Why Should You Hire a Doula?

What is a Doula and Why Should I Want One?

You may or may not have heard of a doula before. Maybe this is the first time you’ve heard the word “doula”. If so, you probably are wondering “What is a doula?” And secondly, you are probably wondering “Why should I want one?” If you’re curious to learn more, read on!

What is a doula?

A doula is an additional support person for the mother-to-be. The word doula actually means “woman’s servant”, and that is just what they do – serve women. There are two types of doulas: birth doulas, and postpartum doulas. They act like guides throughout a mother’s pregnancy, labor, and postpartum experience, helping the mother to find resources and get answers to all of her questions regarding her birth experience.

Birth doulas are trained and experienced in providing emotional support, physical comfort measures, and unbiased information to the laboring mother and her partner or other support persons. They also provide informational and emotional support to the mother before her birth, during her pregnancy. Unlike doctors and nurses, who are often attending multiple patients and cannot stay with you throughout your entire labor, a doula will be with you the entire time that you need her to be. Also unlike nurses, who you often do not get the chance to meet before you are in labor, you will have plenty of time to get to know your doula before your birth. Most doulas schedule at least one (but often two or more) prenatal meetings in order to get to know you, your personality, and your birth plans. Birth doulas often have “packages” available for purchase, which covers the entire expense of the prenatal meetings, birth, and postpartum checkup. Some doulas offer a “sliding scale” fee as well.

Postpartum doulas are doulas which specifically help women in the postpartum period. They are experienced and knowledgeable about common postpartum complications, and can help get you the help and support you need during this time. Postpartum doulas come to your home to help you do whatever you need them to, and can provide support, resources, and information to help you during your postpartum experience. Postpartum doulas typically charge “by the hour” for their services, and “sliding scale” fees are also common with postpartum doulas.

Many doulas provide both of these services, and some provide only one or the other. A great deal of birth doulas provide at least one postpartum visit as part of their services, in which they would help in many of the ways a postpartum doula would help.

What does a doula do?

The specifics for what a doula does will vary from doula to doula, as every doula is different. That’s what’s so great about a doula – the services are customizable to you and your needs! Here is a basic list of what a doula will do for you:

Birth Doulas:

- Act as a guide throughout your pregnancy and labor, helping you to find the resources and answers that you need on your journey.
- Can help you prepare a birth plan, so that you can be more prepared to have the birth experience you desire.
- Aids you in finding local resources to support you during your pregnancy, birth, postpartum, and beyond!
- Helps the mother and her support team to apply techniques to relieve pain, fear, and tension, making her labor easier for her.
- Can give the mother’s partner a break to get a meal, a short nap, or a quick walk to let off some tension.
- Reassures the mother and her partner that they are doing well – she has done this before, and you are doing just fine! Having someone who is more experienced at birth can be reassuring and calming.
- Suggests different laboring positions which may be more comfortable and effective for you. 
- Relieves some of your pain by applying counter-pressure techniques, massage, hip squeezes, use of the rebozo, birth ball, and other laboring tools; these natural pain relief measures will vary from doula to doula, depending on their training and experience.
- Provides unbiased informational support and explanations of procedures which you may not be familiar with and want to learn more about.
- Helps you work through your emotions and fears surrounding the birth, and helps you come up with strategies for dealing with these ahead of time.
- Supports you in making informed decisions by providing you with unbiased facts on things you wish to know more about, and then supporting your choice, even if it might not be what she would choose for herself. She would never pressure you to do something you didn’t feel was the right decision for you.
- Some doulas can take photos or video of the two of you during the birth, or the three of you afterward. 

Postpartum Doulas:

- Come to your home to help you during the postpartum period.
- Can assist with breastfeeding and provide contact information for local lactation consultants should any breastfeeding problems require a greater level of expertise.
- Helps you find local breastfeeding classes, pediatricians, mommy groups, and many other resources available to you, helping you to build a wonderful support network for your postpartum period.
- Recognizes the symptoms of postpartum mood disorders and can help you and your family identify if you may be suffering from one of these; a postpartum doula can never diagnose you with a postpartum mood disorder, but can give you contact information for local counselors and professionals which can help you in these cases. 1 in 8 (some people think this number is actually higher) women suffer from postpartum depression, so this is a very important part of the work that postpartum doulas do.
- Provides you with tips for faster postpartum healing, whether you have had a cesarean or a vaginal birth, and can help answer a vast array of questions you may have during your postpartum time.
- Can watch the baby for you so that you can get some much needed rest or simply take a shower.
- Many postpartum doulas are comfortable doing light household chores or simple cooking, although this varies from doula to doula.
- Many postpartum doulas are also comfortable watching older children so that the new mother can get some rest, and can help the older children become excited and involved with the new baby.
- Some postpartum doulas are also experienced in babywearing, cloth diapering, infant massage, and other “extras” and are more than happy to show their clients how to incorporate these things into their lives.

Misconceptions About Doulas

There are some misconceptions about what doulas do. The most common thing I have people ask me when they hear I am a doula is “Oh, so you’re going to be a midwife/midwife’s assistant?” I’ve also heard “So you’re there to chase people out of the labor and delivery room?” and “Oh, you’re just there because her husband doesn’t want to be in the room,” and “Doulas only support natural birth.” All of these are not true. So, what does a doula NOT do? 

Doulas do NOT:
- Replace the woman’s partner/friends/family in the birth process. I can NOT stress this one enough. SO many people think that doulas are just there because the woman’s partner is afraid of blood, or doesn’t want to be involved, etc… Doulas are there to help support the woman’s partner just as much as they are there to support her. Sometimes dads just need a break! Sometimes they just need a little help knowing what to do. A doula can help encourage a dad to be just the support his wife needs during her birth experience, especially when he may be nervous and unsure of what to do.
- Act as a medical care provider. Doulas are not medically trained and should never act out of their scope of practice. They cannot do medical procedures such as cervical checks, IV placement, or even diagnose you with a medical condition. Those are the role of a medical care provider and should never be done by a doula.
- Tell you what to do. Doulas do not tell you what is the right decision for you. Decisions are yours and yours alone to make. Doulas can help you find the information you need to make the right decision for you, but they will never tell you what to do. 
- Communicate with your care provider on your behalf. This is also out of a doulas scope of practice. A doula should be in communication with her client, and the client should be in communication with her care providers, but the doula should never pass over the client and communicate on their behalf. Many people think that a doula can tell their doctor/midwife what they want while they are in labor. This is not a part of our job. We can remind you of what you want, for instance, if a nurse is pressuring you to get some Pitocin to speed things up, we can mention “Do you remember how we talked about Pitocin at our prenatal meeting? Did you still want to avoid that, or do you want to change your mind?” But we cannot say to the nurse “She doesn’t want Pitocin.” That is not our job. We cannot tell your care provider what you want. We can support you and encourage you to stand up for and advocate for yourself, but we cannot do the communicating for you. Our job is to empower you to feel bold enough to say what you want for yourself.

"But, I don’t need a doula…"

1. "...Because my family/friends/husband/mother/aunt will be there." While it is absolutely wonderful that you have other people there to support you during your birth, it is highly unlikely that these people will be able to support you during your birth in the same way that a doula would. Here are several reasons why: 
- Your partner/family/friends are emotionally attached to you. They do not like to see you hurting/in pain, and may feel tense and worried about you. This tension may pass on to you and cause you to be feeling more pain (causing more worry/tension, and around the cycle goes). A doula will not have this strong emotional attachment to you (which is a good thing in this case). In the case of a postpartum doula, family and friends are often so occupied thinking about the new baby that they neglect the mother during this very fragile and new time in her life. A postpartum doula is trained to equally focus on the baby, mother, and all the other family members during this special time. 
- Your partner/family/friends are not trained and experienced in how to help you during your birth experience. They may not be aware of or trained in different techniques that may help you during your labor. Your family and friends may also not be aware or knowledgeable about different complications and troubles that may be coming up postpartum, and they may not be able to help with certain things that may be going on during your postpartum time, simply because they don’t know how.
- Your partner/family/friends are not as knowledgeable about different birth interventions and procedures that may be offered to you during your birth experience. If informed decision-making is an important part of your birth to you, then a doula can be an invaluable on-the-spot source of information that would not be available to you if you did not have a doula present.
- Your partner/family/friends may be needing support during this time too. Expecting them to be your sole support is expecting an awful lot! Being a labor support person is a tiring job, and it can be overwhelming, especially when you are emotionally involved with the woman going through the labor. Dads especially find that a doula is a great source of comfort, reassurance, and relief, and can provide a sense that “all is well” during labor. It is comforting to know that they are not the only person helping mom, and if they are exhausted/hungry/tense, they can step out for a bit and trust that the mother will be okay, because the doula is “taking care of her” while they are gone. 


2. "...Because I am going to be getting an epidural." Many women plan to get an epidural and assume that doulas only support natural childbirth. This is not true! Birth doulas are there to support all women in their choices, no matter what those choices are. Doulas can be just as invaluable to women planning medicated births for these reasons:
- Sometimes (not to scare you) epidurals don’t work. It is actually not that uncommon for a woman’s epidural to not work completely. For some women, their epidural does not work at all. This can be very frustrating if you were planning on falling back on your epidural to get you through labor and did not plan any other comfort measures. A doula can help you “wing it” through such a situation. Sometimes, a woman’s epidural only works on one side, or doesn’t work all the way, or begins to “wear off”. A doula can also be helpful in these situations.
- Even if you are planning an epidural, you may wish to learn more about other procedures and interventions which may be offered to you during your birth. A doula can still provide valuable information to you about these interventions and procedures.
- A doula is still a great support person even if your epidural works just fine! She can help guide you through the process, and help make your birth even more enjoyable for you by helping you to feel more relaxed and in control of your birth experience.

3. "...Because I am not planning on breastfeeding." Again, many women assume that doulas only support women who choose to breastfeed. This is also not true. If you have done plenty of research and thinking and have still decided that breastfeeding is not for you, that’s your decision, and a postpartum doula can still support you in that decision. Postpartum doulas can still support you in every other aspect of your new life with your baby. They can even help you find accurate information about formula feeding your baby, if that is what you choose.

Sarah Poole, Birth/Postpartum Doula, 

certified through Intuitive Childbirth
253-880-9868 

doulasarahp@gmail.com 

doulasarahpoole.blogspot.com