Childbirth, a timeless and sometimes unpredictable journey, has been an integral part of human experience. In the United States, where rates of avoidable complications and maternal deaths are surprisingly high, the demand for doulas is on the rise. Natalia Richey, interim chief midwife at Massachusetts General Hospital, notes an increasing interest in additional care during pregnancy and birth.
But what does a birth doula do? Unlike midwives or doctors, professional doulas offer emotional and physical support to women throughout pregnancy and the birthing process.
Here's a glimpse into doula care if you're considering it.
Doulas vs. Midwives
While midwives and doulas share some responsibilities, a crucial distinction exists: midwives provide medical care, whereas doulas focus on emotional and physical support. Midwives, like certified nurse-midwives, are trained nurses responsible for maintaining the physical health of both mother and baby during childbirth. On the other hand, doulas don't perform medical tasks; they specialize in helping laboring women stay comfortable and calm, employing various techniques like suggesting comfort measures and optimal positions.
Doula Training and Licensing
It's important to note that doula training lacks standardized rules. Certification from over 100 independent organizations is common, although no formal licensing is required. While private insurers often don't cover doula care, some employers, like Walmart, assist in covering costs. As of February 2023, ten states and the District of Columbia offer Medicaid coverage for doula services.
Impact on Birth Outcomes
A 2023 analysis spanning 22 years and 16 studies found that doula support correlated with improved birth outcomes, including fewer C-sections, premature deliveries, and shorter labor. Emotional support from doulas was associated with reduced anxiety and stress in mothers, with notable improvements in breastfeeding success, especially among low-income women.
Collaboration with Doulas
Agreements regarding care may vary, but typically, doulas meet with expectant individuals throughout pregnancy to discuss birth goals and build rapport. Doulas, akin to obstetricians, are available 24/7 to support clients during labor. This constant support, especially for those with limited resources, can be invaluable.
Doula and OB/GYN Collaboration
Collaboration between doulas and OB/GYN teams is generally seamless. Whether a hospital arranges for a doula or if hired privately, coordination ensures everyone sticks to their roles. Doulas suggest nonpharmacological ways to ease pain, respecting boundaries when medical intervention is necessary.
Questions to Ask When Considering a Doula
Interested in working with a doula? Natalia Richey suggests asking yourself questions like:
- What are my hopes and goals for the childbirth process?
- How do I envision my support team during delivery?
- Do I have friends or family members who have used doulas, and what were their impressions?
When contacting a doula, inquire about their training, the number of births attended, how they can assist during pregnancy and labor, and their approach to collaboration with your partner, spouse, and the medical team.
Take the time to meet with any doula you're considering and make sure they're a good fit, advises Richey. "Because this is someone who will be there during one of the most vulnerable times of your life. Having someone there who doesn't make you feel safe and comfortable can affect birth in a major way.
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