What Does a Doula Do? – A Brief Overview

There is much evidence to support the idea that having a doula alongside a laboring woman, and her partner, is valuable and beneficial to the entire birth process. One aspect of having a doula that is not discussed at length in many publications is the fundamental simplicity and beauty of a woman helping another woman. It cannot be overlooked that more women need to hold space for other women in general. In our culture we seem to be moving away from generational connections between women. No place is this need of support more crucial than during the labor and birth process. As birth is the most intense experience a woman will experience, both physically and mentally, another woman beside her offering continuous emotional and physical comfort, will only serve that birthing mother in the most positive of ways.

Evidence shows that birthing mothers are more likely to have spontaneous vaginal births, have shorter labors and less medical interventions when a doula is present. As a continuous support, and, specifically, one who is knowledgeable about labor and delivery, a doula can suggest various comfort measures to allow a woman to endure the powerful surges of contractions and delivery. These comfort measures include, but are not limited to, position changes, breathing techniques, counter pressure and massage techniques, relaxation strategies and, when available, a warm shower or tub. The utilization of all, or one, of these measures often allow a woman to manage the pain associated with labor and, therefore, reduce the likelihood of an epidural. Long-term studies show that one medical intervention often leads to other interventions. Many women would like to try to avoid this string of events, if possible. It is important to note, however, that if a woman does choose an epidural, a doula will help ensure that she is fully informed and comfortable with her decision. A doula’s main goal is to ensure that a woman feels empowered, informed and a part of all decisions made in regard to her labor, especially when medical interventions are suggested or insisted upon by the medical team. (Obviously if an emergency situation emerges, the doctors may not have time to explain things in detail. The health of the mother and baby are everyone’s immediate concern.)

Most often, doulas visit a client and her partner, in their home, during the last trimester of the pregnancy. During these prenatal visits, the clients and doula get to know each other and develop a relationship. This ensures a sense of comfort for the couple (and the doula) at the birth. The home visits enable the doula to get to know the couple and what they want their birthing experience to look like if all went their way. A doula’s job is to meet the client and her partner where they are. Their job is not to judge or push their personal beliefs on them. This is their experience. The prenatal visits are also the place where the doula explains her role and scope of practice. It is made clear that a doula doesn’t offer medical services of any kind. It is always recommended the couple defer to their medical provider for specific questions regarding her pregnancy. What a doula does offer, however, is an overview of what to expect, suggestions of different comfort measures (as discussed above), help in writing a birth plan, suggestions of questions to ask their provider regarding interventions, etc. While a doula should never speak to the provider on behalf of the client, she can remind the client of her birth plan and ask her if she has any questions to ensure she is fully informed prior to any action taken by the medical provider.

Some couples worry that a doula will take away some of the experience for the partner. The doula is not there to take anything away, but, rather to support their relationship and work in conjunction with them as a team. Partners are encouraged to get involved as much as they are comfortable. A doula will assess how she will interact with the couple as she observes how they interact with each other. Partners often find comfort in having a knowledgeable and calm person along for the long ride of labor (even if hesitant to start with). A doula honors their relationship and what this birth experience means for both of them.

Labor and delivery is an experience one cannot fully predict. It can be a combination of thrilling, joyous, scary, painful, wonderful, and everything in between. One “constant “ a couple can count on is a doula. She will join them on the crazy ride of labor and be alongside them from beginning to end. This, in turn, creates a calm presence and continuity for the couple, which can allow them, hopefully, to greet their new baby with joy no matter how rocky the road was to get there. The goal for the doula is to have the couple have positive memories of the birth experience that will last a lifetime. This sort of positive experience not only affects that particular family, but, in a larger sense, society as a whole. Doulas simply hope to make each birth story a little bit sweeter, while, for themselves, having the honor to witness new life entering the world.

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