Originally published September 2011 @ Philly Parent Circle 

The word doula is an ancient Greek term that translates into “caregiver” or "woman of service" and has been used over the past several decades to describe a woman who provides various non-medical support measures such as emotional support, pain management and relaxation techniques, and information during pregnancy, birth, and the postpartum period.  A doula is professionally trained to provide continuous physical, emotional, and informational support to mothers and their partners so they may have their best birth and parenting experience.  Support can consist of anything from recommending books about pregnancy and breastfeeding to helping make a birth plan to offering a hand to hold or giving a massage during labor. Having a doula can provide expectant couples with the tools to self-advocate in a medical setting and ensure that their experiences are honored and that they are safe. In addition, doulas are there to help validate the women's experiences and choices surrounding their pregnancy outcomes, on their terms. There are two primary types of doulas, birth and postpartum, and we will discuss both in more detail below.

A birth doula “mothers the mother,” by providing continuous, non-medical, non-judgmental, one-to-one support throughout pregnancy and the birth of your baby. Your doula will come to your house to answer questions, help you pack for the hospital, and create a birth plan as you prepare for the big day. During labor, your doula provides the encouragement, knowledge, and comfort measures you need to help you cope with each stage. Using techniques such as massage, breathing and vocalization, counterpressure, visualization, and softening exercises your doula provides a greater sense of relaxation. Your doula will also facilitate communication between you and medical staff and educate you on your birthing options, so that you can make the very best decisions for your childbirth.  By supporting both the mother-to-be and her partner, the partner also experiences a greater sense of relaxation, and therefore has an increased ability to care for the mother-to-be on an emotional level.  A birth doula makes available the nurturing care and support that traditional obstetrical care isn't always able to provide.  Clinical studies show the benefits of working with a birth doula include:

  • 50% reduction in cesarean rates
  • 25% reduction in the length of labor
  • 60% reduction in the rate of epidural use
  • 40% reduction in the need for forceps/vacuum 
  • higher breastfeeding rates

Other benefits include:

  • higher levels of confidence in partners as coaches
  • increased maternal sense of satisfaction in the birth
  • overall sense of well-being following delivery
  • easier transition into parenthood

The doula understands not only the physical processes of labor and birth but also the emotional needs of both the laboring woman and her partner. A doula perceives birth as a profound experience that the mother will remember all of her life and works to safeguard that experience, to the best of her ability,as dictated by the mother’s wishes.  The doula does not judge the mother’s choices, but works to support the mother giving her the confidence to have her best birthing experience. Women who have had a doula present at their birth report greater feelings of satisfaction with their birth experience and less incidence of postpartum depression.

Women are often concerned that their partners will feel replaced or unnecessary if they hire a doula. A doula is trained to provide support to both the mother and her partner, and she strives to support the partner to become as involved with the labor and birth as they feel comfortable. Studies show that with a doula present, partners tend to stay more involved, not less.  A woman’s partner, family members, and friends offer a different type of support than the doula.  The people that mom is emotionally tied to provide a loving, emotional support that is invaluable.  The doula provides, physical comfort measures, emotional support, and information.  Many women take solace in knowing they are fully supported by their partner and doula during labor. 

Couples oft-times question the necessity of a doula if a woman is planning to use pain medication or is having a scheduled cesarean. Research shows that “women who have had epidurals expressed just as much need for continued support as women who had un-medicated births, so much so that satisfaction with the support received during labor had more influence on the woman’s satisfaction with her birth experience than her level of pain relief did”. From our extensive experience in the field, we have seen women requesting pain medication or having scheduled cesareans need just as much continuous emotional support, and maybe even more, than women having non-medicated birthing experiences.  Because a doula customizes her support to the needs of each individual client, a doula can enrich your experience during any kind of birth: natural, hospital, epidural-assisted, or vaginal birth after cesarean (VBAC).

Postpartum doulas can be a great resource after the birth of your baby.  A postpartum doula helps ease the transition into parenthood and is intended to provide a much more personalized kind of support than most women receive from doctor’s visits, parenting books, and online information.  A postpartum doula offers educational support regarding breastfeeding and infant care, as well as support for the mother as she recovers emotionally and physically from the birth. Additionally, theyprovide light meal preparation, assist with newborn tasks, errands, and most anything else that helps a household run smoothly. They do not take over care of the baby, nor do they do heavy housecleaning tasks. Traditionally, women have been surrounded by other wise and caring women as they recovered from birth and adjusted to life with a newborn.  Having someone who is familiar with newborns come to your home on a regular basis can be very reassuring especially in the first weeks after your baby is born.

When inviting a doula into your birth or postpartum experience it is very important to make sure that the doula is a good match for your family.  Many doulas offer a complimentary consult to answer questions and provide a face-to-face meeting for an expectant couple.  It’s important to ask a doula about her training, certification, birth and parenting philosophy, and previous birth and postpartum experience.  A doula may be certified or in-training from an organization such as Doulas of North America (DONA).  DONA is recognized as the oldest, largest and most respected doula association in the world.  The rates for a doula will vary based on your geographic location and the doula’s experience.  Typical rates for the Philadelphia and Main Line area range from $600 for a doula-in-training up to $1200 for an experienced doula.  A doula supports both mom and her partner in having their best birth and parenting experience. If you are interested in learning more, or wish to hire a doula and live in Southeast Pennsylvania, Southern New Jersey, or Northern Delaware please visit our website.

Nikki Graham and Christina Duff are two of the amazing educators at Well Born Baby; a team of Certified Doulas, Childbirth Educators, Professional Counselors, and Lactation Consultants empowering women in Philadelphia, along the Main Line, and the surrounding suburbs to become confident mothers.  They prepare you for the big day from helping you write a birth plan to informing you of your choices surrounding your baby’s birth.  After you welcome your little one, they're on hand to help as you navigate the world of motherhood. Follow Well Born Baby on Facebook.