Trying to decide on a doula? Not sure if you even need one? Don’t actually know what a doula is? That’s okay. Most people have never heard of these highly understated individuals who provide invaluable support to women and their families in the delivery room and beyond. Of all the things you may be considering for your birthing plan, a doula will arguably prove the most beneficial. That’s because no matter what kind of pain-relief method you plan to use, what meditative music you’ve downloaded to your iPod, or what birthing position you insist on being in, once the contractions begin and don’t stop, all of those things go out the window. Why? Because nine times out of ten, a delivery doesn’t go as planned.
What then? Certainly, you will have your doctor or midwife nearby, and perhaps a couple of nurses at your service, but you’d still be missing that one constant, comforting, reassuring presence to actively guide you through the unexpected turns ahead. Unless, of course, a doula was number one on your birthing plan.
What a Doula Does
From a Greek term meaning “mother’s servant,” the word “doula” is reserved for women who are trained and experienced (and hopefully certified) in providing physical and emotional aid to women during labor and delivery. Typically, birth doulas begin working with the pregnant woman and her family in the months leading up to the big day, then are a constant, fully engaged pillar of support during the birthing process. A postpartum doula provides assistance to the new family once everyone is back home; this might entail everything from breastfeeding assistance to recovery advice, from cooking healthy meals to light housekeeping.
A doula is not a midwife (unless, of course, she’s certified as both), in that she has no authority to make medical decisions, nor is she credentialed to deliver a baby. She’s not considered on the level of a nurse, either; doulas cannot administer or regulate medicine, operate monitoring devices, et cetera. In fact, a reputable doula will tell you that she doesn’t even have the authority to speak on behalf of the mother should a complication or other medical surprise surface.
But sometimes it’s the unnameable, intangible aspects of the conclusion of a pregnancy that require the most help and planning. And that’s where a doula is indispensable. In addition to the priceless knowledge and experience she brings to the laboring phase and to newborn-care assistance, she’s a wellspring of intimate emotional and physical support. A doula educates the family ahead of time; keeps the laboring mama focused and lucid; instinctively retrieves things she needs, like water or compresses; supports her body while walking through contractions; suggests different laboring positions; initiates massage and breathing patterns; reassures other labor partners; works alongside hospital staff; advocates for the mother; and, afterward, ensures that the new mommy is getting enough rest, is recovering well, and is bonding with the baby.
From my own birthing experience, and in talking with countless friends about theirs, this type of support is greatly undervalued and overshadowed by the focus on the delivery itself, which can last anywhere from fifteen minutes to three hours. What lasts much, much longer is the laboring phase, not to mention the emotional roller coaster, and accompanying aches and pains, that a pregnant or postnatal mother undergoes. An investment in a doula can translate into confidence, security, and comfort for a new mother—for weeks.
Is a Doula Right for You?
A birthing doula probably isn’t going to be as much help to the woman who is having a scheduled C-section, or the mom who plans to get the maximum epidural dosage as soon as possible. But for the ladies who want to labor “naturally”—that is, without any sort of clinical intervention—a doula can be the perfect choice.
A doula is also a smart addition when a mother doesn’t have family or a network of close friends nearby to call on; when she doesn’t have a labor partner (or wants a backup); or when she simply needs the reassurance of someone experienced at her side.
Keep in mind that a doula shouldn’t take the place of a spouse (or family member or friend) who’s eager to be the best labor companion in the world. Doulas work with, not against, these caring individuals to ensure that the laboring woman has everything she needs—and nothing she doesn’t.
Selecting a Doula
Los Angeles–based doula Lauren Veca says that, like anything, personality is the most important thing to consider when choosing a doula. “Things get very intimate during labor,” contends Veca, who’s been in the field for several years. “It’s important to have an open relationship with a client and her partner. The mom should feel like she can tell her doula anything, that she can call her anytime. That’s how you know the doula is a good fit.”
In addition, Veca suggests that a doula be adaptable to any situation. Surprises, complications, delays, and fear are just some of the potent factors that can derail a birthing plan. And a doula must have the capacity to remain calm in this storm.
Like finding a doctor, dentist, babysitter, or contractor, selecting a doula should start with referrals from people you trust or through reliable online networks. A doula should be certified, and her certification should be current (most must be renewed every three years) through a reputable agency, such as the Doulas of North America; she should have a minimum of twelve births under her belt; and she should work with what you want or need during labor, delivery, and recovery. Familiarity with the hospital and staff where you plan to deliver is a bonus. Interview at least three doulas before making a decision, and do ask for and check references.
When in Doubt …
In case you need one more reason to hire a doula, keep in mind that her duty is always to the mother, and that allegiance doesn’t end just because the baby comes out. A doula will continue to be a resource and helper for as long as she’s needed. Some brand-new mothers can’t help but feel slighted in the shadow of all the attention showered upon the new baby. You might think, “I did all the hard work, and I’m still doing all the hard work, and no one seems to care about me anymore!” And that’s normal. Go ahead and call your doula at 3 a.m.—I promise she’ll pick up, and she’ll ask how you’re doing before she asks about the baby. You’ll appreciate that like nothing else in the world.