What Does a Birth Doula Do?
Originally Published December 12, 2016
MAYBE YOU STUMBLED ONTO MY SITE AND YOU’RE WONDERING WHAT EXACTLY IT IS I DO. MAYBE YOU’RE PLANNING FOR BIRTH AND HAVE BEEN TOLD THAT HIRING A DOULA IS A GREAT OPTION. MAYBE YOU’RE CONSIDERING A CAREER AS A DOULA.
No matter what landed you on this page, I’m guessing you’re here because you’re wondering what exactly a birth doula does. Lucky for you, I love to talk about it.
In short, a birth doula is someone who supports a pregnant person informationally, emotionally, and physically throughout her pregnancy, her entire labor, and the postpartum period. She is not a medical professional but instead she is trained to inform a woman of her choices surrounding birth and helps to turn those preferences into a reality.
Typically, when a pregnant person hires a doula, their journey together starts a couple of months before the baby's due date and will continue throughout the first year postpartum.
Most doulas are self-employed or are in partnership with a few other doulas. Some doulas are employed at hospitals or birth centers but this is not as common. Because they are self-employed, doulas typically go wherever their clients birth. They may attend home, hospital or birth center births and if the client needs to transfer care, the doula goes too.
They work for their clients, rather than the birth place, and ultimately their goal is to support, care for, and empower their clients as they become parents.
My Doula Jayde helping me through a contraction
BEFORE THE BIRTH
In pregnancy, the doula acts as a wealth of knowledge for the pregnant parents. Whenever her clients have questions big or small, they are welcome to ask their doula. She can point them to local and online resources as well as help them know what to expect at their prenatal appointments.
She is an emotional support through this life changing journey and can help ease anxieties and discomforts that accompany pregnancy.
Before the birth, a pregnant person will meet with her doula a couple of times to prepare for the birth. These meetings may include childbirth education and putting together a birth plan.
They may discuss things like where she chooses to birth, how long she wishes to labor at home, how she plans to manage labor pain, as well as her hopes for the immediate postpartum period.
A doula does not make any decisions for her clients but instead informs them of the risks and benefits of every option and then supports them in whatever they decide. She is careful not to try to persuade them one way or the other but rather she presents non-biased, evidence-based information and lets the clients run with that knowledge.
Furthermore, before the birth the doula will teach the pregnant person and her birth partner (her husband, boyfriend, mom etc) different techniques that they can use throughout the labor to manage pain, fully relax, and keep progressing.
Finally, the doula will also help her clients prepare for postpartum. They may discuss things like household chores, setting guidelines for visitors, and understanding postpartum mood disorders.
After these meetings, both the mother and the doula should have a pretty good idea of how they plan to manage labor and postpartum.
DURING LABOR
Usually, the main reason someone hires a doula is to have a trained professional with them throughout the entire labor.
A doula cannot perform cervical checks, take vitals, monitor the baby, or replace the care provider in anyway. She cannot and will not make any medical decisions.
However, unlike the care provider, who is in and out of the room and may leave when his or her shift is over, the doula is right by her client’s side focusing only on her from the beginning until the end.
This consistent presence alone can have a major impact on the labor.
A soon-to-be parent may let her doula know that contractions have started and the two can decide together when to notify the care provider. The doula may come to her client’s home in early-active labor to help her work through contractions if she wishes.
Upon arriving at the birth center/hospital, the doula may take time to set up the room with music, dim lighting, aromatherapy, or whatever the client wishes.
As labor intensifies, the doula will do whatever she needs to do to make the birthing person more comfortable, including massage, applying heating pads, giving food or water, etc.
She will coach her client through contractions, helping her breathe and find her rhythm.
She can also suggest different positions to help the baby continue to descend and to encourage dilation.
The doula continues to be an emotional support throughout the labor and is there anytime her clients need a hand to hold or a shoulder to cry on. She is full of encouragement and validation and her goal is to help her clients find their inner strength.
My doula Jayde helping me through a contraction
If any unexpected circumstances arise, the doula can inform the client of her choices and help her ask questions so she can make the best decision for her and her baby.
The doula does not speak to the care provider on her client's behalf but she does encourage her and the birth partner to speak up for themselves.
The doula can remind the birthing person of her birth plan and preferences to help her achieve her goals.
Finally, when it comes time to push, the doula may help coach the mom in bringing her baby into the world.
It's important to note that a doula does not replace the birth partner in any way. Instead, the doula actually helps loved ones know how to comfort and assist the laboring person. As a result, partners may actually end up feeling more at ease, relaxed, and empowered with a doula present.
Though a doula can never guarantee better birth outcomes, studies have shown that when a doula is physically at the birth there is a lower rate of interventions, epidurals and c-sections. Plus labor tends to be shorter and the birthing person is more likely to have positive feelings about the experience. A review of these studies can be found in The Doula Book by Marshall Klaus, John Kennel, and Phyllis Klaus.
However, a doula is still a valuable asset even if the client wishes to have a medicated birth or is planning a c-section. In these situations a doula can still help her through early labor, she can set up her birthing environment, talk her through pushing, and protect her wishes for the postpartum period discussed in the next section.
IMMEDIATELY AFTER THE BIRTH
After the baby is born, the doula may remind the client and the care provider of any of the client’s wishes for the postpartum period. This may include things like delayed cord clamping, immediate skin to skin, or weighing and measuring the baby bedside.
She can help establish breastfeeding and gives the mom plenty of encouragement.
The doula may get some food for the new parents and she may help clean up the room.
Finally, she may protect the familys’s desire for a quiet, private postpartum period and will leave the birth place shortly after baby’s first feed.
A FEW DAYS LATER
Within the first week or so of baby's life the doula will visit the new family another time. This generally takes place in their home and may last a couple hours.
At this meeting, the doula will answer any breastfeeding questions and will encourage the nursing mother.
She may do light housework for the new family or she may hold the baby while the mother gets some rest or takes a relaxing bath.
They will debrief about the birth and the doula will help the client process her feelings about it. The doula may remind the parents of important events that happened throughout the labor in order to capture a positive birth story that the family can enjoy reflecting on.
The doula takes extra care to check in on her clients throughout the postpartum period. She watches for signs of postpartum mood disorders and is always willing to pass on resources for self care. She is an emotional support in this time and strives to empower her clients with love and information.
Of course, the new parents may contact their doula whenever they have any questions about breastfeeding, postpartum, or newborn care. The doula continues to be a tour guide through early parenthood and it is her joy to watch the family find their groove.
I love my job as a doula. There is nothing quite like witnessing the transformation and strength that bubbles up in new moms and dads. Because anyone who works in this field can tell you that birth is not only about new babies, but it’s also about birthing new parents as well. It is fascinating to watch and it is my honor to be a part of it.
What questions do you have about doulas? Let me know in the comments below!
Are you local to Northern Indiana and interested in a doula? Check out my birth doula packages!