Working With Doulas – Part 1 of 2: Debunking Doulas

Aside from my doctor, the only two people I wanted in the delivery room were my partner and our doulas. Though I’m generally quite private, having our doulas’ support through the most vulnerable and intimate times in my life has been one of the best decisions we’ve ever made. In this two-part series, I’ll first explain what a doula does and address some common misconceptions about doulas. In part two, I’ll share how doulas helped us in each of my pregnancies, and why I wish everyone could have doula-supported experiences!

OK, so what is a doula?

DONA International (the world’s biggest and most predominant doula-certification organization) defines a doula as “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.” I think this definition is almost perfect, with the exception that doulas often support the family, not just the mother. Many studies have shown, and the American College of Obstetricians and Gynecologists publicly agrees, that doula-supported births lead to significantly improved physical and psychological outcomes for families. This, in turn, sets the stage for healthier home lives for families.

But what does a doula actually do?

As the definition above suggests, doulas support families’ physical and emotional well-being through the pregnancy and childbirth process. How they do this depends on the doula, but in general, you can expect a doula to try to understand and help you meet your concerns and goals, provide you with evidence-based information, direct you to additional resources, support you physically (especially during labor and delivery), help ensure you’re receiving appropriate postpartum care, and generally serve as a resource for any questions or issues you may have during the prenatal, labor/delivery, and postnatal periods. Some doulas may provide additional services, and many doulas are also certified in other childbirth-related areas, such as prenatal fitness or lactation.

Because a doula is focused on the family, he or she doesn’t provide guidance or recommendations based on clinic or hospital policy, malpractice-insurance requirements, or the number of beds available or other patients in need of attention. In other words, your doula helps you advocate for yourself in light of all of the other conditions that may impact the type and quality of healthcare you receive. This certainly doesn’t mean that you may receive suboptimal care without a doula; rather, it highlights that there are a lot of competing interests when it comes to carrying and delivering a baby, and a doula can help you navigate through those issues to lead you toward your desired outcomes.

That sounds like everything! What doesn’t a doula do?

Doulas, for the most part, don’t replace your physician or midwife. They don’t offer medical advice or perform clinical tasks like cervical exams, listening to fetal heart tones, etc. Rather, they complement your healthcare team and work alongside those folks during and after your pregnancy and delivery.

Similarly, doulas (again for the most part), don’t replace your partner. Your partner is 100% welcome and invited to participate however you would like throughout the pregnancy, delivery, and time that follows. While a doula may provide support that your partner can’t or doesn’t know how to provide (like answers to certain questions or physical support during labor), doulas encourage and support the present involvement of your partner.

Doulas don’t speak for you, your partner, or your baby. If they see something happening they know you feel strongly about, or something that has the potential to lead to something you’ll feel strongly about, they’ll help you to create the time or space that may be needed for you to advocate for yourselves.

Doulas don’t guarantee that your goals and desired outcomes are met. Unfortunately for you Type A families (like mine), there’s just too much out of their – and your – control. However, doulas excel at finding solutions that will bring you as close to your goals as possible under the given circumstances, and empowering you through the decision-making process so that you’re comfortable with the process and final outcome.

Are doulas most useful in “natural” or first births?

Doulas can be helpful in any type of childbirth experience, not just “natural”* or first births. Because doulas aim to support your goals, which differ from person to person and can change during or between pregnancies, doulas are well versed in the entire range of ways to labor and deliver. This is what makes them so helpful! This also means that doulas can support “natural” births, medicated births, high-risk births, and situations like VBACs (vaginal birth after cesarean) or where there has been physical or emotional trauma. Not to mention, each birth is unique and even (and often) the best-laid birth plans aren’t followed, so doulas are good at going with the flow. It can be reassuring to have the support of a doula to help you through whatever changes you may experience or hope to create. I’ve been extremely grateful for our doula in each of my 3 births, and each for different reasons.

*I put “natural” in quotes because “natural birth” is a commonly understood phrase, but I don’t like it; it implies there’s an “unnatural” – and inferior – way to birth a child. As if!

How do I find a doula?

If you live in the Madison area, there are lots of amazing doulas available! My first tip would be to identify a few factors that are most important to you. For example, if you’re interested in a home birth, search for doulas with a special interest or experience in home-birth settings. Also consider the level of experience, certifications, and additional services you’re looking for in a doula.

Once you’ve honed in on the key skills you want in your doula, check them out online and in person. Great places to start are Lumos Doula Services, the Madison Doula Collective, the South Central Wisconsin Doula Network, Beautiful Birth Doulas, and Madison Family Doulas. Ask for recommendations from friends and family members who have similar goals and interests as you.

Take your time to meet with doulas before you settle in. Most doulas are more than happy to meet for a consultation or meet-and-greet before you commit; doulas are highly invested in making sure you’re a good fit for each other! Some doula groups also offer doula “speed-dating” or other events so you can meet several doulas at once.

Lastly, trust your gut. You’ll know when you meet the right doula for you. And you’ll be so glad you did!

I hope you’ll follow along for Part 2 of the series, where I talk about how doulas aided and improved our experiences and why I recommend doula-supported births!

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