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A birth doula is quite different from the other two types of doulas. She specifically helps a woman prepare for the birth, deal with it, and recover from it. She provides five types of support: physical (like a personal handmaiden), emotional (like a trusted friend), informational (like a walking textbook), mediatorial (like a nurturing protector), and spiritual (having a special woman-to-woman connection). Because every woman’s response to labor is different, the doula must be able to meet her clients’ particular needs. Meeting before the birth, working on a birth vision jointly (like a birth plan), going to an appointment together, attending the birth, helping with bonding and nursing and visiting afterwards creates a trust relationship that develops over time. When the mother develops this comfort with the doula and confidence in the birthing process she tends to have a safe, satisfying, and successful birth. The “wrap-around care” that a doula offers is not provided by any other member of her birth team—it is a truly a unique and special relationship.
Research since 1980 shows that there are many benefits to having doulas: shorter labors, less interventions used, fewer cesarean deliveries, more satisfying birth experiences, more successful breastfeeding, and decreased postpartum depression to name a few. Even though a doula can dramatically reduce the cost associated with births, insurance companies do not routinely cover their fee. Some couples participate in a tax-free employee benefit plan at work which reimburses for medical expenses not usually covered by traditional health insurance. Doula fees are sometimes paid in that case. It’s worth contacting an insurance company or employer to investigate this possibility.
Some worry that the doula might take away from the partner’s role at the birth. In fact, research shows the opposite: dads are more involved because the doula guides, suggests, and models roles for them to follow. She helps them find their comfort level and watches over their well-being, too. After all, he needs to be the rock for the family when everyone disappears after the birth. It is critical for the doula to safeguard dad’s stamina and ability to function as a new parent. She also gives him the opportunity to take a break or eat a hot meal or go for a brisk walk, guilt free. This removes the total responsibility of the mom’s labor support off his shoulders. And he gets to be in the first family photos instead of taking them…that’s a real bonus! Lastly, a doula is fond of her client but does not love her so she doesn’t get swept away emotionally like a family member might. This caring detachment is a real plus when facts need to be gathered or difficult decisions need to be made.
Others wonder why a doula is needed if staff is there. Medical staff work in shifts and go on breaks, so caregivers change often. They also have more than one patient so they go room to room. Also, the staff does not know the parents like a doula does. Some births take place at the client’s home so there is no staff on duty at all.
Some question why a doula would be necessary if using a midwife. Even though their roles overlap, the midwife is still in charge of the medical care whereas the doula’s job is strictly one of “social” support. Midwives need breaks too, for sleep or to eat to be medically ready. But a doula can perform her duties half asleep and hungry and still be effective! Since doulas and midwives tend to have similar birth philosophies, working in alliance for the client’s benefit is especially advantageous.
Giving birth is a rite of passage for a woman so pregnancy, delivery, and postpartum should be a special time for the mother. By hiring a doula to assist during this unique phase in a woman’s life, she can truly feel well-educated, supported and assisted. This combination leads to feeling empowered and confident. After all, generations of women have been helping other women to prepare for and to deal with being a new mother. Why shouldn’t modern women consider taking advantage of a tried and true system that has worked for thousands of years?
 About the Author:
Jan has over 28 years of experience in childbirth education, labor support, breastfeeding and related fields. She is a certified childbirth educator through the International Childbirth Education Association (ICEA) and has certification as a birth doula through both ICEA and DONA (Doulas of North America) and is a DONA-approved Birth Doula Trainer. Jan is also a certified postpartum doula through both DONA and CAPPA (Childbirth and Postpartum Professional Association) and is a CAPPA-approved PP Doula Trainer and served as an initial faculty member for the ICEA Birth Doula Certification Program. She has been published many times, is a consultant and has presented topics locally, nationally and internationally at professional conventions & workshops. Jan is lovingly supported by her husband of 36 years, Frank, and their grown children Frank, Jr., Heather and her husband, Dror.
Visit Jan's website: www.heartandhands.8m.com
 This article appeared in Pathways to Family Wellness magazine, Issue #19.
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