If you’ve spent any length of time with me talking about birth stories, you know that I’m a huge fan of doulas. I had one for both of my births, and it was hands down some of the best money I’ve ever spent! In my opinion, doulas and the care that they provide are absolutely priceless. If you’re curious about how a doula can help you have an empowering birth - and even tip the scales toward more positive outcomes - read on!

What is a doula?

A doula is a trained professional who will come alongside you (and your partner!) to guide you through your pregnancy and birth.

She’ll spend some time before your birth getting to know you, your desires for birth, and helping you to plan and prepare for the type of birth you want to have. She’s very familiar with the inner workings of giving birth in a hospital, birth center, or home, and is equipped to help you navigate the unique landscape of whatever environment you choose for your delivery. She will tailor your prenatal care based on you, your preferences, and your place of birth.

A doula is an excellent touch point for you to have during pregnancy! If you have a non-urgent question that you don’t necessarily need to call your care provider for, she’s only a text away. She can provide information and reassurance as you move through each stage of pregnancy.

Your doula will be “on call” for you as you approach your due date, and will join you once you’re in active labor. If you’re planning a hospital birth, she can meet you at your home, staying with you and helping you determine when it’s time to head to the hospital. Once you arrive at the hospital, she’s an excellent “buffer,” shielding you from the bright, loud, and cold atmosphere of the hospital. Her warm, familiar, and comforting presence will go a long way towards helping your body to relax and feel safe during labor - which will literally help your labor to be shorter and less painful (see below for stats)!

The Four Pillars of Doula Care

When you hire a doula, there are four main categories that her support will fall under: informational, emotional, physical, and advocacy.

Informational Support

During your pregnancy, your doula will equip you with information tailored to your unique situation. During your meetings with her, she’ll help you to develop a birth plan, talk you through the stages of labor and what to expect, and help you to determine which types of relaxation/visualization are most effective for you. And as you move along in pregnancy, she can help you navigate any situations that may arise, guiding you to make the best choices for you and your baby.

And during your labor, your doula can help interpret the medical jargon the nurses and doctors may throw around. She’ll have a keen sense for what’s happening medically, and can be a translator for you and your partner!

(Note: if this is your first baby, you should definitely still take a childbirth ed class - a more holistic class, not through the hospital, preferably! This will give you in-depth information that your doula won’t have time to cover in your prenatal meetings.)

Emotional Support

Maybe the most obvious element of doula care is emotional support. Doulas are masters of empathy and caring, and an experienced doula will be very attuned to you and what you’re experiencing moment by moment while you labor.

She will mirror you, affirm everything you are experiencing, and reassure you that what you’re feeling is normal. I cannot tell you how comforting it is to have someone who is experienced with birth be there with you during labor  - especially if this is your first baby! Everything is so new! A doula is your anchor, keeping you calm and steady when everything can feel crazy and out of control.

Physical Support

A good doula knows how to support you physically through each stage of labor. She knows when and how to apply counter pressure, like the double hip squeeze, and many other comfort measures, and she can teach these things to your partner in real time!! I know that most husbands can feel pretty helpless during labor. Seeing his wife in pain and not knowing how to help can feel paralyzing to him. A doula will absolutely give him confidence to know how to support you and practical ways to do so. (In the end, he may be more grateful for your doula’s presence than you are!)

An experienced doula will go beyond comfort measures and provide physical support and suggestions that, during a tricky labor, can literally mean the difference between a vaginal birth and a c-section. Look for a doula who is trained in or experienced with Body Ready Method and/or Spinning Babies. These programs teach birth pros about the physiology of childbirth and how to optimize the pregnant body for the best outcome.

Advocacy

During the tender time of pregnancy and birth, it can be extremely comforting to know that you have an advocate. Having someone whose main role is to be on your side and on your team can take a lot of the pressure off of you, helping you to relax and trust the process.

It’s important to know that doula advocacy does not mean that she will make decisions for you or speak on your behalf. Rather, your doula will support you in your right to make informed decisions for yourself and your baby.

This could look like:

• Encouraging you or your partner to speak up for yourselves. If a doula senses the medical team deviating from your birth plan, she will gently nudge you to speak up!
• Encouraging you to ask questions when appropriate
• Supporting your decisions
• Redirecting the medical team’s attention to you if you are being dismissed
• Helping you to find space and time to talk and think over important decisions without feeling pressured. For instance, she may ask you, “Would you like for the nurses and doctor to step out of the room for a few minutes so you can process and discuss your options?”
• Pointing out an intervention that a doctor or nurse appears to be about to perform without your consent. For example, “It looks like the nurse is going to turn your pitocin up now, are you okay with that?”

What do Doulas NOT Do?

While a doula is a trained birth professional, she is not a medical professional, and therefore there are many things she will not do! She won’t be able to check your cervix, take your blood pressure, or give medical advice or suggestions.

Your doula shouldn’t pressure you to make certain decisions just because that would be her preference.

And she also shouldn’t take over the role of your partner (as discussed above, she will actually enhance his role and make him a more effective support person for you!)

Amazing Doula Stats!

There have been some pretty incredible studies done on how doulas can help improve birth outcomes!

In 2017, Bohren et al. published an updated Cochrane review on the use of continuous doula support for women during labor and birth. They combined the results of 26 trials that included more than 15,000 people and found that women supported by doulas have:

• A 39% decrease in the risk of Cesarean
• A 15% increase in the likelihood of a spontaneous vaginal birth
• A 10% decrease in the use of any medications for pain relief
• Shorter labors by 41 minutes on average
• A 38% decrease in the baby’s risk of a low five minute Apgar score
• A 31% decrease in the risk of being dissatisfied with the birth experience

Can you believe these numbers?? These stats absolutely blow my mind, and affirm my belief that every woman should have the chance to experience doula care during their pregnancy and birth.

Research has also shown that doulas greatly improved fathers’ experiences of their baby’s birth. In one study, dads overwhelmingly rated their experience with a doula as very positive: 93% said a doula made their birth “very positive,” and an additional 7% as “positive.” These dads said that when there was labor support, their questions were answered, things were explained to them, they were given practical ways to support the laboring mother, and they could take bathroom and meal breaks when needed! (Johansson, 2015)

Questions to Ask When Interviewing Doulas

I believe that it’s a good idea to interview a few doulas before hiring someone. There are many different styles and personalities out there, and it’s important to find someone who really clicks with you. I’d also recommend talking with friends who’ve used a doula - to get personal recommendations from someone you trust!

When you interview a doula, it may happen in person (preferred!) or via video call. Here are some example questions to get you started!

• Tell me about your qualifications/certifications.
• What is your philosophy of birth?
• Why did you decide to become a doula?
• How many years have you been practicing, and how many births have you attended?
• How would you describe your style of practicing?
• Do you have a back-up doula available if you’re unable to make it to my birth? How often have you had to use a back-up?
• How do you typically interact with partners during births?
• Tell me about a time when you’ve had to support a client through something unexpected.
• What do you think every pregnant person should know before giving birth?
• What is included with your services? (How many prenatal meetings? Follow-up visit? Photographs of labor?) Do you offer any additional services, like placenta encapsulation or breastfeeding help?

During and after the interview, you want to ask yourself some questions as well!

• How comfortable do you feel in her presence?
•  Does she ask good questions and genuinely seem interested in you?
• Does she seem caring and empathetic?
• Does she seem confident?
• Could you envision spending an entire day with her while you’re in labor?
• Does she feel like she could be a friend?

This is an important decision. As you reflect on your meeting with her and ask yourself these questions, trust your gut!

Conclusion

I hope that by now you can see why I love doulas so much!

When you hire a doula, she’ll walk with you through your pregnancy, offering support and reassurance along the way. She’ll provide you with tailored information, be an emotional anchor, support you physically through labor, and be your advocate the entire time you’re working with her.

The birth of your baby is a day that you’ll remember for the rest of your life. During labor, you’ll internalize the way your care team treats you, and you’ll always remember how you were made to feel during the most vulnerable moments of your life. I can’t overstate how formative your birth experience will be for you, no matter how it unfolds! I truly hope that yours is positive and transformational.

Cheering you on!!

XO,

Kelly