What is a Doula? Your Questions, Answered

Simply put, a doula is a trained professional that advocates for new parents through birth and beyond with non-medical support and encouragement.

Preparing for birth can feel overwhelming.

Whether you’ve been to a handful of prenatal classes, or asked all of the questions on Peanut, when it comes down to your own birth experience, it can be hard to know what to expect or how to prepare.

For some mamas-to-be, this is where a doula comes into play.

But what is a doula, exactly?

What does a doula do, and how do you even go about hiring a doula?

You may have heard that it’s all a little weird, with wafting sheer flowing robes and atmospheric mist — and just one step away from something that requires a cauldron and “eye of newt”. 😲

Well, I’m here to ease your mind and answer a whole lot of questions you didn’t even know you had.

In this article: 📝

Who am I?

I’m Alicia, mama of one, performer, baker, feaster, head child wrangler, and trained doula.

Not only have I been there birthing my own babe, but I have also supported many, many births along the way — from unmedicated vaginal births to scheduled cesareans, from smooth home births to homebirth transfers.

Birth is always a marvel.

Always.

We’ve been doing it for thousands of years, and yet every time I’m there to witness a baby travel from inside to earthside, I’m moved by the sheer greatness of the moment.

Now it may seem like I’m straying into the moonlit dancing territory of the doula cliché a bit here, but fear not.

Birth can be messy, hard, visceral, beautiful, joyful, strenuous, traumatic, and transcendent.

Even as I sit quietly in the background, hold a hand, mop a brow, or whisper affirmations, I know it’s an extraordinary moment.

It’s awesome in all senses of the word.

And I know one thing for sure, without my own doula, my birth story would have been very different and not nearly as empowering.

Why is it called doula?

The word “doula” comes from the Greek word doulē, meaning “a woman who serves.”

So the doula meaning is a (usually) trained professional who supports a mama-to-be before, during, and immediately after childbirth.

The support they provide can be physical and also emotional, and they can help inform parents to make the best choices for their birthing experience.

They aim to help you have a healthy birth and maintain your well-being after your baby is born.

What is another word for doula?

Doula is primarily a Greek word, but it’s come to be used in the US and UK as well.

But there are other words used to describe doulas that you might be familiar with: birth coach, post-birth supporter, birth companion, birth attendant, labor coach, postpartum coach, or sometimes spelled as “dula” or “douler”, although these are technically incorrect spellings, from the original Greek.

What culture are doulas from?

Doulas are originally from Greek culture, but can now be found all over the world.

What is the role of the doula?

Doulas often get a bad rap in the media.

People tend to think it’s an airy fairy, woo-woo position.

But the reality is they can offer very practical guidance.

There’s also a doula for everybody.

Some folk may be looking for a spiritual experience — others may simply want support.

If you want a doula to provide straight-talking practical advice (I did!), there’s that too.

You do you!

As doulas, we can’t ensure any specific type of birth, but we help you to have the best experience of the birth you’re actually having.

If practices like drumming, hypnobirthing, homeopathy, and aromatherapy hold meaning for you, a doula or birthworker can facilitate that.

But they can also just be there for support.

If you don’t have a partner and you don’t want to be alone, we will be with you.

If your partner is super queasy and you’re not sure he’ll remain upright, we’ll be there to get you your sippy cup.

And if things don’t go to plan, as they sometimes don’t, we help you process that.

There is a common phrase adopted by many doulas as part of their branding: “at your cervix.”

The first time I heard it, I couldn’t help but smile.

After all, it’s a clever play on the idea of service.

But it’s actually very misleading and contributes to the idea that doulas can actually do the baby-catching.

To be clear, a doula should be nowhere near your cervix.

(Truth be told, I myself only have a passing relationship with my own 😉.)

Aside from the simple biological fact that your cervix is INSIDE your body, as a doula I’m more focussed on you, the person, than how far dilated you are.

The latter is the realm of doctors, midwives — and you.

A doula does what your own mother, aunts, sisters, and the old granny down the road would have done in the olden days (as my son would say).

These women would guide and nurture you through the whole birthing process, making sure you’re taken care of.

The wonders of modern medicine aside, we’ve moved very far away from this model of birth.

Now, the thought of your mother hanging over your head and giving her opinion on your pushing technique is perhaps no longer ideal, and I get that!

But having someone there who is completely attentive to you and your needs still has huge value.

Doctors are often focused on the medical side of things.

Your partner may well be overwhelmed.

So your doula can jump in to:

• Provide a source of information and guidance before birth to empower you in labor.
  
• Offer relaxation techniques, such as mantras, aromatherapy, and music.
  
• Suggest different labor positions to encourage your baby through the birth canal.
  
• Guide you through breathing exercises to cope with contractions and pushing.
  
• Non-medical pain management techniques, such as reflexology and massage.
  
• Act as an advocate for mama’s pain relief and birth plan preferences.
  

• Hold your hand when your partner has fainted.
  
• Remind you of your birth preferences when you feel unsure.
  

• Act as a liaison between the medical staff (i.e OB-GYN and midwives) and the family members.
  
• Lactation consultancy and postnatal nutritionist.
  

• Explain a term the nurse midwife casually drops into conversation before rushing off down the hall to another patient.
  
• Reassure your partner that these noises (the range of sounds people make in labor is VAST!) are normal.

And just generally support you through this big, beautiful task.

Every doula works differently but based on my experience, your relationship with your doula may go something like this:

Before birth

Once you’ve decided on a doula, like me (hi!), expect a meeting where they can learn more about you.

Some may do this via phone or video call.

I personally like to meet face-to-face.

I may ask questions to help you solidify what sort of birth you hope for, and I am usually happy to answer endless questions on birth preferences!

But (and it’s a big but) a good doula should never offer biased advice.

There is no “correct’’ way to birth a baby.

As a doula, I am there to make you feel heard and support you in whatever decision you choose to make.

Then in the time leading up to your birth, I am available to answer questions or point you in the direction of resources and evidence-based research.

For example:

You’re experiencing back pain.

I may have a chiropractor/physiotherapist or certain pain relief strategies to recommend.

Or:

You’re living with weird pregnancy symptom #three hundred and millionty five.

And you want to know if it’s normal.

I should be able to put your mind at rest and let you know when to check in with your primary healthcare provider.

During birth

There are a couple of different ways I support people during birth.

And that might depend on how you birth.

But don’t worry, even if that changes at the last minute, doulas are good at going with the flow!

If you are having a scheduled cesarean, I may meet with you at home or at the hospital beforehand.

We’d chat through what to expect, and I’d keep you company until you go up to give birth.

Depending on your vibe, doulas can give you a relaxing massage or even do a guided meditation to prepare you for your baby’s birth.

Depending on hospital policy, your doula may be allowed into the theater with you.

Should your baby need mucus suction (where doctors will use a little gadget to help clear out their airways — a common practice in cesareans) or any other help, the pediatrician may take them over to the resuscitaire.

This is a warm, standing platform where babies can be easily assessed and treated.

In these instances, my clients have said how reassuring it was that I could stay with them, explaining what was happening, so they feel connected while their baby went off.

Some hospitals require mothers to go to recovery alone for monitoring after a surgical birth.

The baby is then sent up to the nursery.

If the other parent (or your best friend or family member) is there, they can follow the baby.

Having one of your “people” sit with you while this happens can be really comforting and means you’re not alone after such a big event.

And this has most often been my role as a doula.

There will, of course, be nurses and doctors coming and going, but they are often focused on things like your blood pressure or filling in paperwork.

Your doula is there just for you.

If planning a vaginal birth and labor has started, you would usually let us know when it’s go-time, and we would then arrive at an agreed-upon stage.

This could be in the early stages if you feel you need extra support at home or when you arrive at the hospital.

Wherever you’re birthing, amongst other things, I’d be able to help with pain management strategies, suggest positions to move your baby down, help you in or out of the shower, or even make your partner a cup of tea. ☕

After birth

Most doulas will stay through the golden hour (the first hour after birth which is super important for mother-baby bonding and help facilitate breastfeeding if that’s what you’re planning on doing. [1]

They can also help you get washed up and settled.

Some doulas may also visit you at home (mine brought cake when she did 🙌), check-in, and talk through any aspects of the birth you have questions about.

We’re often also just a text away in those first few days if you need to ask about burping, diapers, or weird postpartum thing #259.

(And pro tip, I was surprised by just how many weird postpartum things there are. 😂)

How many types of doulas are there?

With that in mind, you might be wondering what a doula can actually do. Well, there are three types of doulas:

Birth doula

This is the most common type of doula.

They help women prepare for birth and then support them through labor, delivery, and the immediate postpartum period.

Postpartum doula

Often a doula will be a birth and postpartum doula.

A postpartum doula will help new parents adjust to life with a newborn, offering practical advice about things like breastfeeding, bathing your baby, and nutritional support for the new parents.

Timing can range from a one-time session to daily support for several weeks.

Antepartum doula

This type of doula can help if your pregnancy is high-risk or particularly difficult, like if you are on bed rest or expecting multiples.

It’s recommended to look for a certified doula (not all doulas are).

Organizations like DONA International have a search tool to help you find doulas in your area. [2]

If you’re wondering, is a doula a nurse?, the answer is usually no, though some nurses are doulas as a side business, or nurses who become doulas as a retirement job.

Do doulas help with breastfeeding?

Sometimes, yes, particularly if they are a postpartum doula or a doula who is also a lactation specialist.

If you’re looking for a doula who is also a breastfeeding expert, it’s worth asking them while you’re going through the hiring process.

Why would a woman want a doula?

So why hire a doula?

Think of them as your birth cheerleader, supporting you through what can be the most challenging and amazing time of your life.

Research has shown that women who have a continuous companion (such as a doula) throughout labor are more likely to have a quicker birth, rely less on medical pain relief, report a more positive birth experience, and have a more successful breastfeeding journey. [3]

However, a doula won’t be for everyone.

Birth is a very intimate and special time, so you may prefer to be alone or have minimal company during your birth experience, and that’s absolutely fine.

But if you’re worried about losing your voice, or not understanding procedures or interventions suggested by your medical team, a doula might be for you.

A doula can also be a great idea if you don’t have a birthing partner — whether you’ve chosen to embark on parenthood alone, or if your partner may be away for work or your family lives far away.

A doula is a trained companion to uphold your wishes and verbalize your preferences while you may be… er… otherwise occupied, ya know, having a baby.

What are the disadvantages of doulas?

One of the main disadvantages of hiring a doula is the cost.

Depending on how long you want to have them around, their salary can add up.

Some doulas don’t have experience, training, or qualifications, either, as they’re not required to become a doula, so it’s worth checking out their qualifications during the hiring process.

Some of our Peanut mamas who hired doulas also mentioned that their partners felt a bit “useless” while the doula was around, too, so it’s worth discussing with them too, if you feel the need.

What should I look for when hiring a doula?

Qualifications and experience are the most important things to consider when hiring a doula.

This part can be tricky, as there are no requirements to have qualifications to become a doula at the time of writing.

However, DONA International has some great resources if you’re looking for specific qualifications or training for the best doula for you. [4]

Next, you’ll want to make sure you get on well with your doula ‒ after all, you may be spending quite a bit of time with them, and they’ll be getting to know you pretty personally, so someone you feel comfortable with is important.

And before you think about hiring a doula, it’s worth working out your budget ‒ you don’t want to have a great interview with a doula, decide you want to hire them, then figure out they’re not in your budget.

What questions should I ask a doula?

If you’ve decided you want one, here are some key questions to ask a doula:

1. What qualifications or training do you have? Training and qualifications aren’t necessary to become a doula, but it’s well worth finding one that is qualified, so you know you’re getting sound pregnancy advice.
   
2. Why did you become a doula? This can tell you a bit more about their personality and their journey to becoming a doula.
   
3. Are you working with other clients with a similar due date to me? If there’s a clash, they may have scheduling conflicts.
   
4. Are you a birth doula, postpartum doula, or breastfeeding doula? Make sure they offer a service that’s what you’re looking for.
   
5. Have you had any birth complications with clients? While this can be a scary question to ask (and a scary answer to hear), it’s worth discussing to see how they react in a stressful situation or crisis.
   
6. How much do you charge and what packages do you offer? So you can manage your expectations when it comes to paying.
   
7. How long have you been a doula? You may be after someone with more experience.
   
8. How many babies have you birthed? This is mainly a question for a birthing doula.
   
9. Do you have insurance? Whether it’s public liability insurance or something else, it’s worth knowing you and your doula are covered.
   
10. Do you have any references or reviews? It’s all well and good talking with the doula themselves, but talking with one of their past clients gives you the real story.

Are doulas only for natural birth?

We’re not really fans of the term “natural birth”, we prefer “vaginal birth” or “unmedicated birth”, depending on what you’re referring to with “natural”.

But no, doulas aren’t just for vaginal or unmedicated births, they can also be used for c-sections and medicated births.

It’s worth asking your doula about their experiences with different types of birth during the interview process, too.

What is a doula vs midwife?

So what is the difference between a midwife and a doula?

A registered midwife is trained in physiological birth. [5]

In other words, they are medically trained to help you safely deliver your baby vaginally.

And they’re incredible at this.

They also know when to refer you to an obstetrician for any complications that may arise.

A doula, on the other hand, is there to support you — before, during, and after birth.

They are a source of knowledge, comfort, and practical advice.

Your doctor or midwife is often focused on your physical health and safety.

We, as doulas, are focused on your heart and soul.

Ok, sounds like more moonlit dancing again here, but the research is clear — how people are made to feel during birth matters. [6]

It can change how they feel about themselves, their role as caregivers, and their place in the world.

And, as doulas, that’s our focus.

What does a doula get paid?

The cost of doula services will vary depending on the level of care you need, so if you’re wondering what is a doula salary?, there is no clear-cut answer.

Some doulas may charge a flat rate while others may charge by the hour.

In the US, doula services regularly cost between $800 to $2500.

It’s quite rare for insurance to cover doulas, but it’s worth checking with your provider.

What is the demand for doulas?

Interestingly, the demand for doulas in the US and UK has been increasing quite a bit over the past few years.

There’s less of a stigma in asking for help, and more of a focus on the mother as well as the baby during childbirth and postpartum.

So if you’re worried that people may think it strange that you’ve hired a doula to help out, try not to fret ‒ you do you, mama.

How many people use a doula?

There aren’t any recent or accurate figures as to how many people use a doula in the US or around the world.

However, in a 2012 study, around 6% of birthing people said they used a doula during childbirth. [7]

How long does a doula stay after birth?

As long as you want ‒ it depends on the service you’ve hired them for, and what you’ve agreed.

If you want your doula to stay for longer than you initially agreed, ask them about their availability and new cost.

Generally, people tend to have a postpartum doula for the first 6-8 weeks after birth, but if you want to have a doula for a few months or even a few years after that, go for it!

What I loved about my own doula

I had a hospital birth with an ob-gyn.

One of the things I loved about our doula was that because she’d worked at that hospital many times before, she knew the staff and the environment.

This meant that when I felt nauseated, she immediately produced the right container for me to vomit into. 🤦‍♀️

And because I was a bit freaked out, she was able to reassure me that it was a good thing — that it probably meant I was at 9cm, and so my baby was almost here.

(If it had just been my husband and me, I would likely have been throwing up all over myself as he looked on like a deer in headlights.)

Similarly, when I had to be moved to surgery after my boy was born, all the nurses and the doctor ran out after me.

So my husband was left alone.

Holding a baby.

In a room that looked like a scene from Game of Thrones.

Our doula got him seated, helped him get his shirt off, lay the baby skin to skin, and then found a warm, clean towel to cover them both as they waited for me to come out of surgery.

This was a perfect example of things not going to plan, and her helping save the day.

Some people are concerned that a doula will replace their partner or make them feel useless.

A good doula helps your partner help you, suggesting how they might physically support you or reminding them what a precious moment this is and how to make the most of it.

My doula was also able to offer my husband a break.

I labored for a good while, and eventually, he needed to get something to eat.

I can say for certain he wouldn’t have felt comfortable leaving me to grab a bite had she not been able to stay with me.

So another benefit of having a doula, especially in a hospital setting, is that they are simply there.

Depending on how busy the maternity ward is at the time, the nurse-midwives may be run off their feet looking after multiple patients.

So they may pop in and out.

Your doctor too.

They often check in every now and then but usually don’t hang around through your whole labor.

There could be long periods when you and your partner are alone.

And it’s super helpful to have someone there who has seen many births and can reassure you when things seem unfamiliar or help you know what questions to ask your medical team as things progress.

Or, as our doula did, know how to turn the sound down on the Fetal Heart Rate Monitor so I could get some sleep.

Super practical.

Finally, I think the single most important thing my doula did for me was remind me I did a good job.

I was devastated that I had asked for an epidural, after working so hard for an unmedicated birth.

My birth had certainly not gone to plan.

Having someone who had supported so many births backed up the fact that I had made the right decision at the time and that I had done a great job in handling a difficult labor meant the world to me.

She helped me debrief and understand and remember how and why things unfolded as they did.

She helped me feel like the superhero I was.

Of course, my husband told me I was amazing and incredible, etc. — but he kinda has to 😉.

What else should you know?

Most doulas work along the same lines in terms of their overarching function — emotional and physical birth support.

They may have added qualifications, though, in things like pregnancy massage, aromatherapy, or hypnobirthing, which inform what support they can offer.

They often also have various packages detailing the scope and timeline of their support.

You may also want specific things from the doula you choose.

You may want a birth with certain religious rights and feel a Christian, Muslim or Jewish doula, for example, may be right for you.

Similarly, if you are a person of color, you may feel more comfortable with a doula of color.

With all this in mind, it’s a great idea to interview a couple of doulas before making your choice.

You need to make sure the chemistry is right.

I wanted a no-nonsense straight talker, a solid, reassuring presence, and someone my husband felt comfortable with so he could make use of their skills too.

There are so many benefits to doula support in birth, and I’ve only just offered up an appetizer. There’s a whole menu on offer.

But what is most important is that there really is a doula for everybody.

And every kind of birth, especially if you fancy some moonlit dancing.

Your doula can probably bring the mixed tape.

Just make sure they know where to find the puke bowls.

Is it worth getting a doula?

Doulas are becoming a more popular addition to the birthing team, so it’s worth doing your research.

Looking for certified doulas in your area can take time, so start the search sooner rather than later in your pregnancy.

While it’s important to nail down the practicalities — like making sure your preferred doula is available around your due date, and you can afford their fees — it’s also really important to make sure you and your doula’s birth philosophies are compatible.

After all, they will be supporting you, and advocating for you, at one of the most important times of your and your baby’s life.

So, to doula or not to doula? That is the question.

And only you know the answer, mama.

Speak to other mamas at Peanut who used a doula, they can offer advice based on their real-life experience!