There are plenty of reasons having a doula on your birthing team can make the experience better. For starters, it can improve your birth outcome. According to the American College of Obstetricians and Gynecologists, “Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support is associated with improved outcomes for women in labor.”
Doulas, of course, offer that continuous one-to-one support — and trust me when I say that no matter how amazing your partner/mom/BFF/OB-GYN is, when you’re about to bring a new person into the world, having someone who’s 100 percent there for you, your baby, your birth and your needs is huge.
But there’s a lot of confusion about the birth process and the doula’s role in it, so we asked Tara Brooke and Gina Giordano, cofounders of Doula Trainings International, a doula and childbirth educator training program, and their doula community members to share what exactly doulas do — plus, what they don’t do — and what they wish their clients really knew about birth. (Full disclosure: Tara Brooke was my doula when I was pregnant with my first child.)
“A doula is really there to say, ‘What do you want? What's going to work for you, your life, your lifestyle?’” says Giordano. “It’s an invitation and permission to look inward and really think about what's going to feel good for you and knowing that your choice is valid because it’s your choice.”
Don’t think you don’t need — or won’t be able to work with — a doula simply because you’re having a C-section or want an epidural. “Doulas should hold zero prejudice over how a baby is being born,” says doula Betsy Finchum. “The amount of moms I run into who don’t think a doula will support them because they are having a planned cesarean is super-sad to me.”
More than one DTI doula stressed this point: If you don’t love your health care provider, try to find another one. “Someone once told me, 'If your birth plan is your sword and your doula is your shield, you’re with the wrong provider,'” says doula Dani Moeser. “I wish clients felt more comfortable asking hard questions of their providers and being honest about if it’s a good fit or not. We can support them in any environment, but we can’t completely reshape it.”
“We're there to be an advocate for the family, talking to them and showing them their options — not making decisions for them,” says Giordano. “We’re reminding them that they can pause to think and really discern the whole situation to see what their options are. We're definitely not saying, ‘This is what I think you should do,’ or ‘You should say no to that.’”
Even if everything goes swimmingly, you’re probably not going to remember every detail of your baby’s birth. Your doula can help you fill in the blanks. And if things don’t go the way you'd hoped, a doula can be even more helpful. “There is a piece of counseling in the doula's role,” admits Brooke. “It's not about getting a person to a place of acceptance, but just exploring where they are in the moment and giving them permission to have those feelings and to explain what happened.”
Again, doulas are there to support you — not tell you what to do or what not to do. “You do not need my permission to make a decision, to change your mind, to do what you feel is best for you and your body and your baby,” says doula Elisa Havens-Stokes.
Sure, you might be especially inclined to hire a doula, as I was, if you don’t have family nearby to help. But even if your mom, mother-in-law, partner and BFF are all planning to be in the delivery room, you may still want a doula. “I've had a lot of clients who have a solid village around them who still choose to work with a doula,” says Giordano. “They want to have that one person to go to for continuous support.”
Don’t be surprised if your doula works with a backup or a partner — someone who may take over if your labor is especially long. That’s a good thing. “If you have a three-day birth, you might want someone who has slept and can really support you during that last phase,” Brooke says. “A lot of doulas feel like they’re letting down their client if they leave, but really, this setup offers the best possible support.”
“Doulas do not replace partners, but enhance their role,” says Finchum. And in fact, doulas can provide support to partners too. “We forget that fathers and partners are emotionally attached to this situation, and they're transitioning into parenthood, and they’ll probably need to take a break at some point,” Brooke says. A doula can reassure your partner and be there for you if and when your partner needs to go get a cup of coffee.
“I wish my clients knew we aren’t saviors,” says doula Sabrina Kline. “We can’t take the pain away. We can’t make decisions for them. We can’t fight the hospital staff for them. We can only help build the bridge, encourage them across it and wait for them on the other side with everlasting love and support.”
“Power is not the only acceptable feeling,” says doula Sophi Scarnewman. When it comes to your birth experience, “you can be salty about it. You can be triggered by it. You can be grateful for it. All feelings are welcome.”
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