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  • Naiomi Catron RNC, IBCLC

What is a Doula?...a Vaginal Gandalf

Doulas serve as a significant resource to new moms during the birth process. As more mainstream TV shows and documentaries feature doulas, such as in Brooklyn Nine Nine where doulas are referred to as the “Vaginal Gandalf”, more families want to know how a doula fits into their birth process. If you hire a doula, will you still need to hire a midwife? Where do you give birth? In this blog, learn all about doulas and how they fit in with your birth plan. And check out the free resources for Doulas and Expecting Parents, at the bottom of this article.

What is a Doula?

A doula is a professional birth assistant that provides physical, emotional, and mental support to moms and their partners throughout the birth process. The doula advocates on your behalf for what you want and provides hands-on support during labor. This might mean using a tens machine, birth ball, or back massager during the long birth process. Your doula will stay with you the entire time you’re in labor and for a period of time afterward.

For many moms, a doula really improved their birthing experience. Research shows that having a doula can reduce cesarean section rates up to 56%. The financial guru Suze Orman told a caller that a doula is a need, not just a want.

Doula vs. Midwife vs. OB-GYN

A doula is different from other birth professionals such as a midwife or OB-GYN. Your doula doesn’t deliver your baby, cut the cord, or take newborn health vitals. As your midwife or OB-GYN checks on other patients, your doula and labor & delivery nurse stay by your side focus on you and your partner during and immediately after the birth. They can give you tools and pain management strategies during contractions or help you get started breastfeeding just after birth. Your doula can educate you on the birth process, breastfeeding, and newborn care. While there is no mandatory training or education requirement to become a doula, most doulas undergo several days or weeks worth of training. Many doulas choose to certify with organizations like DONA International, CBI, DTI or CAPPA, where they must participate in continuing education. Consider asking about the specific training your doula has during the interview process.

In a hospital setting, you can have a midwife and a doula or an OB-GYN and a doula.

A midwife is a medically trained birth professional that helps women throughout their pregnancies, from pregnancy well checks to delivering your baby. Midwives generally care for women that are considered low-risk births. There are certifications and training programs available for midwifery. For instance, the American College of Nurse-Midwives offers a Certified Midwife Credential. There are several kinds of credentials for midwives (that may be a whole post of its own sometime in the future), so please, please, do your homework and research your provider's credentials and record. It would be wise to ask some screening questions about what they consider 'high risk,' what their transfer rate is (transfer to hospital or higher level of care), and how they handle emergencies. You might consider asking who their governing body is so you can verify they are in good standing. These are questions you should ask an OB/GYN as well. Some midwives support moms-to-be when delivering at home or in a birth center. Many midwives deliver babies in the hospital. Midwives are not doctors, they do not perform cesarean sections. Some midwives, working under a physician, can prescribe an epidural and pain management.

An Obstetrician aka OB-GYN is a trained doctor and surgeon with medical training in female reproductive health. They have extensive education and training in reproductive health with a minimum of four years of undergraduate school, four years of medical school, 2-4 years of residency and some even do a fellowship after that. In addition, many Obstetricians go on and become board certified, after all of their standard education and training. Regarding perinatal care these doctor deliver babies, perform cesarean sections, perform surgeries to help women who are experiencing and ectopic pregnancy, miscarriage or hemorrhage . They can also take care of many other duties not related to pregnancy, such as well woman visits, pap smears, STI testing, and hysterectomies. These doctors provide care for women starting during the reproductive years through menopause.

At a home or birth center birth, it is common to have a midwife and a doula. In a hospital setting, you can have a midwife and a doula or an OB-GYN and a doula. In some higher risk cases, you might have an OB-GYN helping your midwife to run and interpret tests, or to schedule a cesarean section.

Advice and Education During Your Pregnancy

Some doulas meet with parents throughout their pregnancies, while others start scheduling meetings in the third trimester. Your doula will give you advice and education during your pregnancy so that you’re more aware of what to expect during the different phases of labor, your pain management and coping options, and how to take care of your newborn. Should unexpected circumstances arise, like your baby shifting to the transverse position, your doula can give you ideas on ways that you could possibly encourage your baby to shift to the right position, such as a referral to a Webster-certified chiropractor or links to Spinning Babies videos.

Support and Advocacy Through Labor

You’ll talk about your birth plan extensively with your doula so that she can help you have the birth you want, as long as medical circumstances do not require something else. She can explain to you what’s happening with your body and encourage you to not give up as you go through that dreaded transition phase.

She’ll ask about your preferred pain management and coping methods, how involved you want your partner to be, and what you want to do with your baby just after birth. Maybe you want to breastfeed right away and have an hour of skin-to-skin contact. Perhaps you want to wait to give your baby his first bath until you are at home.

Hospital, Birth Centers, and Home Births

Doulas can attend births at hospitals, birth centers, and home births. Each state and hospital will have its own policies about what is allowed. Some doulas may not have privileges at certain hospitals. When hiring your doula, it is worth verifying where they can provide services to make sure it’s a match. The good news is that there are many doulas that work in every type of birthing environment.

Vaginal and Cesarean Births

There’s a myth that doulas can only help moms with a vaginal birth. This simply isn’t true. Doulas can continue to provide support, advocacy, and education even if you’ll need a cesarean birth.

Breastfeeding Advice

Not all doulas are lactation consultants. If you have pain or questions about breastfeeding, it is important that you schedule an appointment with a professional lactation consultant as soon as you can (preferably prenatally). They will be able to give you information on proper latch, evaluate for a tongue tie, and provide expert support. However, you may not be able to get an appointment with a lactation consultant for a few weeks after your baby is born. In the meantime, your doula likely has a lot of experience with new moms and can give you invaluable tips on how to breastfeed.

Additional Help During the 4th Trimester

The first three months after you have your baby are called the fourth trimester. It’s a big adjustment to learn how to be parents. More importantly, your baby needs to adjust to life outside of the warm womb with its comforting sounds and never ending supplies of food. Many doulas schedule checkup appointments with clients in the weeks after birth to see how they’re doing and to connect you with resources as you need them.

Some doulas also serve as postpartum doulas and even provide overnight support!

Cleaning, Laundry, and Meal Prep

Some doulas also serve as postpartum doulas and even provide overnight support! They will come to your house and help you learn how to take care of your new baby, answer newborn care questions, clean, fold your laundry, and prepare simple meals to give your new family time to adjust to its littlest member.

At Milk Diva Lactation Services, we’re proud to work alongside doulas to bring the highest quality postpartum support to all families. We've created a free newborn feeding template for doulas to use with their clients. Forward this along to your favorite doula so they can get their free template.

And don't fret...we have something for you as well. If you are expecting please feel free to get your free SURVIVAL GUIDE FOR EXPECTING MOMS

The Diva Diary Blog

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