What is a Doula?
A doula supports a woman and her partner during pregnancy, birth, and the early weeks of parenting, with reassurance, practical assistance, and information.
A doula is someone you come to know well by the time of your birth, and who is there during your labour, by your side, focused solely on you and your partner. She can encourage you, remain objective, and help your partner feel more confident about how to support you. She can also assist you with practical knowledge on comfort measures for labour, such as massage and suggestions for positioning. A doula can provide information when you have questions, and can help you communicate most effectively with your medical caregivers.
The main focus of a doula's role is often on the birth itself, but doula support can also be invaluable during pregnancy (especially if you face questions about tests or complications), and after the birth when she can help out with feeding and adjusting to life with a newborn.
There are a few things a doula is not.
She is not acting as a nurse or midwife, so she does not provide clinical care such as doing examinations on you or checking your baby's heartbeat. The support a doula provides fits together with, but does not replace, the care of your doctor, midwife, or nurses.
Doulas do not make decisions for you, or speak for you. This is your birth, your baby, your life!
A doula supports you by providing information and explanations you may want about your choices, but it's always you who decides what's best for you.
What are the benefits of hiring a Doula?
Studies repeatedly show that doulas help women have better birth experiences. The following statistics are taken from the book Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth, by Klaus, Kennell, and Klaus (1993):
50% reduction in the cesarean rate
25% shorter labor
60% reduction in epidural requests
40% reduction in oxytocin use
30% reduction in analgesia use
40% reduction in assisted deliveries (Vacuum extraction or forceps)
My husband / partner will be with me. Isn't that enough?
Doulas DO NOT attempt to replace your husband or partner. The support and encouragement that you receive from those that you are closest to is of the utmost importance during your labor and birth. Your partner may not feel the pain that you're feeling, but they often feel anguish and a sense of helplessness while watching you go through the birth process. A good doula helps take care of the details and busywork of labor, leaving your loved one refreshed and energized so that they may focus their attention on you, and not on trying to remember everything they learned in childbirth class.
Why do I need a Doula if I've decided to get an epidural?
Many women assume that having an epidural means that you just sit back and relax through your labor. This is definitely not true. It is not unusual for women who receive epidurals to still experience physical discomfort or even pain. If that happens, having a doula familiar with these kinds of issues can be helpful. Often your doctor will want you to be dilated to 4-5 cm before administrating pain medication. (The risks that go along with having an epidural become higher the longer it’s in place.) This can take several hours of active labor. Once an epidural is requested it may also take time for an anesthesiologist to become available. Your doula will be there to give emotional and physical support and to help explain the procedures that go along with an epidural (IV, catheter, monitors, etc.) Once the epidural is in place, you will be restricted to bed, but will still need to change positions frequently to help move the baby down the birth canal. You will also experience the emotional impact of the labor as your body moves through the process. You may get discouraged, fearful, tired or weepy. An epidural may also slow your progress, and the doula can stay with you while other family members or support persons take a break or catch a nap.
What is the difference between a Doula and a Midwife?
Doulas do not perform medical tasks. Doulas are there to offer you information, encouragement and physical and emotional support. Midwives are medically trained and licensed professionals who, by law, may perform exams, administer medications, suture and evaluate the medical condition of mom and baby.
Does the Doula come to my home when I am in labour?
You may spend early labor at home with your doula or you might meet the doula at the hospital. If you plan to stay at home as long as possible, your doula can help make you comfortable and offer support during active labor. We can usually tell when you are entering active labor and will assist in the transition from home to hospital.
How does my Doula work with my other care providers?
A good doula will try hard to work in harmony with your medical team. Unfortunately, in most hospitals the nursing staff is simply not able to spend considerable time addressing your emotional needs. Most nurses appreciate the fact that you have continuous, trained support. When speaking with the doctor, please understand that we do not challenge or argue with him or her at any time. We do not ever speak for you in medical situations. We will advocate for you by giving you accurate information and then supporting your choices. If an unexpected medical situation comes up, your doula can help you understand what’s happening.
Is my Doula covered by my insurance?
Some women have received reimbursement by their insurance companies, but it is not a standard covered charge at this time. We can give you a receipt for your payment along with supporting information that you can submit to your insurance company if you would like to attempt to be reimbursed for our services. That being said, we have partnered with service providers that include our fees with their invoice that is covered by insurance. If you are interested, please let your doula know and she can give you more information.
What if I end up having a Cesarean?
Childbirth can and does take some unexpected turns and your doula will be there to help you navigate through what may be a very stressful time. If you need an emergency Cesarean, we will probably not be allowed in the operating room. In other situations it will depend on the doctor and the hospital regulations. If we are not allowed to go with you, we can use the time while you're in surgery to move your belongings to the postpartum area or we can stay with friends and family members and give them emotional support while they wait for news. We are often allowed into recovery - that way the father can be with the baby in the nursery and you won't be left alone. Some women hire doulas even when they are having a scheduled Cesarean because they know the value of having the prenatal and postpartum visits as well as someone to answer their questions and give emotional support before and after the birth.
What should I look for in a Doula?
The doula client relationship should be just that; a relationship. The most important thing to ask yourself when hiring a doula is “How does this feel? Do I feel comfortable, confident and supported by this person?” Your labor and birth will be a completely unique experience for both of you. Don’t choose someone based solely on their experience or credentials. Make sure to meet a potential doula in person before you hire their services. You will know “your doula” when you find her.
What are the costs for a professional Doula?
There are several factors that go into the fee levels for practicing doulas. Depending on the level of training they have received, certifications obtained, and the number of births they have assisted with, the fee levels can widely vary. For a well trained, certified and experienced doula, one can expect to pay anywhere from 1,000,000₩ to 5,000,000₩ (approximately $1,000 to $5,000 USD) depending on the services they include with those fees. Please be aware of any “doula” charging less than 500,000₩ for their services. They may not have the training, certification and experience you need.
Doulas make a difference!
Research shows that having a doula at your birth can make a real difference to the outcome. The risk of an emergency cesarean is reduced, as well as the chances of other interventions happening like episiotomy and assisted delivery. How a mother interacts with her baby, her satisfaction with her birth and her relationship with her partner are all rated significantly higher with women who have had a doula compared to those who have not!
