- An option for pregnant women before, during, and after birth is having your own doula.
- Make sure you know your doula personally and professionally.
- Make sure you know the benefits and costs of a doula early on.
A doula is a person who provides physical and emotional support throughout your pregnancy and labor experience. Doulas use a variety of techniques in assisting you through the physical discomfort of the birthing process including breath training and massages, that assist you in creating your own oxytocin. (Oxytocin is a hormone secreted by your pituitary gland. It is often known as the “love” or “cuddle” hormone as it is released by touch and social bonding. This hormone also assists in decreasing pain during labor and increasing postpartum healing.)
Doulas are not considered medical professionals and therefore aren’t licensed to provide any type of medical care or emergency medical support. However, certified doulas undergo training and certification programs that prepare them to be the ultimate labor, delivery, and breastfeeding support partner.
Doulas provide an increased level of knowledge, support, and advocacy for women throughout their birthing experience. Doulas can provide assistance during home and hospital births. The advocacy and support doulas provide services such as accompanying you to doctors appointments, helping you learn what type of birth experience options are available for you, and most importantly helping you communicate your wants and needs with your medical team. Prior to labor, doulas will assist you in creating a birthing plan, learning pain relief and breathing techniques, and finding which labor position may be most comfortable for you. Think of a doula as your personal birth assistant here to guide you in your childbirth journey, and tell her you communicate and assert your needs in times of stress.
Different Types of Doulas
Below we will describe the different types of doulas. But you should keep in mind that most doulas will perform a combination of these services. So be sure that as you meet with your future doulas you ask about what services they personally specialize in.
Labor/ Birth Doulas
These doulas specialize in providing support and guidance through your labor and delivery experience. They assist you in creating your birthing plan, learning breathing techniques, learning the different birthing position, and will support you during labor and delivery.
These doulas specialize in supporting you if you have been put on bed rest due to a high risk pregnancy. They will support you in organizing and planning your daily tasks and providing emotional support through your bed rest period.
These doulas specialize in supporting new parents in the first few weeks of birth. They are typically trained breastfeeding specialist and will help you adjust to your new baby’s sleeping and feeding schedule.
When choosing your doula you want to be sure they are licensed!
There are three main recognized certifying agencies:
- DONA (also known as DONA International) is an international certifying agency for all three types of doulas as well as more advanced doula certifications.
- CAPPA which stands for Childbirth and Postpartum Professional Association, they certify doulas, childbirth educators and lactation educators.
- ICEA which stands for The International Childbirth Education Association who certify for childbirth educators, labor doulas, and postpartum doulas.
This may sound like a lot of information but all you really need to remember is to ask your doula if they have one of any of these three agencies (DONA, CAPPA, ICEA) certify them.
When Should I Start Looking For A Doula?
Some people begin the process of searching for their doulas as soon as they’ve confirmed their pregnancy, but usually you will meet with your chosen doula no later than the end of your second trimester. This gives you time to get to know your doula and build a personal connection before your labor and delivery.
Benefits of a Doula
The practice of doulas has been documented for thousands of years, globally, throughout human history. This is because doulas have had massive amounts of success in helping women through the difficulties of pregnancy and birth. A variety of different academic studies have found that having a doula as a part of your medical team increases positive birth outcomes. One study found that using the services of a doula resulted in a decreased rate of cesareans (C-sections) by 50%, reduced labor duration of 25%, decreased use of oxytocin by 40%, and a decreased request for an epidural by 60% among their study population. Current academic literature on doulas has consistently shown that those who use the assistance of a doula have an easier and faster cervical dilation, reduced length of labor, and an overall more comfortable labor experience. Additionally, newborns delivered with the assistance of a doula show higher APGAR (Appearance, Pulse, Grimace, Activity, Respiration) scores at both the 1 minute and 5 minute mark. Eleven randomized control trials also found that six weeks after birth people who used doulas reported higher levels of breastfeeding and lower levels of depression, and a stronger perceived bond with their babies versus the control group.
Paying For A Doula
Paying for a doula can be a little complicated. Many doulas only accept out of pocket cash payments which can vary greatly depending on the individual doula’s pricing system. But many health insurance companies are starting to cover the cost of certified doulas, and many hospitals are beginning to incorporate doulas onto their medical teams. Once you’ve decided you would like a doula as a part of your birth team, you need to first contact your current health insurance and ask about what coverage they provide. Next you will need to identify a doula in your area that will accept this insurance. If your insurance will not cover a doula and you’re worried you won’t be able to afford the out of pocket cost, begin researching local doulas and their association groups for low income families. Many doulas and doula advocate groups have programs to help lower income parents hire a doula at an affordable cost.
- Continuous support for women during childbirth, Cochrane Database of Systematic Reviews
- The doula: an essential ingredient of childbirth rediscovered, Acta Paediatrica
- A randomized control trial of continuous support in labor by a lay doula, Journal of Obstetric, Gynecologic, & Neonatal Nursing
- Doula care, birth outcomes, and costs among Medicaid beneficiaries, American journal of public health