Women have been helping each other through labor throughout history. Before modern hospitals, when a woman gave birth at home, a female family member, friend, or neighbor might have assisted her. If you'd like to have another woman by your side to offer emotional support, advice, and encouragement during labor, you might hire a doula. Doula is a Greek word that means "woman's servant."
Services. A doula is not a midwife. Rather, she is a paid labor coach. Doulas are trained to provide physical, emotional, and informational support to women and their partners during labor and birth, according to Doulas of North America (DONA). DONA is an organization that trains and certifies doulas.
A doula guides a woman through breathing techniques and suggests positions that help labor progress. She may offer massages, breathing exercises, and advice, both before you go to the clinic or hospital and after you're admitted. A doula is not medically trained; she does not perform medical exams, make diagnoses, or actually deliver the baby. She does not take the place of a doctor, nurse, or midwife. Some doulas also offer postpartum care such as breastfeeding support, newborn care, and household help for a new mother.
Who may benefit. Doulas are especially great for women without partners or women whose partners will be uncomfortable in the delivery room. A doula also can be helpful if you've decided to have your baby naturally, with no medical interventions or pain medications.
Before you hire a doula, ask her about her birth philosophy to see if it agrees with yours. If you feel strongly that you want to have epidural pain medication, avoid hiring a doula who is against medication during labor and who will argue with you about your choice. It's also important that you click with your doula on a personal level-you may end up spending a lot of time with this woman, so you'd better like her.
Some doulas work independently; others are employed by hospitals or doula agencies. Either way your health insurance is unlikely to cover the cost of a doula, although it's worth asking. To find a doula, ask your doctor or friends for a referral. Or contact DONA (www.dona.org), which maintains a list of certified doulas in the United States.
Fees. You'll need to pay a doula somewhere in the range of $300 to $1,500 in most places. That amount usually covers several prenatal visits, her stay with you throughout labor and delivery, and a follow-up meeting. Always discuss your decision to hire a doula with your midwife or obstetrician; some providers find the presence of any sort of labor coach intrusive. Other providers might be able to offer you some good referrals, and you may benefit from the extra support.
Originally published in You & Your Baby: Pregnancy.
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