What Does A Doula Do?

Elissa Lash, DONA International Certified Doula

You’ve come across the word doula in birthing books, or at a childbirth class – maybe a friend worked with a doula, or you even heard the recent piece on National Public Radio about doulas helping to decrease the rate of pre-term labor.  Yet, you still aren’t completely clear on what a doula does for a birthing mother, and what doesn’t a doula do, and how much do they cost and should you have one?

Vineyard Birth Collective recently held a potluck brunch titled “Meet the Doulas” where we strived to answer those questions and more.  I’ll try to encapsulate the information in this blog post for those who missed the event.

I’m a certified doula, trained by DONA International.  I had a doula at the birth of both of my children, now ten and six, so obviously I’m a fan of labor support.  However, I also know that the birth of your baby is a deeply personal and sacred event and there is no one-size-fits-all recommendation for what will make your labor and delivery the best possible experience for you.  Choosing a doula, or whether to have a doula, is an important decision with no right or wrong answer.

“Doula” is an ancient Greek word that roughly translates to: a woman who serves women.   In today’s world, the word doula has come to mean a person who is trained and certified in childbirth support and who attends births at home, at birth centers and at hospitals, by offering physical, emotional, and informational support before, during, and after birth.  Not to be confused with midwives or labor and delivery nurses, certified doulas are not trained or licensed to offer medical care, prescribe medication or actually deliver babies.

Physical support often includes positioning/movement suggestions and assistance for the birthing mother, massage, counter pressure, hydrotherapy, breathing practices and other physical (non medical) pain relief techniques, as well as coaching for the husband or partner to be also able to assist in comfort measures.  Emotional and informational support includes helping the clients ask the appropriate questions, suggestions for alternative perspectives, and coaching clients on how to advocate for their birth preferences.

A certified doula will have completed training in these techniques and will have had actual childbirth experience and practice. The doula certification process requires coursework on the physiology of childbirth, attendance at three births with sign off from the attending physician or midwife, as well as an essay, interview and payment of professional dues.  Many doulas complete this process through DONA International or other accredited organizations that offer oversight, protocols, and education for childbirth educators and labor assistants throughout North America.

Typically, a doula’s services will include a prenatal intake to determine a couple’s birth preferences, and allow time to discuss strategies to deal with labor and birth as well as postpartum.  Once a doula is professionally booked with a client, she may have the client sign a contract and/or request a deposit or “on call” fee.  Most doulas agree to be on call and available for a birth for two weeks prior to and post a woman’s estimated due date.  On Martha’s Vineyard, that means no off-island trips without prior agreement with the client.  Some doulas work with a back-up person or partner to help cover on-call dates or times that may be difficult.  The doula should discuss partner/or back-up coverage at the first meeting. 

Doula services include support for the entire duration of the birth, no matter how long.  Fees are set well ahead of time, and doulas do not charge “by the hour”.  Many doulas also include a postpartum visit to discuss the birth, and talk about strategies for self-care and healing after the birth, as well as help a new mother connect with resources she may need for herself or the baby.

Most Island doulas offer a sliding fee scale that can range from $400 - $1200 – don’t be embarrassed to ask about fees upfront.  The money part can be an important factor for many families, and most doulas are able to work with a client to make sure that services are affordable and available.  In fact, some doulas in training will agree to support a birth on a sliding scale, for little or no charge.

If you have questions or want to find out more about a local doula, please contact me, or any of the doulas listed on the site.  We’d be happy to have an informational interview or email with you!

I wish you a healthy, happy, empowered birth.

Elissa Lash has worked as a prenatal yoga instructor, doula and childbirth educator for over ten years in New York, Boston and on Martha's Vineyard. She teaches a free prenatal yoga class every Monday night at the YMCA (membership not required) and can be reached at eelash@hotmail.com.