1. What is a doula?
A doula is a professional trained in childbirth who provides emotional, physical and informational support to the woman who is expecting, in labor or has recently given birth. The doula's role is to help women have a safe, memorable and empowering birthing experience.
2. Have they increased in popularity lately?
Our popularity has increased since the 1990's. Many of the reasons can be attributed to families taking more of an interest in their healthcare and educating themselves about choices in birth.
3. What services are offered
The range of services every doula offers and provides are wide-ranging. Some doulas are strictly "labor and birth doulas" and some only perform postpartum work. There are even doulas who specialize in antepartum (pre-birth) care!
4. What are the costs associated with a doula?
Doulas typically ask for either a deposit for a due date or a retainer fee to work against if they are performing pre or post birth work. Doulas also spend many hours with clients. They are also typically women who have had children, some of them are still young children. Costs doulas build into a contract may reflect travel expenses (gas, tolls, etc.) or childcare or other related expenses to keep their practices running. (Anything from business cards to training!) Doulas also spend many hours with clients. This is one of the main reasons why families work with doulas; the continuity of care.
5. At what point in your pregnancy should you look for a doula?
Some doulas have specific preferences for scheduling purposes and for the ability to build a solid relationship with the family. Birth is a very intimate and emotional experience. You may have a better outcome if you and your doula have worked together for a couple of months versus calling a doula the week before you are "due". This is not to say you cannot call a doula close to your birth, it is just recommended for relationship building, and the ability to get on a doula's calendar, that you try to call no later than your fifth or sixth month.
6. What certifications should a doula have?
Most doulas go through certification programs. There are several agencies for doulas to choose from and the type of programming (antepartum, labor and birth and postpartum). Does a doula need to be certified to be a doula? No. Is it a good idea that your doula is or was certified at some point? Yes. Some doulas do go through the rigorous certification programs but once the certification lapses, they chose not to recertify. If your doula keeps up with current medical trends and is working on a steady basis, this is more than enough than a recertification process.
7. What is the difference between a doula and a midwife?
A midwife (in most states) is either an RN (nurse) who becomes a CNM (certified nurse midwife) via college education. CNMs are permitted to deliver (or "catch") your baby in a birthing center or at a hospital.
A midwife could also be a CPM (certified practical midwife); these midwives all go through rigorous training and apprenticeship but are generally restricted to homebirths.
There are also DEM (direct entry midwives) who are midwives who typically are doulas who have attended a significant number of births. This type of midwife has very little regulation and are only "recognized" in a handful of states.
A doula can be layperson or a nurse or a midwife, but when they are working or hired with the intent of being there for doula support, they do NOT deliver or catch babies.
Doulas provide mental, physical and emotional support. They are restricted by their certifying agencies and sometimes by personal codes, as to how much they do. Most doula contracts state they do not perform ANY medical tasks; such as pulse taking, temperature checks, cervical dilation checks, blood pressure monitoring.
8. What happens at a hospital when you have a doula?
Many families use hospitals for birth. This is generally why families hire a doula. Some families are not comfortable birthing at home or at a birth center, but they do want to have as a non-interventionalist labor and birth as possible. Giving birth at a hospital but having a doula is a good choice. There, doulas will guide you through hospital protocols and procedures, provide education and guidance, and help you achieve a non-medicated labor and birth. Some moms do get medication or epidurals even with doula support. A good doula will respect your decision and is still able to offer support during the pushing phase and your first breastfeeding session.
9. Why would a woman choose to have a doula?
Not only should a woman choose to have a doula, the family should choose too! It is a team effort to support mom while she is in labor. Doula and dad or partner can trade off massage, acupressure, hand holding, brow mopping and the like. A long labor can be draining on the dad or partner too and having a support person, like a doula, can be invaluable. Not only do doulas share the physical and emotional workload of a birth, they support the family as a whole; explaining procedures the hospital is suggesting, listing options the family may want to consider, "translating doctor-ese" and being a strong advocate for what the family wants.
10. What additional services do doulas offer?
Doulas can offer childbirth education classes, belly casting, expectant/new family support circles, Blessingways, help writing birth wish lists/birth plans - almost any pregnancy related concern a doula can meet or direct to appropriate and trusted resources.
Jennifer Mossholder founded and runs Before, During & After Doula Service, LLC in the Philadelphia Suburbs. She has been in business since 2003. Jennifer specializes in Small Group and Private Childbirth Instruction, Birth Plan Preparation, Labor and Birth Doula Services and Postpartum Care. She has personally experienced fertility treatments, both natural and medicated, multiple births and postpartum depression. Her memberships include: Associate Member of PALM; Pennsylvania Association of Licensed Midwives.