If you’re like us, you’ve been hearing a lot more buzz about doulas lately. in fact, an estimated 6 percent of moms in the U.S. choose to have a doula as part of their childbirth support team—and that number, while relatively small, is growing.
But what exactly is a doula, and what do they do? And how do you know whether you need one? Read on to learn more and decide whether a doula is right for you.
What is a Doula?
According to DONA International, a doula is “a trained professional who provides continuous physical, emotional, and informational support to their client before, during, and shortly after childbirth to help them achieve the healthiest, most satisfying experience possible.”
Birth doulas specialize in guiding pregnant women through labor and birth and the immediate recovery period. They can also help you prepare for childbirth, including putting together your birth plan.
Meanwhile, a doula who tends to you and your little one in the fourth trimester is called (you guessed it!) a postpartum doula. A postpartum doula can provide services such as lactation support and newborn care (bathing, sleeping, etc.). Really, they help your entire family—partner and siblings included!—adjust to life with a new baby.
Some doulas offer the full spectrum of services, which can be nice if you’re looking for consistency.
What are the Benefits of Having a Doula?
Research shows that having a doula is correlated with positive outcomes for both moms and babies. For example, moms who use doulas:
- Are less likely to ask for pain medicine during childbirth
- Are more likely to try breastfeeding
- Have a lower likelihood of a cesarean birth
- Often see the benefits in their postpartum mental health
And babies born with a doula present have higher scores on postnatal health evaluations.
A doula can be incredibly powerful. This is especially true for Black and Indigenous families and other people of color, who face unjust inequities in maternal and infant care. The impact of community-based doulas is evident in improvements in maternal and infant outcomes.
What Can a Doula Do?
Think of a doula as a neutral person whose role is to coach you through childbirth and postpartum. They are not medical professionals; your obstetrics team has that stuff covered. Your doula is also not (usually) part of your personal network—so they don’t carry all the emotion that comes with being, say, a new parent or a proud grandparent-to-be.
But a doula does know ways to manage pain without medication (that’s the physical support) and can help you stay calm through the ups and downs of labor (emotional support). Doulas can also help explain medical information and point you to evidence-based resources, so you can make informed decisions about your pregnancy and birth (informational support).
Basically, you tell your doula what matters to you—from achieving a medication-free birth to keeping your expertly curated playlist humming for hours—and they’ll do their best to make it happen. When your partner wants to take a nap or grab a snack (lucky duck!), and your doctor needs to check on the patient in the next room, your doula will be there, providing continuous support.
Note: A doula should never make decisions for you, insert their own opinions, or contradict your doctor’s recommendations. Their role is to advocate for your preferences.
Are Midwives and Doulas the Same Thing?
They are often confused, but midwives and doulas have different training and responsibilities. A certified nurse-midwife (CNM)’s background is similar to that of a nurse practitioner. They have had years of advanced training in midwifery and must be certified by the American College of Nurse-Midwives. Midwives are licensed to care for patients with low-risk pregnancies and to deliver babies (vaginally, not by C-section). They often handle routine gynecological care, too.
Doulas, on the other hand, are not medical professionals. They don’t need to be certified—although some doulas do pursue. Also, many doulas are certified as lactation consultants, which can be oh-so-helpful as you and your little one get the hang of breastfeeding.
Are Doula Services Covered by Insurance? Can I Pay for a Doula with My HSA or FSA?
Doulas typically charge a flat fee, which can range from several hundred to a couple thousand dollars depending on where you live. A standard doula package may include prenatal visit(s), continuous support during labor and birth, and then a postpartum visit or two. You can also expect communication support (via text, email, and phone) throughout your relationship.
Doula services are covered by private insurance and Medicaid in a handful of states. It may be helpful to research your options for coverage in your state. Progress is being made, but there is still a lot of work to be done in supporting pregnant and birthing people and their families.
If your insurance doesn’t cover the full cost of a doula, you may have better luck using your health spending account (HSA) or flexible spending account (FSA) dollars. You don’t want any surprises here, so contact your providers as early as possible to learn whether your doula’s services will be covered or are HSA/FSA-eligible. If the answer is yes, you may need to provide a letter from your doctor or midwife explaining why a doula was medically necessary or beneficial.
How Can I Find a Doula Near Me?
Referrals are always a good place to start, so turn to your neighbors and local friends. You can also ask your ob-gyn practice for doula recommendations. (Bonus: The doulas on their list are likely already familiar with your medical team as well as the hospital or birthing center where you’ll give birth.) Another option is to search an online database, like this one from Loula.
It’s wise to interview more than one doula before making your final decision, as you would with any service provider. Get to know their level of experience, approach to childbirth, and personality. You’re going to spend a lot of time with this person, during one of the most important moments of your life—you want to be sure they are a good fit.
When Should I Hire a Doula?
There is no hard and fast rule here, but know that experienced doulas book up quickly! Plan to secure your doula before the end of your second trimester. This way, you should have plenty of time to get to know each other and plan for your birth.
A Personal Choice
Rest assured, you’ll be in good hands with your doctor/midwife and nurses. And surely your partner, family, and friends are eagerly standing by, ready to cheer you on. For some pregnant mamas, that’s all they need or want.
But if you think you could use some extra guidance and reassurance before, during, and after childbirth, hiring a doula could be the right choice. You can’t predict exactly how your birth will go, but you deserve to feel supported throughout the experience, no matter what.
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