As a mom of two who's been writing about parenthood, pregnancy, and kids pretty much since my oldest child was born (she's about to turn 7), I like to think I'm pretty well-informed about all things in the realm of motherhood. Recently, however, I hit it off with a friend of a friend on a girls' night out, and after a couple of glasses of wine and some chitchat about our kids and mutual acquaintances, I asked what she did for work. When she informed me that she's a doula, I was surprised. Not only was I not sure exactly what a doula was, but I assumed if I ever met one, she'd be covered in henna tattoos, carrying a mug of hemp tea, and constantly touting the virtues of water births. I was totally wrong.
Luckily, my new friend Tina Morton of Cloud Nine Births, located in St. Charles, IL, about an hour west of Chicago, was willing to set the record straight about her profession. Here's everything you need to know about doulas if you're pregnant and thinking about hiring one, and why you might want to consider looking into it even if you're not.
What Exactly Is a Doula?
There are two types of doulas, according to Morton, who's certified in both types. A birth doula supports a mom and her partner prenatally and during labor. Their goal is to "help expecting mothers have a safe, memorable, and empowering birthing experience," Morton says. During pregnancy, the doula will meet with the couple to talk about their birth wishes and plan. Do they want a natural birth? See how far along they can get without meds? Support during a C-section? It's the doula's job to provide emotional, physical, spiritual, and educational support to expecting and laboring mothers.
A postpartum doula helps a new mom and her baby by providing similar types of support, especially in the areas of newborn care, breastfeeding, and mom's health and wellness, either personally or by providing appropriate resources in the community. A postpartum doula will also help with the emotional adjustment as your family incorporates a new baby.
Why Would I Hire a Doula?
In short, you'd hire a doula because you have a specific vision of how you want your birth to go, and you want an advocate to help make sure you can get as close to that goal as possible. "A lot of times, it's simply a matter of that when a laboring mom gets in the hospital room, it's easy to forget about the plan," Morton says. "The doula is going to be there to remind her to do all the things they've discussed beforehand to keep her birth plan on track."
"We bridge the gap between our clients and the medical providers," she continues. "When a situation arises in labor, we're able to explain what's happening and help them make decisions in a calm, educated way. We want our clients to have a birth that feels personal and not just like something that happened to them. We respect that medical providers know more than we do, but we don't want our clients to just submit to the medical system because they don't have the support they need to make their own decisions."
Are Doulas Only For Home Births?
Absolutely not, says Morton. Most of her clients' births take place in a hospital, she says, though she's also been a part of many home births. "The biggest misconception is that doulas only work with clients who want natural, at-home births," she says. "That's not the case at all. A doula's role is not much different if the client is giving birth at home versus at the hospital. A doctor or a midwife is the medical professional who's dealing with actually delivering the baby. A doula is there to advocate for and support the mom."
Morton adds that most hospitals are great about working with doulas. "As the doula profession evolves, we're finding a hugely positive welcome from providers, especially the nurses. We're on the same team. We just want the best for mom and baby. They're appreciative that we're there to help."
What Does the Process of Working With a Doula Entail?
Morton suggests her clients interview at least three doulas to find one they have the best connection with. "You have to be able to be at your most vulnerable in front of this person," she says. Plus, doulas will have different price points (expect to pay $500 to $1,500 or possibly more depending on where you live and what level of services you'd like your doula to provide).
You'll meet with your doula during a consultation, then one more time when you're around 36 weeks pregnant, when most doulas will spend at least two hours with their clients discussing a birth plan. "Then we're on call 24 hours a day to answer questions and provide support and when labor begins, to help decipher whether mom's actually in labor," Morton says. Then, of course, the doula's biggest role will be during the actual labor and delivery. Plus, "we usually stay at least two hours after birth to facilitate skin-to-skin contact and the first latch," Morton says.
How Is a Doula Different Than a Labor and Delivery Nurse?
"Labor and delivery nurses are really busy and have a lot of work to do; they're in the hospital room between 21 and 31 percent of the time during labor. The rest of the time, the mom and her partner are alone," Morton says. "Some people prefer it that way, and some get really intimidated by that."
Doulas, on the other hand, never leave the couple's side, so they are always there to offer information, support, and to act as a buffer, mediator, or advocate when things get scary or overwhelming.
Does Having a Doula Mean I Can't Have an Epidural?
It does not, Morton says, though she acknowledges that most of the births she supports do not involve an epidural. "If the course of the birth changes, and they do want medication, we support them in that," she says. "We tell them the risks, side effects, and benefits without judgment."
What Kind of Training Are Doulas Required to Complete?
There are various agencies a doula can train with to become certified, Morton says. Most of them involve a long weekend of training, which includes learning about birth options, medical interventions clients might want to avoid, and alternative comfort measures. The certification process also involves a lot of research, studying, essay writing, and practical training with clients. While you should make sure any doula you hire is certified, there isn't one general agency that provides doula certification.