As one might expect, I think everyone deserves doula support as part of a strong, cohesive birthing team. I know the benefits of a trained professional support person for birthing parents, and I've seen firsthand the strength many draw from our presence.
I also know, however, that sometimes we have to prioritize our investments, and in the long lists of supplies you might be considering to prepare for an addition to your family, you're having to consider which things you really need. Hopefully, this quick guide can help you out.
A doula is a professional trained in comfort measures, emotional support, tools to help you communicate effectively with your medical team, the mechanics of labor and birth, breastfeeding basics, and the culture surrounding pregnancy, birth and the postpartum period. Most doulas are caring, compassionate people, but they are professionals, with professional standards and codes of ethics, which places certain limitations on what their roles are in the birth environment. These restrictions are due both to their own professional standards (which vary, but almost always require them to be clear about their non-medical role) and by laws about medical confidentiality, patient consent, and other concerns that may not apply to a non-professional support person who is related to you. Some doulas are trained in additional tools, such as advanced comfort measures (acupuncture, therapeutic massage, aromatherapy, herbal medicine, etc) or advanced breastfeeding support, but while these may be offered as part of support packages by those who are certified in both areas, as a general rule these tools are not a standard part of doula support.
A doula is not just any person who supports someone in labor. Although there are many excellent support people who are not professionals, or who provide other kinds of birth support, they are not doulas--the word refers specifically to those with specialized doula-focused training in providing support during pregnancy, labour, birth, and/or the postpartum period. While this distinction isn't one made in every conversation about doulas, for the purpose of this article, it's an important one.
This is an Intimate Experience. Why Might I Want Professional Support?
There are many benefits to having good birth support generally and professional doula support specifically. Numbers vary, but research has consistently shown that having a trained, non-related support person provides significant decreases in the chances of cesarean, increases in the odds of an intervention-free vaginal birth, reduction in the need for pharmaceutical tools for induction or pain relief, and a significant increase in reported birth satisfaction for everyone involved.
So Do You Need a Doula to Support Your Birth? Consider the Following:
Do you want a doula? Do you even think you might want a doula? If the answer is yes, consider hiring one. There's nothing to be lost by interviewing a few options to see what's out there, and if something in your gut is telling you you'll want extra help, it's worth looking into.
Do you have a support person? If you don't, and you're not sure you'll be able to meet your birth goals on your own, consider a doula.
Are you and your support person preparing for them to be your primary support? Are you taking classes, reading, and frequently discussing your goals and the plans you have to meet them? If your primary support person is feeling unprepared and classes and research aren't helping, a doula might be worth considering.
Does your primary support person want to support you on their own? If they are having any doubts about their ability to do tough physical and emotional work lasting potentially many hours, when things might feel overwhelming because more than one person they love is struggling, a doula might be a good bet.
Do you think your birth will benefit from extra help, even if you're not sure what that help might look like? Chatting with a few doulas about what they do and how they support partners as well as labor may be worth the time.
Is your doubt about doula support coming from you, or from external pressures? If your partner isn't sure, but you want the help, encourage them to come with you when you interview doulas to get a good idea of how they can work together to support you without violating your closest relationships. A doula should be prepared to explain how she supports involved partners when she talks about what she can bring to your birth team.
If another family member isn't sure, but you and your partner both think you'd benefit, consider whether the doubters are planning to help you in your labor (not just attend, either--any person in your labor zone should be preparing to help you). If you're going to have more than one person who is attending classes and doing research on how to best support the birth you're aiming for--and is 100% on-board with your ideas--then their preferences might carry more weight than someone who wants to be in the birth room just for the sake of being there when the baby is born.
If your medical care provider isn't sure, follow up on why that is. Are they unsure about what doulas do? Did they have a bad experience with one doula and now discourage all their clients from seeking extra support, even though they may or may not be the person in attendance at the birth themselves? Are they concerned about having a trained person observing and potentially judging their practices? Although the best birth teams consist of several people in different roles working well together, if your primary provider is anti-doula, you want to know why and what that means for your birth plans. In some cases, a reluctant provider is reason to seek doula support, rather than to avoid it.
You can ask similar questions to determine whether postpartum doula support is right for you. If your concerns are about finding or affording a doula, please consider the following articles:
TBS | How to: Find a Doula
TBS | How to: Contact a Doula
TBS | How to: Afford a Doula