In addition to the more widely known support from medical professionals, such as midwives and OB-GYNs, doulas can help support people during pregnancy and childbirth.
Being pregnant and giving birth can be hugely fulfilling events in a person’s life, but they can also present a range of challenges. Having the right support in place can make a big difference, and many people find doulas helpful in having positive pregnancy and birth experiences.
Doulas provide flexible assistance to an individual during pregnancy, regardless of where and how they plan to have their birth. However, doulas are not trained medical professionals and should not be a replacement for midwives and doctors.
Read more about what doulas do, the benefits of having one, how they differ from midwives, and more.
There is currently no rigid definition of a doula.
While they do not need medical training, many doulas have some form of certification. People can receive education through programs such as DONA International-approved training workshops or New Beginnings Doula Training.
A doula can be anyone playing a supporting role to an individual throughout pregnancy, childbirth, and the postpartum period. They can be a helpful addition to a medical team that comprises licensed professionals such as midwives and doctors.
The doula’s role is to provide practical and emotional support to a pregnant individual, their partner, and family members.
During a person’s pregnancy, a doula will spend time building a trusting relationship with them. They will support them, help them create a birth plan, and answer their questions.
The doula is usually present during birth. They can provide one-to-one support, and in many circumstances, they can also advocate on an individual’s behalf if they become unable to do this. Doulas can also provide support to partners. During labor and birth, they can help normalize the birth process, provide reassurance, and offer suggestions on how the partner can be most supportive.
After birth, a doula may continue to support the new parent and their family. This can include helping with child care, assisting during feedings, and discussing questions or concerns.
Although doulas and midwives both support people during pregnancy and childbirth, there are some key distinctions between their roles.
One key difference is apparent during labor. Doulas can be there for the individual and offer physical and emotional support as well as words of reassurance and encouragement.
However, the role of the midwife is that of a medical expert. They have the training to independently manage the labor and birth, including delivering the baby and handling the most common complications. Midwives can work in hospitals, medical centers, and freestanding birth centers and assist with home births. And in the event of a major complication that arises during labor or birth, midwives collaborate with doctors to handle the situation.
In the United States, certified nurse midwives and certified midwives perform a wide range of functions, including:
- primary care, gynecologic, and family planning services
- care before, during, and after pregnancy
- care for a newborn during the first 28 days of life
- treatment for sexually transmitted infections
- medications and contraception prescriptions
- laboratory and diagnostic tests
Midwives provide their services in various settings and are an invaluable part of labor and delivery wards. They work in ambulatory care clinics, private offices, community, and public health systems, homes, hospitals, and birth centers.
In contrast, doulas are not licensed medical professionals. However, they can still support in several ways, including:
- providing information about the birth process
- providing comfort and sharing coping skills
- offering unbiased, evidence-based information
- providing encouragement
- being present during labor
- providing continuous care
- supporting the family
One study in the Cochrane Database of Systematic Reviews found evidence of significant benefits associated with having a doula. They included:
- increased rates of vaginal birth
- lower risk of cesarean or instrumental birth
- a shorter length of labor
- reduced need for pain medication or epidurals during labor
- lower rates of inducing labor
- increased satisfaction with the birth experience
- lower risk of the baby having low Apgar scores in the first few minutes after birth — Apgar refers to:
A 2019 study in
- single women
- women whose partner could not be present at the birth
- women living with vulnerabilities, including social isolation, mental health issues, domestic violence, or recent migration
- women involved with children’s social care services
The authors found that doulas can have a positive effect on a woman’s emotional well-being by reducing anxiety, unhappiness, and stress while increasing self-esteem and self-reliance.
Some people may also benefit from the support of a doula if they need support that caters specifically to their culture. One example may be a person who wishes to keep her body covered during childbirth for religious reasons. A 2019 study found that doula support can help improve equity and culturally responsive care.
Some people may choose their doula from their network of family and friends. Others may want or need to find an experienced doula from outside their circles.
People can search for a doula through organizations, such as DONA International, the world’s first and largest doula certification organization. The organization has certified more than 12,000 doulas across more than 50 countries. Another service, called Doula Match, can help parents find a doula close to where they live.
Formal doula training is available through The International Childbirth Education Association and the Standards of Practice and Codes of Ethics. These training programs and practice guidelines cover birth and postpartum doulas. Additionally, many other organizations provide doula training.
Although doulas usually have some certification, there is currently no legal requirement for them to do this.
Doulas can support two different points in the parenthood journey: pregnancy and birth and postpartum.
A birth doula spends time getting to know the client and building a trusting relationship during their pregnancy. This type of doula also provides support and reassurance during labor and birth and works to help ensure the fulfillment of a client’s needs.
Some doulas play a supporting role after birth. A postpartum doula cares for their client after the baby is born, and they may also help the new parent or parents to care for their infant.
Doulas may earn a salary or work voluntarily, while some offer their services on a sliding scale basis. Some health insurance companies are starting to cover doula services.
While a doula can provide valuable emotional and physical support throughout the journey to parenthood, there are limits to their support. They do not have the qualifications to provide the services of medically trained midwives or doctors.
Midwives have the skills and training to perform medical assessments and procedures and administer medication. Doulas do not have the training or qualifications to practice at this level. They should always defer to the relevant healthcare professionals when a client requires assistance a doula is not qualified to give.
Unlike midwives, doulas have no legal requirement to undertake certain types of training and education. However, formal doula training and certification are available.
Doulas can provide essential emotional and physical support to individuals and their families. While they can never replace the services of medical experts, such as midwives and doctors, they can provide valuable support to new parents and their families. Research suggests doula care can help provide a wide range of benefits for birthing people and their families.