The Low-Down On Doulas

By Jessica Austin


 photo by Morag Hastings

More and more families are choosing to use doulas for added support during childbirth. Many midwives and doctors are also strongly encouraging their clients to hire doulas. While doulas are becoming increasingly common, a lot of people still have questions about what exactly a doula does and how to go about choosing one. Here’s a quick low-down on some of the most common questions people have about doulas:


What can a doula do for you during a birth?


When I was a new doula, I used to think that what got me hired was my tool-kit of things to do for comfort. From rebozos, TENS machines and birth pools to hands-on comfort measures like the notorious “hip-squeeze”, specific massage and acupressure techniques, doulas often have a variety of tools to support women in having more comfortable births.


The more births I go to, the more I realize that while the tools mentioned above are certainly valuable, in some ways they are mainly nice-to-have options that may or may not be useful at any particular birth. It’s absolutely fantastic to have access to these tools and skills from your doula in case they are needed, but the real value in having a doula with you for support is something much more simple.


Having a woman with you who understands birth, who has sat with many other women during the birth process and can confidently look at you and tell you what you’re feeling is normal and that you are doing amazingly well can do wonders for a woman’s confidence and ability to stay calm and strong during the birth process. One of the reasons I think epidural rates are so high in our culture is that medical attendants like doctors and nurses are busy focusing on their clinical roles and charting duties, so they don’t quite have time to tell a woman she is safe, to remind her to use her breath, to put pressure on just the right spot on her back during every wave. To look at her partner reassuringly and tell him/or her, that everything is all good. When you hire a doula, you are hiring someone who does not have those clinical responsibilities, so she can focus completely on helping you feel supported and comforted.


In addition, sometimes there are options given and choices to be made during the birth process. As a parent, you probably have never had to navigate having conversations around these options, or may only have done so once or twice before during previous births, and in the moment, it sometimes can be hard to remember what questions to ask. Doulas are part of these conversations with their clients and their primary attendants all of the time! This means they can often help turn potentially confusing or overwhelming discussions in to a conversation where you will feel informed and clear, where you feel like all of your questions have been clearly answered by your primary attendant and where you’re able to make a confident decision about whatever option you are being given.


If you’re having a hard time visualizing what it looks like to have a doula at your birth, check out What Does A Doula Really Do for a photo-blog that explains the role of a doula with words and images.


What exactly is the difference between a midwife and a doula?


A lot of people find understanding the difference between midwives and doulas confusing. If you are working with a Registered Midwife, her primary role is to monitor the physical well-being of you and your baby, and will only come to stay once you have sunk more deeply into the active phase of your birth. Your doula will typically join you much earlier than your RM will join (and stay) with you, and will be focused on making you feel comfortable, supported and confident while your RM focuses primarily on physical assessment and charting.


How do doulas work with partners during a birth?


A common misconception is that a doula is unnecessary, or may even be a hindrance, if the birthing woman has a partner who wants to be her primary support person during a birth.


The truth is that doulas complement and add to the role of the partner. I always tell clients that there are certain things that I’m allowed to say to you as a birthing woman that just plain won’t be helpful if your partner says them. “These sensations are normal and safe, your body is just stretching, your cervix is melting away,” have some weight coming out of the mouth of a doula who’s been to many births, but from a partner who has never given birth or seen one happen, these things might be a bit harder to trust!


Most importantly, though, you want your partner there to support you as your partner, not as a birth professional! To be a good birth partner, you don’t need to have done doula training or gone to obstetrics or midwifery school. What women need to know from their partners is that they love them and that they believe she can do it! Having a doula around takes the pressure off of a partner to remember things like “When did the midwife say we should call?”, “What am I supposed to do in this phase again?”, “Is she supposed to look/sound like this?”. Having a doula there makes more space for the partner to fill the role they WANT to fill, without the added stress of remembering and applying everything they learned in prenatal class!


So how do you go about choosing a doula?


When it comes to how to choose a doula, I always tell people it comes down to two simple things:


1. During the interview, was she able to confidently answer the questions you had? Does she seem to have the type of knowledge that you are looking for? It almost doesn’t matter what questions you have, you want to work with a doula who has the answers to the questions that are important to YOU about your birth experience.


2. Could you see yourself enjoying hanging out with her for potentially a few days straight? This is probably the MOST important thing! Birth can sometimes be long, and you want someone with you that you’ll be completely comfortable with that entire time.


There are a variety of ways to track down the right doula match for you. Asking around is a good place to start. A few google searches and asking your midwife or prenatal class teacher for some referrals will get you a decent selection of options right off the bat. Your friends, massage therapist, or yoga teacher may also have a few names for you.



Jessica Austin is a birth doula and informed choice activist who believes women’s rights to choices about their births are of utmost importance. She strives to promote a gentle and informed birth culture through her free educational blog and by participating in local campaigns to raise awareness about important issues in maternal health care. Her strong ties to both the medical and unassisted / non-medical childbirth communities give her a uniquely well-rounded perspective on the range of options for birthing families. Her educational blog and successful doula business, Birth Takes a Village, is a widely used resource for both doulas and birthing families. She also trains new doulas through the Wise Woman Way of Birth doula certifying program and teaches home-birth-focused prenatal classes at Birth At Home.


Get to know Jessica (Birth Takes a Village) better by following her on facebook or visiting her doula website and blog




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