One of the most common questions I hear, often even during a consultation interview, is “what IS a birth doula, anyway?”
I hear frequently from families who have decided to look into hiring a doula because friends or family members encouraged them in that direction. But they aren’t quite sure what a doula is or does, how a doula is different from a midwife, or whether a doula is really right for their situation.
So, what is a birth doula? Read on to learn more about the role, scope, and training that make birth doulas what they are (and what they are not).
1. An Educated Birth Professional
A doula is a person (typically a woman, but not always) who has been educated about the normal physiologic processes of pregnancy, labor, and delivery. This education may have come from a certification course, an apprenticeship, self-directed education, or from working in a related field such as maternal-fetal nursing or midwifery.
A doula’s education is important because a doula is an educator! One important thing you can and should expect from a good birth doula is education about evidence-based birth practices, labor coping and management, the progression of your pregnancy, and your rights as a patient in the care of a doctor or midwife.
2. A Birth Support Person
You may have heard a doula described as a “labor coach,” “birth support worker,” or “childbirth assistant.” All of these descriptors can be accurate. Like a running partner when you’re training for a marathon, a birth doula is there to encourage you as you prepare for and then undertake the endurance race of giving birth.
How closely your doula matches those specific descriptors will vary both on the individual doula and on your needs. Some people don’t want or need active “coaching” in their labor and are more interested in having someone there to simply witness or provide silent support to their birth experience. This is a practice often referred to as "holding space."
Other people are looking for an active guide and cheerleader. Every doula brings her own style and approach and should be able to share with you whether she feels she can provide the style of support that you need.
3. An Unbiased Partner
Doulas don’t have an official “code” or “pledge.” We don’t recite the Hippocratic oath when we become doulas. But nearly all doulas share a strong belief in the idea that a woman has the right to be in charge of her own body, especially during the emotionally and physically significant moments associated with pregnancy and birth.
Because of this, doulas work hard to learn how to set aside personal ideas and preferences in favor of helping make sure you have the birth that YOU want and need. A doula is there to support you in making the decisions that you feel are best and to help you advocate for yourself during your birth experience without her personal bias getting in the way.
What a Birth Doula is NOT
There are other things that a birth doula should not do as it is outside the scope of her training. When you hire a doula, you should not expect her to be able to be the following things for you.
1. A Medical Professional
While doulas are often highly educated about things that relate to the practice of medicine, such as physiology, anatomy, medical jargon, and so on, they are not medical caregivers. A doula cannot prescribe medicine, diagnose or treat illness, or safely give medical advice or opinions. A doula does not fill the role of a medically trained care provider such as an OB/GYN or a CNM or other midwife.
A doula’s role is strictly on the non-medical side of birth work. While this can often include translation of medical terminology, or explanations of research and evidence about birth, it should never include direction about what medical decisions you should or should not make.
2. A Replacement For Your Existing Support Network
Some women who hire doulas do so because they do not expect to receive any birth support from a partner or family members. But if you have a partner, family, or close friends who want to support you, they need not feel that a doula is a replacement for them! A birth doula can provide education and support to your entire birth team and can help empower your partner or other family members by giving advice and suggestions for the best way to support you.
Some of the most rewarding work I do as a doula is helping fathers feel that they know how to support their partners during labor and birth. In our culture, men often have little to no experience of birth before their own first child is born and they may feel uncertain and anxious about how to provide for their partner in a totally uncharted situation. A doula is not there to push your partner to the side but to help show him or her what they can do to be involved.
3. A Decision Maker
Your birth doula is not there to make decisions or choices about your birth but rather to make sure that you are reminded and empowered to make decisions for yourself. This is the opposite side of being an unbiased partner -- a doula MUST remain hands off when it comes time to make decisions about your care. This can be frustrating when you feel that you don’t know what to do in a given situation! But ultimately you are the one who has the right to consent to or decline each step of your care, and so it is you who will have to decide.
Your doula is not there to tell you how your birth should go or what you should do or not do. If you make a plan and then change it at the last minute, it’s ok! Your doula is not there to tell you what to do but to help you when your decision is made. I have had clients who wanted a natural birth who decided at the last minute to have an epidural. I have also had clients who wanted an epidural and decided at the last minute to try birthing naturally. Those births have been marked by the joy of knowing at the end that each family did what turned out to be best for them in that time.
A Birth Doula is an Evidence-Backed Resource For You to Use
Most importantly, a birth doula is a resource that you can use, backed by research and evidence. The data suggest that having a birth doula, even if your doula is hands-off and quiet throughout your labor, can shorten the average length of labor, reduce the likelihood of interventions such as epidural and C-section, and increase your chances of feeling satisfied with your birth.
What do you think are the most important attributes of a doula? Share in the comments below!
Shama Doula Services offers full-spectrum support from conception to birth and the postpartum period. Interested in learning more or scheduling a free consultation with doula Beth? Click the button to request more information and get started.