Hiring a doula is becoming increasingly popular with parents-to-be in the hope of an improved birth experience. When we think of doulas, calming whale songs and meditation tend to come to mind — but what do doulas, in fact, do?
Depending on the specific type of doula (birth, antenatal, or postpartum), a doula’s role consists of providing physical and emotional support to the mother during pregnancy, labor, birth, and beyond. This includes assistance with breastfeeding, birth recovery, liaising with hospital staff, and more.
The idea of birth support goes back centuries when women would be surrounded by both medics and female friends during a home birth to help bring their baby into the world.
Today, there are many more services a doula can offer besides cheering you on and mopping your brow. We’ll answer your need-to-know questions about doulas below and cover how to go about becoming one yourself!
What Is a Birth Doula?
Also known as a birth companion, a birth doula is a trained individual hired to prepare a woman for childbirth and provide continued support during labor.
Doula care can cover pregnancy (antepartum doulas), childbirth, and postpartum care, but birth doulas specifically provide assistance from the second or third trimester onwards in the following ways:
Discussing birth plans/preferences – where you’d like to deliver, preferred delivery method, choice (if any) of pain relief, etc, and communicating these wishes/concerns to your midwife team.
Mentally preparing mothers for the birth – helping you understand and know what to expect about each aspect. They may also provide coping strategies such as meditation, breathing techniques, etc.
Physical and emotional support during labor and birth – things like assisting you in and out of the shower or bath, massage, pain management, positive visualizations, and other strategies to help mom feel calm, motivated, and reassured at every stage.
Why Are Doulas Important?
Doulas can be a great mental boost and tireless advocate for women and their partners throughout pregnancy.
In what can be a stressful and worrying time, doulas essentially ensure a pregnant woman’s voice is heard and respected as much as possible by her medical team to generate a more positive experience.
What Do Doulas Do?
Depending on the duration of their hire, the responsibilities of a doula may include:
- Providing mothers with emotional, physical, and educational support.
- Listening to and providing advice regarding any fears/concerns.
- Sitting in at prenatal meetings/appointments to become familiar with the mother’s medical needs and preferences.
- Making home visits after the birth to assist with childcare while the mother heals and providing recovery advice/support.
- Offering practical support postpartum such as help with breastfeeding, making meals, light housework, help with errands, etc.
Are Doulas and Midwives the Same?
No. Midwives are certified medical professionals who complete graduate-level midwifery courses and are later licensed and certified by the American College of Nurse-Midwives.
Doulas, meanwhile, do not need to be certified or require a background in medical education (though many are certified).
Doula care also focuses more on emotional and practical support during and after pregnancy while midwives are trained to prescribe medication and carry out medical procedures such as gynecological exams and the hands-on delivery of your baby.
How Do Doulas Improve Birth Outcomes?
Founder of Evidence-Based Birth and registered nurse Dr. Rebecca Dekker, Ph.D., discussed a study that compared the birth outcomes of women who received continuous labor support from traditional in-hospital care teams and those who received support exclusively from doulas.
Results showed that there was a “39% decrease in the risk of cesarean births with doulas” (compared with a 25% decrease in risk with other types of support) and a “15% increase in the likelihood of vaginal births with the support of a doula” (compared with 8% alongside normal care).
Other studies have also highlighted a positive impact on birth weight and a slightly lowered risk of complications for some doula-supported mothers.
What Do Postpartum Doulas Do?
Postpartum doulas provide practical and emotional support in the weeks or months following birth.
This can entail everything from helping the mother recover and assist with early infant care and breastfeeding to generally helping both parents find their feet, offering coping skills while assisting with meal prep and chores.
Be careful not to confuse postpartum doula support with the role of a night nanny or nurse as, depending on their training, hands-on childcare may not necessarily be a part of their duties.
How Do You Become a Doula?
Before taking on the rewarding role of becoming a doula, it helps to have a semblance of experience and education in the field.
Some doulas are ex-midwives, but others may have simply attended a few births and have a passion for holistic care.
Others are sometimes inspired by their own birth experience and/or complications and wish to provide others with the help they lacked.
Attending births, joining doula workshops, and signing up with doula organizations such as The Doula Foundation or DONA International are all recommended to learn more about the process and discuss your relevant skills and qualifications with certified doulas.
Can Anyone Be a Doula?
Doulaing is largely unregulated, so technically anyone can become a doula.
While doulas are increasingly becoming certified and working within hospitals and agencies, the role of a doula is an ancient profession and is still viewed by many cultures simply as “labor support.”
It is entirely up to the birth mother and her partner to consent to use a private, unregulated doula, so this could simply be the casual help of a close friend or relative with no medical training.
How Long Is Doula Training?
According to the natural health school directory Natural Healers, a birth doula’s training can last around 16 hours on average, based on data from the American College of Nurse-Midwives and DONA International.
Around 7-12 hours of childbirth education and the attendance of 2-5 births are also expected.
What Is a Doula Certification?
A Doula Certification verifies that you have the skills and education required to facilitate the mental and physical needs of an expectant mother from pregnancy through labor, birth, and postpartum.
While a Doula Certification isn’t always necessary to become a doula, it instills client confidence and widens the net of work opportunities for you since hospitals and medical centers will expect doulas to possess the proper credentials.
How Long Does Doula Certification Last?
According to leaders in evidence-based doula training DONA International, certified doulas “are required to recertify every three years.”
Recertifying as a doula is important as it shows a “dedication to keeping up with evidence-based information and trends, as well as keeping their skills up to date.”
What Kind of Doula Makes the Most Money?
Your potential earnings as a doula will depend on how much you charge per hour or per birth.
For example, if a birth doula charging $1,500 per birth assists with 4 births per month, then earnings can be expected to be $72,000 per year as a full-time doula.
A full-time postpartum doula, meanwhile, has a more continuous support role with an hourly salary, increasing their yearly earnings.
Can You Be a Doula Part-Time?
Yes, the role of a doula can be quite flexible, particularly if you work as an independent contractor as opposed to fulfilling a quota set by hospitals or birth centers.
Most doulas can take on as many or as few clients as they are able to.
Where Can You Work as a Doula?
Doulas normally travel from their home to wherever their client has agreed to meet. This may be the client’s home for pregnancy, home births, or postpartum support or the hospital or birth center for traditional labor and birth support.
How Do Doulas Find Work?
Certified doulas can find work by contacting a doula agency that will either hire doulas as employees or as independent contractors to work directly with clients.
You can also contact your local hospital or healthcare center to enquire about doula roles, and you may even find potential clients in baby shops or midwife groups in your area.
How Many Clients Can a Doula Have?
Depending on your availability and career ambitions, you may opt for full-time work as a doula and take on 4-6 clients a month, or you may choose to take on clients as part of your supplemental income.
When Do Doulas Go on Call?
Doulas essentially go “on call” at a time agreed upon with the client.
Typically, doulas will be needed in the window between late pregnancy and labor, though a family member (usually the birth partner) may only request the support of a doula once the client has gone into labor.
Being on call should also mean that if doulas cannot reach their client(s) in time, they will provide a backup doula (as agreed upon by all parties beforehand).
Do Doulas Need a Business License?
Doula business coach and founder of Inspired Birth Pro Darlene MacAuley advises that “some may require you obtain a business license, while others may only require you register your business name.”
If you plan to sell any products alongside your doula services, you may need a special permit to pay sales tax to the state. Be sure to research your own state, county, and city regulations.
Can a Doula Become a Midwife?
Any experience as a doula may help you determine whether midwifery is right for you, and doula certification is a great step in the right direction.
Training as a midwife can take several years though, so if you know you want to become a midwife, skip being a doula, and start your midwifery apprenticeship and education straightaway.
How Much Do Doulas Make?
A doula’s salary varies depending on location, training, and experience in addition to birth fees or hourly rates.
The doula team behind the Wildwood Birth Collective estimate the average annual salary for doulas in the US to be $40,000 to 50,000 or over $100,000 for experienced doulas in larger cities.
How Much Do Doulas Cost?
According to Very Well Family, birth doulas can range from $800-$2,500 depending on postcode, experience, services, etc. while a postpartum doula may cost around $20-$50 an hour.
Are Doulas Covered by Insurance?
“Doulas should have their own insurance covering them for Public Liability and Professional Indemnity” according to Mother & Baby.
Standard insurance plans may not cover the costs of doula services, but it’s worth researching as some providers offer maternity care coverage that may include doula care.
Do Doulas Take Medicaid?
Some states including Florida, New Jersey, and Oregon actively reimburse for doula services under Medicaid, and many more states have implemented or plan to implement Medicaid doula programs in 2023.
Are Doula Expenses Tax Deductible?
The cost of doula services is not currently tax deductible, but you may be able to claim doula expenses as a medical expense on your income tax return.
Are Doulas Worth the Money?
It depends entirely on your budget and personal choice.
A doula can be a huge support for fearful first-time mothers or for those who may have experienced a previous traumatic birth and wish for their needs to be met and honored the second time around.
Perhaps you will find it helpful to read why mom-of-two Nicolle thinks a doula is truly a great resource.
How Many Doulas Should You Interview?
It’s advisable to interview at least three possible doulas before making your decision.
It’s easy to become overwhelmed with choice, but it’s simply about finding a certified doula you feel a good connection with and who understands your needs.
What To Look for in a Doula?
When interviewing a potential doula, look for the following:
- Considerable childbirth experience
- Excellent communication and interpersonal skills
- A calming, encouraging presence
- The ability to advise and answer your questions/concerns in a non-judgemental manner
- Excellent knowledge of childbirth as well as pre and post-natal care
Also, don’t forget to ask if they can provide testimonials from previous clients, if they are up to date with vaccinations, and any other questions that may be important to you.
Hopefully, you now feel much more informed as to what a doula is and how they can assist you during your perinatal journey.
A doula can be a great option if you are nervous that your birth plan may be abandoned in the heat of the moment as they will fight in your corner when you can’t.
They’ll also provide much-needed emotional support for as long as you need it.
If your own birth experience has inspired you to help other new moms in this delicate time, perhaps you could even consider putting your natural compassion to great use by training to become a doula!
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Rebecca is a seasoned copywriter and researcher with over a decade of experience, specializing in parenting topics. With a passion for all aspects of raising children, from breastfeeding to potty training.