Doulas – What Is a Doula And Why Do So Many Women Want One?

What Is A Doula?

The word ‘Doula’ (pronounced ‘doola’) is a Greek word meaning ‘woman servant or caregiver’. More recently, it refers to someone who offers emotional and physical support to a woman and her partner before, during and after childbirth. A Doula (also known as a birth attendant) believes in ‘mothering the mother’, enabling a woman to have the most satisfying experience that she can, from pregnancy and into motherhood. This type of support allows the whole family to relax and enjoy the experience too.

Despite Doulas being fairly unheard of in Australia, they have been actively supporting women for a very long time and are fast growing in popularity after much positive word of mouth and the need for increased support.

Doulas are trained and experienced in childbirth and are usually mothers themselves. They have a good knowledge and awareness of female physiology, but a Doula does not support the mother in a medical role – that is the job of the midwife or doctor. She also does not make decisions for the couple, but she supports them through the decision making process and provides balanced information so the couple can make their own decisions.

A Doula works in birth centres, private and public hospitals and at homebirths in conjunction with midwives – but never as the sole carer at birth. (Birthing without a midwife or doctor present is known as freebirthing however BellyBelly recommends birth with at a qualified midwife, or doctor).

There are two types of Doulas, Birth Doulas and Post-Natal Doulas, with many Doulas performing both roles. The difference is that the role of the Post-Natal Doula is to nurture the mother at home after childbirth. This may include further breastfeeding support, light home duties, massage, emotional and physical support for the mother and so on. Post-Natal Doulas are particularly in demand as support for new mothers has reduced in modern society. Needless to say, studies show that Post-Natal Doulas make a huge impact on the well-being of mothers.

What Are The Proven Benefits Of A Doula?

There are many studies from around the world which have demonstrated very impressive benefits for the mother, father and baby, including:

• 50% less caesarean sections
• Reduction in the use of forceps by 40%
• 60% less requests for epidurals
• 40% reduction in the use of synthetic oxytocin for inductions or augmentations
• 30% reduction in use of pain medication
• 25% reduction in labour length
• Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
• Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum

These are not misprints! The benefits are significant. Most of the women in the studies were accompanied by male partners, however study results show that women who had the support of a male partner and a doula fared best, for example, the caesarean rate of women supported by both a male partner and a doula was significantly lower (15.4%) than the caesarean rate for women supported only by their partners (24.4%). Studies also clearly show the positive benefits of doula support occur regardless of a woman’s economic status or whether or not they were privately insured.

What About The Father?

According to studies, rather than reducing the father’s participation in the process, a Doula’s support complemented and reinforced the father’s role. Fathers felt more enthusiastic and that their contribution to the labour and birth was meaningful and helpful. Not only did fathers report higher levels of satisfaction after the birth, but mothers reported feeling more satisfied with their partner’s role at birth too.

The Promise Of A Doula

1. You cannot hurt my feelings in labour
2. I won’t lie to you in labour
3. I will do everything in my power so you do not suffer
4. I will help you to feel safe
5. I cannot speak for you; but I will make sure that you have a voice and I will make sure you are heard

What Will My Ob/Hospital/Midwife Say?

More Obstetricians and Midwives are becoming aware of the Doula as they become more popular; most are very supportive or are not bothered by a Doula – in fact Obstetricians and Doulas rarely cross paths. If they do, it’s often for a very short time, during the birth.

There is the occasional story I hear about some Obstetricians not wanting a woman to have a Doula present, however ultimately it is your own choice and decision as to the level of care you receive. In the case of the Obstetrician, they are not present for you throughout most of the labour, only if you need intervention or to catch the baby (if they make it!). So continuous support from a known carer is crucial while you labour – what happens during the labour can of course affect the outcome.

What Training Do Doulas Receive?

In Australia, there are several ways a Doula can train, through courses conducted by very experienced Doulas, some of which are also midwives, doctors and educators. Again, this is not medical training – Doulas are trained in professional birth support. As part of a Doula’s training, she may be required to read certain materials, attend several births (as an unpaid trainee), write assignments/reports and other requirements. If you are interested in becoming a Doula, see our BellyBelly article, Doula Training In Australia.

What Do Couples Think of Doulas?

Check out THIS short video on YouTube featuring couples talking about doulas.

Here are a few short testimonials from Australian couples who have used professional birth support:

“A very special thank-you… You made such a difference at the birth for us both, encouraging me when it all seemed too hard and helped me achieve the birth that has given our little girl the best start in life. Thanks for sharing this special time with us. I hope our paths cross again. You are a beautiful person with much to give the world.”—Catherine & Jason – 2006

_“Thank-you for helping us achieve a wonderful birth experience. I felt safe and far more relaxed knowing I had the right support. Everything went exactly as I wished for with minimum intervention and stress¦ I feel sooooo grateful that we had such a great outcome. I am sure it is even helping me get through these difficult first months. I now know I CAN get through anything with determination, knowledge and support!— Meredith & Chris – 2006_

“Wow I’m still in shock when I think about that long labour and the fantastic result – it was sooo worth it. I truly know that I couldn’t have done it without you – that is a fact. You are amazing and are truly made for the job – I really can’t thank you enough.”—Bronte & Michael – 2006

How Much Does A Doula Cost?

This varies greatly dependant on experience, the state the Doula is located in and what packages are on offer. A package offering pre and post-natal visits (generally around 2 hours long each) as well as the duration of the birth generally costs around $800-$900 for the more experienced Doula. Inexperienced Doulas usually charge a much lower fee and most Doulas offer reduced rates for those in genuine need.

Many Doulas only attend 1-2 births a month, as many are mothers with young children. Finding last-minute childcare as well as spare time to do visits and attend births is a tricky balance – it often happens during family time on weekends or after hours. So it’s not something women do for monetary benefits, but passion.

Finding a Doula

If you would like to have a Doula support you, there are several Doula locators on the internet. BellyBelly has a Doula locator in our Find-A-Doula section, as well as offering birth support services as BellyBelly Birth Support.

We recommend speaking to several Doulas as every Doula is unique and has something different to offer. You will know who you click with. It’s important that you and your partner both meet the Doula. You can download a copy of our Doula Interview Sheet if you aren’t sure what to ask the Doula.

References and Recommended Reading

1. Klaus M, Kennell J, Berkowitz G, Klaus P. Maternal assistance in support and labor: Father, nurse, midwife, or doula. Clin Cons Obstet and Gyn 1992; 4:211-17.

2. The Doula Advantage, Rachel Gurevich, Prima Publishing 2003

3. The Doula Book, Marshall H. Klaus, M.D., John H. Kennell, M.D., and Phyllis H. Klaus, C.S.W., M.F.T. Da Capo Press, 2002

4. Sosa R, Kennell J, Klaus M, Robertson S, Urrutia J. The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. N Engl J Med 1980; 303(11):597-600.

Kelly Zantey is a birth attendant (aka doula) the creator of BellyBelly, mum to two beautiful children and has just opened the BellyBelly Pregnancy Centre in Canterbury, VIC.