Everyone Deserves a Doula
Average read time: 7 minutes
“What’s a doula?” A question I’m asked constantly as I explain my job to people. I tend to start with the basics:
A doula is a person who provides emotional, physical and informational support before, during and after the birth of a baby.
But let me break down what I actually do, because that is just the beginning:
Doula support begins when the birthing person is still pregnant. Leading up to the birth, my main focus is helping the birthing person and their support team prepare for birth. Everyone has their own preconceived notions about birth that come from their families, their friends, movies/TV, social media, etc. There are so many options (and opinions) to navigate once you tell the world that you’re pregnant. One of my jobs as a doula is to help you weed through that information to make an informed decision while you weigh the benefits and risks. This helps give you time to process the challenging questions before decision time comes, such as: When are you comfortable with an induction vs. going into labor spontaneously? What do you want pain management to look like for you? Who do you want in your birthing space and what roles do you want them to play?
These questions, and many more, are the beginning of creating your birth preferences plan. As your doula, we will work together with others on your birth support team to come up with a general idea of what you’d like your birth to look like.
Quick pause here: many people assume that doulas only support unmedicated births. This is definitely not the case. My job as a doula is never to assign judgment to a decision you are making for yourself and your family. It’s ONLY to support you to make an informed decision. I want you to know the benefits and risks of the choices you’re making so that you are empowered. This is your body, your baby, your family. Another of my jobs as a doula is to help you sift through the noise to find what decision(s) makes sense for you. No matter what choices you make, doulas provide support through the entire process.
Ok, back to what doulas do! Prenatally, other support that I provide as a doula is talking through the “what ifs?” We know that you can’t ever plan for childbirth, so it’s important to discuss the “what ifs” beforehand, so you feel less scared and more empowered if things do come up. We discuss what happens if an emergency c-section becomes necessary, what to expect, who can support you, and what recovery looks like. We talk about what happens if you and your baby need to be separated (such as in the NICU), and make plans for who you’ll lean on, what to expect, and how to navigate through the hospital systems to the best of your ability. We will talk about your fears and your hopes, and I will help answer any questions you may have.
One thing to know about me: I was a middle school teacher for many years before becoming a doula. One of the main beliefs that drives me as a human is that knowledge is power. When you have the knowledge about childbirth, it gives you the power to believe in yourself. To trust yourself. Childbirth is transformational, regardless of the process you go through. And by giving yourself the knowledge of what to expect, you empower yourself to be the driver, to decrease fear, to remove tension, so that you are able to lean into the deeply personal transformation that is becoming a parent.
This is why part of my prenatal services includes a deep dive into childbirth education. What are the stages and phases of labor? What can you expect to experience at each stage? What language do healthcare providers use? What comfort measures may (and may not!) work during each stage? And what can your support team do to be your foundation? Childbirth is very different from what we’ve been shown in the media. As your doula, it’s part of my job to help you understand what to expect so that on the big day, you are like, “Oh yah! I knew that was coming!”
Finally, during the prenatal period, a doula helps with physical comfort measures that will provide some comfort or support in the final weeks of pregnancy and throughout the childbirth process. We practice different positions, exercises, and stretches that will help your pelvis open and move to prepare for your baby. We will talk about the importance of breath during labor, and I’ll help you practice any breathing techniques to help you release tension in your body. Labor is a physical task, so I’ll also talk through how to nourish and hydrate your body to prepare for the big day.
And then that big day arrives! Now, I tried to write in paragraph format all of the things that a doula does during labor, but I’m not sure we have time for a 12-page essay. Instead, I’m going to list some of the ways support has looked like, but please remember that this is not an exhaustive list. Supporting each family is an individual experience. Each birthing parent is different. Each supporting team is different. I tailor my doula work to fit the needs of the family I’m supporting on the big day (yet another reason doulas are so great!!)
A (non-exhaustive) list of what doula support might look like during labor:
Help time contractions
Remind birthing parent to nourish their body, hydrate, and rest (and provide the tools to do these things)
Provide acupressure points to try to help you navigate contractions
Provide massage, and teach your support team how to massage
Help explain terms and choices presented to you by your healthcare team (please note: I will never make any decisions for you. That is the job of you and your family. My role is to help you understand what your choices are so that you can make an informed decision).
Support other members of your family, reminding them to rest, nourish and hydrate as well
Help you move into different positions throughout the labor process, and give advice on different positions to try during the different stages and phases
Provide verbal encouragement and hype
Present breathing and visualization tools to help navigate pain management
Aromatherapy
Help use the props and tools that your birthing space has to offer (peanut balls, ice packs, etc.) AND know what is available, who to ask, when to use it, etc.
Create an environment of safety for birthing parent
There’s so much more to this list that I didn’t put here. One thing I love about being a doula is the on-the-spot creative thinking to help foster that feeling of safety and empowerment. I cannot stress enough that birth is such an individual experience, and so it’s up to me and your support team to help you in the ways that you need. What worked for another client of mine may not work for you, and my job is to make sure your focus can just be on you and your baby.
To conclude, I want to talk a bit about after the baby is born. A doula’s support immediately post-birth really varies from family to family, depending on the choices that they make and the health of the family. If photography is something the family has requested (and is permissible by the birthing location), this is the time where I snap thousands of photos - baby on chest, baby’s first cry, baby and family, kissing, hugging, tears, you name it. This is a moment many people want to remember, and I try my best to capture everything. During this time I also explain what is happening around the family. Healthcare providers will be monitoring the birth of the placenta, the health of the birthing parent, and the health of the baby. If something requires the baby to be taken from the birthing parent, I’ll stay with them to explain what’s going on, answer any questions, to hold hands, to be there. If the baby is able to stay with their parent, I’ll help make that “golden hour” (the hour immediately after the birth) as special as possible, so that you can spend time soaking in your sweet babe. I’ll gather your belongings (usually you’ll move space in some capacity, depending on the location of your birth). I’ll bring you nourishing food to start to eat, and I’ll continue to encourage everyone to take care of themselves. Generally, once your family is settled within that golden hour (or hours, as that time really should be two), that’s when I make my goodbyes. Your family has added a member, and I want you to be able to focus on that.
Phew, as I reread this blog post, I just know I’ve left out so much that doulas do. I also want to clarify that there are some things that doulas do not do:
We don’t replace the support of partners. Instead, we work together! The way I like to think of it: Doulas know birth, and the partner knows the birther.
We are not medical professionals. I know a lot of the procedures and protocols that you can expect to encounter in a birthing space, and know how to generally explain them, but I will never make any recommendations, nor will I ever participate in procedures.
We are not here to force a specific agenda on you. This is your birth, and you get to make the decisions. My job is to help you be informed while you make those decisions.
This blog is just one doula’s reflections on my role in birth support. However, I want to point to some data points that offer research on the benefits of a doula. Evidence Based Birth is a website that navigates research around birth broadly. Their article on the evidence for doulas states that doula support during birth leads to:
25% decrease in the risk of cesarean
Shortened labor by 41 minutes, on average
38% decrease in the baby’s risk of a low APGAR score
31% decrease in the risk of being dissatisfied with the birth experience.
This same article goes on to discuss how doula support can lead to better care, more respect, and better birth outcomes for people who identify as Black, Indigenous, and LGBTQIA+, and uses data from around the world from organizations such as the World Health Organization (WHO), the Association of Obstetricians and Gynecologists (ACOG), and other leading research and medical institutions. I highly recommend clicking the links above to read the article, which is also available as a podcast, and has a link at the top for a one-page version.
My final note: I obviously think doula support is critical, or I would not have become one myself! I believe that this career --supporting families through such an important event in their lives -- is my calling. Ready to discuss this further? Contact me today! I’d love to talk more about the many ways I can support you as you get ready for your family to expand.
