What is a doula?
The Greek word doula means “Caregiver,” or “Woman who serves.” Today, the word doula describes a trained and experienced labor companion who supports a birthing person and their partner in whatever ways are needed during and just after childbirth. Our responsibilities include continuous emotional support, physical comfort, environmental enhancements, and assisting with information gathering and advocacy. Our tasks can range from helping you labor more comfortably at home, prepping your hospital room to create the ambiance you want, stepping you through creating a birth plan, or even taking your dog to the sitter when you go into labor (my doula offered to help us with this and it was a HUGE load off our minds)!
The DONA way
According to DONA International, the organization through which I am pursuing certification, a birth doula:
Recognizes birth as a key life experience that the client will remember all their life
Understands the physiology of birth and emotional needs of a client in labor
Assists the client and their partners in preparing for and carrying out their plans for birth
Stays by the side of the laboring client throughout the entire labor
Provides emotional support, physical comfort measures, an objective view point, and assistance to the client in getting the information they need to make good decisions
Facilitates communication between the laboring client, their partners, and clinical care providers
Perceives their role as one who nurtures and protects the client’s memory of their birth experience
The role of a doula on your birth team
When you’re laboring at a hospital, you’ll be cared for by a whole team of people, each of whom has a distinct role. A common question for couples considering a doula is, “what role will they play when I have all these other people supporting me?” Here is a list of each of the people who may attend your hospital birth and the role they usually play, along with some color commentary from the births I’ve experienced.
OBGYN: Responsible for clinical well-being of a client and baby; occasionally present during labor.
I absolutely LOVE my OB. After experiencing a difficult pregnancy loss I interviewed a ton of practitioners in the Boulder/Louisville/Golden area to find the one I ended up with. I was very excited to birth with her. She did an incredible job guiding me through pregnancy and delivering my baby AND I’m glad she wasn’t the source of support I was relying on because I saw her for a total of about 20 min - just long enough to coach me on that last push and stitch me up.
Midwife: More present than an OB during active labor, Midwives’ primary responsibilities are still providing clinical care to the birthing person and child. Although they will provide intermittent support and comfort, if an emergent situation arises, they will need to attend to the physical realities rather than the client’s emotional state.
I know people who have given birth with midwives and speculated that they were less likely to need a doula because midwives provide more holistic care than an OB. While that can be true, there are a number of reasons why they don’t replace a doula. Most midwifery practices have a number of practitioners and you never know who you’ll have the day of your birth. If you’re looking for continuity of care, working with a midwife does not guarantee that. Midwives are also still primarily responsible for the medical aspects of the birth. Because of that, during situations where providing medical care requires their full attention, the birthing person and their support person can be left without anyone to attend to their emotional needs (which can definitely be more pronounced during difficult situations).
L&D Nurse: Labor & Delivery Nurses provide clinical care as dictated by the caregiver’s orders and hospital policies. They are in and out during active labor, providing intermittent support and comfort. They also keep your OB or midwife appraised of your progress.
L&D Nurses are incredible human beings. They often possess incredible capacity for empathy, a wealth of knowledge about the birth process, and vast experience to draw from. However, they are not continuously present with you during your labor, and if you have a longer labor they’ll likely rotate off at the end of their shift. They also meet you for the first time when you arrive in Triage, so they don’t know your intentions/preferences for your birth or what your preferred comfort measures are. They also work with a different set of tools than doulas, so if you are hoping for a low intervention birth, you might not want to rely on the nurse to support that goal (they may have the best intentions, but just lack the experience or latitude to do what you need).
Client’s support person/people: Continuous or intermittent presence, and varying amounts of support and comfort (this really varies depending on who is there, how familiar they are with the support you need, how comfortable they are seeing you in labor, and how you are feeling about the comfort they are providing).
When I told my grandma that I was training to become a doula she reacted incredulously, “Isn’t that what you women have your husbands there for these days?!” This is not an uncommon response when a birthing person suggests hiring a doula. Many assume that a doula is unnecessary if they have an engaged, educated, hands-on partner. While this can definitely work for some, having an amazing partner is not a guarantee that they will provide amazing support during your birth. For example, when a birthing person hopes to go unmedicated, the concern of well-meaning partners can actually result in them getting an unwanted epidural because their partner feels cruel denying them pain relief instead of feeling confident helping them navigate the pain constructively. On top of all that, though, even the best partners/support people need to eat and pee occasionally. Labor is the wild west and you never know how long it is going to go. Doulas can provide much-needed self care space for your support people.
Doula: Continuous presence for emotional support, physical comfort, non-clinical advice, and support for partner.
While everyone else above will need to come and go, has priorities outside the birthing person’s physical comfort and emotional state, and has their own needs to think of, a Doula is here for YOU. I don’t perform clinical tasks, so I won’t need to divide my attention. I have met with you beforehand so I know you hopes, dreams, goals, and preferences, and you know me and my approach and philosophies; we’re already in sync. You’re paying me, so if you don’t like something I’m doing I won’t take it personally, and I have a ton of other things in my bag of tricks to try. I’m a pro, so I know how to stagger my snack and pee breaks so that they don’t come at the most difficult points in your labor, and I don’t need to take care of a tiny human when this is over so I can leave it all on the field getting you the support you need.
Have more questions about what a doula does or how one could help during your birth? Get in touch! Our initial conversation (and the coffee/tea) is on me, and whether you decide to work together or not, I’d love to meet you and chat.