If you read my last blog post, you know that I get asked a lot about what a doula brings to a birth. However, the most frequently asked question that I get by most people who hear that I am a doula is, “What is a doula?” This post will address that question in addition to some of the evidence for doula support and why a doula might be a good addition to your birth team.
In short, a doula provides emotional, physical, and informational support to birthing persons and their family before, during and after labor. This primarily consists of a prenatal or birth plan visit where we discuss the birth plan if that is already known or we create it together. I also discuss what I bring with me to a birth and some of the interventions that I can do for various aspects of labor, such as the comfort measures. I am then “on-call” for the last few weeks of gestation and keep in contact with the parents to ensure everything is going well. When it comes time for the birth, I join the family when active labor begins whether that be in a hospital, a birth center, or at home. This is where the bulk of my doula duties come into play. This involves those comfort measures I mentioned, like hip squeezes and using the birth balls. I am hoping to write another blog post soon about my favorite comfort measures. In addition to these physical interventions, I also help the partner or other family members present feel involved in the birth experience. Another thing that doulas are amazing for is emotional support and encouragement for laboring persons. Labor and deliver can be intimidating and intense, so having a strong birth team present who are all there to support the laboring person can be extremely beneficial in both the emotional and physical experience. The doula support that is provided is continuous and one on one. After delivery, I usually stay a few hours to make sure all is well. Then, we schedule a postpartum visit when it is most convenient for the new parents. This postpartum visit is used to check up on the new family, screen for postpartum depression, and see how breastfeeding is doing if that was the choice of the parents. One other question that I get asked is, “Do you deliver babies?”. Sometimes people also just assume that if you are present at a birth, you are doing something to literally help deliver the baby. This is a common misconception about doula work. Doulas do not deliver babies; it is out of our scope of practice.
Not many people actually know this, but there is strong evidence supporting doulas as tools for pain relief and overall birth outcomes. My absolute favorite website to review this research is Evidence Based Birth. This company was started by a nurse, Rebecca Dekker, who was inspired by her birth experiences to find and summarize all of the available evidence on various aspects of birth. One of the topics that Dekker reviewed was the use of doulas. In fact, I often carry a few copies of the one-page write up on this topic with me to client meetings. The link to EBB’s article on doulas can be found here, however, I will mention a few key data points in this post. This article mentions a Cochrane Review update from 2017 that discusses 26 trials of over 15,000 participants where each laboring person was given continuous labor support provided by one person, such as a nurse or doula. The results showed that those who were provided this continuous care had labors “shorter by about 40 minutes and their babies were less likely to have low APGAR score at birth.” Additionally, they were, “more likely to have spontaneous vaginal birth and less likely to have any pain medication, epidurals, and negative feelings about childbirth, vacuum or forceps-assisted birth, and caesareans”. The EBB article also discuses some evidence for lower risks of postpartum depression. Other evidence based research is discussed in this article and that can be reviewed in the link provided above.
Now, you may be wondering if a doula is right for you. Well, I generally recommend doing some research at home, reading some doula websites, and then if you are still uncertain, scheduling a meeting or consultation with a doula. Interviews with doulas are a great way to see if doulas are right for you and then if you know that want to have a doula on your birth team, finding the best doula to fit your needs and one that you click with. Birth Boot Camp, the wonderful organization that I trained with, states that a doula is the perfect combination of a best friend and a mother. I think that is pretty accurate and is a good way to help you decide which doula to go with if you are interviewing with multiple. Another thing to consider is who will be present at your birth. If you are a military family and are far from family members, doula support can be incredibly helpful and be that extra support when family is missing. Doulas also work as advocates for expecting parents. Therefore, if there is a history of trauma of any kind, doulas can help be an advocate for those parents to ensure minimal cervical checks or other potentially triggering interventions. Nevertheless, doula care is amazing and something that everyone can benefit from.