple and their birth plan, and can help advise in otherwise stressful situations in the delivery room, whether things are going as planned or not. A doula is also trained in pain- and stress-relief techniques including relaxation, breathing, and massage, and after delivery will help the new mother begin the breastfeeding process.
Doulas do not replace dad.
Let’s be perfectly clear here: A doula isn’t there to replace the dad-to-be in the delivery room. She might remind him of the things he learned in labor class. “It’s really hard to see a loved one in pain,” says Darby Morris, owner and founder of San Francisco-based Sweetbay Doula. “You can suddenly stop thinking rationally and forget what you learned. That’s definitely one of the things I’m there for.” And some couples decide they don’t want the father on the hook as the labor coach, in which case, a doula can completely relieve him of those duties.
There’s more than one type of doula.
Birth doulas are the first kind of doulas that come to mind when the word is mentioned, but there are other types of doulas.
- Antepartum doulas support expecting mothers who have been put on bedrest or other high-risk pregnancies.
- Postpartum doulas are increasingly popular as couples opt to have children away from family, or simply prefer professional help with their new baby. Postpartum doulas cover everything from infant soothing, sleep, and breastfeeding to walking the family dog and helping clean the house.
- There are also death doulas that assist individuals (and their families) at the end of life.
There is more than one kind of doula certification.
Doula certifications span a wide range. At one end is DONA International, America’s largest doula-certifying organization, which has certified more than 12,000 doulas since its inception in 1992. It’s among the most comprehensive programs in the world, with the longest process for achieving birth doula certification that includes a multi-day workshop, home-study, webinars, participation in live births, and evaluations by the family and medical provider. DONA works closely with Lamaze International for childbirth education. At the other end of the spectrum are small, local establishments that in some cases certify participants on-the-spot for attending a home-grown workshop.
Choosing a doula is personal.
You’ll want to first inquire about a prospective doula’s availability, certification, continuing education, and birth philosophy. If your requirements in those areas have been satisfied, your choice becomes highly personal. Morris says the key is to find someone you’re comfortable with and feel like you can completely trust. Most birth doulas understand how important their connection is with the couple, and don’t charge for an initial consultation. Take the time to interview several doulas to find the best match.
Costs vary greatly.
There are doulas in all 50 states, as well as in other countries, and their rates tend to vary the same way housing prices do. A doula will cost much more in San Francisco than in a small town in Ohio. With that said, most birth doulas charge a flat rate for a package of services that includes a certain number of prenatal visits; creation of birth plan; conditions on availability by text, email, and phone; presence at birth; and number of postpartum visits. Some hospitals in larger metropolitan areas, like California’s Bay Area, have volunteer doulas or doulas on staff who are available at the time of labor and/or delivery. Just remember these folks are advocates for what the hospital considers the safest, most efficient birth plan, not the couple. Whether a doula’s services are covered by insurance varies by location, with Minnesota being the only one to cover all birth doula services by law.