The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to trained and experienced professionals who provide continuous physical, emotional and educational support before, during and just after birth; or who provides emotional and practical support during the postpartum period.
What does a doula do
The doula-client relationship can begin at anytime but usually begins a few months before the baby is due. During this time, the doula develops a relationship where the birthing person (and partner) feels free to ask questions, express fears and concerns, and takes an active role in creating a birth plan. Doulas make themselves available to the mother by phone or email in order to respond to their questions or explain any developments that might come up during the course of the pregnancy. Doulas do not provide any type of medical care. However, they are knowledgeable in many medical aspects of labor and delivery. Consequently, they can help their clients gain a better understanding of the procedures and possible complications of late pregnancy, delivery or during the postpartum period.
During delivery, birth doulas are in constant and close proximity to the birthing person. They have the ability to provide comfort with pain relief techniques that include breathing techniques, relaxation techniques, massage, and laboring positions. Doulas also encourage the partner to participate at their comfort level and offer reassurance. A doula acts as an advocate for the family, encouraging and helping fulfill specific desires that they might have for their birth. The goal of a doula is to help the birthing person experience a positive and safe birth.
After the birth, many labor doulas will spend some time helping begin the breastfeeding process and encouraging bonding between the new baby and other family members. Postpartum doulas will provide support in the first few weeks to months after baby is born. The postpartum doula offers many services to their clients, but their main goals are to help the birthing person and nurture the entire family as they transition into life with a newborn. This would include doing things to help the whole family feel more confident in their roles, sharing education on family adjustment, and tending to the unique needs of new parents.
When should I hire a doula?
Ideally, you should hire your birth doula sometime in your 2nd trimester. It gives you plenty of time to interview potential candidates & then gives you time to get to know each other. However, in more metro areas the sooner you look, the better, especially for a baby due in the summer months or around holidays. Postpartum doulas can be hired after the birth of a baby but it is usually better to interview and hire a postpartum doula before birth as you will most likely have more time and will be able to book the time you are most interested in.
What effects does the presence of a birth doula have on birth outcomes?
Numerous clinical studies have found that a doula’s presence at birth:
tends to result in shorter labors with fewer complications
reduces negative feelings about one’s childbirth experience
reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction
reduces the requests for pain medication and epidurals, as well as the incidence of cesareans
Studies have also shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate parents in the postpartum period.
What services does a postpartum doula offer
Some of the duties that a postpartum doula will perform include:
Help with the emotional and physical recovery after birth
Light housekeeping so that the parents do not feel so overwhelmed
Assistance with newborn care such as diapering, bathing, feeding and comforting
Light meal preparation
Baby soothing techniques
Referrals to local resources such as parenting classes, pediatricians, lactation support and support groups
Most postpartum doulas provide service for a family anywhere from a few days up to a few weeks after bringing home a new baby. Families may have the doula work 1-3 days a week or as many as 5 days a week.
Does a doula make decisions on my behalf?
A doula does not make decisions for clients or intervene in their clinical care. They provide informational and emotional support, while respecting a family's decisions.
Will a doula make my partner feel unnecessary?
No, a doula is supportive to both parents and any other family members, and plays a crucial role in helping a partner become involved in the birth to the extent they feel comfortable. A postpartum doula will help the whole family by providing support and education including baby care. "A doula has an intimate knowledge of birth, while your partner has an intimate knowledge of you." Jennifer Valencia
Do I need a doula if I'm taking a childbirth class or baby basics class
Doulas will help to further explain and clarify the information from your classes. Your doula will be with you to remind you (and your partner) during labor and after your baby's birth of the things you have already learned in your class.
If hire a doula what happens to my options for pain medication in labor
Nothing. Some people may assume that a doula is not for them based on the common misconception that doulas will only support a un-medicated birth. Some people who desire doula services thought they would be ineligible due to their plans for pain management and other common birthing situations.
This is your birth. A doula is there to support you during your birth. It’s as simple as that. Everyone has their own agenda walking into each birth, you, your partner, your families, the nurses, the doctors, the tech who comes to draw your blood, everyone. A doula comes into the door with an open mind, loving heart and strong body.
A doula cannot tell you how to birth, only give you ideas and tools derived from evidence based care to use during your pregnancy, labor and immediately postpartum. A doula can remind you of your choices but ultimately it's your choice to implement these ideas.
If you choose to use IV medications or an epidural as pain relief during your birth, it is just that, your choice. It is not within a doula's scope of practice to tell you whether or not to use these forms of pain relief. Doulas will help you find the information necessary to make an informed decision about your pain relief choice, and support you no matter the decision you make.
Should you choose to have your labor induced or to have a surgical birth, this also does not preclude you from having doula support.
If you still have questions about whether or not you want a doula to attend your birth, please do not hesitate to ask. We are more than willing to answer your questions during a free initial consultation so you can make a more informed decision.
How much does it cost to hire a doula?
This varies somewhat, based upon the services the doula provides, experience level of the doula and your location. Average birth doula services in the South Jersey/Philadelphia area range from $400 to $2000 and a postpartum doula can charge anywhere from $15 to $50 per hour. However, we feel that everyone deserves a doula if they want one. Whenever possible THBS is willing to set up a sliding scale or payment plans for those with those who find affordability a concern, or will help you in finding another doula who can serve your birth. Finances should never be the deciding factor in your choice to hire a doula.
Are the costs of Two Hands Birth Services covered by my insurance?
As more and more families are choosing doulas for both birth and postpartum, and more research is being done showing the positive benefits of doulas, more insurance companies are covering the cost of doula services. Many insurance providers will also cover the cost of lactation counseling and childbirth classes, whether private or in the hospital. Postpartum doula service may also be paid for using money from a family’s flexible spending account (FSA) or health savings account (HSA) dependent on what the guidelines are for their particular plan. Although it can't be guaranteed your insurance company will reimburse for services. Two Hands Birth Services will provide all receipts and any information you may need for filing insurance reimbursement.
What are the benefits of breastfeeding?
Breastfeeding has so many benefits for baby, the breastfeeding parent, the whole family and the environment. Le Leche League International has a great page and many resources about the benefits of breastfeeding. Two Hands Birth Services offers many classes and sessions to guide you to a successful experience with your baby.
Photo by Hayden Trace
"To discuss my experience with Vanessa, she was nothing short of amazing. My husband and I chose a natural water birth, and without Vanessa I'm not quite sure I would have made it through those contractions without an epidural. Vanessa was attentive, supportive and flexible."