What is a doula?

“If a doula were a drug, it would be malpractice not to use it.” ~Dr. John Kennell

Here’s the 30 second “elevator speech” answer to the question “What is a doula?”…….

Doulas are individuals who are hired by families looking to have additional support during their pregnancy and birth.  We are there to help with emotional, physical, and informational support – we don’t make medical decisions, nor do we “replace” dads and partners.  Doulas give prenatal support and continuous labor support.  Having the sort of support that doulas are able to give has been shown to reduce the rates of interventions (including cesareans) and improve satisfaction rates.  And the research has shown that there are no known downfalls.  Thus the quote “if a doula were a drug, it would be malpractice not to use it.”

And here’s what the research shows – women who received continuous support were less likely to….

-have epidurals
-give birth with the assistance of forceps or vacuum extraction
-give birth by cesarean
-report dissatisfaction or a negative experience

If you’d like to read more, here are a few resources (thank you to the DONA website for the resources):

Cochrane Review (a systemic review of the medical lit available on doulas)

Cochrane for Clinicians: Caregiver Support for Women During Childbirth: Does the Presence of a Labor-Support Person Affect Maternal-Child Outcomes?

Social support by doulas during labor and the early postpartum period

Yes, but what does a doula actually do?….

Not every doula is the same.  But in a nutshell, here is what I do.

I meet twice prenatally with clients (after the initial – and free – meet and greet “date” to see if we’re a good fit), and the meetings are 1.5-2hrs in length.  We work to get to know one another; I find out what information clients are aware of and what other resources they are looking for; we also go over the process of writing a birth plan/preferences sheet.

Folks have access to my video and book lending library if they are seeking additional resources (though I do not recommend hiring a doula in lieu of taking a childbirth class, four hours is not enough time to get to know one another AND do a childbirth class).

I am available for phone consult should any issue come up during pregnancy, and with the average clients I do a number of back and forth phone calls as early labor is beginning to get established.  I am happy to support families at home if they choose to spend more time at home as they labor; I also meet folks directly at their place of birth.

Once labor gets a move on, I’m there pretty much til the end.  (If things went really long – as in 18hrs+ of active labor, I may call in a colleague to give a reprieve so that clients are able to get the best possible care.)  During labor I do any number of things.  Most simply I am there to be a gopher – getting water, ice, snacks, spelling dads and partners for bathroom and meal breaks.  I work with partners to make sure moms are doing what their bodies need/want to do to keep labor progressing – position changes and suggestions, as well as other pain management strategies (tub/shower, massage, acupressure, vocalizations, etc).  I am also there to make sure that families have the time and space they need to get all the information they want/need to make a decision, should the need for intervention become necessary.

I remain with families for a couple of hours following birth – making sure breastfeeding is getting well-established and things are calm and mellow.  I follow up with a short one hour visit sometime in the first few days following the birth, and I am happy to do a longer post-partum visit anytime after that time period as people begin to sort out and process the birth – no matter how it went.  I also remain available for referrals to other resources within the community as families begin their parenting journey.

A local parenting blog Raising Madison did a nice piece on doulas and a few clients reviewed my services, if you’re interested in reading more. Clients have also reviewed my services on Google.