What does a Doula *actually* do for me?”

What is a doula?

“You’re a what?? Is that like a midwife?”

That is the number one response when I tell someone what I do for a living. And no, a doula is not quite like a midwife! A doula is someone who is trained and experienced in childbirth, but does not perform medical tasks. She provides continuous physical, emotional, and informational support to the family before, during, and after childbirth. Many doulas are multi-talented and have a special area of expertise such as massage, photography, placenta encapsulation. (Yes, that’s a thing.) Training and experience can vary wildly; be sure to ask your doula specifically about hers.

What are the benefits of a trained doula?

  • Shorter labors, fewer complications, and shorter hospital stays
  • Reduction in negative feelings about your childbirth experience (something that a woman will remember all her life)
  • Reduction in the need for interventions (Pitocin, forceps, vacuum)
  • Reduction in requests for pain medications, cesarean births, and postpartum depression

But what does a doula actually do for me?

All over the internet are these generic descriptions of doula “support.” But what does that really look like? The following are just a fraction of the specific tasks I usually do when working with families during pregnancy, birth, and post-partum.

 

A doula will….

A good doula will NOT…

  • Meet with you prenatally to review your birth preferences (“plan”) and give you tips and suggestions based on her experience with that hospital staff.
  • Tell you her preferences on how to birth.
  • Provide you with resources and be a sounding board as you make decisions in pregnancy – if you keep her in the loop.
  • Provide her opinion on a birth/parenting decision – unless you ask for it.
  • Help you track contractions when necessary and help you weigh your options on when to head to the hospital or call your midwife.
  • Decide for you that it is time to go to the hospital or call your midwife.
  • Support you prior to your midwife’s arrival or before your transition to the hospital. She can help you feel as comfortable as possible while you stay home, be a constant presence while your partner gathers last-minute things in the home, reassure you as things progress, set up your birth pool if you’re using one, and help keep you focused and calm.
  • Act the role of a doctor, midwife, or nurse and do medical tasks like fetal heart rate monitoring, blood pressure, cervical checks, etc.
  • Help with a smooth transition from home to car to the hospital or birth center, and help you get you settled in and calm amidst the check in/question process.
  • Burst into the hospital and boss the staff to make sure they know what is on your birth plan.
  • Work with your partner to help get you comfortable. If she is experienced, she may have been to dozens of births and worked with dozens of dads. If they forget what techniques to use she can respectfully provide some suggestions at the appropriate times. Her suggestions and reminders can help dads feel more confident in the birth process, in helping you, and in being a father.
  • Ignore or belittle your partner or try to do everything herself. She cannot take the place of the oxytocin “love hormone” between you and your partner.
  • Notice the little details that make birth more bearable: When a contraction is coming so she can resume the pain management technique that is helping, the right timing for a cool cloth, a refill on your cup of water, turning off lights when you’re focusing on sensations, pulling back strands of  hair, offering lip balm, and so much more.
  • Be oblivious to your need for quiet and darkness (if that is what you prefer).
  • Check on your partner and make sure he is taking care of himself by snacking and drinking water.
 
  • Know the right time to squeeze your hips or suggest a position change.
  • Let you sit in one spot your whole labor. J
  • Talk with you through your options for pain medication if your preferences change during labor. She can recognize the difference between someone who is coping well and someone who is starting to flip out.
  • Try to convince you to do your whole labor unmedicated because that’s what was on your birth plan or that’s what she thinks is best.
  • Remind you and your partner or clarify any changes in your birth preferences during the pushing stage so you can remind your doctor of your wishes.
  • Step between the doctor and you if it looks like they are about to give you an intervention you said you didn’t want. This is a great way for your doula to get kicked out.
  • Physically assist you in changing positions to something more comfortable for you, even when you think you cannot move during the pushing stage. She might whisper a reminder that you are welcome to push in whatever position seems most comfortable at the moment.
  • Force you to move if there is a medical reason for a certain position.
  • Snap some photos of you and your partner meeting your new family member for the first time. Dad can enjoy the moment without fumbling behind a camera.
  • Take shots that make you uncomfortable knowing your lady parts are recorded on the back of a camera.
  • Recognize when things are getting close and help get your clothing situated during pushing if you are planning on holding your baby skin-to-skin immediately after birth.
  • Strip your top off before you’re ready and let you feel vulnerable.
  • Relay information, answer questions or refer to the nurses for answers as appropriate, encourage you to speak up for your baby if necessary, and reassure you and your partner if something unexpected happens (ex: If your baby’s lungs need to be checked out at the baby warmer across the room where you can’t see.)
  • Grab the baby and bring him to you if the hospital staff is doing a medical task.
  • Observe and assist you through your first breastfeeding. Nursing staff typically thins out by this point so a doula’s reminders, information, and suggestions can help you feel more confident and get off to a solid start.
  • Manhandle your boobs and force the baby on.
  • Help tidy up after your home birth and help you situate your very uncomfortable post-birth bottom so you can enjoy your baby.
 
  • Step back and let you enjoy your precious moments post-birth with your family.
  • Post on social media or text the world that you are in labor or just had your baby. That is your news to share.
  • Follow up with you after the birth and assess for issues within her scope of practice. Sometimes she may refer you to more advanced practitioners if she suspects you may be dealing with serious problems like a baby’s tongue/lip tie or post-partum mood disorders.
 
  • Provide evidence-based resources on baby care, birth recovery, feeding, and parenting skills.
  • Share one-sided information to fit her own agenda.