* I am currently only taking
on clients who are planning a homebirth.*
What is a doula?
word doula is a Greek word that
means Women’s Servant.
Women have been serving other women in childbirth for centuries and
have proved that support from another woman has positive effects on the
labor and birth process.
doula is a childbirth professional who understands the natural
of having a baby. The doula accompanies the woman in labor, provides
emotional and physical support, suggests comfort measures, and provides
support and suggestions for the partner to create the most positive,
healthy, and enjoyable experience possible. Whenever possible, the
doula provides antepartum and postpartum emotional support, including
explanation and discussion of practices and procedures as needed.
doula does not perform clinical or medical tasks such as taking blood
pressure or temperature, fetal heart tone checks, vaginal examinations,
or postpartum clinical care. A doula advocates for
wishes as expressed in their birth plan, in prenatal conversations, and
intrapartum discussion. She helps the mother incorporate changes in
plans if and when the need arises, and enhances
between client and caregiver. A doula does not speak for or make
decisions for the client. The advocacy role is best described as
support, information, and mediation or negotiation.
What are the benefits of
hiring a doula?
studies have revealed the benefits to having a doula present during
labor. A recent Cochrane Review, Continuous Support for Women
During Childbirth, revealed a very high number of positive
birth outcomes when a doula was used. When a doula was present, women
were less likely to have pain relief medications
administered, less likely to have a cesarean delivery
and reported having a more positive childbirth
often use the power of touch and massage
to reduce stress and anxiety during labor. According to physicians
Marshal Klaus and John Kennell, massage helps stimulate the production
of natural oxytocin. The pituitary gland secretes
oxytocin to the bloodstream which causes uterine contractions and also
secretes it to the brain, which results in a feeling of well being,
drowsiness and a raised pain threshold. Synthetic
can not cross into the blood stream and brain, so it increases
contractions without the positive psychological effects of natural
least thirteen scientific studies evaluating the effectiveness of
doulas have shown that having a doula present at your birth can have
the following results:
Shorter labor by 25% (average two hours less for first time mothers)
Reduced need for pain medication
40% reduction in the use of forceps
40% reduction in the use of Pitocin
50% reduction in cesarean rate
60% reduction in the request of epidurals
Greater satisfaction with the birth
Better mother infant interaction/bonding
Improved neonatal outcomes
Increased breastfeeding success
What do birth doulas do and
what do their services include?
doula and client relationships begin a few months before the baby is
due. During this time they establish a relationship that gives the
mother complete freedom to ask questions, express
fears and concerns and take an active role in creating a birth
Most doulas make themselves available to the mother by phone to answer
questions or explain any developments that may arise in pregnancy.
Doulas do not provide any type of medical care. However, they are
knowledgeable in the medical aspect of labor and birth so they can help
their clients get a better understanding of procedures and
complications that may arise in late pregnancy or during birth.
labor, doulas are in constant close proximity to the mothers at all
times. They can provide comfort through pain relief
techniques, such as breathing, relaxing, massage and laboring
positions. Doulas also encourage participation from the partner and
offer reassurance. The goal of a doula is to help the mother have a
positive and safe birth experience.
the birth, many labor doulas will spend a short time helping mothers
begin the breastfeeding process and encourage bonding
between the new baby and family members.
birth doulas provide:
At least two antepartum (prenatal) visits to get acquainted and provide
birth plan counseling
Availability by phone/email 24/7 to answer questions and go over
Continuity of care during labor and birth
Immediate postpartum support and breastfeeding support after the birth
Breastfeeding support if needed
At least one postpartum visit
Does the doula take the
place of the father?
role of the doula is never to take the place of the father or partner
in labor, but to compliment and enhance
their experience. A doula can actually bring a couple closer together.
By ensuring that the partner’s needs are met (food, drinks,
emotional support) only then can s/he give the mother undivided
attention. Today many more partners are taking a more active role in
the birth process, but still some partners feel that this is a huge
expectation, and would rather be able to enjoy the birth without having
to stand in as labor coach. Birth can be a stressful time for both
mother and partner. Many times partners worry that they are not doing
enough or the right thing. A doula helps by giving suggestions,
providing encouragement or giving needed breaks
during a long labor.
study showed 60% of fathers
that have taken birth education classes become mostly a spectator, as
they become overwhelmed with the surroundings. The feeling of insecurity
and the sometimes lack of knowledge of what is happening takes its toll
on both parents. A doula has accompanied other couples through the
birth experience and gained the knowledge needed to help each couple
achieve their desired birth experience. She helps the father to be more
involved and more effective. The nurses/midwife/physician cannot be
with you at every moment or may not be at liberty
to answer your questions in an unbiased manner. The
doula fulfills this role so that parents receive the information they
need to make informed decisions.
This in essence, frees up the father to provide uninterrupted emotional
support to his partner, and not having to play the role of advocate,
liaison, educator, etc., as well as provide support.
What other services does a doula offer?
doulas offer other services along with professional labor support, such
Quality childbirth education (even for moms on bed rest since they are
done in your home!)
Birth plan counseling
Photographing or videotaping your birth
Breast feeding support
Postpartum doula care
What if I have a midwife or
am giving birth at a birthing center or at home?
doula can still provide a valuable service, including personal
and labor support. Not all midwives provide labor support and this is a
very good question to ask her when interviewing a midwife. Some
midwives prefer to attend you later in labor or may prefer not to
provide physical labor support. The best way to determine how your
midwife will be is to ask former clients and see how well they felt
supported during labor. Even with a supportive midwife, you may still benefit
from a doula's services. Ask your midwife/midwives how they feel about
How can a Doula help me if I
am not having a natural birth?
presence of a doula can be beneficial no matter
what type of birth you are planning. Many women report needing fewer
when they have a doula. The role of the doula is to help you have a
safe and pleasant birth, not to choose your type of birth. For women
who know they want a medicated birth, the doula
still provides emotional support, informational
support and comfort measures to help the women through labor and the
administration of medications. Doulas can work along side medication by
helping mom deal with possible side effects and
filling in the gap that medication may not cover; rarely does
medication take all discomfort away.
a mother who faces a cesarean, a doula can be
helpful by providing constant support and encouragement.
Often a cesarean is an unexpected situation and moms are left feeling unprepared,
disappointed and lonely.
A doula can be with the mother at all times throughout a cesarean,
explaining what is going on throughout the procedure while the partner
is able to attend to the baby and accompany the newborn to the nursery
if problems arise.
What kind of training does a
are several paths to becoming a doula. The
profession of doula,
does not currently have any state regulation and does not require
training or certification. There are many wonderful doulas that have
chosen not to certify with any of the current organizations. If a doula
does decide to become certified then there are several organizations
that provide certification.
basic requirements differ from organization to organization, but
comprise some basic training including required reading lists,
attendance at a workshop, evaluations from a minimum number of births
and an audit of a full series of childbirth education classes. The most
important attributes of a good doula are a caring heart, a willingness
to work with birthing women, professionalism and hands on experience. A
lot of very good doulas have done this work for years, before
certification and training was available. Most doulas attend
workshops/seminars, keep up with current trends in birth and read
childbirth literature and medical journals; whether they are certified
How much does a doula charge?
it depends on the services offered/desired. An average of $400.00 to
$1200.00 is not unusual depending on where you live and what services
are offered. You are paying for a doula's experience, so it is not
unusual for more experienced doulas to charge on the higher end,
whereas a more inexperienced doula may charge a reduced fee. Most
doulas require a retainer (usually $50.00 to
signing the contract for services and the remainder two or three weeks
prior to your due date. Most doulas are willing to work
with families if done in advance or upon signing a contract.
Are doula services covered
by health insurance?
this time only a few insurance companies cover doula services, but the
numbers are increasing gradually as providers are
beginning to recognize the benefits of both
improving parental satisfaction and bottom line savings
when parents employ a doula for their birth. Factors that may increase
your chances of reimbursement include:
Submitting a doctor or midwife's referral or prescription for doula
Submitting well documented statistics of doulas' influence upon birth
Actually achieving a low intervention, low cost birth
Submitting a superbill for doula services complete with diagnosis and
Resubmitting with more documentation if first claim is denied
material in this website is provided for information purposes only.
This information is not a substitute for, medical diagnosis, medical
advice, or medical treatment prescription. Consult your health care
provider for more information. If you are in Pittsburgh and
midwife, send email to PghMidwife (at) naturalattachment.com