How a Doula Can Help During and After Childbirth

Marissa isn’t the only one singing the praises of doulas. Doulas are increasingly seen as an important addition to a positive birthing experience. A small 2013 study found that pregnant women who worked with a doula had better birth outcomes compared to those who didn’t. A 2017 review of several studies suggested that birthing people who received continuous labor support, such as that provided by a doula, had births with fewer interventions, shorter labors, and lower rates of postpartum depression compared to those without that type of support.

But what is a doula, exactly, and how does having one help during labor or the newborn phase?
A doula is a professional who provides physical and emotional support during childbirth and/or the postpartum period. There are generally two different types—labor doulas and postpartum doulas. Here, we examine both kinds to help you decide whether a doula is right for you.

What Does a Birth Doula Do?

A birth doula, or labor doula, is a trained nonmedical person who provides support—emotional, mental, and physical—during pregnancy and childbirth. There are a few ways they do this.

Preparation for Birth

Joini James, a birth doula in Westwood, New Jersey, says she discusses birth preferences, comfort measures, fears or worries, and how to prepare the body for labor with each of her clients.

Certain doulas also have additional specialties, like prenatal yoga, massage, nutrition, and photography.

Support During Labor

During labor, birth doulas offer hands-on comfort, coping skills, breathwork, guided meditation, and directives on position changes and movements that can help birthing parents through the process, says Zoë Etkin, a birth doula based in Memphis, Tennessee. They also provide support for your partner so they can be as present as possible during the birth experience.

“It’s a common misperception that the nurse will fill this role,” says Sarah Ludwig, a doula in Nyack, New York. “While some nurses do go above and beyond in their jobs, that is certainly not guaranteed and should not be expected.”

An Advocate by Your Side

Perhaps one of the most important roles of a birth doula is to advocate for the birthing parent. “Doulas facilitate informed, collaborative decision-making by encouraging respectful and constructive communication between clients, their families, and the medical team,” says Ariana Guilford, a doula in New York City. She adds that since they are not medically trained, they don’t replace an ob-gyn. “They supplement the provider by advocating for the client.”

Christine Riedel, of Washington Township, New Jersey, regrets not using a doula for the birth of first daughter, but was happy to have worked with one for her second delivery.

“She talked me through the entire process and spent so much time beforehand with me on the phone and in person,” Christine says. “She taught me my rights as a patient and the things I could do. It made me feel empowered to make those decisions on my own. It gave me the ammunition to call the shots when it came time to give birth.”

A labor doula may interact with your healthcare provider during your labor and delivery or accompany you to a prenatal visit. Cheruba Prabakar, M.D., a board-certified ob-gyn who practices in Oakland, California, says she has worked with many doulas.

“If labor is scary, it can be helpful to be with someone who has seen this and can be by your side,” Prabakar says. Doulas aren’t supposed to give medical advice. Rather, they are there to hold your hand and be a support system. “They are not there to do something different than the doctor,” explains Prabakar. Often, doulas will reinforce what your provider is explaining, which can help you feel like your team is on the same page.

Should You Hire a Birth Doula?

Birth doulas are good for anyone, but James points out that they may be particularly good for:

• Black/Indigenous pregnant people, who can experience racial bias in the delivery room
• First-time parents and birthing people who need emotional support, whether for anxiety or a previous birth trauma
• Families birthing in any setting who want someone alongside them to help support them in navigating the experience smoothly
• Families who want unmedicated births, an epidural, or are planning for a cesarean section
• Those who want to take charge of their birthing experience

All this help isn’t free, of course. Both experience and location factor into doula fees. Prices typically range from $800 to $3,000 or more, according to both James and Ludwig.

It’s rare for insurance plans to cover the cost of a doula. Christine said she had to pay out of pocket. Still, she loved her doula so much she maintains it was well worth the cost. Several states have passed bills or budget items to have doula care covered by Medicaid. Some organizations, like the Doula Foundation, also work to provide lower-cost doula services to families.

What Does a Postpartum Doula Do?

A postpartum doula begins their work immediately after birth to help new families adjust to the fourth trimester. “They support a family in the transition period to life with a newborn,” Ludwig says.

Among the many things postpartum doulas may assist with include:

• Help with physical and emotional healing
• Providing baby care education (swaddling, dressing, bathing, and burping)
• Assisting with nursery organization
• Providing sleep support for you and baby
• Doing the laundry
• Performing light cleaning
• Helping with meal prep
• Providing chest/breastfeeding support

“While many people are focused on the baby, we take care of the family,” Ludwig says. “You’ve heard the adage ‘It takes a village’? A postpartum doula is your village in one person. We are an extra set of hands to do whatever needs doing around the house, and experienced and knowledgeable ears to listen and normalize all of the ups and downs of the newborn period.”

A postpartum doula can also look after the baby while you rest, eat, shower, or just take some time to yourself. “They aren’t prescriptive or agenda-driven,” Etkin says. “They read what each family needs and make recommendations based upon what they observe.”

Therefore, the care a doula provides during the postpartum period can be individualized to your needs. “[Postpartum doulas] create environments that honor and protect the family and create specific systems that work for the family,” Guilford says. She adds that some postpartum doulas may also specialize in herbal care, placenta encapsulation, and postnatal massage.

Should You Hire a Postpartum Doula?

James says doulas are good for the mind and body. ”Supporting a pregnant or new parent is not only about holding the baby but really about [asking] did they eat? Have they showered? And how is their mental health?”

A postpartum doula is helpful for any new parent, but Etkin says they could be particularly useful for:

• People who don’t have a local support system
• Someone who wants a knowledgeable supporter and guide
• First-time parents
• Those who added a sibling to the family
• Those who need support during the day
• Those who need support overnight

Fees vary based on where you live and the experience level of the postpartum doula. They’re typically set at an hourly rate, and you may expect to pay $25 to $50 an hour, Ludwig says.

How to Find and Choose a Doula

Word of mouth is often an ideal way to find a doula. Ask your doctor, family, and friends for their recommendations. You could also use a resource like DONA International if you don’t know anyone who has used one.

Once you identify a doula you’d like to work with, the next step is typically an interview or consultation. It’s important to consider a doula’s training, certification, experience, availability, services, fees, and compatibility.

You might also consider the benefit of having a doula for both birth and postpartum, says Talitha Phillips, a labor and postpartum doula in Los Angeles. “One doula prepares you for labor and childbirth; the other helps you transition post-delivery,” she says. “If someone can afford both, the experience, hands-on support, and ongoing education are invaluable.”

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