Frequently Asked Questions
What is a doula?
A doula is a person who provides
physical, emotional and informational support during pregnancy, labor, birth
and postpartum. She is trained to provide emotional and physical support through
labor, assisting women and their partners with various comfort measures as
labor progresses, as well as instilling confidence in the woman's ability
to birth her baby. It can be difficult to navigate the twists and turns of
labor when things come up that are unexpected. A doula will draw upon the
relationship she has established with her clients to help honor the wishes
and plans they have for their birth. And if
changes must be made she will help them make informed decisions about their
care by advocating for themselves and getting the information they need from
their caregivers. A doula will stay by the couple's side through labor and
for an hour or two postpartum and she will not have a shift change. Her only
responsibility is to the clients she is serving at that time.
Why use a doula?
In order to have a positive birth experience, most women need continuous labor support. Although obstetrical nurses are experienced in dealing with a laboring woman's emotional and physical needs, they can seldom guarantee the support they provide will last throughout the labor - especially in hospital settings where shift changes, breaks, heavy paperwork and busy nights regularly occur. Some OB nurses handle up to six laboring women at a time. Midwives may be able to offer some labor support, but they too have clinical duties to which they must attend. However, the doula will remain with the couple through the duration of labor and can provide many techniques to assist in comforting the laboring woman and her partner.
Studies also show that when a doula is present there is a significant reduction in the length of labor, lowered use of pain medications, fewer interventions (like pitocin, vacuum extraction forceps, or cesarean sections), as well as lowered risk for postpartum depression. A doula can also be instrumental in helping the woman feel secure and cared for, promoting breastfeeding success and greater self-confidence in the mother, and encouraging a smoother transition to new family dynamics after baby's arrival.
Will a doula replace the husband/partner and make him feel unnecessary?
No, a doula does not take the place of the partner or husband. In fact, a doula enhances their role by making sure the partner is taken care of and encouraged, too. Research in this area indicates that the presence of a doula during labor actually increases the physical support and affection shown by the partner. The role of the doula is to provide not only comfort and information to the mother, but also to demonstrate effective techniques that can be used by the partner during each stage of labor, to offer reassurance about the normal progress of labor, and to allow the partner the freedom to simply be with the mother and love her without any pressure to 'coach' her or relieve her pain.
A doula supports and encourages the father and enhances his support style rather than replaces him. A doula's role changes, depending on the needs of the couple. She may be the primary support person for the woman or have more of a background role of support, providing gentle reminders of how to ease discomfort or encourage labor progress. She is supportive of both the mother and her partner, and plays a crucial role in helping the partner become involved in the birth to the extent he or she feels comfortable.
The father or partner, may be extremely willing and able to provide continuous emotional and physical support but has little actual experience dealing with the forces of labor. Even fathers who have had intensive preparation are often surprised at the amount of work involved (more than enough for two people). Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a strenuous environment. If it comes time to make decisions about the course of labor, the doula can instill clarity and confidence in the couple by drawing upon information shared at prenatal visit regarding their birth wishes to insure that an informed and well-communicated decision is made.
Does a doula make decisions for the woman?
No, a doula does not make decisions for the woman or intervene in her clinical care. The doula's role is to help her effectively communicate with her caregivers. The doula provides informational and emotional support, while respecting the decisions of the couple. She can help them get the information required to make an informed decision regarding their care, and can encourage good communication with their hospital caregivers.
Does hiring a doula mean having to labor without pain medications?
No. A doula is there to support the woman's decisions every step of the way whether she chooses to have pain medications or not. It a woman intends to use pain medications, there is usually still a need for hands-on labor support until a steady labor pattern has been established and an epidural can be most successful. However, if the goal is to have an unmedicated birth, a doula can be an integral part. She will help the woman stay focused on her birth plan and can provide a variety of coping techniques and comfort measures during labor that will aid in relaxation and encourage labor progress. She can also provide reassurance and a belief in the woman's ability to achieve the natural birth she desires.
Does a doula replace the nursing staff?
No, a doula does not replace the nursing or medical staff. She does not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postpartum clinical care. A doula is there to comfort and support the mother and to enhance communication between the mother and medical professionals. She can also enhance the role of the medical staff, allowing them to perform their tasks confident that the laboring woman is getting continued support when they have left the room to tend to their other patients.
What is a doula's role at a cesarean birth?
A doula can still be a source of informational, physical and emotional support with a cesarean birth. She can stay by the woman's side during the procedure, if permitted by the care providers, and can help preserve the events of the birth through video, photographs, or by writing them down on paper. If the husband remains in the operating room following the birth, the doula can accompany the baby to the nursery. Once the mother is settled back into her room, a doula can bring the baby to her when requested as well as show her breastfeeding positions that won't irritate her incision site.
What if the woman gets an epidural?
The majority of women giving births in hospitals will receive epidural anesthesia. But most doctors will not allow an epidural until the woman has reached 4-5 cm dilation. This could take a very long time in some cases. The doula can provide hands-on labor support using the many comfort measures in which she is trained, helping the woman progress in labor to a point when the epidural will be most effective. After the epidural has been administered, the doula can protect the woman's back and hips by maintaining appropriate positioning for her. She can also keep the couple engaged in the labor and help them feel more connected to the birth by talking about their child's upcoming arrival. A doula can also be an invaluable support during the pushing phase of labor. When the legs and lower torso are numb it can be difficult for a laboring woman to push effectively. A doula can remind her how to push and encourage her with each contraction, affirming her efforts.
