Where does the word ‘doula’ come from?
The word ‘doula’ comes from ancient Greek, meaning ‘woman’s servant’. Another translation is ‘to mother the mother’. Throughout history and in much of the world today, a cadre of women support a woman through labour and birth, educating, giving back rubs and providing continuous emotional support. Like their historical counterparts, doulas know how to help a woman in labor feel better. However, today’s doulas are much more diverse than their predecessors. Our work is evidence based and has decades of research supporting it.
What is the difference between a midwife and a doula?
A midwife is trained to do medical procedures and evaluate the well being of both mother and child, whereas your doula’s priority, as a non-clinical care provider, is your emotional support andand physical comfort. Not only that, she also spends a great deal of time with you prior to the actual birth, helping you to understand the birth process, providing you will realistic expectations and educating you about your place of birth. Because of a complex hormonal brew, women need to truly feel safe for their labor and birth to progress normally. While your midwife or OB may spend time with you explaining the process, your doula, usually has more time for you to ask the nitty gritty questions that relate to your fears, anxieties, referral resources and parenting expectations.
As shifts change within the maternity ward, you may see many different midwives throughout your labor, whereas your doula stays with you continuously. Your doula focuses only on you, but a midwife has other moms and babies to look after and some can only check in on you, even whilst you’re in active labor, every half hour or hour.
Do I really need a doula if I have a midwife?
Most couples will answer ‘yes’ to this question. Although there is some crossover between the roles of doulas and midwives, there are many important distinctions. Primarily, the midwife’s responsibility peaks at the time of the birth, which is when she must be at her most alert to perform her job effectively. This means that she must conserve her energy throughout your labor to perform her job as best as she can. This does not mean that midwives do not provide labor support – they do- just that they have many other responsibilities that must take precedence.
In contrast, a doula’s responsibility peaks during active labor and transition, when you need the most help coping with your contractions. By the time the birth rolls around, the doula has already accomplished most of her work–she has helped you through your labor to the point of birth. As a result, a doula can afford to spend most of her energy in the labor stage.
As the midwives are busy setting up for the birth, taking fetal heart tones, charting, and many other important tasks related to monitoring the health of mother and baby, your doula is there with you, coaching you through each contraction, heating up your hot packs, adding fresh water to your bath, and fetching a glass of juice for you, and a cup of coffee for your partner. Doulas are also very helpful at a homebirth, where an extra pair of hands to help with the clean-up, or whip up a post-baby meal can come in very handy. Ideally, doulas and midwives work hand-in-hand at every birth.
Does a doula replace medical staff (e.g midwife)?
No. Doulas do not replace midwives or other medical staff. Doulas do not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postnatal care clinical care. They are there to comfort and support the mother and her partner and to enhance communication between the mother and medical staff.
Does a doula make decisions on our behalf?
A doula does not make decisions for clients or intervene in their clinical care. She provides informational, physical and emotional support, whilst respecting a couple’s decisions. She cannot speak on their behalf, but will often facilitate more effective communication between the couple and the caregivers. This enhances the decision making processes and creates a clear understanding for informed consent.
Who has a doula?
Some couples appreciate having a doula for their first birth and others with subsequent births. Women who have some anxiety around being in a hospital, or who have anxiety about the unknown especially benefit from having a gentle guide helping them through the process. Some women who have been dissatisfied with a previous birth experience and wish to achieve a better outcome hire a doula for subsequent births. Women without the desired support people available also hire doulas. Doulas attend births at hospitals, birth centers and home births.
What are the limitations of the doula service?
Doulas are not midwives, nurses or doctors and do not give medical advice or perform clinical tasks during labor such as monitoring baby’s heart rate, performing vaginal exams, assessing baby’s position, taking blood pressure etc. Doulas do not make decisions or speak on behalf of the couple, yet they can help the couple make informed decisions by ensuring all information is obtained from the medical staff and understood. The doula agreement outlines the role and limitations of the doula.
Can I have a doula at a homebirth?
Doulas are very helpful at homebirths, often arriving to support the couple before the midwife. They provide an extra pair of hands for the midwife, whose primary responsibility is the wellbeing of the mother and baby. At a homebirth, doulas provide the physical and emotional support for the woman and her partner. Practical aspects are often the doula's responsibility; keeping the birth pool warm enough, drinks, snacks, taking photos, taking care of any siblings, helping with mother and baby soon after birth, with the clean-up, or whipping up a post-baby meal. Ideally, doulas and midwives work hand-in-hand at every birth.
What effect does the presence of a doula have on the mother?
When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, reduced chance of maternal fever and infection, have fewer caesareans and requests for medical intervention, and less postnatal depression. Mothers also feel more secure, more in control, have reduced levels of anxiety, reduced maternal bleeding following birth and have a higher regard and increased sensitivity towards their babies. (source)
What effect does the presence of a doula have on the baby?
Babies have shorter hospital stays and fewer admissions to special care nurseries. Mothers are more affectionate to their babies in postnatal period and there is an increased chance of successful breastfeeding. (source)
What research is there on doulas/birth support?
See 'Doula Support' for links to studies and analysis.
What about the partner?
Doulas definitely support the partners and husbands too! During the prenatal visits, the role the partner wishes to take throughout the labor and birth is discussed. It’s important also for them to feel they can change their mind when the time comes around too! My role is to respect their wishes and support them through this process as well. This is a journey for birth of you.
Some partners like to take a very active role in labor, confidently supporting the mother through every contraction with unflagging energy, encouragement and good humor. Others calmly provide massage, cool cloths and endless hours of walking and slow dancing.
Still others like to be a quiet presence, happy to be nearby but feeling somewhat overwhelmed, anxious in the medical environment, and unsure of what support is needed or wanted. Some aren’t sure how they feel and the doula can provide reassurance, encouragement, and practical advice and also facilitate communication between them, the woman, and medical staff.
Sometimes the role the partner and I take can change throughout the woman’s labor. I model emotional and physical support techniques, and give them the encouragement and space to develop their own style of labor support. I then take care of practical and logistical tasks so the partner can focus on the birthing woman. Birth can be an immensely exciting time for partners, and one that can be extremely validating and confidence building as they make the transition to parenthood. But it can also be an overwhelming and anxious time for them.
Supporting a woman to labour and birth normally can be hard physical and emotional work. For a partner working by themselves supporting the mother is a marathon task, as they do not have the wonderful endorphins provided to the woman by her body, relieving her pain and rendering her unaware of the passage of time. Having a doula present enables the partner or husband to participate in the birth at their comfort level.
As a doula, I can also prepare food for you both as necessary, and also provide reminders to you both to eat and drink. When your partner needs a break to attend to their own needs, they can be assured that you will be supported through every contraction by your doula.
No one can replace a woman’s partner or husband at the birth because of the incredible connection that exists between you. It is an honor to be witness to this and it fuels everyone throughout the labor. The emotional support and comfort that your husband/ partner can bring to you during labor are of a quality no other can provide. As a doula, I understand that this support is essential to you in labour and by doing the physical work of heating up the hot packs, filling the bath, applying counter pressure to your lower back or taking photos, enables your partner to focus their full energy on providing you with this wonderful form of support and attention.
When in my pregnancy should I book a doula?
The earlier the better! Some women have even contacted me well before they have become pregnant! Once pregnant, the number of prenatal visits we will have will be the same whether you book at 12 weeks or at 32 weeks. The difference is that you’ll have someone that you can call on or email with those “Is this normal?” or “What does this mean?” sort of questions throughout your pregnancy. The longer we have known each other the more opportunity we have to build a relationship. Contacting and/or booking in early also gives you a greater chance of our availability.
What geographical areas do you cover with your services?
Being based in Union Square, we can easily get to any part of Manhattan or the outer boroughs. If you are birthing elsewhere, please also get in touch. If you are planning a homebirth and are unsure whether your location is suitable, please just contact us.
Will you be attending hospital tours and doctors visits with me?
We can, but we would ask for a small additional fee for this extra time since it is not included in our package.
Hospital tours are really a time for you to get the lay of the land. You will want to know where to park, where to enter, if you need to bring any preregistration forms, how many people can be in the room, what you can bring, if you can eat or drink. You can also simply ask "What are the hospital policies that I should know?" and they'll get you covered. This is also a chance to get a feel for the environment you'll be in. If you have any concerns, definitely reach out to your care provider.
In regards to attending doctor's visits, we believe that everyone on board should act as a team, so this can be a great way to have connections formed, but it can depend on your comfort level and the doctor's preferences. Talk to your care provider if this is allowed.
Where do the prenatal and postpartum visits take place?
Consultations happen at the office, but once you book a doula the prenatal visits and postpartum visits are in your own home. The home is where you will be spending most of your time in labor and where you will be getting to know your new baby, so we like to come to you to offer our support.
How do I book a doula?
You would first either attend our free Monthly Open House or schedule a consultation. If you decide to work with us, great! Please email us and we will send you the service outline and contract to be returned with your signature. Once we have your contract, we will send you an invoice for the initial deposit. Sending us the deposit means we confirm our availability with your due date and will reserve that time for you. From there, we can move forward and schedule prenatal visits.