Doula (pronounced doo-lah) is a Greek word meaning “women’s servant.” A labor or birth doula is a formally or informally trained support individual who provides a range of support to those who are pregnant, birthing, and postpartum and focuses on them with continuous one-on-one attention during labor.
Doulas have been around in one form or another since the dawn of humankind (even some non-human mammal species have been observed laboring with “birth attendants”). This article adeptly details the history of birth attendant work.
Some birth/labor doulas may choose to refer to themselves as a labor companion, labor support specialist, birth professional, birth/labor assistants, birth coach, birth consultant, or birth keeper.
What I Do Before Birth
- share resources & information pertaining to you
- help you formulate your unique Birth Plan
- assist with questions you may not feel comfortable immediately asking your care provider
- make referrals to local pregnancy-related resources as needed
- connect personally with you as a comrade through this journey
- visit with you during a scheduled prenatal meeting
- remain on-call 24/7 from 38 weeks of pregnancy onward
What I Do During Birth
- provide comfort with pain-management techniques of your preference (massage, counter-pressure, etc)
- assist with water therapy
- apply hot/cold sensations
- ensure you are nourished by giving food & drink
- maintain the birth environment
- birth pool set-up/clean up
- suggestions for physical support, in case of virtual services
- help you keep perspective
- …and work through fears & doubts
- give early labor support via phone (or throughout, in case of virtual services)
- give reminders to eat & use the bathroom
- time contractions if desired
- explain medical procedures & options (not medical advice)
- suggest beneficial laboring positions (important even with an epidural)
- …movement ideas
- …breathing & relaxation
- assist partner by giving them a break without leaving you unsupported
- help partner interpret labor progress
- take non-professional photos as situation allows
- support without judgment
- hold space; your agenda is my agenda!
- facilitate communication between parents & birth team
- amplify your voice if it isn’t being fairly recognized
- empower you to ask questions & verbalize your position
- serve as a witness, providing peace of mind
- stay aware of intended procedures so parents have opportunity to give informed consent
- provide a record of events during labor
What I Do After Birth
- assist with beginning breastfeeding, if needed
- help explain birth place procedures
- help you get settled in your recovery room, if at the hospital
- visit with you during a scheduled postpartum meeting
- debrief the birth experience with empathy
- discuss risk factors and/or any concerning symptoms of postpartum mood disorders (100% shame-free; I’ve been there myself)
What I Do NOT Do
- perform clinical tasks (vaginal exams, fetal heart monitoring, etc.)
- give medical advice or make diagnoses/prescriptions
- make decisions for you
- speak to birth staff on your behalf
- impose personal preferences upon you
- usurp the role of your partner (if applicable)
- attend intentional free-birth (planned unassisted)
- predict or guarantee any aspects of your birth
- bear responsibility for your birth’s outcome
- drive you (client) to the birth location
- catch your baby
- in case of virtual services, I do not physically meet you in labor at any point
As a doula, I do not provide medical care and cannot take the place of a midwife, obstetrician, or other clinical worker at a birth. However, I’m knowledgeable about an expansive number of medical aspects that may arise in childbirth, giving you a better shot at making informed decisions.
What The Stats Say
Partner’s Role in Birth
“In one landmark study that evaluated the effects of doulas and fathers working together, researchers found that combining a supportive partner and a doula significantly lowered the mother’s risk of Cesarean compared to just having a supportive partner alone. In 2008, McGrath and Kennell randomly assigned 420 first-time mothers to have routine care (including a supportive partner) or care that also included a professional doula whom they met for the first time during labor. […]
The results showed a substantial improvement in outcomes for women who had both a birth partner and a doula, compared to having a birth partner alone. The Cesarean rate for these first-time mothers was 25% in the group with a partner only, and 13.4% in the group with a partner and doula.” – Evidence Based Birth
- “A grounded theory study of effective labor support by birth doulas.” In Human Development and Family Studies, Vol. Doctorate University of Wisconsin, Madison, Wisconsin, pp. 452. Gilliland, A. L. (2010a).
- “A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates.” McGrath and Kennell. Birth. 2008 Jun;35(2):92-7.
- “Continuous emotional support during labor in a US hospital.” Kennell, Klaus et al. JAMA. 1991 May 1;265(17):2197-201.
- “Continuous support for women during childbirth.” Bohren, Hofmeyer et al. Cochrane Database Syst Rev. 2017 Jul 6;7:CD003766.
- “Impact of Doulas on Healthy Birth Outcomes.” Kenneth J. Gruber et al. J Perinat Educ. 2013 Winter; 22(1): 49–58.
- “Listening to mothers III pregnancy and birth: Report of the third national U.S. survey of women’s childbearing experiences.” New York: Childbirth Connection. Declercq, E. R., Sakala, C., Corry, M. P., et al. (2013).
- Benefits of a Doula Present at Birth – American Association of Pediatrics Journal
- Doula Care and Breastfeeding Success – Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN)
- Evidence On: Doulas – Evidence Based Birth
- Having a Doula: Is a Doula For Me? – American Pregnancy Association