There are many reasons why women and their partners choose to hire a doula to support them during pregnancy and childbirth.
For some, a doula will play a crucial role if a woman’s partner is unable to attend the birth – for example, if he or she works in the military or overseas.
For others, having a doula is an additional, amazing layer of support and comfort for both the mother and her partner.
Couples love that a doula can provide a trifecta of care, unlike anyone else who will care for them in the birth room.
This trifecta allows for the fantastic outcomes doulas have consistently produced in countless studies from around the world.
What is the trifecta?
- Provides continuous care. Doulas are present during labour and birth in its entirety, no matter if it takes 3 hours or 18 hours.
- Is experienced. Doulas are trained in normal, physiological birth. There’s no need to be trained in complications, thats what doctors are for (and thank goodness we have them, when there is genuine medical need). Doulas do not work on the premise that childbirth is a complicated and scary event. They help to keep things normal without interfering in any medical decisions.
- Is well known to the woman. The doula was specifically chosen by the mother, who has built a relationship with her doula before the birth. Trust has been established.
It’s rare that anyone else supporting a labouring woman in a hospital setting can provide all three. Her partner is not experienced nor trained in birth, and a member of hospital staff will not stay by your side without interruption (due to shift changes, other women to attend to), and in most cases, they aren’t known to the mother until the day.
It's because of these huge benefits, a review of available doula studies a few years ago found a doula’s support was more effective than hospital staff or the mother’s family and friends. It meant fewer interventions, lower dissatisfaction with the birth and fewer complications.
The review concluded: “Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.”
What The New Doula Research Says
Research recently published in the American Journal of Managed Care identified another great reason for hiring a doula.
Having a doula's support during childbirth was linked to an almost 60% reduction in the likelihood of a woman giving birth by c-section. This figure rises to 80% for non-medically indicated c-sections.
The researchers analysed the results of pre-existing medical surveys, detailing singleton births that took place in a US hospital between 2011 and 2012. This particular survey was used because it is the only survey that included information on doula care. The survey asked not only whether a doula was present at the birth, but whether a doula was desired by the mother. The survey also allowed participants to indicate whether they were aware of the role of doulas or not.
The study found that only 6% of the participants gave birth with the support of a doula, though another 27% of participants would have liked to have a doula with them during the birth. Unfortunately, 40% of the participants were unaware about doulas.
However, this study is considered groundbreaking, because for the first time, it offered a comparison of the outcomes for women who had doula support, with those who would have liked to have it. The study showed that wanting a doula’s support does not produce the same benefits of actually having a doula present.
What Doulas Do
Doulas are trained, non-medical birth support professionals, who provide continuous labour support to both mother and baby. Studies have identified that women who receive continuous care during labour have higher rates of spontaneous vaginal birth, shorter labours, less pain relief requests, lower rates of medical intervention and more. Hospital staff are often dealing with more than one labouring woman at a time, leaving them unable to provide continuous care.
Doulas offer education, information and support during pregnancy and birth, in order to enable women to have the most satisfying birth experience possible. Doulas do not offer medical care, but instead provide a service that helps women and their partners to feel empowered, in control and fully able to relax. Doulas may have additional skills such as Calmbirth/Hypnobirth training, massage, naturopathy and photography to name just a few. Studies have also shown that doulas help birth partners to feel engaged and involved with the birth.
Choosing A Doula
If you like the idea of having doula support at the birth, you will be relieved to hear that there are plenty of doulas available for you to choose from – you can even find your perfect doula in the BellyBelly directory here (Australian listings only at present, international coming soon!). Organise meetings with a number of doulas from your local area, so that you can find out more about the unique skills and experience each one has to offer. It’s not wise to select the first doula that you meet – while doulas are lovely people, meeting several gives you the opportunity to see how you feel around different doulas and what feels good to you. BellyBelly has an article HERE containing questions you should ask a prospective doula.
Be sure to choose a doula who makes you feel comfortable and who you feel will be best able to support you during the birth. It's also important that your partner gets on with the doula too, since they'll be working together to support you.
Doula care at birth usually starts at around $800-$1000+ depending on your location and the skills doulas offer. Some doulas are also massage therapists, naturopaths, nutritionists and other types of therapist, therefore they put together packages to include these offerings. Its important to compare what you get in the packages because they do vary from doula to doula, and the cost often reflects the value, experience and skills you’ll be getting. Bear in mind that packages include prenatal visits in your home, the entire birth (usually no matter how long it takes) and postnatal visits – so you get a great deal of intensive, one on one care that you can trust.
If this is out of your budget, some organisations offer funding to women in need. Speak to the doulas in your local area to find out about any local funding schemes. Student or newly qualified doulas sometimes offer very low cost care as a way of gaining experience, so contact your local doula training centre to see if they can put you in touch with any students.
Is Doula Care Covered By Medical Funds?
Doula care is not usually covered by medical insurance companies, however the researchers felt that their study highlighted the potential financial value of doulas. Caesarean sections cost a great deal more money than vaginal births, and rising rates of caesarean sections means rising costs. If medical insurance covered the cost of doula care, it would significantly reduce the risks and costs involved with caesarean sections, by around 60% or more.