What is a Doula and Why Do I Need One?

More and more families are turning to doulas for support before, during and after childbirth. From higher birth satisfaction scores to better health outcomes for parent and child, doulas provide parents with the support families need when navigating life's biggest journey.

Having a baby is an exciting process, full of new — and sometimes intimidating — experiences. Whether you are having your first baby or your fifth, it’s important to have an experienced and confident support system in place. This is where hiring a doula comes into play.

Benefits of hiring a doula
Hiring a doula can be one of the best decisions you make for the health of you and your baby. Thank you @alenapiksaeva for the great photo.

What Is a Doula?

A doula is a certified birth professional whose role is to support the birthing parent. From the time they are hired (usually months before the actual birth), they provide encouragement, recommendations, and physical, emotional and informational support to soon-to-be parents.

The breadth of their services covers pregnancy or the preparatory period (if you’ll be adopting), labor/birth, and even immediately postpartum. Doulas can also be hired to extend their services further into the postpartum period, helping families and new parents adjust to such an exciting shift in their home.

While there are some doulas practicing without certifications, finding one with credentials will ensure that they are well-educated about the birth process. You may also want to ask your doula how many births they’ve attended and how long they’ve been practicing.

Currently, doulas can be certified from a number of different organizations. The three largest, and most recognized, are:

It’s important to keep in mind that each certification agency will have different teaching methods and requirements. When selecting a doula, it would be beneficial for you to review their certifying organization to see if it aligns well with your needs, beliefs, and requirements.

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Why You Would Want to Hire a Doula

A doula won’t replace certain members of your team, such as your OB/GYN or midwife. However, they make an excellent addition to your existing team and can have a tremendous impact on the experience as a whole. For instance, many recent studies suggest that the presence of a doula can result in more positive birth outcomes, such as shorter labor times and less intervention.

A doula’s purpose isn’t to provide medical services to the birthing parent or baby. They won’t be the one monitoring heartbeats, checking test results, or ordering procedures. Instead, a doula is there to provide informational, emotional and various forms of physical support for the family (and particularly to the birthing parent) before, during, and after the birth.

This emotional and physical support, shared knowledge, and advocacy can be invaluable to the new parents. The right doula’s expertise can help facilitate a happy, healthy, and fulfilling birthing experience for all, as well as ensure that parents feel confident and empowered in the decisions they make for themselves and their baby.

From the day they’re hired, a doula is available to answer questions that you may have about pregnancy, birth, or the postpartum period. This can be very helpful, especially if you don’t want to bother your medical provider all the time or have concerns you don’t feel comfortable voicing. They can also walk you through the process of creating your ideal birth plan.

On the day of the birth, your doula will be there to advocate for you and said plan. This might mean offering suggestions for relaxation or pain management, giving massages, or even encouraging participation from your partner.

They will also act as an intermediary between you and your medical team. A doula will ensure that you are always aware of what’s happening, can translate technical terms for you, and can encourage you to speak up if a planned procedure doesn’t align with your wishes. This not only serves to educate and empower you, but can also be comforting in an otherwise-scary or foreign situation.

After the birth, doulas are available to provide support to the new parents at home. This can come in the form of chest or breastfeeding education, help with cloth diapering, or even being a mother’s helper by cooking, cleaning, or caring for siblings.

Doulas Make for Better Birth Experiences

Having a doula attend your birth is akin to having a very good friend by your side — except that this friend is experienced, educated in childbirth/pregnancy, and isn’t afraid to advocate for your wishes. As you’d imagine, this results in birthing experiences that are happier, safer, and more empowering.

That’s not all, though: the science backs up this claim. In fact, results from a recent Cochrane Review study suggests that doula-attended births are statistically better.

This study showed that birthing parents who have a continuous support person present for the birth — someone who is trained, experienced in providing labor support, is there solely to provide support to the birthing parent, and is not an existing member of the birthing parent’s own circle — have more positive birth outcomes than parents who don’t have a similar support person present.

These positive outcomes include:

  • Birthing parents were less likely to require interventions such as forceps, vacuum assistance, or C-sections.
  • Birthing parents were less likely to use pain medication (yet still reported higher levels of satisfaction).
  • Doula-attended labors were shorter by about 40 minutes, on average.
  • Babies born to doula-supported parents were less likely to have low five-minute Apgar scores and less likely to require a stay in the NICU.
  • Births with a doula present were less likely to involve the administration of oxytocin (and in fact, some studies point to the presence of a doula as increasing the birthing parent’s own oxytocin production).

While doulas have typically had a symbiotic relationship with other (more natural-leaning) birth providers, such as midwives, their relationships with more traditional medical staff — such as OB/GYNs — have recently started to take shape. The tremendous impact that doulas provide on the birthing experience is finally beginning to be recognized by professionals and medical associations alike.

For instance, the American College of Obstetrics and Gynecology (ACOG) has begun touting the effect of doulas on birth outcomes. In a recent committee publication, they called attention to evidence showing the positive impact that the presence of a doula can have on laboring parents and their infant and recommended programs to integrate trained personnel (such as a doula) into the care environment.

The Role of Your Doula

The Greek word doula actually translates to “mother’s servant.” It shouldn’t come as any surprise, then, that a doula’s job is to provide a wide variety of physical, emotional, and psychological support to the birthing parent, during pregnancy, labor, and even postpartum.

During pregnancy, a doula can:

  • Answer questions about labor, birth, or the postpartum period
  • Help parents to explore and create a birth plan that suits their needs and desires
  • Be available for emotional support, as needed
  • Offer suggestions for decreasing discomfort, easing anxiety, improving sleep, or even safely inducing labor

Of course, a doula doesn’t replace your medical team, so be sure to also contact your doctor or midwife if you have serious questions or concerns.

During labor and birth, a doula can:

  • Encourage your partner (and even older siblings) in their role
  • Remind you, and the team, of wishes outlined in the birth plan
  • Provide physical support such as ice chips, cool cloths, warm compresses, massage, TENS unit application, breathing exercises, counterpressure, and more
  • Provide emotional support through encouragement, reassurance, positive affirmation, empathy, and praise
  • Advocate for the birthing parent with the medical team, ensuring that the parent understands what is happening, that it’s in accordance with their wishes, and that the birth plan is followed as much as possible
  • Create a soothing environment by dimming lights, closing curtains, playing music, diffusing essential oils, etc.
  • Assist the birthing person with their laboring needs and desires, such as water therapy or walking around
  • Take photos

After the baby is born, a doula can:

  • Help establish the breastfeeding process and answer questions
  • Offer suggestions for healing
  • Facilitate bonding between the partner parent and older siblings
  • Support the birthing parent by bringing food, drinks, etc.

Whether your baby’s birth is at home, in a birthing center, or at a hospital, a doula is an incredible asset to the experience. Your doula will ensure that you are informed, feel safe and empowered, and that your desires are followed, as well as provide constant and unwavering support.

physical doula support
During labor, your doula can provide physical support such as ice chips, cool cloths, warm compresses, massage, TENS unit application, breathing exercises, counterpressure, and more. Photo credit to @lifewjess.

While doulas and midwives have worked side-by-side for ages — attending birthing center and home births together — doulas have now become familiar faces in hospital maternity wards, too.

It’s believed that one-tenth of births are now attended by doulas, ensuring that doctors, nurses, and researchers alike have been able to see firsthand their impact on positive birth outcomes. Hospitals have started offering doula services to their pregnant patients, and many OB/GYN offices have doulas on staff. This means that medical staff is both comfortable and well-versed in working alongside doulas, and shouldn’t be surprised if you plan to bring one along on the day of your baby’s birth.

Even the American College of Obstetrics and Gynecology has begun to sing doulas’ praises. They recently came out stating that doulas are one of the most effective tools for reducing cesarean section rates!

Additional Services

Some doulas offer extra services to birthing parents, beyond the standard doula duties. These are usually an additional fee, but can be an easy way for you to take advantage of beneficial services (that you might not have even know you needed!) from an already-trusted source.

Many doulas also provide services such as:

  • Placenta encapsulation, tinctures, and preservation
  • Belly casting
  • Photography
  • Belly binding
  • Pre- and post-natal massage
  • Reiki
  • Yoga or fitness classes

If you’re unsure of which services you want (or need), that’s okay. Your doula can let you know more about the benefits of each, or you can browse our blog here to learn more.

Things Your Doula Cannot Do

Of course, the role of a doula is limited. Since they are not medical professionals per se, there are some things that a doula cannot (or should not) do.

Your doula will not:

  • Offer medical advice, diagnose conditions, or perform exams
  • Intervene in the birth or catch the baby
  • Make medical decisions for the birthing parent
  • Replace the role of your partner (A doula is an excellent support option if you don’t have a partner or if your partner will be unable to attend the birth. However, a doula will never overshadow your partner if they are in attendance, and will instead encourage their interactive role in the birthing process.)

A doula can offer suggestions based on their own experience and training. They can also advocate for you by facilitating active communication between you and your medical team.

While your doula will not speak for you, they will ensure that you have the best opportunity to make informed decisions about your baby and your body.

Postpartum Doulas

The first few days (and even weeks) after you bring your newborn home are chaotic, exhausting, and often overwhelming. This is even more true if you have older children at home, are recovering from a cesarean section, or don’t have round-the-clock support from your partner or family members.

That’s why many parents hire postpartum doulas. These providers offer an encouraging (and experienced) support team in the days, weeks, and months following your baby’s birth.

postpartum doula cooking
Whether its chest / breastfeeding support or cooking a light meal for you and the family when things are tough, a postpartum doula can prove to be an invaluable support person. Photo credit to @hellomikee.

Postpartum doulas are available from day one until your baby is a few months old. Their duties include:

  • “Mothering the mother” by caring for their emotional, physical, and psychological needs
  • Assisting with feeding and providing breastfeeding support (if applicable)
  • Offering techniques and advice for baby soothing, diapering, and bathing
  • Caring for older siblings
  • Light housework, cooking meals, or running errands
  • Night nurse duties

Having the support and encouragement of a doula in the difficult, sore, sleep-deprived, and emotional period after your baby is born can be invaluable.

How Much It Costs to Hire a Doula

The price you can expect to pay for your doula depends on a number of factors, including your location, whether your doula is certified, and the services provided.

You’ll find that doulas typically charge somewhere between $600 and $2,500, with the national average being $1,200. This fee depends on the region in which they’re located and what they include in their doula package.

Just like any other birth service, you can shop around to find the provider that best suits your needs (and budget). If you’re lucky, you may even be able to get insurance coverage for the expense.

Filing an Insurance Claim for a Doula

Doulas are beginning to be recognized as important members of a birthing team by insurance companies. There are at least 20 insurance providers who recognize doulas as potentially-covered expenses, though the amount they will pay varies.

You can call your insurance company beforehand to get their requirements and see how much, if any, they will cover for doula services. The CPT codes that are likely to be used are 99499 (Other evaluation and management services) and 99501/99502 (Home visit for postnatal assessment and follow-up care/Home visit for newborn care and assessment).

It’s also important to remember that insurance providers will almost never cover the cost of a doula who isn’t certified. So, if you intend to file a claim, make sure that the one you choose has a valid certification from an organization recognized by your insurance company. You will often be required to pay for your doula’s services in full, then request reimbursement from your insurance company later.

New York State Doula Pilot Program

A handful of states are beginning to recognize the exceptional benefits that doulas provide in the prenatal and birth settings (such as Oregon, Minnesota, and the District of Columbia). As a result, they are streamlining both access to and coverage for birth doulas, to parents who need them. If you’re an eligible New York parent-to-be, this coverage might come from the exciting New York State Doula Pilot Program.

This initiative is designed to offer prenatal visits, labor & delivery support, and postpartum visits from trained and approved doulas. It is being introduced in an effort to improve health outcomes among birthing parents and infants within the state, while also addressing racial disparities among those health outcomes.

The program is, for the time being, limited to two counties within the state. These counties — Erie and Kings — currently see the highest number of infant and maternal mortality rates, as well as the highest number of Medicaid-covered births. Phase 1 launched on March 1, 2019 and phase 2 is expected to launch once the required number of providers are enrolled.

Is Hiring a Doula Right for Me?

If you’re a parent expecting a baby — or planning to add to your family in the near future — you should absolutely consider the value of a doula in your journey. These professionals can provide a number of exceptional benefits for you, your partner, and even your child.

While doulas are popular within the natural birth crowd, they can help you attain the birth you want, regardless of what that means.

Doulas provide an incredible support system for parents who plan induced, medicated, and/or cesarean section births. They can offer guidance and assistance whether you breast-, chest-, or formula-feed your baby. There are even doulas available to help you navigate those important weeks of bonding following an adoption placement.

No matter how your family is expanding, a doula can help make the process as smooth, joyful, and empowering as possible.

Begin your doula search here, to learn all about the exceptional providers in your area.

Meela Team

We’re a close-knit team that recognizes the passionate pros who support growing families. Rather than accepting a broken birthcare system, where impersonal office visits and medical interventions take priority over education and individualized care, we’re flipping the script. We believe that one-on-one support and informed decision-making can turn the fear and anxiety associated with birth into pure joy and excitement. The way it should be. At Meela, we’re here to support our pros and empower parents as they embark on their journey into parenthood.


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