By definition, a doula is a certified professional, who provides personal, non-medical support to women and families throughout a woman’s pregnancy, childbirth, and postpartum experience.1 However, even knowing this, the role of a doula can be somewhat unclear, especially to someone hearing the word doula for the first time. What does a doula do? How is a doula different than, say, a midwife? The following information will help to clarify these questions and explain the overall role of a doula.
The best place to start is explaining what doulas do. In a nutshell, doulas provide continuous support to women in labor; in other words, they are with women constantly. They do not have other patients, like a nurse or doctor would, to attend to. A doula’s full attention is on the mother she is supporting. She (or he, though most doulas are women) only leaves the room to take a quick break or at the request of the mother or couple. Throughout the whole experience, doulas continuously provide emotional,
physical, and informational support.
Perhaps the foremost of those three is providing emotional support. Imagine running a marathon without someone cheering you on or the support of your friends, running partners, or family. Childbirth is very demanding, and having someone there to encourage you, to support you when you feel you can’t keep going, and to celebrate with you is crucial. A doula provides such support constantly, without interruption.
She also provides physical support. A doula is well-trained in knowing and suggesting different positions for a laboring mother to get into to both provide her comfort and also to facilitate the progression of labor. A trained and experienced doula is good at reading the signs of labor. If labor stalls, she suggests a variety of positions for the mother to labor in, each time gauging the progression. Mothers with doulas often walk, change positions, or use a variety of supports like birth balls, birthing stools, or perhaps a supported squat with the help of her partner.
All the while, doulas provide informational support, too. The end goal of having a doula is not to have a “natural,” or un-medicated birth, as most people assume. The goal of a doula is to help the mother become an informed decision maker, so she can know her options and make informed decisions about her birth, as much as the circumstances allow. More and more, there is a push (pun intended) to have all patients, in all areas of healthcare, informed of their options so they can make decisions according to their own desires and values, again, as much as the circumstances allow. This emphasis allows the woman to feel as though she is an active agent in her birth experience, instead of feeling as though birth is being “done” to her. Doulas play a critical role in helping mothers to understand their options, so they can make decisions accordingly.
It is also important to know what a doula does not do. First, a doula is often confused with a midwife. While doulas may work hand-in-hand with midwives regularly, a doula is not qualified to perform any medical procedures, deliver a baby, or make decisions about the health and well-being of the mother or baby. A doula also does not advocate for the mother on her behalf. For instance, a doula would not talk directly to the provider on behalf of the mother about whether or not to perform a procedure. The mother makes the decisions about her birth experience, not the doula.
Finally, a doula does not replace the partner or anyone else in the room. This last piece is often misunderstood, as well. Many women say they do not need or want a doula because they have a supportive partner. A doula is not meant to take the place of the partner. Instead, she works with the partner, such that both have a synergistic relationship in supporting the mother. Labor can be very long and taxing. Supporting someone through that experience can become very draining, especially if labor goes particularly long. Even the most loving and supportive partner might wish for some support for him or herself or simply just a break. A mother never stops laboring, so she should never have a gap in support. Having a doula alongside a partner helps to achieve the goal of continuous support.
There is much more that a doula does for a mother, so this is just a glimpse. Because a doula traditionally meets multiple times with mothers in the third trimester of her pregnancy, to discuss her hopes and plans for birth, the two often form a relationship prior to birth, only deepened by sharing such a momentous time together. When a woman gains a doula, she not only gains a support but also a friend.
1. Doula HB 3311_Available at: http://www.oregon.gov/oha/legactivity/2012/hb3311report-doulas.pdf. Accessed March 29, 2014.