What is a Labor Doula?

The doula’s role represents a return to the traditional care given to women during pregnancy, labor, birth and postpartum period. The word “doula” comes from the Greek, which means "with women.” Through history, expecting women have always been surrounded by other knowledgeable, experienced women. The doula brings back this time-honored, personal support.

Childbirth is intense, demanding, unpredictable and painful. It can also last anywhere from a few hours to 24 hours or more. Even if you and your partner are well prepared, you might find it difficult to apply your classroom learning in the real situation. It is important that a birthing mother is under the care of a caregiver, whether this be an OB, family doctor or midwife. They will be present for the birth of your child. However, most caregivers will not be in attendance for the majority of the labor. During labor, there will also be one or more nurses present. However, their job, like the caregiver’s is focused on the clinical aspect of birth. They also might be attending multiple patients during their shift.

The labor doula guides and supports the woman and the birth partner continuously through labor and birth. She is trained and experienced in providing emotional support, physical comfort and nonclinical advice. She reassures, encourages, comforts and empathizes with the mother. She advises the partner on how to help and suggests when to use particular positions and comfort measures. The labor doula cannot and does not take over the role of the birth partner. Rather, she helps the birth partner be the best support possible. The labor doula does not make decisions for the birthing mother or project personal preferences. Instead, she helps you get the information you need to make good decisions. The labor doula helps the mother have a more satisfying birth experience through education, reassurance, comfort and support.

The Cochrane report recommends

All women should have continuous support during labour. Continuous support from a person who is present solely to provide support, is not a member of the woman's social network, is experienced in providing labour support, and has at least a modest amount of training, appears to be most beneficial.

Studies have shown that births have

  • shorter labor
  • reduced epidural requests
  • reduced cesarean rate
  • reduced Oxytocin use
  • reduced forceps delivery
  • reduced analgesia use
    ...with a Doula in attendance

A Labor Doula Does

  • Provides comfort such as massage, positioning aid, relaxation and more
  • Facilitates communication, shares information, encourages informed consent
  • Complements nurse’s role and functions as a non-medical part of the birth team
  • Provides flexible support throughout different scenarios
  • Encourages and provides gentle guidance to partner throughout labor, birth and early postpartum

A Labor Doula Does Not

  • Perform clinical tasks such as cervical exam, fetal heart monitoring or delivery of baby
  • Offer medical advice, judge choices, push a personal agenda
  • Create a barrier between nurse and patient or a hostile environment
  • Micro-manage the family’s birth experience
  • Attempt to replace her partner or family members

CAPPA Scope of Practice

The labor doula assists the woman and her family before, during, and after birth by providing emotional, physical, and informational support. It is not within the labor doula’s scope of practice to offer medical advice or perform any medical or clinical procedure.

During pregnancy, the labor doula’s role is to assist families in preparing a birth plan, to provide information about birth options and resources, and to provide emotional support. The labor doula supports the birthing woman as she understands her values and needs surrounding birth, and encourages her to seek care and a place of birth that most closely mirrors these values and needs. While CAPPA respects parental decisions, it is important to note that it is outside the scope of practice for the CAPPA Labor Doula to attend births that are intentionally unassisted.

During labor and birth, the labor doula provides the mother and her partner with physical, emotional, and informational support. She facilitates and promotes self-advocacy, informed choice, and effective communication between the family and care providers. She seeks to foster a cooperative, respectful, and positive atmosphere with all members of the birth team so that the mother can birth with confidence.

During the postpartum period, the doula assists the mother in processing her birth experience, answering questions about newborn care and breastfeeding within her scope of practice, and referring the family to appropriate resources as needed.

Frequently Asked Questions

  •   Women have been giving birth for thousands of years. Doesn't my body just know how to do it?

    Yes! Your body does know how to birth. Just as your body is equipped with everything needed to grow a baby, your body is equipped to birth your baby. However, our complex human brains have the ability to override our natural instincts. Many things can slow or stop the natural progress of birth. Doulas help create an environment where a birthing mother can access her body's natural ability to birth.

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

    A midwife is a type of care provider. She is an alternative to an obstetrician. She is a trained medical professional who fills the role of your clinical care (vaginal exams, prescribing medication, catching the baby, etc.). Although the doula also receives training, she is not a medical professional. Doulas are primarily there for physical and emotional non-medical support. In most cases, a midwife offers some of this same support, however, because she is the medical professional, she will need to focus on clinical aspects of labor.

    Can a midwife and a doula work together?

    Yes. These are complementary roles. Whether you plan to birth at home, at a birth center or a hospital, a doula plays an important role in the birth team. Set up an interview with me so you can ask all your questions about how I can contribute to your unique birth team.

  •   Doesn't the hospital supply birth support?

    A labor and delivery nurse can provide some of the support a doula does and many are willing and happy to provide that support. However, in most hospital situations, nurses have more than one patient in their care during the same shift. They are not able to provide continual support even if they desire to do that. They are also in charge of documentation of birth progress and the administration of certain procedures. If you have a long birth, you could potentially have two or more nurses during your labor depending on shift changes. Your care giver will also come in and out and be there for delivery. However, they cannot be there for continual support. This can even be the case when a midwife is employed by a hospital.

    How a Doula Contributes to Your Birth Support Team

    A doula provides continual support regardless of how long your labor is. She will be there until your baby is born and make sure you receive continual support throughout the labor process.

  •   My husband/partner is already planning on being my birth coach. Why would I want a doula?

    The support from your husband, partner, or other loved one is essential. They love you and your baby in a way that cannot be matched by anyone else. It is not ever my job to take over that important role. My desire, and one of my most important goals, is to make sure the birth coach is free to fully participate in the birth experience with you by being physically and emotionally present. The birth coach can participate at whatever level they feel comfortable. I can remind or teach the birth coach tools and techniques to keep you as comfortable as possible. I suggest position changes and help the birthing mother and coach to assess how well a technique is working. I am also there to look after the needs of the birth coach. I give the coach the opportunity to grab a bite to eat and rest, if necessary, without worrying that the mother is laboring alone. In short, I tend to the details so the birth coach is free to focus on the birthing mother.

  •   Ok, I would love to have a doula present, but my husband/partner is still reluctant. What should I do?

    This is probably the most common reason that women do not hire a doula. It is understandable that your partner might be apprehensive of inviting an outsider to the birth of their child. In this case, I highly recommend scheduling an interview with me. An interview does not mean you must hire me. There is no obligation when you meet me for an interview and it is free! I encourage you and your partner to bring questions you have and I will take time to answer them so you can both understand how I contribute to the birth team.

    Besides, after an interview and two prenatal visits, I won't be a stranger anymore. :-)

    Recommended Resources

  •   I want someone to advocate for me and speak on my behalf. Is that part of the role of the doula?

    It is true that I am your advocate. However, I will not speak for you to your care provider or nurses. I will encourage communication between you and all of your birth team.

    I will encourage your birth partner to speak for you if you wish. I will provide you with the information you need to make informed decisions. I will then allow you and your birth partner to make a decision. Whatever decision you make, I will support it and continue to give you emotional and physical support. It is your birth and your birth story.

  •   I plan on having a cesarean. What can you offer as a doula?

    Even if you are birthing by a planned cesarean, there are plenty of ways that a doula contributes to a better birth experience.

    • I will meet with you before the big day to help you process your wishes for the birth.
    • I will also be present during preparation and through the surgery. In some hospitals I might be allowed to accompany you during your surgery if you wish. If not, I will wait in the waiting room.
    • After the baby is born, I can be with you immediately after, so your husband/partner can accompany the baby.
    • I will also help you establish initial breastfeeding if desired.
    • I will meet with you for a postpartum visit to help you process the birth, answer questions and admire your new little one.

    For more information, schedule an interview and we can go over all the details including reduction in cost.

  •   I want to have an epidural. Why would I want a doula?

    That is great question! It is a common misunderstanding that doulas are only for mothers who want to attempt a non-medicated birth. That is not the case at all. This is your birth and I will support whatever decisions you make for that birth.

    In the case of an epidural, there are some things to consider. First of all, an epidural is not usually available the moment you come to the hospital. There will be a window of time where you will need to manage contractions until your care provider or nurse verifies that an epidural will not impede labor progress. After that, it will still take some time to get you prepared and time for the medicine to take effect. I will help you get through the waiting period and keep you focused.

    I still offer beginning breastfeeding support and other parts of my package deal. Schedule your free, no-obligations interview with me and I will walk you through all the ways I support birth plans that include an epidural.

  •   I have another question

    Feel free to ask about birth, labor, labor doulas, etc.

    Contact me or connect on facebook.