Frequently Asked Questions About Doulas
Here you can find some frequently asked questions about doulas. What Is a Doula and Should You Hire One for Your Baby's Birth and afterwards? What is a postnatal doula?
What is a doula?
A doula is a professional support provider who trusts and understands the physiological process of childbirth and respects the psychological and social impact a birth experience has on the whole family. Doulas provide practical, emotional and informational support and have no agenda of their own. They know that everyone will birth and parent in ways that are right for them and that to be able to make informed choices in the childbearing year, expectant parents need access to evidence based information.
A birth doula:
A postnatal doula:
A birth doula:
- Recognises birth as a key life experience that will be remembered for life
- Understands the physiology of birth and the emotional needs of a person in labour
- Assists the woman or birthing person, and the partner (if there is one), in preparing for and carrying out their wishes for the birth of their baby
- Stays by the side of the labouring woman/person throughout the entire labour
- Provides emotional support, physical comfort measures, an objective viewpoint and assistance to the woman or birthing person in getting the information they need to make choices.
- Facilitates communication between the labouring woman/person, the partner and medical care providers
- Perceives the doula role as one who nurtures and protects the woman’s or birthing person's memory of their birth experience
A postnatal doula:
- Recognises that becoming a mother/parent is a life changing event
- Understand that each new mother/parent needs to find and discover their own way of mothering/parenting
- Offers education, non-judgemental physical and emotional support during the first three months or more following the addition of a new baby to a family
- Assists with new born care, family adjustment, meal preparation and light household tidying
- Offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents
- Signposts and makes appropriate referrals when necessary
WHAT KIND OF CARE DOES a DOULA PROVIDE?
From the beginning of time, women have received compassion, kindness and support during pregnancy and childbirth, from the community. Sisters, aunties, mothers and friends from the village would support the new family and guide them through the early weeks and months with a newborn. However, today this support is often not there because our lives usually involve more travel and relocation. Therefore, this important role is now provided in a professional capacity – the doula!
WHAT ARE THE BENEFITS OF DOULAS?
BIRTH DOULAS:
A Cochrane qualitative evidence synthesis carried out in 2019, which complements a previous Cochrane review published in 2017, explored the effect of continuous support for women during childbirth. The results of these reviews concluded that if a woman/birthing person has continuous support during childbirth, which means having someone there the whole time, both mothers and babies are statistically more likely to have better outcomes.
The Cochrane review was able to look at six outcomes and document the difference a birth partner made in these areas: use of any pain medication, use of artificial oxytocin during labour, spontaneous vaginal birth, caesarean births, the baby’s admission to special care nursery after birth, and negative birth experiences.
Two out of the six outcomes showed the best results when the support was provided by a doula – someone who was not a member of the hospital staff member and who was not part of the woman’s social network.
The researchers found that overall, women or birthing people who have continuous support during childbirth experience a:
There is a lot more research and studies on this website too.
POSTNATAL DOULAS: Research by experts tells us what many have long suspected, that those new parents who have support and feel secure and cared for during this time are more successful in adapting than those who don't. Studies have shown that cultures in which women are cared for by others for a defined period of days or weeks and are expected only to nurture themselves and their babies during that time have superior outcomes in postnatal adjustment. We know that women who experience support, compared to those that don't, have:
Coming into the home during the fourth trimester following birth, the doula's role is to provide education, non-judgmental support and companionship; and to assist with newborn care and family adjustment, meal preparation and light household tasks. Postnatal doulas offer evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and can make appropriate referrals when necessary.
The doula can serve as a buffer for new parents who receive a great deal of unsolicited and possibly outdated advice. The doula can help friends and family members to foster and support the parenting decisions of the new parents. By modelling a deep respect for the wisdom and decision-making abilities of the new parents, they makes clear that supporting them in their own choices will have the best possible results. By dedicating themselves to the family in this way, doulas validate and enhance the parents' intuitive ability to nurture and this encourages them to develop and implement their own parenting style.
(From the DONA Position Paper on Postpartum doulas)
A Cochrane qualitative evidence synthesis carried out in 2019, which complements a previous Cochrane review published in 2017, explored the effect of continuous support for women during childbirth. The results of these reviews concluded that if a woman/birthing person has continuous support during childbirth, which means having someone there the whole time, both mothers and babies are statistically more likely to have better outcomes.
The Cochrane review was able to look at six outcomes and document the difference a birth partner made in these areas: use of any pain medication, use of artificial oxytocin during labour, spontaneous vaginal birth, caesarean births, the baby’s admission to special care nursery after birth, and negative birth experiences.
Two out of the six outcomes showed the best results when the support was provided by a doula – someone who was not a member of the hospital staff member and who was not part of the woman’s social network.
The researchers found that overall, women or birthing people who have continuous support during childbirth experience a:
- 25% decrease in the chance of a caesarean birth; if the birth partner was a doula it was a 39% decrease
- 8% increase in the likelihood of a spontaneous vaginal birth; if the birth partner was a doula 15% increase
- 10% decrease in the use of any pain medication
- Shorter labours, on average by 41 minutes
- 38% decrease in the baby’s risk of a low five minute Apgar score
- 31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff
There is a lot more research and studies on this website too.
POSTNATAL DOULAS: Research by experts tells us what many have long suspected, that those new parents who have support and feel secure and cared for during this time are more successful in adapting than those who don't. Studies have shown that cultures in which women are cared for by others for a defined period of days or weeks and are expected only to nurture themselves and their babies during that time have superior outcomes in postnatal adjustment. We know that women who experience support, compared to those that don't, have:
- greater breastfeeding success
- greater self-confidence
- less postnatal depression
Coming into the home during the fourth trimester following birth, the doula's role is to provide education, non-judgmental support and companionship; and to assist with newborn care and family adjustment, meal preparation and light household tasks. Postnatal doulas offer evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and can make appropriate referrals when necessary.
The doula can serve as a buffer for new parents who receive a great deal of unsolicited and possibly outdated advice. The doula can help friends and family members to foster and support the parenting decisions of the new parents. By modelling a deep respect for the wisdom and decision-making abilities of the new parents, they makes clear that supporting them in their own choices will have the best possible results. By dedicating themselves to the family in this way, doulas validate and enhance the parents' intuitive ability to nurture and this encourages them to develop and implement their own parenting style.
(From the DONA Position Paper on Postpartum doulas)
WHERE DO DOULAS WORK?
Birth doulas support birth in all settings, home births and hospital births in both birth centres and labour wards.
Postnatal doulas usually work in your home, but have been known to accompany clients on holidays and other outings.
Many doulas also offer remote as well as in person support via various online platforms such as Zoom or FaceTime. This means that you can get doula support virtually if you are not comfortable with in person support or would prefer remote support if you are elsewhere in the world for example.
Postnatal doulas usually work in your home, but have been known to accompany clients on holidays and other outings.
Many doulas also offer remote as well as in person support via various online platforms such as Zoom or FaceTime. This means that you can get doula support virtually if you are not comfortable with in person support or would prefer remote support if you are elsewhere in the world for example.
DO DOULAS WORK ALONE OR IN A TEAM?
The answer is actually both! All doulas are self-employed and run their own doula businesses or work with other doulas in collectives. Find out from the doulas you speak to how they work, if they have doulas available for back-up or if they have shared-care agreements.
HOW ARE DOULAS REGULATED, SUPERVISED AND INSURED?
There are no official or governmental regulations for doulas anywhere in the world. A doula is a 'lay' person, offering support and guidance in the childbearing year. In theory, a doula should not be the sole carer for children or babies as they are not there to take over the care from the parents. A doula is there to support, encourage and offer information so that the parents can discover what type of parenting feels right for them.
As there are no regulations, there are no requirements for doulas to hold any type of insurance or to have undergone a criminal record check, known as getting a Disclosure and Barring Service (DBS) check. However, the doulas listed on The Doula Directory have been recommended to have a valid DBS checks as well as Public Liability and Indemnity insurance cover.
As there are no regulations, there are no requirements for doulas to hold any type of insurance or to have undergone a criminal record check, known as getting a Disclosure and Barring Service (DBS) check. However, the doulas listed on The Doula Directory have been recommended to have a valid DBS checks as well as Public Liability and Indemnity insurance cover.
AT WHAT POINT CAN I BOOK A DOULA?
You can connect with doulas as soon as you find out that you're pregnant and some doulas also offer pre-pregnancy services. It's never too late to look into having doula support though and a doula can be booked at any time during your pregnancy as well as in the postnatal period.
THERE ARE many DOULAS IN MY AREA, HOW DO I KNOW WHICH ONE IS RIGHT FOR ME?
You might think that hiring an Accredited Doula with lots of experience will guarantee you having all the benefits that doulas can bring, however, the most important thing is to find someone who you really connect with. After all, they're going to be sharing in one of the most intimate times of your life, so they have to be the right person. And what that looks and feels like is going to be different for everyone. Yes, experience is useful; it's where the learning happens and it’s definitely how we grow as doulas, but it's not the be all and end all. Some look for a sisterly doula, others for a motherly doula and there are also the grandmother doulas out there. Women have been supporting women during the childbearing years ever since time began. Your job is to find the right one for you.
Some newly registered doulas may have been working in a doula capacity for many years, supporting friends and family members as they birth their babies, without even really knowing the role had a name. Others, are former midwives, antenatal teachers, HypnoBirthing practitioners or have worked as doulas in other countries. There's even some who have been working professionally as doulas and have only now decided they'd like to join a doula organisation. And as the vast majority of doulas are already mums themselves, they have at the very least, experienced their own births. Just because they're not yet officially accredited, doesn't mean that they don't already have plenty of wisdom and support to offer. A doula who hasn't given birth has the advantage of not having any preconceived ideas and many midwives have not got children either.
If you feel a connection, you feel safe and uplifted, you feel that this doula is right for me - you should go with your instinct!
Some newly registered doulas may have been working in a doula capacity for many years, supporting friends and family members as they birth their babies, without even really knowing the role had a name. Others, are former midwives, antenatal teachers, HypnoBirthing practitioners or have worked as doulas in other countries. There's even some who have been working professionally as doulas and have only now decided they'd like to join a doula organisation. And as the vast majority of doulas are already mums themselves, they have at the very least, experienced their own births. Just because they're not yet officially accredited, doesn't mean that they don't already have plenty of wisdom and support to offer. A doula who hasn't given birth has the advantage of not having any preconceived ideas and many midwives have not got children either.
If you feel a connection, you feel safe and uplifted, you feel that this doula is right for me - you should go with your instinct!
In which ways can a doula enhance already established services?
- Unless the woman or birthing person is cared for by an independent midwife, they are likely to see different midwives during their pregnancy – the doula stays the same
- Unless they have booked a 'domino delivery' with their midwife, they are likely to labour at home on their own before transferring to hospital – the doula would come and stay as soon as the woman/birthing person wanted them
- By the time they go to hospital, the doula has established a working relationship with the labouring mother/person, which is of immense value for continued progress and minimal emotional upheaval
- If the woman/birthing person has booked a home birth, the doula is very familiar with the surroundings, will find things quickly and will stay until their client is emotionally settled; if the midwife feels that the birthing woman/person needs to transfer into hospital, the doula is with them during those crucial times, when the midwife is busy with making arrangements and during transfer – during all these changes the doula provides emotional stability and continuity of care
- Soon after birth, the midwives will be busy cleaning up and writing notes, however, the doula will still be by their client’s side
- In the time following birth the woman/birthing person will normally see several different midwives and a health visitor, however, the doula will be able to consistently be there to listen to any concerns
What is NOT included in doula support?
Doulas are not medically trained and do not give any kind of advice. They do not:
- Carry out any midwifery tasks such as vaginal exams or monitoring the baby’s heart tone
- Diagnose conditions
- Make decisions on behalf of their clients
- Pressure or try to convince their clients to do what they consider to be the best thing
- Take over the partner’s role but instead offers support to them too
- Usually change shifts or leave after a certain number of hours
- Usually don’t plan to catch the baby
