What Is a Doula?

Whether you have prenatal complications, this is your first pregnancy, or you just want a birth advocate on hand, a prenatal doula can offer non-medical physical, emotional, and informational support during pregnancy, labor, and after childbirth.

"Doulas provide hands-on comfort techniques and act as a go-between with medical staff," explains Kelly Cox, a registered birth doula and co-founder of Share the Drop, an app that matches breast milk donors with recipients. "Doulas work with clients beforehand to develop a wish list of families' preferences, and they can advocate for the family during labor."

Although there are doulas for nearly any and every life transition, prenatal doulas truly focus on preparing families for the birth process well before birth begins. Prenatal doulas may or may not also join families at their birth, so their job is to educate families about the physiological and medical processes that will take place.

“A doula can be a wonderful, consistent support for a pregnant person and their partner, especially in large [medical] practices, where you may not know the clinical provider attending your labor and delivery,” explains Erin V. W. Andrew, MPhil, MSN, WHNP, CNM, a trained doula and a certified nurse midwife in New Jersey. 

What Is the Definition of a Doula?

A doula is a skilled non-medical professional whose priority is to support and provide guidance to birthing people. They empower parents to communicate their needs while helping to actualize their vision of a healthy, positive birth experience.

"A doula is employed to provide guidance and emotional and physical support to a pregnant person during labor and delivery," Cox says.

Doulas can assist in any facility where they are permitted to enter. Many hospitals and birthing centers welcome them. They can also be particularly helpful during home births, where there isn’t a rotation of doctors waiting in the wings. They can prepare the space, ensure supplies are ready for the baby, and help older kids understand the birth and labor process. While home births are usually attended by a nurse midwife or midwife, a doula can also offer much-needed family support and comfort.

What Services Are Included With a Doula?

Unlike doctors and midwives with years of advanced medical training and experience, prenatal doulas have no mandatory training requirements. They also cannot offer any medical services. They may go through many months of training in certification programs, and most have studied under midwives or more experienced doulas. But this preparation is not a legal requirement. When choosing between doulas, you may see any number of different certification programs listed as credentials.

“Doulas are not licensed to provide any clinical care or clinical recommendations. Many doulas are, however, very well-informed on best practices and can be a wealth of knowledge and guidance,” Andrew shares.

During labor and birth, a doula offers support through various techniques, including comforting touch, massages, and verbal encouragement. They may assist with breathing, positioning, and offering birthing parents the nutritious food and fluids needed to make it through labor.

Different Types of Doulas

The services doulas offer will depend on their experience and niche. In the birth sphere, there are several common types of doulas.

Antepartum or Prenatal Doulas

These types of doulas support birthing parents well before birth. They can offer labor courses, assist birth parents on bed rest, and counsel on ways to avoid preterm labor. They may be willing to help with household tasks or provide childcare for older kids, so parents can prepare for birth.

"Prenatal support can include prenatal yoga, referrals to specialists, and education," says Cox.

Birth or Labor Doulas

These doulas provide continuous care during pregnancy, labor, and childbirth. "A birth doula meets with the expectant mother and her partner before labor to discuss what to expect during the last few weeks of pregnancy as well as labor and delivery," Cox says.

A few weeks before the estimated due date, the doula will set aside time to be available 24/7 for expectant parents. They then offer labor support, including physical touch, to relieve pain. Doulas will provide breathing and relaxation coaching to deal with contractions, suggest positions to try during labor, and offer pushing support. "

Most birth doulas also offer a few postpartum visits in the family's home after delivery," says Cox.

Postpartum Doulas

Postpartum doulas provide guidance and support for birth parents and loved ones during the first few weeks after childbirth. They assist with lactation and breastfeeding, baby bonding, and healing for birth parents. They may help with household tasks and prepare nutritious meals for recovery.

"Postnatal doulas visit families in their homes and offer guidance around childcare, specifically breastfeeding issues and concerns," adds Cox.

Fertility Doulas

These types of doulas provide support for parents trying to conceive, and are especially beneficial for families who might be struggling to get pregnant.

Pregnancy Loss Doulas

Pregnancy loss doulas support families who have experienced pregnancy loss, due to termination, stillbirth, or miscarriage.

The Benefits of a Doula

Research shows that with the help of doulas, many people can forego epidurals, avoid cesarean births, and have less stressful births. Other studies show that birthing people who receive doula care are less likely to suffer from postpartum depression or anxiety.

“Continuous support in labor, such as by a doula, has been scientifically proven to improve labor and delivery outcomes,” says Andrew.

Doulas can take over for the partners of the pregnant person, giving them a break from remembering all the instructions from the childbirth classes. This break allows partners to enjoy the process and focus on providing the birthing person with the emotional support they may need.

"Having a doula makes partners more emotionally available to the birthing mother," says Cox

Giving Birth With a Doula

Before childbirth, a doula will help answer all your questions about the birthing process. They will also help you understand the labor and delivery procedures, possible complications, and the best way to handle them. They will help develop a birth plan if parents don’t already have one in place.

They offer significant value in facilitating communication between the birth parent and the hospital staff. For example, they can work with medical personnel during labor and birth to provide a safe space by controlling who has access to the room.

A doula can help uphold preferences and ensure they are adhered to. To avoid birth parents feeling pressured or distracted, doulas may take on the responsibility of answering questions and sticking to the plan. If the plan must change due to medical reasons, doulas can communicate the gravity or subtlety of the deviations in a way that birthing parents can trust.

How to Find a Doula

Recommendations from healthcare providers, family, or friends are always a good way to find a doula. Since some hospitals are more restrictive than others, you may want someone experienced in working at the hospital where you plan to deliver. Search online for certified doulas within your region on sites like DONA International, International Childbirth Education Association, and Madriella.

When interviewing potential candidates, ask about their training and experience, their philosophies about childbirth, the services they provide, and their fees. Also, ensure that birth partners and any children also trust the selected doula.

It is essential to work with someone you feel comfortable with and who you trust with your family. Birth is an intimate process, so a healthy and trusting relationship will include a comfort with some level of nudity too. If you feel uncomfortable with your doula in any way, it’s best to move on and find someone you can truly confide in.

Although having a doula is an investment, many doulas offer sliding scales and affordable rates. “Alternatively, you can contact doula training programs to find out about newly minted doulas who may be offering free or reduced-price services as they build their clientele,” suggests Andrew. 

Most parents find that a doula is worth it, especially if they do not already have a trusted family member or friend in their close network who plans to attend the birth.

A Word From Verywell

Deciding whether to hire a doula comes down to knowing the role they play in pregnancy, labor, and delivery. A prenatal doula can help you prepare for childbirth, answer any questions, and advocate on your behalf. If you’re seeking someone to care for other siblings or perform household duties, those typically fall outside the primary services of a doula. However, some are also trained as midwives, nurses, and lactation consultants, and are willing to offer those services too—if agreed upon in advance. If you are wondering whether a prenatal doula is right for you, you can consult with your healthcare provider.