What is a Doula?
A doula is a trained or lay professional who provides a holistic approach to care through emotional, physical, and educational support to a woman through pregnancy, birth, and postpartum, as well as the birth partner. There are doulas that are specific to birth, or to just the postpartum, and then those who do both aspects of care. Some birth doulas also provide support to women through miscarriage, stillbirth, or neonatal loss. These doulas are often referred to as bereavement doulas, and usually have specific training for the particularly sensitive needs for these families.
The doula-client relationship is a very special one, usually developing months before the birth. The doula-client relationship is often times more intimate than found with doctors or midwives. This special relationship allows the birthing woman and partner a stable individual to communicate with, and to trust to help them communicate with the rest of the birth team.
Throughout the pregnancy, the doula is typically available for emotional support during regular business hours. They help answer questions, provide resources, and some even provide childbirth education. Then, at a set time agreed upon between the doula-client, the doula goes on 24-hour call until the birth. At the time of the labor and birth, the doula will likely stay with the birthing woman providing emotional support and physical assistance in helping the woman to the bathroom, changing positions, drinking and eating, and massage. The doula will likely provide various elements of education and support to the birthing partner as well.
A Cochrane Review found that continuous support by doulas for birthing women led to much higher numbers of positive birth outcomes. These findings also revealed that women were less likely to require pain-relief medication, as well as much lower cesarean births. Positive birth experiences may also decrease the likelihood that a woman, or her partner, may have difficulties with postpartum mental health complications.
After the birth, the doula may assist the woman in breastfeeding if needed/wanted, and will offer support however needed in the initial bonding period. If the birthing woman received medication or had a cesarean section, the doula may help aid her client in the recovery process. Once home, the doula will likely continue some amount of postpartum support, or refer to a postpartum doula. If a greater need arises, beyond the qualifications of the doula, s/he is able to help the family find resources to better meet their needs.