Baby

When & Why Might You Want a Doula?

Pregnancy can be a slightly confusing and emotionally overwhelming time. Your body is changing, your hormones are raging, and you often need to make huge decisions about your birth plan and life after your baby is born.

Who can you turn to?

Our first instinct may be to go to our doctor, our friends, or even the Internet for advice. But that’s not always enough.

  • Doctors and midwives provide medical care for your and your baby’s physical health, but do not give emotional support.
  • Family, friends and your partner can provide emotional support, but they can’t give practical, medically-sound advice. When you’re worried about labor, they will just tell you everything will be okay—not tell you what to expect, and how you can relieve the pain.
  • Books, forums and the Internet can give information, but they’re not tailored to your needs. Every family and every pregnancy is unique, and you’re still left asking, “How do I know what’s right for me?”

You need a competent, credible and caring partner who knows how to provide practical physical and emotional support to you and your family. And that’s what a doula can do.

What is a doula?

Doulas are not medical professionals, and will not be giving you medical recommendations. However, they are your sounding board and your advocate, and are trained to help you navigate the most common (and most confusing) parts of pregnancy.

1. Before birth

You will usually meet your doula in your second or third trimester. She can help you prepare for birth by answering questions you have about pain, the hospital admission process, or what to expect during delivery. This can be very helpful if this is your first baby.

She can teach breathing and other natural pain management techniques, and help you finalize your birth plan.

2. During delivery

Your doctor and midwife are still your primary caregiver during labor. However, the doula can help keep you more calm, comfortable and feel more in control.

Doulas can provide natural therapies to help manage the pain without medication. She can help massage you or help you get into the right position. She may bring music and aromatherapy, or teach you meditations and deep breathing techniques that can help you ride the contractions.

She can help relay your birth plan and preferences to the hospital staff, and provide emotional support to the nervous dad-to-be, too!

But let’s be clear: a doula does not give advice about the labor procedure, and can’t interfere if your doctor decides that they need to change the birth plan for your and your baby’s sake.

Her role is to keep you and your partner calm and comfortable—and remember details that are often forgotten in the chaos, like giving you ice cubes or taking lots of pictures.

3. After delivery

You can also get a postpartum doula who can help you and your partner in the first few weeks after bringing your baby home.

She can teach you how to care for your newborn (like how to give a bath or deal with colic), and make sure you’re getting enough food, water and sleep.

She can help your family adjust to a new routine—especially if you have other young kids, or if your partner has to go back to work right away.

She can help you adjust to breastfeeding, help your baby latch, and teach you natural ways to increase milk production.

If you are on bedrest or have to take it easy because of possible birth complications, your doula may also help out with chores or childcare.

Are doulas really helpful?

Several studies, including a 2017 report on the benefits of continuous support for women during childbirth,  have found that a doula can make a big difference in a mom’s labor experience.

  • Lower risk of cesarean section. There was a 15% increase in vaginal births, and a 25% in Cesarean sections. This may be linked to how doulas are able to help women facilitate labor with their position and breathing.
  • Less need for pain medication. About 10% of women with doulas did not need pain medication; others needed less
  • Faster labors. Labors were shorter by an average of 41 minutes
  • Less fetal distress. There was an average 38% decrease risk of babies getting a low Apgar score

However, these studies don’t measure other factors that can affect labor and delivery: your age and  medical history, the baby’s condition, etc.

Even if you have a doula, you may need to have an emergency cesarean if your blood pressure drops or if the baby is in distress. But assuming a relatively normal birth, having someone there can help put you in “the best emotional and physical state” for giving birth.

Experts believe that doulas are effective because they add a human touch to an otherwise clinical and cold birth experience. The hospital environment—bright lights, surrounded by strangers, needles and machines, and being left alone in the delivery room—can be very stressful and overwhelming.

A doula’s encouragement presence not only boosts your confidence, but can even help you release endorphins to naturally relieve pain, and oxytocin which can help promote labor contractions.

Researcher Dr. Amy Gilliland, an acknowledged expert in labor and delivery, said that the Doula Effect was to attachment.

Doulas act like the “secure base” which Moms can rely on, and soothing behavior like eye contact and massages help release the right hormones for smooth delivery, as well as the psychological effect of having someone credible and trustworthy by your side.

How do I find a good doula?

Most moms will usually hire a doula in the last trimester, typically around the seventh month of pregnancy.

However, you may want to begin looking for one in the fourth or fifth month, since it may take time for you to find a doula that you like. Trust and rapport are very important.

So aside from making sure that your doula is competent, qualified and certified, there’s also that factor of finding someone who you click with.

  • Ask your ob-gyn, hospital or local community for doulas in your area. You can also check websites like dona.org and cappa.net.
  • Begin interviewing candidates. Ask about their certification, past references, and the kind of services they’re willing to offer. Some doulas are only licensed for birth, while others are also trained to provide prenatal and postpartum care. Others are also licensed for lactation or breastfeeding counseling, or have additional training in pregnancy massage.
  • Once you’ve found a doula you really like, discuss rates, number of sessions and hours, and what to do in case she needs to work excess hours.
  • Inform your ob-gyn that you are getting a doula, and introduce them. Proper communication between your medical team and your doula are important for a smooth and stress-free delivery.

Should you get a doula?

Some moms may not need a doula, but there are certainly situations where extra physical and emotional support can certainly come in handy.

  • This is your first pregnancy
  • You do not have any close family or friends who can help you out
  • You want to have a natural delivery, with minimal use of pain medicine or other interventions
  • You have a specific birth plan
  • Your partner will not be able to be with you during labor
  • You have a high-risk pregnancy and may need bedrest  
  • You want to have a calm, comfortable, and positive labor experience

All moms need to have a good support system.

Parenting isn’t easy, but you don’t have to go through it alone.

A doula can help make pregnancy less frightening, and labor and delivery less painful. They can give you advice, help you with the work, and hold your hand when you need it most and remind you to breathe.