For Sakinah Irizarry, the best part of being a doula is being in a room just as a family becomes a family. “The moment a new baby arrives, a family becomes complete,” says Irizarry, a Saugerties, New York doula. “I enjoy doing what I can to help the birthing mother or the birthing partners reach that moment of becoming.” Helping birthing moms and their partners is the very core of what doulas do. Defined by DONA International (the leading doula-certifying organization) as “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible,” doulas have been holding moms’ hands and helping them through labor for centuries. But it’s only in recent years that the number of these “helpers” has exploded in response to the growing call from moms to have someone on their side in the birthing room. Should you have a doula ready for your text when you’re about to give birth? We’ll let you decide that for yourself…but here’s a little information that can help you make the choice.
What do doulas do?
Unlike a doctor or midwife, whose focus is on delivering the baby, a doula’s primary concern is the person giving birth. She (or he) is in the birthing room to act as a laboring mom’s support system, advocating on her behalf by engaging the medical staff, guiding her through natural pain relief and relaxation techniques, stepping in to massage or help her get more comfortable, and answering questions posed by both mom and her partner if one is present. Essentially, a doula is an extra set of hands in the room, but one who comes in with experience and knowledge of the entire birthing process as well as information provided by a mom about what she hopes to have happen during the birth. “Some folks shy away from hiring a doula because they feel the role of supporting the laboring mom belongs to the birthing partner,” Irizarry says. “I think that having a doula frees the birthing partner to fully be present to support mom, physically and emotionally.” Doulas typically meet with expecting parents weeks or even months before the delivery will take place to talk over what a mom wants to happen during during the birth. Trained and certified doulas can help an expecting parent or couple craft a birth plan, putting together a mom’s wish list to execute on her behalf. The goal isn’t for a doula to tell a mom how to birth but to help a mom feel empowered and advocated for in the birthing room. In fact, one of the DONA requirements that doulas have to sign off on is a promise to “make every effort to foster maximum self-determination on the part of his/her clients.” When the text arrives that baby’s on their way, the doula springs into action to do what they can to ensure mom has a safe and positive birth.
What the Science Says
Given the growing number of doulas in America, it’s no wonder the scientific community has started to take notice and is giving these professionals their due respect. There’s a growing body of evidence that having a doula on hand to help a mom and her partner in the delivery room is correlated with healthier outcomes for both mom and baby. One study by Lamaze International found that doula-assisted moms were four times less likely to have a low birth weight baby, two times less likely to experience a birth complication, and significantly more likely to initiate breastfeeding. While the positives could be ascribed to the fact that a mom who can afford to hire a doula is also more likely to be able to afford better prenatal care, the researchers dug deeper, positing that “communication with and encouragement from a doula throughout the pregnancy may have increased the mother’s self-efficacy regarding her ability to impact her own pregnancy outcomes.” Other studies on doula assistance during birth have linked their presence to a reduction in preterm and C-section births and a reduction in racial and income-based disparities in birth outcomes.
What Your Doctor Says
With statistics and studies to back them up, why aren’t doulas lining the halls of every modern maternity ward? Unfortunately, the traditional medical community may be playing gatekeeper—preventing doulas from becoming regular participants in the birthing experience. Studies found that some doctors resist having an extra person in the delivery room, and when hospital rules limit attendants in the delivery room, many women find themselves forced to choose between family members and a doula. If you want a doula in the room, do your research. If you’ll be delivering at a hospital or birthing center, ask how many people are allowed in the room. Talk to your doctor or midwife about what they allow. Don’t be afraid to advocate for yourself. If you think a doula’s the right choice for you, make the case!
By the Numbers
Of course, when it comes down to it, deciding whether or not to have a doula may not just be about what they can do for you in the delivery room. It may come down to cost. Depending on where you live, a doula can cost anywhere from $500 to $3,000. Doulas fees cover their actual services, but they also help offset the cost of being on call. After all, most women don’t know exactly when they will go into labor when they contract their doula. Some insurance companies do cover the cost (or part of the cost) of having a doula present at a birth. DONA also offers a guide to getting third party reimbursement. If your insurance company refuses and you’re not sure you can swing the price, you don’t have to give up on the dream of having an advocate in the delivery room. You may find someone in your community who has the chops to be your right hand during labor. And becoming as knowledgeable as you can about birth will help you be an empowered advocate for yourself. “Take a birthing class,” Irizarry suggests. “Ask moms, your doctor, hospitals, your local library. Many birthing classes are cheap, or free.” If you can bring a few friends to the class, all the better—they’ll be more informed and better able to coach you in the delivery room. “Labor is grueling, but so is labor support,” Irizarry says. “Having two people as support means they can relieve each other and that mom is never alone.”
Find Your Friend
The easiest way to find a doula who’s up to the task is to ask other moms for recommendations. That said, it’s always wise to check up on their credentials, too. DONA International offers a find-a-doula service on its site and the International Childbirth Educators Association will let you search its membership rolls to see if a practitioner has been certified. The Childbirth and Postpartum Professional Association also offers a search for certified doulas in your area.