What Does a Doula Do?

If you're pregnant, you might be wondering what a doula is and how they assist with birth. We turned to experts to learn more, along with the pros and cons.

pregnant person and doula holding a calendar

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A doula is a trained professional who empowers you before, during, and after childbirth. Their primary role is helping you achieve the most satisfying birthing experience possible by providing emotional, physical, and informational support.

If you're considering hiring a doula, or if you just want to know more about what a doula does, keep reading. Below you'll find everything you need to know about doulas, including how much they cost and how you might benefit from having one.

Key Takeaway

A doula can be an excellent addition to your birthing team, as they're able to provide support throughout your pregnancy, labor and delivery, and beyond. It's important to remember that a doula is not a medically trained professional and doesn't substitute the need for medical care during birth.

Doula vs. Midwife: What's the Difference?

Although the two can often be confused, a doula and midwife actually have quite different roles when it comes to your labor and delivery.

For instance, a midwife is a nurse who is medically trained in childbirth. Not only will they monitor your labor process and help deliver your baby, but they also can help you make decisions about the use of medications. On the flipside, doulas are not medically trained professionals, but they can provide emotional and physical support.

“A midwife can perform medical tasks like checking vital signs or cervical dilation, and is qualified to deliver a baby and perform emergency care when needed,” says Kristin Mallon, C.N.M., M.S., R.N.C.-O.B., a board-certified midwife, CEO of FemGevity Health, and a former doula. “Many midwives also [may] assist surgeons with a cesarean birth. A doula is primarily there for the emotional support of the laboring patient and doesn't perform any medical care or medical tasks.”

What's the Difference Between a Doula and an OB-GYN?

An OB-GYN is a medical professional who is both an obstetrician and gynecologist. They care for people and their babies during pregnancy and childbirth, and also specialize in treating reproductive conditions. A doula does not replace the need for medical professionals and does not provide medical care.

“Doulas work alongside medical staff to provide emotional and physical support to the parent-to-be,” says Lauren Elliott, M.A., M.H.F.A., a maternal mental health advocate, and founder and CEO of Candlelit Care, a digital clinic that trains doulas on postpartum mood changes and disorders. “Additionally, doulas can support any birth plan, whether [unmedicated] birth or one involving medical interventions."

Types of Doulas

There are a few types of doulas: birth doulas, postpartum doulas, and antepartum doulas.

  • Birth Doula: Provides assistance before and during labor and childbirth
  • Postpartum Doula: Helps new parents after their baby is born (though some doulas offer both birthing and postpartum services)
  • Antepartum Doula: Supports pregnant people with high-risk or difficult pregnancies, such as those on bed rest

Doula Services During Pregnancy and Postpartum

When you hire a doula, they'll be by your side during labor and delivery to provide comfort, encouragement, and support. For instance, they might help you relax or assist with breathing exercises, or they may offer suggestions on labor positions. 

“Doulas are an integral part of any labor and delivery team, especially for patients who are experiencing birth for the first time,” says Mallon. “They don't perform any medical tasks, but instead really focus on the emotional and mental state of the laboring patient. They usually focus on providing physical and emotional comfort as well as encourage mental fortitude.”

During Labor and Delivery

A doula serves as your birth advocate and as a liaison with the birthing team, says Elliott. “They stay with you constantly to provide comfort and support; use massage and touch; help you get into comfortable positions; and ensure your preferences are honored by your medical team.”

They can assist with other non-medical aspects of your care, too, such as creating a birth plan and advocating for you during labor and the immediate postpartum period, she adds. 

Doulas also ensure your wishes are respected, and they might improve birth outcomes by reducing the need for medical interventions. What's more, doulas play an instrumental role in pain management by providing comforts such as massages, hot or cold packs, and assisting with breathing techniques. 

People “who use a doula during childbirth typically use less pain medication and have higher satisfaction rates with their birth experience,” says Elliott.

During the Postpartum Period

Doulas are not only essential to the labor and delivery process; they can be very valuable during postpartum as well. If you decide to hire a postpartum doula, they're there for you and your family during the first few weeks or months following the birth of your baby, says Liesel Teen, B.S.N., R.N., a labor and delivery nurse and the founder of Mommy Labor Nurse. 

“The doula should offer physical and emotional support to the mother primarily,” says Teen. “[But], the exact roles of a postpartum doula might differ from person to person depending on what their specific needs are at that time.” For instance, a postpartum doula might provide emotional and physical support, help with infant soothing, or facilitate bonding. Doulas can even help with breastfeeding and basic newborn care, adds Elliot. 

The Pros and Cons of Using a Doula

When trying to decide if a doula is right for you, it's important to consider both the benefits and the drawbacks. Here are some of the pros and cons of hiring a doula.

Pros of Using a Doula

Aside from the support, empowerment, and comfort that doulas provide, research also shows that expectant parents-to-be have better birth outcomes when they opt for a doula to assist them, says Vanessa M. Safie, a certified birth doula (D.T.I.).

“Statistically, the use of a doula is attributed to better outcomes for birth,” she adds. “These include decreasing the length of your labor, decreasing the odds of a cesarean section, and decreasing the need for augmentation.”

In fact, research shows pregnant people who used a doula were four times less likely to have a low birth weight baby, and two times less likely to experience a birth complication. Researchers believe that communication with the doula, as well as their encouragement throughout the pregnancy, may have caused these positive outcomes.

Some studies even show that people who receive doula care have 52.9% lower odds of a C-section. They also had 57.5% lower odds of postpartum depression or postpartum anxiety.  It's also important to note that doulas can significantly improve the birthing outcomes of underserved and marginalized groups, who systemically experience bias, lower quality of care, and a higher mortality rate.

Cons of Using a Doula

When it comes to hiring a doula, some potential downsides include cost and availability. It may also be a challenge to find a doula who's compatible with the medical staff and parent-to-be. Make sure to discuss the possibility of a doula with your health care provider beforehand, as some medical professionals might be concerned that a doula will interfere with the care they provide, says Elliott. 

Another potential doula con: You run the risk of not meshing well with your doula once you're in labor. Most of the time, this can be avoided by meeting with your doula several times during your pregnancy to ensure your personality clicks, advises Teen. “The last thing you want to do is find out in the middle of labor that you don’t get along well with your doula.”

How Much Does a Doula Cost?

The fees for a doula can vary widely based on where you live, and they will also depend on the doula’s experience level. The cost may also be influenced by whether or not they work at an agency or on their own, and whether or not you have one doula or a team, says Safie.

On average, though, Elliott says doulas often charge between $300-$5,000 per birth, though prices may vary depending on your needs. Keep in mind, too, that most insurance companies will not cover any costs associated with hiring a doula. This is something a parent-to-be decides to do for themselves so that they have the support system they desire in the labor and delivery room.

Where Do You Find a Doula?

Depending on where you live, you may find that there are a number of doulas to choose from. Meanwhile, in other areas, there could be just a handful of doulas available. One of the best ways to find a doula is by word of mouth, especially if a friend or family member had a good experience, says Safie.  

“There is also a well-known directory called DoulaMatch, where doulas are listed by cost, area, and availability,” she says. “Sometimes your pregnancy care providers have recommendations for doulas as well.”

Another option for finding a doula includes DONA International, a doula certifying agency. Or, you could try Birthworks International or the National Black Doulas Association.

How Do You Choose a Doula?

When looking for a doula, it's essential to consider what kind of person you want by your side and how they meet your birthing plan needs. For instance, a good doula should be able to put themselves in your shoes and understand how overwhelming it can be to go through labor without any support, says Elliott. 

“They should have a strong sense of empathy,” she adds. “[And] if you are a mom of color, ensure that your doula is culturally competent in advocating for your needs to your medical delivery team.”

Also make sure that your doula has the proper training, and that they have trained with a reputable organization. While doulas don't have to be certified to assist with a birth, it 's wise to look for someone who has not only been certified, but also is familiar with a variety of different births.

But most importantly, you want to find someone compassionate with whom who you connect, and who also can articulate your goals for your birth experience. “Finding your doula should feel like breathing a sigh of relief,” says Safie. “When you talk with them about your goals and questions, they should make you feel heard and safe. You should feel comfortable sharing space with them for a while; and your partner should feel as though they could take direction from the doula as well.”

Questions to Ask Prospective Doulas

When trying to find a doula, you should ask about their experience level (including any special training or certifications), their availability to answer your questions before labor and after delivery, their ability to help you achieve a successful birth, and what their back-up arrangements are if they can't make the birth for any reason.

Latham Thomas, a maternity lifestyle expert and labor support doula in New York City and founder of Mama Glow, recommends asking the following questions:

  • What inspired you to enter this field of work?
  • What certifications do you hold?
  • How long have you been a doula, and how many births have you attended?
  • What types of births have you attended—home, hospital, birthing center?
  • How do I get in touch with you when labor begins? Are you always on call? When and where will you join me?
  • If you are unavailable when I go into labor, do you have back-ups?
  • What is your philosophy on childbirth? (Make sure your birth preferences are compatible with the doula's practices and beliefs.)
  • What techniques will you use to help me move through labor?
  • How long will you stay with me after labor?
  • What happens if I need a C-section?
  • Do you provide postpartum services? Do you have experience helping nursing parents?
  • What's your fee and refund policy? What does it cover?

Ultimately, remember that "doulas are support coaches; they are not supposed to impose their views on your birth," says Thomas. "Their job is to carry out your vision to the best of their ability, given the circumstances that arise, and help make it a day to remember. It's a celebration, after all."

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