A doula (doo-la) is a Greek word that means ‘woman who serves.’ A doula is a professionally trained woman who provides information, physical and emotional support before, during and immediately following birth. Women have attended birthing women for centuries in all cultures. Ancient hieroglyphics show women birthing with other women supporting them. It is only in modern times that we have begun to stray from this support with the medicalization of birth. The need for one on one support in labor is so crucial to the birthing woman’s perception of the birth experience and ability cope with birth. Women supported by a doula frequently report a significant decrease in the length of labor, the perception of pain and the need for anesthesia or analgesia as well as fewer cesarean sections.

I am a doula, I think every woman should have a doula. It’s not because I am trying to justify the profession or the cost or to promote myself, but I really believe that no woman should have to birth without someone who is trained to support a laboring woman. There is a big difference between a doula and a loving partner, a doula and a best friend who has had five kids and a doula and the grandma. While a doula does form a relationship with her clients, she doesn’t have that intimate relationship these other people do and can help the laboring woman without the emotions that are often involved with these family members. Doulas are also trained professionals who study birth and labor and ways to make labor easier and more comfortable with different positions and massage and other techniques that even someone who has had a few kids of their own may not know. Doctors, midwives and nurses often times have several patients at once and cannot stay with the laboring woman.

The research has shown that the presence of one-on-one support such as that of a doula a less likely to have:

have a cesarean section;
give birth with vacuum or forceps;
have regional analgesia (e.g., an epidural)
have any analgesia (pain medication)
report negative feelings about their childbirth experience

With a doula you can have up to*

• 50% reduction in the cesarean rate
• 25% shorter labor
• 60% reduction in epidural requests
• 40% reduction in Pitocin use
• 30% reduction in analgesia use
• 40% reduction in forceps delivery

Doulas can also help incorporate the partner into the labor experience. Often times partners are very inexperienced in childbirth and they are nervous and worried and are scared of labor pains. They are often scared and unsure of how to help their partner even though they very much want to. I have found that they are relieved to have the help of a doula, especially once labor kicks in to high gear and they do feel more of a part of the labor process when they are shown ways to help the mother. It gives them a greater sense of importance and usefulness that they very much appreciate. I love working with the partners as much as the moms because they are so willing and grateful by the end. Even the strongest, most loving and supportive dads benefit from having a doula around.

With every birth I attend, I believe more and more that no woman should birth without a doula and that every woman has the ability and probably should birth without drugs. I have not had a client get an epidural yet but I would completely support a woman if she chose to.

The average range of doula fees are between $300-$1200 depending on what area of the country they work in. Considering that this is for one of the biggest and more important experiences in a woman’s life, it is a very wise investment. Most doulas will offer payment plans if necessary and if the fee will cause a hardship to the family they will often times discount their fee or work out a trade with the client. Doulas who are working on their certification often times work at reduced rates as well. I believe every woman who wants a doula should have a doula and will work for expense reimbursement only if necessary. If you truly want a doula, shop around, interview, compare fees and find someone who fits best with your expectations.

For more information on doulas  please see my blog www.doulamomma.wordpress.com

*Information was obtained from Mothering the Mother: How a Doula Can Help You Have a Shorter Easier and Healthier Birth, Klaus, Kennell, and Klaus (1993)