Doula

What is a doula?

A doula is a trained professional who assists you before, during and shortly after childbirth. Doulas aren't medical professionals, and they can't deliver your baby. Instead, they complement the care you receive from your healthcare team (obstetrician-gynecologists, nurses, midwives, etc.). Doulas share nonmedical information about giving birth. They offer physical and emotional support to provide you with a positive childbirth experience.

Who should hire a doula?

Hiring a doula may be a good idea if you'd like someone in your corner who's working to provide you with the best experience possible during this major milestone in your life. A doula can advocate for your birthing preferences (ex. delivery methods, preferences regarding pain meds, where you'd like to give birth, etc.) They can offer comfort and reassurance during delivery. Doulas also help with household commitments, freeing you to focus on taking care of yourself and your new baby.

What kind of support does a doula provide?

Doulas offer different services, often reflected in their titles (birth doula, postpartum doula, etc.). These services often overlap. The same doula who supports you during delivery may also help you adjust to life after your pregnancy and delivery.

Birth doula

Birth doulas — also called birth companions or labor doulas — prepare you for childbirth and provide ongoing support while you're in labor. Your relationship with your doula often begins in your second or third semester during pregnancy.

Birth doulas:

• Discuss your preferences and expectations of childbirth. A doula will consider where you'd like to give birth, the delivery method you'd prefer, your feelings about pain medication, etc. They will support your needs and wishes.
• Prepare you mentally and emotionally for childbirth. A birth doula can help you understand what to expect during labor and teach you strategies to make the experience more comfortable (ex. breathing exercises, relaxation techniques).
• Provide physical support during labor. Birth doulas help with posture and movement, coach you through relaxation and breathing exercises to manage pain, ensure you're drinking plenty of water, etc.
• Provide emotional support during labor. Doulas coach and encourage you during labor. They also provide a calming influence for you and your partner.
• Advocate for your birthing preferences. A birth doula communicates your needs and preferences to your healthcare team, freeing you from these concerns.

Antepartum doula

Antepartum doulas assist with pregnancies that require special care and attention. They provide physical and emotional support to pregnant individuals with high-risk pregnancies, who are on bed rest or who are experiencing unmanageable symptoms, like severe morning sickness.

Antepartum doulas also:

• Plan and prepare meals.
• Plan and organize the nursery.
• Assist with housework and childcare.

Postpartum doula

Postpartum doulas provide assist you in the first few weeks or months after you've had your baby. In addition to offering emotional support to help you adjust to life with an infant, postpartum doulas:

• Help with housework.
• Help take care of the baby.
• Help with proper breastfeeding techniques.
• Advise you and the other caregivers in the household on how to care for the new baby.
• Coordinate household responsibilities and divvy tasks among family members.

A postpartum doula's role overlaps with other trained caregivers, including maternity nurses, newborn care specialists and lactation consultants.

Full-spectrum doula

Full-spectrum doulas offer support that extends beyond the more traditional role of birth doulas. They offer support for a range of pregnancy experiences. Full-spectrum doulas:

• Provide support that's similar to birth and postpartum doulas.
• Offer informational and emotional support to families and individuals across various circumstances, including abortion, miscarriage and stillbirth.
• Provide pregnancy support for members of the LGBTQIA+ community, including individuals and families who wish to conceive a child or adopt.

End-of-life (death) doula

End-of-life doulas care for a person in the days leading up to their death and assist with their passing. They may work on their own or within a hospice organization. End-of-life doulas:

• Ensure that you're comfortably positioned in bed, keep your bedroom tidy, etc.
• Provide companionship and emotional support to help you transition.

How much training is needed to become a doula?

There aren't any laws requiring doulas to be accredited, but most doulas go through training to receive certifications. Training and accreditation for doulas vary, but most programs require doulas to:

• Read required materials.
• Audit a childbirth class.
• Attend several births.
• Complete multi-day training programs or workshops.
• Obtain recommendations from healthcare providers and pregnant individuals they've assisted.

What are the benefits of having a doula?

Support from a doula can improve your childbirth experience during delivery and afterward. Doulas improve healthcare outcomes, too. Research has shown that doula-supported births are associated with:

• Increased vaginal births, as opposed to cesarean sections (c-sections).
• Less use of pain medications during labor.
• Shorter labor times.
• Increased breastfeeding.

How do I find a good doula?

Ask medical professionals, friends and family members for recommendations. During your initial meeting with a potential doula, ask:

• Where they received training.
• What certifications they've received.
• How many births they've attended.
• How many new parents they've assisted in their official role as a doula.
• How much their services cost. (Most insurance companies don't cover doula services.)

It's important to establish rapport with your doula. A good doula should be knowledgeable and an excellent communicator, but they should also be someone you like and trust.

What is the difference between a doula and a midwife?

A midwife has medical training that qualifies them to deliver a baby during low-risk births. They can also prescribe medications. Midwives can't perform surgeries, like C-sections.

Doulas aren't medical professionals and can't provide treatment or medical advice. Instead, they are trained birthing companions that advocate for you during the various phases of childbirth. They attend to your physical and emotional needs.

Can a doula deliver a baby?

No. A doula can provide support and advocacy during birth. Only a medical professional can provide treatment or deliver your baby.

Can a man be a doula?

Yes. People of all genders can be doulas, but this thinking is new.

Translated from Greek, "doula" means "a serving woman" or a "female caregiver." The term emerged during the natural birthing movement in the 1960s when more people sought nonmedical support for childbirth. The thinking was that the people with the reproductive anatomy capable of bearing children themselves would be the best at helping someone prepare to give birth or breastfeed.

Most doulas are still cisgender women, people who are designated female at birth (DFAB) and who identify as women. Still, the thinking around gender and the role of doulas have changed significantly since the 1960s. Doulas who are designated male at birth (DMAB) are increasingly receiving doula certifications and offering compassionate support to pregnant people.

Is having a doula worth it?

Many people who work with doulas are glad they received the additional support. Providers also recognize the important work that doulas do. Having a doula attend to your emotional needs in the delivery room enables your care team to focus entirely on helping you deliver a healthy baby.

A note from Cleveland Clinic

Reach out to your network for recommendations if you’re thinking of hiring a doula. Many people who have worked with doulas are eager to share how they benefited from the relationship. Having a trained professional on hand whose primary concern is to advocate for you can improve your experiences of pregnancy, childbirth and newborn care. Vet multiple doulas so that you find someone you respect and trust.