Doulas
So - what is a doula? For a long time, many people have confused doulas and midwives. But they are very different birth providers! Doulas are best classified as a “support person.” They are most often known as helpers for labor and birth, but there are doulas who also serve families postpartum too! They are incredible supporters of physiological birth, and often have many tricks to help with pain management, fetal positioning, and movement and mobility in labor, as well as healing and support after birth.
Benefits to Using a Doula
There are a variety of reasons people choose to utilize a doula. A doula’s care model focuses on physical support, emotional support, and educational or decision-making support, for both the laboring person and their partner. A 2017 Cochrane review related to doula support in labor states that:
"Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences. We found no evidence of harms of continuous labour support."
Did you catch all of that? When people had continuous labor support, the likelihood of cesarean section, Pitocin, instrumental delivery, and pain medication use all decreased, labor duration is shorter, the likelihood of vaginal delivery increased, and there was a decrease in low 5 minute Apgar scores and maternal dissatisfaction with labor experience. These are some pretty wonderful benefits!
I think it’s also important to note the value a doula can offer to the non-laboring partner. They can assist them in supportive techniques, coach them in ways to help, and step in to be supportive if or when the partner needs a break. Often, people wonder if their partner can be their doula. I really think the answer to that is “no.” An educated partner can be an absolutely incredible birth supporter, but often, the right doula offers a special type of support that just can’t be replicated by someone else.
Choosing a Doula
Doulas are non-clinical, meaning there are a variety of things they cannot do in the labor and birth process, because they are not trained or licensed to do so. It is also important to understand that while many doulas are licensed by Doulas of North America (DONA), this is not required to call yourself a doula or to offer services to women and their families.
As you make your doula decisions, pay attention to licensure and training. Do some learning about your options and consider interviewing them! Often, these providers spend time with you in your home prenatally, they may labor with you at home, and they will be intimately involved in your birth process, wherever that occurs. Typically, these support people are not covered by insurance and they can be pricey, so whatever you pay for their help will come out of your own pocket. If you have an HSA or FSA fund, I would encourage you to see if those funds can be spent on this service.
Ultimately, I believe that the choice to use a doula is one you and your partner should make together. Do you have to have one? Nope. Can your birth partner be a wonderful support for you? Yes! But, the right doula can absolutely change the story of your birth, supporting you, your partner, and your baby in ways you didn’t even know you would need. If you are desiring one and your family can financially afford one, I think they can be a wonderful contribution to your birth team.