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Hire a Birth Doula During Pregnancy to Have a More Healthy Childbirth Experience

Updated on February 13, 2020
Melis Ann profile image

I'm a mother, environmental scientist, and former Covid contact tracer who researches a variety of health-related topics.

The support of a doula during childbirth has many advantages including success with natural childbirth and reduced need for medical interventions.
The support of a doula during childbirth has many advantages including success with natural childbirth and reduced need for medical interventions. | Source

Women may be planning a natural birth or expecting to use epidural anesthesia for pain during labor. Having a doula present is an important step toward ensuring a healthy delivery for both of these situations. Hiring a birth doula should be on your to-do checklist during pregnancy. Due to the unexpected nature of labor and childbirth, it's helpful to use a doula even if it isn't your first child. A doula provides childbirth support for pregnant woman and sees her through the amazing transformation from pregnancy to motherhood. Although hiring a doula may be an additional expense, doing so is an opportunity to secure a more healthy childbirth experience.

Copyright © 2018 Melis Ann

What is a Doula?

The role of the doula varies around the world. Generally, a birth doula is a trained labor coach who is hired by an expectant mother to assist her during childbirth; at home during labor and/or at the hospital.

Birth doulas meet with couples before labor to understand their goals and help answer questions during pregnancy. The doula is on-call to assist during labor. They can also continue their role as postpartum doulas: giving breastfeeding advice and assisting the mother in her transition to being home.

Note that although this article is written to encompass doulas within an international scope, the perspective here is one from personal experience in the U.S. There are differing viewpoints with any topic and this article does not attempt to cover choices revolving around the use of doulas for home births, for example. Regardless of differences around the world, there are benefits to having a doula at your side during labor.

The Role of the Doula

The doula attends the birth of your baby as your personal labor assistant. The role of the doctors and nurses at the hospital remain unchanged. Prior to the birth, you will have met with your doula to communicate your personal goals and expectations. According to what you've agreed with your doula prior to labor, the doula will provide the support you've requested.

Doula support is advantageous in many ways:

  • positional techniques to help labor progress
  • massage for back labor or relaxation
  • emotional support and verbal encouragement
  • advocate your wishes to the medical staff
  • support for spouse by giving breaks to rest or helping figure out the best way to help

Having a doula present lends the mother and father to feel more safe and comfortable with the unknowns of the birthing process. The spouse is more able to attend to the emotional needs of the mother since the doula is providing birthing support. When the mother feels more secure and comfortable, she is more able to manage the pain of labor naturally. When labor can progress as naturally as possible, labor tends to progress more smoothly and without unnecessary stress to inhibit progression.

Massage techniques used by doulas help reduce stress and promote relaxation, allowing the body to focus on natural pain management.
Massage techniques used by doulas help reduce stress and promote relaxation, allowing the body to focus on natural pain management. | Source

Benefits of Doula Support

The benefits of having doula support are numerous.

  • cesarean delivery rates reduced
  • assisted delivery rates reduced (use of forceps, vacuum extraction)
  • complications during delivery reduced
  • requests for epidural anesthesia reduced
  • use of oxytocin and pitocin reduced
  • shortened duration of labor
  • breastfeeding success increased
  • satisfaction with birth process for both mother and father increased
  • lower rates of postpartum depression

Not only are these benefits invaluable, there are no risks associated with doula support.

Doulas Reduce Cesarean Rates

Having a doula present during birth has been shown to decrease the need for medical interventions such as cesarean delivery and epidural analgesia. A study was performed in 2008 titled A Randomized Controlled Trial of Continuous Labor Support for Middle-Class Couples: Effect on Cesarean Delivery Rates .

The study showed that cesarean delivery occurred half as often for women who were assisted by a doula. The data were even more dramatic when women were induced to help labor progress. In this case, women without the help of a doula were almost five times more likely to deliver by cesarean than women who were assisted by doulas.

A cesarean section being performed in the operating room. Assistance of a doula during childbirth has been shown to significantly reduce the rate of cesarean births.
A cesarean section being performed in the operating room. Assistance of a doula during childbirth has been shown to significantly reduce the rate of cesarean births. | Source

Doulas Reduce Need for Epidural Anesthesia

With added emotional support and better labor techniques, the help of a doula reduces the need for women to need epidural anesthesia. By helping labor progress more efficiently, through movement for example, and by providing relaxation techniques, a pregnant woman has her best chance of feeling in control. Physical pain can be reduced through this process, avoiding the need for epidural anesthesia.

The effects of interventions, like anesthesia, snowball into further interventions during labor. The reduction of interventions, or delay of interventions at the very least, leads to a more smooth progression of labor. Since interventions can also be linked to side effects for both mother and child, one could argue that needing less intervention would be linked to a healthier end result.

Doula Training and Certification

It's important to know that doulas are not medically trained, and this should not be looked at as a disadvantage. Their purpose is to provide practical and emotional support during the birthing process. Coming from a parent whose baby needed immediate medical intervention when born, the doula does not replace the need for a medically trained professional.

The certification process around the world varies depending on location and type of training organization. No standard training certification has been developed, therefore, level of expertise varies among doulas. Typically, doula certification consists of a combination of self-study of birth related text, training courses and attending births.

Training and certification occur under one of a number of doula associations which are discussed in more detail below.

Asking a few key questions during an interview with a doula will give you an idea of experience level. If the doula has been through birth herself, you might consider this is an added qualification. Other areas of study and work experience, i.e. nursing, may make your doula even more valuable.

Questions for Doulas

There are standard interview questions you should ask your doula about the logistics of her business. There are also questions you want to ask to find out about her philosophies on the birthing process. If you find any answers concerning, perhaps that doula is not the right fit for you. You will want to feel excited about the ideas she presents for making your experience easier and feel comfortable about going through a personal experience with her by your side.

  • Training - What kind of certification does the doula hold? How many births has the doula attended?
  • Children - Has the doula been through childbirth on a personal level? If you know the advice your getting is only theory, it may not help you mentally persevere through labor. On the other hand, you might prefer a doula who is not biased by her own birthing experiences.
  • Backup - If the doula is unavailable at the time of the birth, is there a backup available? You will want to meet the backup in preparation.
  • Fees - Find out what the fees are and how a refund policy is structured. Is there some sort of discount if you end up having a c-section following labor, where her services are not needed?
  • Philosophy - Find out the doula's birth philosophy. You will want to make sure your doula is in line with your thoughts and expectations. Depending on your personality, you may want someone to push you to have a natural birth or someone who is more flexible to your uncertainty.
  • Services - What are the typical services provided prior to birth, during labor and during postpartum period?

A newborn baby with mother and doula.
A newborn baby with mother and doula. | Source

Controversy Around Doulas

Some medical institutions do not allow doula support, claiming that doulas interfere with the medical aspect of delivery. Other complaints about doulas revolve around the idea that they are against medical interventions or medications during delivery. As with any profession, there are a variety of personalities where some may be more extreme with their views and how they interact with medical personnel.

I've personally hired two different doulas and have known several people that have used doulas (on my recommendation). No problems were encountered in any of these experiences, and each of us couldn't be happier with the decision to hire a doula.

Asking questions and expressing your concerns during an interview with a doula will reveal any potential problems relating to the above.

Free Doula Services

In some countries, there are non-profit organizations that provide free doula services to women who qualify. Another option is to secure a doula-in-training to attend your birth.

There are many doulas looking to attend births to fulfill their certifications requirements. Although a doula-in-training does not have a lot of experience practicing as a doula, they will have gone through a practical training program, and may have already been through childbirth themselves.

Doulas are International

More popular in certain regions, the role of the doula has expanded around the globe. Depending on local custom, the role of the doula varies. The following organizations can help you locate a doula.

Childbirth International
A resource useful to parents worldwide. Childbirth International is a great resource for pregnant women looking for a doula, representing 78 countries.

Doulas of North America International (DONA)
The oldest and largest doula organization, founded in 1992. Internationally respected in over 20 countries, including the U.S., Canada, Israel, and Australia.

Childbirth and Postpartum Professional Association (CAPPA)
Founded in 1998, it is one of the largest doula educational associations with headquarters in the U.S. There are CAPPA branches around the world: Canada, Israel, India, Ecuador, and the Caribbean.

Doula UK
A non-profit organization run by a network of doulas. Their services include continuing education of doulas as well as providing doulas to women who could not otherwise afford their services.

Doulas in Australia
At the bottom of this article are several doula training organizations located in Australia.

Birth Arts International
Originally a regional organization started in 2000, it has expanded to a U.S. wide level.


Have you hired a doula?

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Hiring a doula gives pregnant women the best chance at avoiding complications and interventions in order to achieve a natural birth.
Hiring a doula gives pregnant women the best chance at avoiding complications and interventions in order to achieve a natural birth.

Disclaimer: Note that this website portrays my opinion. I want to help others consider a new or different view. Any action taken based on these opinions is the responsibility of the reader.

Copyright © 2018 Melis Ann
Original content written by Melis Ann published only on HubPages at the following web address:

Hire A Doula

Since doulas provide so many benefits during childbirth, it is advantageous to hire a doula during pregnancy. It's a good idea to start this process in the second trimester. It takes time to arrange for doula interviews and make sure that the doula of your choice has availability around your due date.

© 2012 Melis Ann


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