Birth Doulas: Reclaiming the Birth Experience
So, you’re pregnant. Maybe it was intended, maybe it wasn’t. You’ve considered your options, and you’ve decided you want to remain pregnant with the intent to give birth. Let’s do this!
When it comes to pregnancy and giving birth, you have so many decisions to make–it can feel daunting! Take a deep breath, start reading and learning about pregnancy and birth, and begin sorting through your options.
One important decision to make is selecting who you want to accompany you through the actual birth process. Depending on where you are giving birth, there might be restrictions about who is allowed in the delivery room. Be sure to check your local or hospital policies before making any final decisions.
Some folks decide that during birth they want a partner to be present; others want a different family member–be they blood relative or chosen family–or someone else entirely to accompany them. Birth doulas can be a great option if you are looking for some additional support, especially around the emotional aspects of labor and childbirth.
Doulas are trained individuals who provide emotional support to folks going through intense situations. There are actually lots of different types of doulas–birth doulas, death doulas, abortion doulas, transition doulas. Birth doulas offer pregnant folks emotional support during the entire labor process.
Doulas are trained by various global certifying organizations in a variety of topics including pregnancy hormones, effective communication skills, emotional support techniques, physical support for birth, breastfeeding, and postpartum care. This ensures that they are providing the highest quality care to their clients.
Working with a Doula: What to Expect
Finding the right birth doula is important; you will want to find someone with whom you feel really comfortable because they will be intimately involved in your birth journey. Do your research, pay attention to their credentials and certifications, have several meetings with different folks, and take your time selecting someone.
Once you’ve found the right doula for you, the doula will typically offer a meeting or two during your pregnancy to get to know you, ask about your birth plan (what you want your labor process to include), and explore strategies for managing the pain of labor. They then provide 24/7 in-person support once you go into labor.
Doulas can arrive as early or as late in the labor process as you prefer. In the early stages of labor, they can help ensure the external environment is comfortable for the laboring person and check in with the laboring person to see what is needed. They can reduce anxiety of both the pregnant person and their partner (or anyone else supporting or part of the labor process) by keeping everyone updated on the progress and reassuring them.
Throughout labor, doulas employ a number of techniques to reduce pain, discomfort, and anxiety, which are typically discussed and selected beforehand with the pregnant person so the most effective and appropriate techniques can be used for that particular person. Doulas can encourage movement by suggesting different poses or encouraging walking around, use touch to hold or massage the laboring person, or encourage various deep breathing techniques.
In hospital settings, doulas can advocate for the laboring person and their birth process so that the pregnant person’s wishes can be honored as much as possible. Doulas work with medical professionals – although they do not provide medical advice – to ensure that the delivery is as safe and comfortable as possible.
In the final stages of labor, which are typically the most intense, the doula can provide helpful reassurance as the laboring person goes through the final pushes. When the baby is born, the doula can advocate for what the new parent wishes: do they want immediate skin-to-skin contact with the infant or for a healthcare professional to first ensure the baby is healthy?
Following labor, doulas typically check-in with the new parent to debrief the labor process and see how everyone is doing.
Where Can I Find a Birth Doula?
Many cities have local doula centers or independent doulas. Try using a search engine with the search phrase “doulas in my area” and see what pops up. Reach out to several people that you find in those results who appeal to you, and request an informational meeting. Some doulas, especially ones who work independently of a birth center, may be open to texting first, if you prefer. Ask questions, interview several options, and see which one feels like a good fit for you.
It’s important to note that health insurance policies may not cover the cost of hiring a doula. You may need to plan to save up some money or inquire about free or sliding scale options.
Often doulas are doing this work because they care; if money is an issue, some doulas can be flexible with their prices so it never hurts to ask. Some hospitals also may even offer free doula services, particularly for teens.
There’s a Long History of Better Birth Stories (of Which Doulas Are Often Part)
Despite how most American media portrays birth–a woman laboring alone in a hospital bed with a terrified male partner and a team of no-nonsense doctors that only shows up for the final delivery–laboring alone is actually relatively new.
Throughout history, laboring folks have been surrounded by supportive others, particularly other women or gender-diverse people, during childbirth. And the process of birth has been cherished, ritualized, and viewed as sacred across the world.
Amongst aboriginal Australian cultures, the skills involved in childbirth are often passed down matrilineally from grandmothers to mothers and daughters, and birth is considered a rich spiritual process, full of prayers and rituals.
In many parts of Africa, traditional birth rituals include joyful songs and dancing by female family members, who also assist in the labor process.
In much of Latin America, female relatives and friends support new mothers during “la cuarentena”--“the quarantine,” or the 40 days after birth when new mothers stay home–by cooking, cleaning, and taking care of the new baby.
Across the world, gender non-conforming folks have played an important role in birth, too. Historically, the hijras of India were present during births to perform dances, songs, or rituals and to provide blessings on the new child and parent(s), and some two spirit folks indigenous to the United States were gifted songs to aid in childbirth. The involvement of gender diverse individuals at births declined, however, with the rise of colonialism that murdered and ostracized folks who didn’t conform to the gender binary.
In the U.S., Black women living under slavery also supported each other during birth, and many became skilled midwives that would support births across entire regions of the U.S.
With the rise of the White male-dominated physician schools and training in the U.S. and Europe, the work of childbirth moved to hospital settings. Black female midwives and traditional female-centered birth practices were pushed out and replaced by White male doctors who would deliver babies under a sheet, without ever looking at the vagina.
But throughout history and across the world, laboring communally, particularly with other women, was–and still sometimes is–the norm. For example, today approximately 75% of births in Sweden, Denmark, and France are attended by a midwife, compared to less than 10% of births in the U.S.
The recent doula movement has really been about reclaiming the birth journey, remembering this rich history and tradition, and putting childbirth back in the hands of laboring people themselves.
And, research has shown that there are tons of benefits for using doulas, both medically and emotionally.
Benefits of Doulas
Lots of research has shown that having continuous support during labor actually improves* health outcomes (Our Bodies, Ourselves). Labor with doula support can be several hours shorter (and who doesn’t want that?!), and laboring folks with doulas are less likely to need pain relief from epidurals and other pain medications (The Doula Book). Countries that have high rates of midwives overseeing births have significantly lower maternal mortality rates. High risk births are also less likely to require a C-section (or when doctors surgically remove the baby via an incision in the abdomen) if they have a doula (The Doula book).
Studies have also shown that teen parents who had a doula during their labor had lower C-section rates, higher rates of breastfeeding, significantly lower likelihood of asking for an epidural for pain relief, and babies with healthier birth weights (The Doula Book). In addition to the health benefits, having additional emotional support from a doula can be especially helpful for teens and young parents, who often experience stigma or lack family support due to their pregnancy. Having more people on your team when you’re having a baby is never a bad thing.
Emotionally, doulas may help laboring individuals have a more positive birth experience. With the rise of hospital births overseen by white male medical professionals, it can be hard for laboring folks, especially Black people and other folks of color, to feel empowered by their bodies’ natural processes and to feel the full range of the emotions and sensations that come with birth. It can be difficult to advocate for your needs and wants when historically the pain of women of color has not been taken seriously, when there has been so much medical malpractice on folks of color and LGBTQ+ folks, and when women, trans, and gender-diverse people have been socialized to stay quiet rather than communicate their needs. Having a doula who sees you and supports you exactly how you are can feel incredibly empowering, allowing for a more positive birth experience overall.
Just remember, even though birth doesn’t always go according to plan, you are entitled to a positive birth experience. You deserve to have choices and to make decisions that feel right for you. You deserve to be supported by people who lift you up and make you feel amazing. You have the right to receive high quality medical care on your terms (as much as your body and baby allow, at least). You are allowed to ask for what you need.
Claim the birth experience as uniquely yours. You’ve got this.
Shout out to the great sources that contributed to this article: