What Does a Doula Do? The Role of Doulas in Home Birth
Engaging a doula is one of the best decisions a mother can make to support a favorable birth experience and outcome. Though you don’t have to use one to have a positive experience, doulas offer an additional layer of support many women find indispensable.
In my own experience, I received great comfort from my doula during every contraction. She took wonderful care of me, placing a towel with ice water and lavender oil on my head and neck, pouring water down my back, and generally offering a soothing, steady presence for hours on end.
To help you learn more about doulas, let’s get into the specifics: What does a doula do, what types of doulas are there, and what might you consider before hiring one?
What Does a Doula Do?
The main role of a doula is to uplift and support the family unit during whatever transition they’re going through. Doulas aren’t present to replace any family member, but to provide assistance that allows everyone to function optimally in their own role.
For instance, a doula may advise dad on how to comfort mom during labor, like the best way to squeeze her hips or rub her back. Then, when dad needs a break, the doula can take over while he pauses for a quick meal. A good doula doesn’t take dad’s place, but helps him thrive in the role he and mom want for him. For mom, doulas ensure she doesn’t feel unduly stressed or overstretched, allowing her to focus on her primary jobs: laboring, caring for her recovery, and bonding with her baby.
Doulas comprise the non-medical, or non-clinical, portion of a woman’s birth team, providing emotional, spiritual, and physical support as well as advocacy and information. They often work alongside midwives, and though the two roles are distinct, not everyone knows the differences.
While both doulas and midwives play a supportive role during labor and birth, midwives take on the medical aspect of responsibilities. Midwives, for instance, help mothers understand safe options and decide on a birth plan, and they monitor mom and baby throughout pregnancy and labor. Doulas, on the other hand, help advocate for moms’ birth plans and provide emotional, spiritual, and non-medical physical support while following the midwife’s lead on medical subjects.
For a visual representation of how this symbiotic relationship works, picture the doula positioned alongside dad at mom’s head, helping with coaching and visualizing as she pushes. Meanwhile, the midwife is in charge of medical safety, monitoring mom’s progress and baby’s health and helping with the actual delivery.
Many doulas seek certification through programs like Doulas of North America, but not all do. The U.S. doesn’t require certification for doulas, and I’ve personally worked with some phenomenal doulas who, though lacking formal certification, have a natural gift, extensive experience, and admirable dedication for the profession.
One common misconception about doulas is that a woman can only engage one if she’s planning an unmedicated birth. In reality, doulas attend all types of births to provide mothers with information, support, and care.
What Is a Doula? Two Types
Doulas can fill many different needs for women before, during, and after birth. Here, we’re focusing on two types of doulas: the labor doula and the postpartum doula.
What Does a Labor Doula Do?
Perhaps the most well-known type of doula, a labor doula supports mom and her family during labor and birth. These doulas often arrive early during the labor process, staying through the birth and even helping mothers establish breastfeeding and getting them tucked in with their new baby afterward. They’re gifted at identifying what stage of labor a woman is in and reassuring mothers about what’s normal and expected during the process.
Labor doulas typically meet with clients at least once during pregnancy, talking through the stages of labor and finding out the mother’s preferences and birth plan. During labor, they offer guidance, comfort, and advocacy for the mother’s birth plan. A labor doula’s assistance with pain management can help support mothers who want to avoid using pain medications, and many studies show that doula-assisted births are far less likely to end in cesarean sections.
Labor doulas may also make a postpartum visit, especially for clients who struggle with breastfeeding or emotional challenges.
What Does a Postpartum Doula Do?
The postpartum doula supports mothers and their families after the baby is born. Their goal is to provide another set of knowledgeable, helping hands in the home to optimize mom’s rest, healing, and restoration as she deepens her bond with her baby.
Postpartum doulas usually work in shifts, perhaps four to six hours at a time, though this varies according to the situation. Some postpartum doulas might come during the day simply to hold baby and let mom rest or take a shower. Or, they might clean the house, help with childcare, or cook nourishing meals. Others might take overnight shifts, supporting mom by burping baby after a feeding, changing a diaper, and resettling them for sleep afterward.
A postpartum doula’s tasks vary greatly depending on the person, family, and agreed-upon arrangement, but these doulas are gifted at jumping in on the tasks of postpartum life to support and care for mothers. They’re experts at seeing the big picture, prioritizing demands for depleted mothers, and offering support options when moms don’t know what to ask for.
How to Find the Right Doula for You
If you’re looking for a doula, recommendations from friends and family or a referral list from a local mom group can be excellent places to start. You can then reach out to a doula you’re interested in and set up an interview.
The interview could be as simple as a cup of coffee, or it could be a more formal meeting, but the main goal is to discover whether you “click” with the person. They’re going to be present during one of your most intimate life experiences, so it’s important that you feel comfortable inviting them to that space.
Beyond this crucial component, I also recommend asking questions like:
What training have you had?
What services do you provide?
What are your fees?
What is your philosophy regarding childbirth?
Would you be available to meet with me before the birth to discuss my birth plan?
What happens if for some reason you aren’t available at the time I give birth?
For some final questions, I like to ask doulas:
Why are you a doula?
Why are you passionate about birth?
Can you tell me a story of a birth experience that was special to you?
These latter kinds of questions let you see if a person lights up or not in response. You get a sense of whether they will really show up well to support you, or will just treat the role like any other job.
What Are the Disadvantages of a Doula?
Medically speaking, there are no disadvantages to having a doula. In fact, as mentioned, doulas statistically reduce the need for interventions like medications and cesarean sections.
On the experiential side, however, having a doula who isn’t a good fit could be unpleasant, which is why it’s so important to take the time to find a good match. Some women, too, may not want to add another person in the birth room. If you’re easily overwhelmed or just want a very intimate experience, be sure to consider which roles are vital to you on your birth team.
Unfortunately, doulas aren’t covered by most insurance plans, though some health share plans may cover them. If you don’t have doula coverage, however, some communities benefit from volunteer doulas, which can help with financial burden.
What Does a Doula Do? Final Thoughts
While it’s easy to justify the costs of clear-cut medical tasks, not everyone understands what a doula does, or is convinced that doulas are worth the money. Though the support a doula provides isn’t as easy to line-item, in my opinion, it’s every bit as important as medical tasks. It even leads to more favorable medical outcomes.
I can’t recommend doulas highly enough, whether for a first birth or a sixth. I’ve had two babies, and at the time of this writing, I’ve already hired a doula for my upcoming third. Even for a mom (and midwife!) with two births under her belt, working with a doula is non-negotiable for me, and worth every penny.
Carolyn Denning, CNM, MSN
Carolyn Denning, a midwife at Haven Birth and Wellness, grew up in the suburbs of Detroit and earned a degree in Human Physiology from Michigan State University. Her passion for supporting women through pregnancy led her to midwifery, starting as a doula while completing her nursing degree. She gained valuable experience as a Pediatric Emergency and Labor and Delivery nurse at Vanderbilt.
Carolyn and her husband, Dustin, served as missionaries in South Africa, where she supported pregnant women and experienced her own transformative home birth. She is a proud mother of two girls, Levy and Josie, and enjoys traveling, exploring nature, and learning about different cultures.
Disclaimer: The content on the Haven Birth and Wellness website is created and/or reviewed by qualified Certified Nurse Midwives and healthcare professionals. We strive to provide accurate and detailed information for our readers. However, this blog is intended for informational purposes only and should not be considered a substitute for professional medical advice. Your own healthcare provider is best equipped to understand your unique situation and medical history. Always consult with your healthcare provider before making any decisions that may affect your health.