Why doula? This is a question that every doula (including me!) has fielded at least once. I am a strong believer in doulas and our positive effects on birth outcomes. Perhaps you already know a lot about doulas, but hopefully you’ll learn something new today from the information I’ve gathered here.

Here are my thoughts on some frequently asked doula questions:

What is a doula?

Doula comes from a Greek word for “female servant,” but most doulas today prefer to be called a labor attendant, birthworker, or right hand to the laboring mother. There are both labor doulas (who attend women during birth) and postpartum doulas (who visit several times after birth to assist with household chores, breastfeeding, and newborn care). I am a labor doula, and most people who call themselves simply a “doula” are referring to their role as a labor doula (also called “birth doula”). Because of that, I will focus mainly on outlining the role of the labor doula.

Labor doulas are essentially birth attendants who are there to meet the physical, emotional, and educational/informational needs of the laboring mother.

What does a doula do?

A doula’s main job is to assist the laboring mother in whatever way she needs. Most times this involves “keeping the space” or helping to maintain a certain level of reverence, peace, focus, and respect within the birthing space. It means helping the mother into various positions to assist in the descent of the baby. It means helping the mother’s birth partner or spouse (if she has one) to feel involved and know how to best help her. Some doulas specialize in acupressure or massage techniques to help soothe the laboring mother and also to assist labor progression. Others are trained in aromatherapy, and bring those tools with them to assist in the labor space. Some doulas offer birth photography services, help with creating a prenatal belly cast, or placenta encapsulation services postpartum.

Every doula is different and brings unique strengths to the birthing space.

Some doulas specialize in particular types of birth (cesarean, adoption, multiples, child loss, and others). Many doulas enjoy advocating for a mother’s right to unmedicated and low intervention (“natural”) childbirth, and they choose to work with clients who also value those things. Most doulas enjoy helping a laboring mother achieve whatever birth experience feels most empowering to her. The doula’s job is never to make decisions on behalf of the laboring woman, nor to push her into making a decision based on the doula’s beliefs. Doulas are there to provide information, advocate for the laboring woman’s preferences, and support her through the entire labor and birth process, on into the early postpartum period.

Doulas are generally available to the family for one or two prenatal appointments. During these visits, the aim is to get to know each other better, to discuss wishes for the birth and perhaps write a birth plan, and to go over any questions the family has for the doula. Most doulas are able to provide excellent prenatal education and can answer a family’s questions about the physiology of labor as well as breastfeeding support and basic newborn care.

Doulas are usually on call and available at any moment for labor support from two weeks before the mother’s guess date (due date) until several hours after the birth (usually after breastfeeding has been established). Then, the doula will usually make a follow-up visit to the family in the early postpartum days, to discuss thoughts and reflections about the birth and assist with breastfeeding or any concerns about newborn care.

What does a doula not do?

Doulas do not provide medical care or treatment to clients. Doulas do not “catch” babies, check dilation, or perform any of the other clinical tasks of birth. Doulas do not make decisions for the family nor (in normal circumstances) should they actively intervene between the family and medical staff. Doulas are there to remind the family of their (previously stated) wishes and provide information so the family can make informed decisions for themselves.

Who can be a doula?

Anyone who is passionate about helping families through the birthing process can be a doula. Doulas can be of any age, gender, race, ethnicity, sexual orientation, or socioeconomic status. Doulas do not have to have any personal experience with giving birth. Anyone who has a respect for the birthing process and wants to help families navigate through it can be an excellent and effective support person.

Why work with a doula?

While I don’t believe that every birthing mother needs a doula, I do believe that every woman deserves to have the option of having an experienced support person in attendance during birth to see to her needs only. This is one reason why I advocate for expanding Medicaid coverage (here in the US) to cover doula services.

There are many, many benefits to having a doula attend women in labor. Research has shown that doula presence reduces length of labor, reduces requests for epidurals or other pain medications, reduces need for pitocin usage to augment labor, reduces both vacuum and forceps-assisted delivery, and reduces the incidence of cesarean birth. Mothers who have a doula present during birth report greater satisfaction with their birth experience and have lower rates of postpartum depression than those who do not have a doula. Furthermore, babies of mothers who have had doulas have shorter and fewer hospital stays, and also have greater success with breastfeeding.

Where do doulas work?

Doulas attend birth anywhere birth is happening: home, hospital, birthing center—wherever! Doulas attend planned cesarean births and unmedicated home births alike.

How much does a doula cost?

Fees vary greatly, and are based on your location, the training and experience of the doula, and any special services the doula provides. Average fee for a doula is $400, but fees may run anywhere from $250-$1000 (and sometimes more). Many doulas work on a sliding fee scale (based on what the family is able to pay) and many others will be willing to barter for their services or even take on pro bono clients in special circumstances.

If you are in need of a doula but cannot afford one, consider hiring a student doula who is working through the certification process. Many student doulas will attend births for free or at least at a greatly discounted rate as they are gaining the experience necessary for certification. If you are looking for a doula, consider using this doula locator from DONA International.

Finally, why I love being a doula:

I became a labor doula in May 2009, after completing a course offered through Birthingway College of Midwifery in Portland, OR. I met my doula partner Crystalyn during our training there, and we’ve been working together ever since, helping families through the birthing process.

I love being a doula because birth is awesome. I never get tired of being witness to the power and divine that’s present in birth. I love helping a mother achieve the empowering birth experience she envisioned. There’s nothing like being present for the moment when a new person enters this world, and I feel so blessed to be invited to help in such incredible and intimate moments.

The thing I enjoy most about being a doula is keeping the space. I don’t tend to converse much with the laboring mother (unless that’s what she wants), preferring to provide support through my presence and attention to the moment. I enjoy the natural rhythm that a mother falls into during labor, as she feels out the sensations and her body’s power.

Birth is simply amazing. I am so lucky to be able to help!

Amy writes about the things she holds close to her heart: family, delicious food, and many aspects of natural parenting. She is passionate about natural childbirth, breastfeeding, gentle, intuitive parenting, and respecting all people, no matter how small. She’s figuring it all out as she goes, following her instincts with her son as her guide. Amy writes at Anktangle.