What is a Labor Doula?
The original word “doula” is Greek, and means “a woman who serves.”
A labor doula is a trained, non-medical support person who provides education, emotional, and physical support to a birthing person and partner during pregnancy, labor, birth, and postpartum. Doulas strive to help facilitate a positive birthing experience for the entire family, supporting them in the best way possible.
Evidence for having a doula
There is so much evidence and information that having doula support during labor greatly increases the satisfaction of the birthing parent and family. Numerous studies have shown that the presence of a doula cuts down on medical interventions, can shorten labor, and much more.
Evidence-based improvements in birth outcomes with doula support:
39% decrease in unplanned Cesarean birth
15% increase in the likelihood of a spontaneous vaginal birth
10% decrease in the use of any medications for pain relief
Shorter labors by 41 minutes on average
38% decrease in the baby’s having a low five minute Apgar score
31% decrease in the risk of being dissatisfied with the birth experience
*(Statistics from Evidence Based Birth - see below)
What is the role of a doula?
Labor doulas are not just there for support during labor alone. Most labor doulas will be available for phone/text support from the moment you hire them. Have a question? Ask your doula. Need a referral? Ask your doula! They also offer a set of prenatal and postnatal meetings to help you plan and get ready for a satisfying birth experience. These usually include an initial consultation, prenatal meetings, labor support, and postpartum meetings. Let’s look at what each one of these consists of…
Initial Consultation - Most doulas will offer a free initial consultation to meet, discuss your birth preferences, and answer any questions you might have. This also involves a discussion about the terms of the contract and payment. And it’s such a great opportunity to see if your personalities fit together well, and if they will be a good addition to your birth team.
Prenatal meetings - Your doula will likely offer you one to two prenatal meetings for education, discussing your desires for birth, making a birth plan, going over comfort measures and coping techniques, and making a postpartum plan. This is a great time to bring all of the questions you might have! Most doulas are extremely knowledgable about the entire birth experience.
Labor Support -
Early labor - Your doula will probably be on call starting at about 38 weeks for 24 hour support. When contractions start, water breaks, or you feel labor is coming on, contact your doula. They will aid in support over the phone and assess when you are ready for them to join you. They will also have ideas on positioning or other ideas to try to get labor moving along if you are experiencing prolonged early labor.
In-person support during early active labor at home - When you are needing more than just phone support, your doula will join you in your home to aid in coping with contractions, positioning, and to help you decide if you’re ready to go to your birthing location (or have your midwife come for a home birth).
In-person support during active labor at the birthing location - When you feel that you are ready and in active labor, your doula will accompany you to the location of your birth and support you throughout labor. This will include physical support (position changes, comfort measures, supporting your partner, etc), emotional support (helping you get through each and every contraction, when to use pain management, dealing with unforeseen complications), and education (knowledge about stages of labor and normal progression). Your doula will stay through the birth until you and baby are all settled in. Through all of this, they are there to make sure you have confidence to ask questions, your birth plan is followed as much as possible, and you are supported the way you need.
*During COVID-19 many hospitals are only allowing one support person. A doula would switch to virtual support at this point if you prefer to have your partner support you in person. Your doula will still aid in position changes, comfort measures, answering questions, and give your partner ideas for how to help you through labor.
Postpartum check-ins and phone support - After you are home and settled, your doula will check in with you one to two times. They are likely trained in lactation and can support early breastfeeding/chestfeeding as well as answer any questions you may have about you or about the baby. The second postpartum meeting is to discuss your birth with the doula. They are there to listen to your experience with compassion and love, and to help you process anything that may come up.
A doula does not provide medical advice or procedures. For more information, see DONA International Code of Ethics and Standard of Practice.
How can a doula help you?
Pregnancy is such a unique and special time for many, and having a doula certainly adds to the experience. Your doula is like a walking book, they are full of knowledge about the birth process and everything involved. If you or your partner have questions, your doula will either be able to answer them, or to refer you to someone who can. Feel free to ask absolutely anything, doulas have experienced everything under the sun, and there is no such thing as a dumb question!
Does doula support take the place of the partner in supporting the birthing parent? Absolutely not! Doulas are trained to help the whole birthing family. That means empowering the partner to be able to support the birther according to your preferences.
Your doula can help you advocate for yourself during your pregnancy and birth. Through education and seeking space for you to ask questions of your primary care providers, you will be empowered to have the birth you desire.
If you'd like to discuss more about the benefits of a doula or to hire me to attend your birth, contact me.
*Statistics from Evidence Based Birth, written by Rebecca Dekker, PhD, RN
For more information about the role of a doula, see DONA International.