Doula - The Essential Guide
Our comprehensive guide to Doula support and all of its many expressions
What is a doula?
A doula is a trained support person who provides physical, emotional, informational, and advocacy support through transformative times in life such as childbirth, miscarriage, abortion, or death. The support provided by a doula can extend to partners, family, and friends of the person undergoing transformation.
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A full spectrum doula is a trained support person who provides physical, emotional, informational, and advocacy support to people during the full spectrum of pregnancy including childbirth, postpartum, abortion, miscarriage, or adoption.
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A birth doula is a trained support person who provides physical, emotional, informational, and advocacy support to people throughout childbirth including pregnancy, labor, and the postpartum period.
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A postpartum doula is a trained support person who provides physical, emotional, informational, and advocacy support to people during the postpartum period of three months after childbirth.
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A miscarriage doula is a trained support person who helps people cope with the emotional and physical aftermath of pregnancy loss and often provides ongoing support for future pregnancies and births.
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An abortion doula is a trained support person who provides physical, emotional, informational, and advocacy support to people considering, seeking, or undergoing an abortion.
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A death doula is a trained support person who provides spiritual, physical, emotional, informational, and advocacy support to people who are dying and their caregivers before, during, and after the loss.
What does a doula do? (Birth Doulas)
A doula provides physical, emotional, informational, and advocacy support to birthing people and their support team throughout pregnancy, childbirth, and the postpartum period.
1. Birth doulas offer professional labor support.
We are trained and certified to provide physical, emotional, and evidence-based informational support to birthing people and new families. Expectant parents often approach a doula for pregnancy guidance and then benefit from their support throughout their pregnancy, labor, delivery, and postpartum experiences.
2. Birth doulas offer unbiased information support.
The circumstances of your pregnancy, labor, and delivery will be unique. Your personal hopes and desires, your individual needs, and the needs of your partner or family will also be unique to just your birth. So, the information and education we provide will be offered without bias, agenda, or judgment. We offer evidence-based information that will help you make your own informed decisions about your birth.
3. Birth doulas offer support when and where it is needed.
Doulas fill many other important and varying roles, some of which include:
providing hands-on comfort measures (such as massage, acupressure, and recommending position changes)
verbal and non-verbal affirmations during labor
“holding space” in the delivery room
being aware of and cultivating the ideal environment for the birthing process
minimizing distractions
empathizing with and normalizing challenging aspects of the experience
A doula-assisted birth
Beyond working with a doula for pregnancy support, there are so many ways to benefit from a doula-assisted birth. Here is a brief list of some doula support opportunities to help guide us along this journey to understanding “What does a doula do?”
Birth Plan Support
As your Wildwood Birth doulas, we love to help answer questions and give guidance when needed when it comes to writing your birth plan or birth preferences document. Wildwood Birth doulas are well educated in all aspects of pregnancy and childbirth (and will perform due-diligence research if there are aspects we are not as familiar with), are up-to-date on local hospitals policies and procedures, and know what is important to consider and include.
Writing the birth preferences document is a great opportunity for you to become educated and prepared for the transformational experience of giving birth. We call it “birth preferences” because when it comes to birth, there is a lot we can do to influence the experience, but so much of the process is hard to plan for and control. Planning for the unexpected is an important part of preparing for labor and birth, and having a doula walk you through scenarios prenatally and be by your side in the delivery room is a great way to ensure your memory of labor and childbirth is positive and empowering.
Water Birth Support
Laboring and/or birthing in the water is a great option, especially for those who desire an unmedicated birth. Submerging the laboring body in warm water helps to ease tired muscles and relax the entire body. The buoyancy of the water helps to relieve pelvic and back pain from the weight of the baby. It is no wonder that the birthing tub is endearingly referred to as “the midwives’ epidural!” Many Portland-area hospitals and birth centers in Oregon now offer water birth as an option, as water birth risks have been minimized through professional training. As your doulas, we will likely encourage you to use the tub or shower at some point during your labor for non-medicated pain relief!
Home Birth (VBAC) Support
A doula can be a great addition to your experience of giving birth at home! Beyond providing comfort measures, a doula can make snacks and tea, prepare the birth tub, help with older siblings, etc. If you have had a cesarian but you’re attempting a vaginal birth for your next child, a birth doula can provide support for your home birth VBAC. Please note that a midwife must attend the birth. Most doulas will not be present for a (planned) unattended birth.
Hospital Birth Support
For your hospital or birth center birth, hiring a birthing doula comes with the additional benefit of “advocacy.” There is a common misunderstanding of what doula advocacy means, so it is important to define it here: a doula will advocate for the birthing person and their family by ensuring that their voices are heard, they understand what is happening, and they have everything they require to make an informed decision.
As your doulas, we never speak for or on your behalf or that of your family. We aim to be a wonderful resource for mediating effective, respectful, and informed communication between you, your support person, and your care team.
Epidural-Supported Birth
Whether you plan to get an epidural or not, your doula can help you to talk through the pros and cons and process of getting an epidural. Sometimes, laboring people opt to get an epidural for pain relief. In contrast, others decide to get an epidural upon enduring a very long labor when the best thing for them would be an epidural for therapeutic sleep.
As your doulas, we look forward to supporting you with your epidural to help keep you cool, stay hydrated, change positions, minimize distractions (such as lights and beeping machines so you can get the sleep you need), and when you’re not sleeping - keep you company! We love to be a source of emotional support throughout, and regardless of whether you’ve had an epidural, extra support, guidance, and encouragement during the pushing stage can be quite helpful.
Birth Doula vs Postpartum Doula
A birth doula will provide postpartum support and stay with the birthing person and their families for 1-2 hours during the immediate postpartum to assist with comfort measures and recovery, breastfeeding, taking photos, preparing to change rooms, talking with the birthing person, etc. They are then available up to 6 weeks postpartum via phone/email to answer questions, research, provide information, process the birth story and provide clarifying information, check in about recovery, and provide professional recommendations in any areas in which additional support would be helpful.
A postpartum doula provides continued support throughout the fourth trimester and is another role entirely — please check out our postpartum doula page to learn all about their role supporting families through the three months following childbirth.
What is a doula vs midwife?
Ahh, the midwife-doula question: What is the difference between receiving support from a professional midwife and receiving doula support? While doulas and midwives often work in tandem and both follow the biodynamic model of care, their roles and responsibilities are very different. So, to answer the midwife-doula question:
How do you define “doula”?
The best way to define doula is to ask what is doula care? A role of doula is to provide physical, emotional, and informational support to a birthing person and their families.
How do you define “midwife”?
A midwife is responsible for all of the medical/clinical aspects of pregnancy and childbirth such as doing cervix dilation checks, assessing heart tones, taking blood pressure, etc… and delivering the baby!
What does a doula cost?
The average cost of a doula is difficult to establish because doulas can cost between $0 and $3,000. You may be wondering why doula prices vary so greatly… why would one doula cost so much less/more than another?!
Volunteer Doula
Some doulas choose to offer their services on a volunteer basis. A doula volunteer may be self-employed or work directly through a hospital volunteer doula service.
Doula in Training
Student doulas offer their services for free to fulfill requirements for certification (3-5 births, depending on the certifying institution). Please reach out to us if you’d like to learn how to find a doula in training.
Professional Doula
Professional doula fees can vary depending on how much education and experience a doula has had. A doula who is just starting out and only has a weekend workshop and few births under her belt, for example, might charge $500. A doula who has had many years of experience (hundreds of births) and many hours of continuing education and/or offers another service in addition such as massage or prenatal yoga sessions, might charge in the upper range.
Flat Fee for Doula Work
Keep in mind that most doulas charge a flat rate instead of an hourly fee. Mainly because it is unpredictable how many hours of labor will take. A labor doula will spend 7-10 hours with you during prenatal and postpartum visits, but labor itself can range from 3 hours to 3 days. Charging a flat rate levels the playing field - imagine if your labor went for three days and you were paying by the hour. It would cost a small fortune!
Doula Medicaid
A major victory to celebrate regarding doulas is Oregon Health Plan coverage. Oregon is the first state in the country to cover doula support in the state Medicaid program. It is our hope that this will help pave the way for private-pay coverage in the near future!
What is the history of doula?
Women's companionship of people in labor is not a new concept; this role has existed since prehistoric times, as evidenced by art and pictorial depictions. The modern idea of a doula in the United States, however, began in the 1960s when a movement of women revolted against twilight sleep and demanded unmedicated, low-intervention experiences of childbirth. With the embrace of fully conscious, unaltered (by medication, anyway) experiences of giving birth came a need for support from people who are knowledgeable about the stages of labor and have experienced the wide range of “normal,” and the many forms of childbirth can take.
How to choose a doula
There are so many doulas! How to choose!? This depends entirely on what is important to you.
Is it important to you that your doula has been trained and certified by a reputable institution?
Is it important to you that they have attended any or many births?
Is it important to you that they have given birth themselves?
Do you have any specific cultural or spiritual beliefs or customs that you need your doula to be comfortable with?
If you answered “yes” to any of these questions, they would be good questions to ask when interviewing a potential doula. But the most important consideration, above all, is to choose a doula that you feel comfortable with. Pay attention to your initial feelings and your intuition: is your body relaxed when talking with them? Does the conversation flow naturally? Does being in this person’s presence make you feel good? Do you feel safe to share more of yourself with them?Your doula will learn important, personal information about you, will be with you for many hours, will offer a bridge for gaps in your memory, and will see you at your most vulnerable (and powerful!). The more comfortable you are with your doula, the more you will feel safe, your body relaxed, and your mind at ease when it comes time to birth your child.
“Elizabeth was kind, thoughtful and well prepared as a doula. She advocated for what my partner and I wanted/needed during the birth and brought a calming voice to the experience. I am forever grateful to have shared such a special moment in my life with her.”
“Vera is a wonderful doula. I would highly recommend her to anyone. She was attentive, patient and supportive through my entire LONG labor. She was my advocate in the hospital and helped explain the procedures to me in ways that were easy to understand during such a stressful time.”