What Is A Doula?

CAPPA‘s definition:  A doula is a woman who attends the birthing family before, during, and just after the birth of a baby.  The certified doula is trained to deliver emotional support from home to hospital.  She eases the transition into the hospital environment, is there through changing hospital shifts and alternating physician schedules, serves as an advocate, labor coach, and support partner, to give the mother and her partner the added comfort of additional support throughout the entire labor.  There is a variety of titles used by women offering these kinds of services such as “birth assistant,” “labor support specialist,” and “personal labor assistant.”

The Birth Book‘s definition:  [A doula] is an anchor offering emotional support to the laboring mother as well as praise, pep talks, encouragement, and empowerment.  She helps keep your birth wishes in perspective if complications set in and difficult compromises and decisions need to be made.  She affirms and works through joyous accomplishments and disappointments in the postpartum period.  This special person is also a teacher, instructing the mother in labor-saving techniques, answering questions, explaining labor events as they occur, and preparing the couple for what is ahead.  The anticipatory guidance she provides can alleviate most of the fear of the unknown.  She makes no medical decisions but helps interpret the suggestions of the medical attendants to the parents.  She assists the parents in asking the right questions so that they are informed enough to take an active part in the decisions.  She also helps ensure that interventions are avoided or at least decided on mutually.  She has a sensitive presence, knowing when actively to assist the mother and when to retreat quietly into the shadows and leave the laboring couple alone so that the mother does not feel watched or judged.  Best of all she is a comforter, touching and tuning in to the mother during contractions, helping her relax, and assisting her in using her natural resources to ease her discomfort and steady the progress of labor.  And when the mother’s strength seems gone, her own strength is offered to the woman, encouraging her beyond her perceived limits to meet her goal of birthing her baby.

A doula works to create a positive birth experience by providing a continuous presence during the birth, nurturing the mother, and offering physical comfort measures through breathing, relaxation, positioning, and movements, as well as emotional support and encouragement.

A doula is knowledgeable about the labor process, breast-feeding, and newborn and mother care.  She is available to provide evidence-based information and support a mother and her partner as they make informed decisions about the care of mother and baby. 

A doula offers continuous encouragement and reassurance to laboring women.

A doula encourages and motivates a woman to feel in control of her pregnancy.

A doula strives to reduce tension and fear and increase feelings of safety and confidence during a mother’s labor.  Studies have found that the presence of a doula offers numerous benefits both to the mother and baby.  Women with support have a reduction in the duration of labor, less use of pain relief medications, lower rates of operative vaginal delivery, and, in many studies, a reduction in cesarean deliveries.  Newborns in supported births have lower rates of fetal distress and fewer are admitted to neonatal intensive care units.  In addition, one study found that six weeks after delivery, a greater proportion of doula-supported women, compared to a control group, were breastfeeding, and these women reported greater self-esteem, less depression, and a higher regard for their babies and their ability to care for them.  It has also been noted that women in the doula-supported group reported their infants as less fussy than the group without any doula support.

What A Doula Is Not

A doula is not a replacement for medical staff (OB/GYN, Midwife, or Nursing Staff).  A doula can not offer medical advice or diagnosis.  A doula can not perform clinical tasks, such as vaginal exams or fetal heart-rate monitoring.  While a doula may assist in gathering information, she does not make decisions for a mother and her partner or act as their voice.  A doula does not impose her own goals or ideals on a mother or her partner.

The roles of the doula and medical staff are vastly different.  The main role of a doula is to ensure the woman feels safe, encouraged, listened to, and supported.  The main role of medical staff is to ensure the safety of the mother and baby.  The work of a doula and the medical staff should compliment each other.  Ideally, they will work together to help ensure a safe and positive journey along with a safe and positive outcome for mother, baby, and partner.