Birth Support (Doulas)
Every birthing person deserves support - and lots of it. Whether that support comes from a partner, provider, or birth/postpartum specialist (also known as a doula) we're here to help you evaluate the options and make an empowered decision about what's right for you.
Birth doulas offer emotional and physical support for both the birthing person and their partner before, during and after labor. Contrary to popular belief, doulas are not just for planned, unmedicated births. Months before labor you and your doula will talk through your birth preferences, address any fears or concerns, and guide you through each stage of pregnancy. During labor, using evidenced-based practices, doulas advocate for their client and communicate needs, questions, and/or concerns with medical staff, doctors, and midwives.
Doula Facts & Statistics
According to a recent Cochrane review:
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Receiving continuous support (doula being one form of support) during labor led to roughly 40 minutes shorter labor than those without support
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31% of birthing people reported fewer negative birth experiences when they had continuous support during labor
Furthermore, research has found that:
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Birthing people who had a doula present experienced less pain and anxiety during birth
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Use of a postpartum doula may lower the incidence of postpartum depression
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The use of a doula in under-resourced communities improved multiple health outcomes for mothers and babies, particularly in communities of color (see Birth Equity & Racism)
Evidence Based Birth has an incredible doula resource page packed with useful information to consider when thinking of adding a doula to your support team.
Doula Certification
It's important to note that a doula and midwife are not the same thing. In the US, the most common type of midwife is a Certified Nurse-Midwife (CNM), which is a state-licensed medical provider with advanced clinical nursing training.
To become a CNM, a registered nurse (RN) must graduate from an accredited master’s or doctorate nurse-midwifery education program and pass a national examination. CNMs are backed by the American College of Nurse-Midwives (ACNM).
Doulas, on the other hand, are not required to hold a nursing or medical degree, or have passed a national exam. While some doulas are RNs, many are simply laypeople with a passion for empowering mothers through the pregnancy, birth, and postpartum period.
For this reason, when searching for and interviewing doulas, it is critical to ask what certifications the doula holds. Ideally, a doula will have received training on birth and/or postpartum, and can demonstrate that they have met the requirements of a rigorous certification program.
There are many doula certification programs with differing requirements. Some of the largest include DONA International, CAPPA, Childbirth International, and ICEA, but there are many more. Most of these offer a search option on their website to help you locate certified doulas in your area.
Questions to Ask When Interviewing Doulas
It is crucial to ask, ask, ASK as many questions as possible to potential doulas. Take the time to speak with and interview at least three doulas and do not settle if you don't feel 100% comfortable. Your doula is meant to be your support system during pregnancy and birth, and serves as an extension of you and your thoughts/wishes during an incredibly vulnerable time - you need to feel complete trust with whomever you select as your doula.
Be sure to ask:
What are your certifications?
Doulas should hold a number of certifications in various areas - this will ensure the best possible care for you and your baby. A birth doula should have at least 7-12 hours of childbirth education under their belt and have been present at a minimum of two births (more is better!).
Are you a full spectrum doula?
A full spectrum doula is equipped to handle it all. From pregnancy, birth, lactation support, and "fourth trimester" needs, to pregnancy loss including miscarriage, TFMR, and stillbirth. You need to know that your doula is still qualified to support you whatever may come, and will be able to provide you with appropriate resources no matter the outcome of your birth.
What are your birthing philosophies?
It is important to know that your beliefs and birthing vision align with the doula's practice. For example, some doulas are very resistant to any form of medication intervention. You may hope for an unmedicated birth, but if you decide during labor to change your mind, how would your doula respond? You may hope to go into labor naturally, but if your medical provider notices signs of distress in your baby and recommends an induction to reduce the risk of stillbirth, would your doula be supportive? You want to make sure that anyone you add to your birthing team will respect your choices at all times - and that includes your doula! A doula can provide wonderful physical and emotional support, but remember, they are not a replacement for your medical provider - so make sure you've found a doctor or midwife that you trust as well! (See #AdvocatingForYourself.)
The questions above are only just a small sampling of what you should ask a doula candidate - there are many more excellent resources to help you find the right match for you!
