What is a Doula?
As a doula myself, I tell my patients that a doula is like having their best friend at their birth, with the added benefit that their best friend knows all the "tricks of the trade" to help provide the quickest, most comfortable birth possible.
Doulas are trained in the art (and it is an art) of birthing. They provide knowledge during the time prior to the birth, prepare the mother and her support partner for the birth process by teaching relaxation and breathing skills, and act as an "interpreter" when the mother has difficulty understanding medical terminology or when she is too stressed to process information from medical staff. Doulas bring birthing aids, such as a birth ball, aromatherapy, music, massage tools, and even games, to help ease their client's discomfort and to pass the time. During the birthing process, doulas assist with position changes and breathing techniques, and they offer support and encouragement.
A doula does not take the place of the support partner; she understands that often the support partner is excited, nervous, and distracted by his or her own emotions and may not be able to provide the kind of support the mother needs. A doula assists the couple by focusing on meeting the mother's needs, thereby taking pressure off the support partner. She sometimes teaches the partner how to provide comfort and support. Also, when a laboring mother has no support partner, a doula can be an invaluable resource for her.
Doulas do go through a training process, but they are usually not medical professionals. It seems to me that the doulas I have had the pleasure of working with over the last seven years are, and I use this term endearingly, "birth junkies." They are women who choose to become doulas often because they either had very negative birth experiences themselves and want mothers to have a better experience, or they had a wonderful birth experience and want all mothers to experience the same. I must stress, however, that giving birth is not a prerequisite to becoming a doula. Some of the best doulas I have worked with have never given birth!
A mother who decides to work with a doula usually meets the doula during her last trimester. At the meeting, the doula asks the client about her concerns and fears. If this is not the mother's first birth, the doula and the mother discuss ways the mom would like this birth to be different from her last birth. The doula gives the client and her support partner information, training, and tools to make the birth more comfortable and manageable. The doula does not perform any medical duties during the birth. Her main concern is the wishes and needs of the mother and her support partner. Doulas have no agenda of their own; they focus on the mother's comfort.
During the weeks prior to birth, doulas are usually available for questions and concerns.
Then, depending on the couple's preference, she may meet the couple in their home when early labor begins and work with them until they decide to leave for the hospital. If the client prefers not to have the doula present for early stages of labor, the doula may meet her at the hospital once she is in active labor. The doula stays with the client until the birth is complete, which could be anywhere from two hours or two days. She also stays for an hour after the birth to help the mother breast feed or help the mother/couple bond with the new baby.
Generally, a doula meets with the couple at some point during the postpartum period to review the birth with them. I always tell my patients that their baby's birth is like their wedding—they were there, but sometimes they feel like they missed it. It's so nice to be able to re-live the birth through someone else's eyes, and a doula makes that possible.
The cost for a professionally trained doula varies. The average cost for a doula is usually between $500 to $1,000. Some institutions provide doulas to their clients free-of-charge. Even if a mother must pay for the doula, hiring a doula is one of the best investments she can make. I have suggested doulas to countless couples, and the feedback from them and their support partners has been wonderful. A doula can help to ensure a positive birth experience and is, therefore, a worthwhile expense.
