Key takeaways:
A doula is a person who helps guide and coach you through a life transition, such as giving birth.
Birth doulas provide different types of emotional and physical support to help during the birth of your baby.
There are pros and cons of hiring a birth doula, and it’s important to make the right decision for you.
Many expectant parents are looking for additional guidance and coaching as they prepare for the birth of their baby. A doula is someone who can help guide you through this exciting and overwhelming time. Read on to learn more about who a doula is, who a doula isn’t, and if finding a doula might be the right choice for you.
A doula is someone who helps you through a major life change or transition. The word “doula” comes from ancient Greek and means a “woman who serves.” Doulas help provide physical and emotional support. Birth doulas join you during the birth of your baby to assist, encourage, and guide you through it.
There are also postpartum doulas, who help provide support after a baby is born. They may help you with physical discomfort, as well as with breastfeeding, caring for your infant and any other children, or other household tasks.
And, in fact, there are additional types of doulas to help through other life transitions — including death doulas.
A birth doula helps you with nonmedical support during pregnancy, labor, and giving birth. For example, a birth doula may:
Help with nonmedical pain management through techniques such as massage, breathing, and birthing positions
Provide one-on-one attention during childbirth
Help manage anxiety
Provide emotional support
Advocate for a person’s birthing preferences
Facilitate communication with a medical team and inform decision-making
Studies have shown that mothers need less medical intervention and feel more satisfied with the birthing process when working with a doula.
Doulas do not have medical training. Many doulas complete a certificate program (such as through DONA International) that includes courses as well as attending live births. Training requirements vary by state and by training program. There are currently no federal regulatory or legal requirements for doulas.
There are important differences between a doula and a midwife. A midwife is a medical professional with training and certification in prenatal care and childbirth. A midwife would provide medical care and be the one to manage your pregnancy and deliver your baby. A doula would provide nonmedical emotional and physical support.
The decision to hire a birth doula is a personal one, based on many factors. While most people do not have a birth doula, it’s been estimated that about 6% of American mothers hire a doula.
A meta-analysis of 26 trials comparing one-on-one labor support (having a person present throughout the birth to provide support, like with a doula) with usual care (the typical experience of giving birth in a hospital) found improvement in outcomes and no harms. These improved outcomes included:
Increased number of spontaneous vaginal births and decreased cesarean sections, or C-sections
Decreased need for pain medication
Decreased use of epidurals for pain control
Decreased use of vacuum or forceps for delivery
Decreased time of labor
Decreased negative feelings about the childbirth experience
All of these outcomes lead to lower overall costs associated with childbirth. Studies have suggested that if Medicaid programs provided coverage for doulas it would help state programs save money.
There are many benefits to having a birth doula, including:
Encouragement and support: having a cheerleader
One-on-one attention during the labor and delivery: more than is provided by a nurse or healthcare provider
Pain management: through natural methods such as massage, meditation, breathing exercises, and birthing positions
Coaching of partners: addressing what can be an overwhelming time for partners, too
A birth doula may be especially important for someone who may not have another support person to be with them during labor.
There are some potential cons to hiring a birth doula:
They may get in the way of your partner.
They can be expensive.
They do not have as much training as your healthcare provider or nurse.
They may be inexperienced or unhelpful.
It’s also important to be aware that, depending on COVID-19 restrictions, you may only be able to have one support person in the room with you.
When thinking about hiring a birth doula, there are some important issues to address, including cost, insurance coverage, and if the doula is a good fit for you.
The cost of a doula varies widely, from a few hundred dollars to thousands of dollars. The price will depend on where you are located and the doula’s experience.
The cost of a doula is usually paid out of pocket, which makes it a barrier for many people. And while some state Medicaid programs and private insurance companies now cover the total or partial cost of doula services, it is still rare. So make sure to check with your insurance plan.
To reduce the cost, you can search for volunteer or sliding-scale doula programs. Check with your healthcare provider about programs in your area.
As you start looking at options for birth doulas, ask yourself these questions:
What is the doula’s training and experience?
What hours does the doula work?
What is the cost?
How do you feel when you’re around the doula? Do you feel comfortable and at ease?
What are the doula’s references?
Giving birth is private and personal. It’s crucial to trust the person you are inviting into that experience. When it comes to finding a doula, take your time and make the right decision for you.
Giving birth is a major life transition, and many people benefit from some additional help during this time. A birth doula can help make this a more comfortable, relaxed, and enjoyable experience. When choosing a doula, it’s important to do your research and find the right fit.
Bohren, M. A., et al. (2017). Continuous support for women during childbirth. Cochrane Database Systematic Reviews.
DONA International. (n.d.). About DONA International.
Dukehart, C. (2011). Doulas: Exploring a tradition of support. NPR.
Ellin, A. (2021). ‘Death doulas’ provide aid at the end of life. The New York Times.
Haelle, T. (2020). What is a doula? And do you need one? The New York Times.
Kozhimannil, K. B., et al. (2016). Modeling the cost-effectiveness of doula care associated with reductions in preterm birth and cesarean delivery. Birth.
Radical Doula. (n.d.). Volunteer programs.
Safon, C. B., et al. (2021). Doula care saves lives, improves equity, and empowers mothers. State Medicaid programs should pay for it. Health Affairs Forefront.
Strauss, N., et al. (2016). Overdue: Medicaid and private insurance coverage of doula care to strengthen maternal and infant health. The Journal of Perinatal Education.