Historically, women in childbirth have counted on the wisdom and support of other women in their community to nurture and guide them into motherhood. To continue that important role, today's birth doula is a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth, with the goal of helping the birthing woman achieve her own definition of the healthiest, most satisfying experience possible.
Birth doulas do not replace birth partners (when applicable), but rather complement partners and even provide them with physical and emotional support to be as involved as they would like with the birth. The doula is different from the partner in that the birth doula is typically more equipped to understand the multi-faceted dynamics of labor. Together, the partner and birth doula make a great team to support a woman in her birth.
Birth doulas provide non-medical care, in the form of suggesting labor comfort measures, reassurance, encouragement, relaxation techniques, visualizations, massage, and other similar modes of physical and emotional support. Birth doulas do not perform medical tasks, such as but not limited to taking blood pressure, fetal heart tone checks, cervical exams, or advising the client on any medical decisions.
Birth doulas promote the client’s capacity to make decisions for themselves and offer evidence-based research prenatally and postnatally. During labor and birth, with the goal of the client having self-determination and giving informed consent to every procedure, the doula offers reminders as to the type of birth the client desires so that the client and partner can gather information from the care providers. If the client’s plans need to change during labor, the birth doula helps to navigate and incorporate new choices into the unfolding birth for the betterment of the client and partner’s experience. The birth doula serves the client’s interests above their own and above the care provider’s. When the client has a need outside of the birth doula’s scope of practice, multiple local referrals are given by the doula so that the client can continue to get her needs and desires met.
There is incredible evidence that shows how birth doulas improve birth outcomes! Women with companions (such as a doula) who are neither on the medical or midwifery staff nor in the woman's social network are typically less likely to rate their childbirth experience negatively. Women with birth doulas are more likely to have a vaginal birth, which is favorable over a cesarean due to the shorter recovery period, decreased risk of infection, and increased likelihood for future vaginal births. Additionally, clients with birth doulas show a decreased use of both synthetic oxytocin (Pitocin) to speed up labor and pain medication. The doula plays a unique role not only in positively affecting the woman's satisfaction with the birth experience, but also in limiting the amount of medical interventions a woman will utilize.
Birth doulas and clients enter into a contracted agreement together, ensuring that the clients get the continuous support they desire, whether from the birth doula or a back-up doula in the case of an emergency or unavoidable event. DONA birth doulas are well-trained and are required to continue their education in order to maintain certification. A woman desiring the support of a birth doula can trust that a DONA-certified birth doula will support and advocate for her individual best interests and deepest desires.