What’s a doula?
A doula is a trained professional who is part of the birth care team. Birth Doulas provide continuous physical, emotional and informational support to their clients through pregnancy, birth & early postpartum. In much of the world today and throughout history, women support women through labour and birth.
What are your qualifications?
I am a Master Doula, highly educated and experienced in birth work. Please see my About page, which includes my professional background and creds. In a nutshell, I’ve attended over 400 births, taught prenatal classes to thousands of expectant parents, trained hundreds of doulas, and processed hundreds of placentas. My education includes an Honours Science degree, Master Herbalist degree, and many other programs and certifications.
What’s the difference between a midwife and a doula?
Doulas work as part of a team with doctors or midwives, but not instead of. They provide non-medical support and comfort measures (e.g. encouragement, massage, positioning suggestions). They do not perform clinical tasks such as heart rate, blood pressure, or internal exams.
Midwives are medical providers, highly trained in the medical aspects of normal birth. For homebirths, they carry oxygen, medicines, resuscitation equipment and other gear. They are primary medical care providers at home and hospital birth. In North America primary/medical birth care is offered by either a midwife or a physician.
Why choose a doula over simply using a friend or family member as support?
Doulas are trained and experienced in childbirth support. They know the sounds and behaviors of laboring women, and what that may indicate about progress. Doulas are trained in pain-reducing comfort measures, natural methods to keep labor progressing, and to support the laboring people and partners / birth companions. There’s a significant difference in outcomes when trained doulas attend birth – more on that below.
Experienced doulas are familiar with local hospital policies & practices and have often built a rapport with the doctors, nurses and midwives. Personally, I know my way around the hospitals in which I work, and where to find things such as extra blankets, food outlets, squat bars, parking, quiet spaces.
In most Canadian hospitals, maternal patients are allowed 2 support persons – usually that’s a partner and a support person. Some hospitals accommodate a 3rd support person. Homebirths and birth centers encourage women to have all the support they wish.
What difference does the presence of a trained doula have on birth outcomes?
The presence of a doula tends to result in shorter labours with fewer complications, less pain, and lower rates of interventions. When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, have fewer caesareans and requests for medical intervention, and less postpartum depression. In case of unplanned circumstances, doula support helps reduce negative feelings about one’s childbirth experience. Studies have shown that babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period.
Analysis of six randomized trials demonstrates that lack of doula presence correlates with:
- Double the overall caesarean rate
- 33% increase in length of labour
- 67% increase in oxytocin use
- 2 ½ times more requests for epidurals
Will a doula make my partner feel unnecessary?
A responsible doula compliments and enhances the father/parent-to-be, partner, birth-companions in their supportive role rather than acting as a replacement. (While I respect people’s individual circumstances, I will use father and male words for most of this paragraph, as that’s who most often asks this question. It comes up so often that I wrote an article just for Dads and Doulas.) The presence of a doula allows the father to support his partner emotionally during labor & birth without the pressure to remember everything he learned in childbirth class! The father typically has little-to-no actual experience with the birth process, yet is expected to act as a “coach”. Some partners feel (accurately) that this is a huge expectation. Many fathers experience the birth as an emotional journey of their own and find it hard to be objective. A doula is supportive to both the birthing person and their partner, and plays a crucial role in helping a partner become involved in the birth to the extent they feel comfortable. Studies have shown that male partners participate more actively during labor with the presence of a doula. There is significantly more eye contact and more touch between the couple.
When a couple works well together during the birth process they’re better able to handle the challenges of early parenthood. An incredible bond can form or be made stronger.
How does a doula assist with communication in hospitals during labor & birth?
Doulas do not speak on a client’s behalf nor intervene in their clinical care. They do not make decisions for clients, nor judge the decisions clients’ make, but are there to support those decisions. A doula may remind or encourage their client to ask the questions necessary to understand a procedure and make informed decisions.
During prenatal meetings, I learn what’s important to my clients, discuss how to make informed decisions, and how to communicate their specific preferences with their medical care providers. (My prenatal classes also cover the important topic of informed choices.) I help my clients create a birth plan that builds bridges of communication with the staff, meaning less need to verbally communicate every wish to every new staff member who comes in the room. My educational background includes some medical training. While I don’t work as a medical care provider, this experience allows me to be a great translator and explainer, turning fancy words into everyday language that my clients can understand.
Partners and birth companions are an important part of decision-making. Part of our birth prep includes teaching them how to navigate these conversations and how to be supportive of their labouring partner’s wishes.
When recommendations are made regarding medical care, then I am comfortable being in the conversation with the medical team, discussing options and asking questions that help my clients make their best choice. It is the responsibility of the labouring woman to consent to or decline interventions.
How does the doula fit in with nursing staff?
Doulas do not replace nurses or other medical staff, but rather work as part of the team. Doulas provide comfort and support while nursing staff take care of medical needs and charting (often in a supportive manner of course). Nurses change shifts; doulas stay.
I’ve had many wonderful experiences working with nurses to help my clients have a satisfying and empowered birth. After all, we all want the same thing and have different – often complimentary – tools to help make it happen.
How do meetings work? When, where, how do we meet?
After we’ve had an intro meeting and agreed to work together, we’ll meet at least twice more before the birth; as many times as we need to feel prepared. I do not charge extra for additional meetings. I use easy, convenient online booking. We can meet online, at my office, or at your local home/place of choice.
It’s never too early in pregnancy to start our meetings. I ask that the two main meetings are complete by 35 weeks, ideally. After your baby is born there will be a minimum of one postpartum visit, and more if needed or desired. I welcome questions and communication from my clients between prenatal meetings and through the first eight weeks postpartum. (I am happy to receive photos and updates beyond that!)
Are doulas only useful if planning an unmedicated birth?
The role of the doula is to help attain a safe and pleasant birth, not to choose the type of birth. The presence of a doula is beneficial no matter what type of birth is planned. In fact, people who choose a medicated birth need as much support as those who choose a natural birth, but a different kind of support. For women who know they want a medicated birth, doulas still provides emotional support, informational support and comfort measures to help through labor and the administration of medications. Doulas can help with possible side affects and by filling in the gap that medication may not cover; rarely does medication take all discomfort away and sometimes there’s a wait involved.
For a people who are facing a caesarean birth, a doula provides comfort, support and encouragement. Often a caesarean is an unexpected situation and parents-to-be can be left feeling unprepared, disappointed and lonely.
When medical interventions are part of birth, I help my clients make informed choices, navigate the resulting detours, find comfort and positions that work around monitors and tubes, and feel more empowered in their circumstances. Some people know ahead of time that interventions will be part of their birth and in that case, we can plan ahead.
What if I planned a drug-free birth then change my mind during labour?
Doulas don’t make decisions for clients or intervene in clinical care, nor do they judge their choices. They provide informational & emotional support while respecting their client’s decisions.
One of the things my clients and I discuss in prenatal meetings is this very situation. What’s the plan if they want a natural birth and then ask for pain meds? What can we do instead, if they want that option? We discuss strategies for comfort, the idea of “compassionate use of epidurals”, how the timing of epidurals can affect birth, how interventions can change the birth experience and how pain meds can be a useful tool.
We know how to handle this situation in labour because we are prepared. My clients can be in control of using pain meds or not, and can feel good about their decisions.
What kind of comfort measures do you use during the labour & birth process?
While there are common comfort measures taught in doula training courses, each doula also brings their own tools and methods. Mine include the following:
- Positioning suggestions specific for stages of labour, circumstances, client preferences, situations that arise through the birth process. Many of these positions help keep birth moving along efficiently.
- Massage, pressure, and various touch methods.
- Homeopathy & Bach Flowers (optional; no extra charge).
- Aromatherapy (optional, you provide the oils; only available out of hospital due to scent policies).
- Words: Encouragement, reassurance, what to expect, normalizing the normal things, info to prepare for the unexpected things.
- Setting up the birth space to be as functional and comfortable as possible.
- Heat or cold as desired.
- Hydrotherapy (water for comfort in labour, and/or water-birth).
- Create space for partner, and recommendations to help partner to offer support.
- A calm, reassuring presence who trusts the birth process.
- Quietly holding space when that’s all that’s required.
- For partners, reminding them to take bio-breaks and meet their own needs, answering their questions, ensuring they know what to expect at various stages and with a variety of circumstances, helping them to be the supportive partner or take breaks when needed.
Everything in the above list is optional. I am happy to respect people’s boundaries. Part of birth planning and getting to know my clients includes determining how comfort looks at various stages and what their general preferences are. When working with couples, we discuss how they’d like to work together and if the partner has any special needs or requests through birth.
My comfort tools and methods are tailored to what my clients need and want in the moment. Birth support often varies with the ebbs and flow of labour.
When do we call you in labour?
Details are discussed in our prenatal meetings. My clients know when and how to reach me. Labour support includes questions and updates, ideas and suggestions by phone or text even before we are together in the same room.
When and where do you join us in labour?
That depends on the labouring person, partner, and what’s going on in labour. Labour support includes questions and updates, ideas and suggestions by phone or text even before we are together in the same room. Early support often takes the form of checking in by phone/text, and/or dropping by your place. I join you at your home (or local labour spot), hospital or birth center once you need in-person support, which is typically in the active stages of labour. I’m usually with my clients until 2-3 hours after the birth.
How do shared-care and back-up doulas work?
Doulas often team up to provide enhanced service through busy times, holiday seasons, summertime. Clients benefit from combined experience, education, and availability. Since doulas are on call for up to a month for each client, shared care allows them time for important life events and days off without having to turn clients away or rely on unfamiliar back-up. In cases of unusually long labours, a doula-colleague may be called in to provide a break for the primary doula. Fees remain the same.
When I work with clients, I plan to attend their birth. If I know I’ll be unavailable for part of my clients’ on-call time, then I’ll offer them to meet my colleague prenatally. I am extremely choosy in my doula team.
What if you can’t be at the birth?
When I work with clients, I plan to attend their birth. In the rare circumstance that I can’t be there, you will be well supported. I am extremely choosy in my doula team, reliable back-up doulas who offer excellent care. Fees remain the same. If a back-up is likely to be part of your care, then a meeting with my doula-colleague can be arranged.
What kind of postpartum support do you offer?
Doulas usually stay for 2-3 hours after the birth, until new or new-again parents are ready to be on their own with their baby. I visit my clients on the first day postpartum, in-person if they’re in our local area, and virtually if they’re farther away. Postpartum visits are typically 45-60 minutes and can be a little longer if needed.
Then I follow them for 8 weeks postpartum, offering basic breastfeeding support, answering questions, and reviewing their birth. Additional visits are available at no charge if desired. During this time I share important info such as what’s normal and what requires medical attention for mother and baby, typical newborn behaviour, mental health information, how to navigate life as a new or newly expanded family. I am available for questions, to share educational resources, and referrals such as lactation consultants, pelvic floor physios, tongue-tie experts, and skilled practitioners for newborn and maternal postpartum recovery.
What if I need extra help with breastfeeding or baby-care?
The information above describes the care I provide as a birth doula. Another kind of doula, a “postpartum doula”, specializes in extended care and breastfeeding support. They typically offer 3-6 hour sessions in your home, light house tidying, and some offer overnight care. I train postpartum doulas and can make recommendations.
There are also breastfeeding counselors and lactation consultants that can be arranged through public health or hired privately. I can provide resources and contact info for them. If you’re in hospital then the nurses or unit Lactation Consultants can provide support until you’re discharged.
How much do your services cost?
There are many ways to work with me as a prenatal educator and a doula. I teach a variety of classes and offer a few different birth doula packages. Please see my Fees page.
More Info & Next Steps
Pregnancy & Birth Support, Online Prenatal Classes & Preparation 