What Is a Doula?

Posted by Jen Reichert on

What is a doula?

To my mind, doulas are magical, mystical angels.

Back in 2010, as a newly expectant mom-to-be, I really didn't know what a doula even was. I was lucky enough to find a local doula who worked with my husband and I long before my labor began and who held my hand for as long as I needed far beyond the birth of my baby. 

Using a doula for both births of my children was a magical, rewarding experience for both my husband and myself. 

My beloved doula Kelli (owner of Cabo Doula Services) and I decided to do a Q&A. I asked Kelli some questions about working with a doula that I thought might help new moms out there. We're sharing it here for anyone interested in learning more about understanding what a doula is and what he or she can bring to the table during one of the most intimate, amazing chapters of your life. 

Thanks to Kelli for sharing this knowledge! 

The Search For A Doula 

The physical presence of a doula has been statistically significant in reducing intervention rates and the need for pain management, therefore, allowing moms to have a more natural birth.

The number one way most moms find a doula is word of mouth. Typically, a local Mom who had a wonderful birthing experience with a doula and will share that knowledge with another expecting Mom. Another way to hunt is via DONA: Doulas of North America. They have an online directory that you can find a doula in your area whether it be in the United States or in another country.

Nowadays doulas are located all over the world so Google will undoubtedly be a worthy search tool. You can also look for recommendations for doulas in your area via Mommy Facebook groups or even in What To Expect or Babycenter communities.

doula working on birth plan with Mom
The Job of A Doula

Doulas spend a lot of time with mom discussing what she wants, what her mission and vision are for her birth ahead of time.

I spend time meeting with Mom and discussing her birth plan, seeing what worked for her last birth (if this is the second or third birth) and understanding her needs for this pregnancy and birth. 

Listening is a very valuable part of the work that we do before birth. 

I listen to her fears and worries. I'm deeply listening to what the mom needs.

Additionally, I give mom the information she needs to make the best possible decisions and plan for her birth. Each mom is different, each birth is completely unique, so Mom’s needs are always going to vary.

Before Birth

We discuss the birth plan, we might meet with the doctor, we might do a review of the location to ensure she will have everything she needs. We guide her to resources to get the information she needs to be able to create the birth of her dreams.

Whether that's going to be in a birthing center or a home birth or a hospital. If Mom wants a hospital birth, then she has to decide which hospital is best for her. We act as a guide and support along her journey, helping her understand what she can expect throughout the process.

Going through the birth plan will help guide us to what the mom is looking for and how we can help her with that.

During the birth, what does a doula do?

It’s worth mentioning that communication between doula and Mom don’t just happen during birth.

Numerous calls and messages will be exchanged during the pregnancy and then especially when labor begins. A lot of questions come up that Mom maybe doesn’t feel comfortable asking a family member or husband about.

Questions like: ‘I have a certain kind of mucus;' perhaps she’s unsure if she just lost her mucus plug or maybe her water breaks. Maybe it’s a call because she’s worried about her water breaking and what wants to confirm the color the water should look like so we give a lot of guided information ahead of time.

During birth, a doula then will meet with the mom.
Prior to birth, we will have already discussed what time Mom wants us to be there. Perhaps we'll meet at home or at the hospital. Once we're with her, we're with her until the baby's born.

It’s typical for us to stay usually two to three hours after the birth to help with newborn latching and making sure mom and baby are doing well.

During the birth a doula, we hold your hand, we listen to the breathing and we either work with you in the breath with whatever breath technique that you learned. Recently, there's a lot of different techniques that are used now like vocalization. We put on music. We may or may not use essential oils depending on what’s been asked of us prior to birth.

We may or may not use flashcards or guided imagery so it just depends on what the mom has requested. There's a lot of massage that's usually done. We help to prepare the birthing environment; I like to create a spa-like feel to the room. There’s a lot involved as far as getting the room set up, making the mom comfortable, helping dad feel comfortable.

We check to see if mom needs water, we apply a cold towel, doing different massage techniques on hands and feet, getting on the floor, trying different positions, maybe using a birthing ball and generally helping her with the birth process to help her remain calm. We provide constant information, allowing the mom to be able to feel like she can express herself and really just going through the whole of the birth process with her and holding her hand through that.

Every hospital is different. Some hospitals allow us to be involved through the whole experience and other hospitals don't. A birth doula can be included at the point where you deliver and sometimes we have to wait outside of the room when you're delivering. It just depends on what your hospital’s policies are, who your doctor is and what their rules and regulations are but generally speaking, we're there during the labor and birth process.

We begin our active role when a mom is usually in active labor or sometimes in early labor.

After birth, what does a doula do?

A doula helps to clean and organize. I usually help with getting the baby's stuff together or sometimes we take pictures for the parents if they're busy doing other things. Helping with whatever tasks are necessary at the moment. We answer lots and lots of questions about breastfeeding, about meconium, about the baby's first bowel movement. We guide mom into what she can expect depending on what kind of birth she had and what kind of interventions were given.

After birth, we'll discuss if her birthing experience met her expectations and find out what her emotional experience was. About a week after the birth we regroup and see what went right and if it didn't or if anything changed, how does she feel about that or what would she have like to have done differently.

Most of the time moms are really thrilled when they have a doula. They're thrilled with the outcome of their birth and very pleased that everything usually goes to plan. And even when it doesn't go to plan, the best and most optimal decisions were made so that's always rewarding.

What questions should an expectant couple be asking a potential doula when they meet her? Here are a few of the most important topics you may want to ask:

  • How many births a doula has done?
  • What kind of educational background she has?
  • What are her normal procedures?
  • What does she like to do?
  • What her experience has been with a cesarean?
  • What her experience has been with natural birth?
  • What her experience has been with using an epidural?
  • How does she feel about certain things?
  • What's the most difficult situation that a doula's ever been in and how did she handle that?

You want to get a feel and see if there's a good connection between the doula and the mom because the doula is really like a surrogate mom, sister or a best friend but with a lot of great information. She’s already been through the labor and birthing process with other Moms and Dads.

More than anything, it’s important to be on the same page with their philosophical views. When you're interviewing a doula, ask yourself if this person will make you feel that your needs will be heard.

Will this doula be the best person for you based on their philosophical views of birth and laboring? And for everyone, it's truly different.

What are some things that a doula can bring to the table during the actual labor, i.e. essential oils, music, etc?

In my bag of tricks I have my birthing ball, I have [???] which are giant big pads for mom and I have a really big Mexican blanket that I like to put on the floor so she can have room to get on hands and feet or do some exercises with.

I have little tiny massage balls that I use. For comfort measures, I use essential oils and massage oils. I have a special oil blend for labor and I have hot pads and cold pads which are great for lower back pain for mom.

I also use ambient spa music and electrical candles rather than regular ones for safety reasons.

Depending on where you're going to have your baby, what hospital, here in Mexico we kinda need extra stuff so I like to plan for in case for all worst-case scenarios in case we're gonna be there for a little while longer than we would normally expect. So for those things I also bring in my car changes of clothes, bedding, sheets and food for me, more than anything else so a lot of the stuff that I bring also is for me in case I have to be there for a long time.

Are there any challenges to having a doula being involved in the birth process? 

It could be a challenge if a doula's perceived as somebody who's taking away the moment from the dad or the couple. A doula can be a challenge if she has very, very strong opinions, isn't really grounded and is using her beliefs to create problems with the nursing staff and the doctors.

Doulas need to be very respectful of the couple and very respectful of the doctors and nurses. Making sure that they are working in conjunction with and not against making sure that the doula is not talking over a mom, partner or for a couple. That the doula is really respecting the mom's wishes but also allowing the mom to be autonomous and to take her own initiative to be able to speak very clearly for herself.

A doula's job is to help remind the parents to stay focused on the birth plan, to give options or information, not to make any decisions for them. So in that respect, it's important that doulas create a very loving, respectful environment and try to use the best words possible when something needs to be accomplished so feelings aren't hurt and things can move very smoothly. Her job is to be a part of a very fluid team. We want a team that's working together and not working against anybody, right?

Part two coming soon.... 

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