Are a doula and midwife the same thing? What's the difference?

No, they are actually two completely different roles, but they work great together. The easiest way to explain this is a midwife is a healthcare provider who has medical training and catches the babies (or just patiently watches and is there if needed 😉). A doula doesn't do any of the medical stuff. Instead, a doula is the non-medical, continuous labor support person who can focus on the needs and support of the birthing woman at all times without the interruptions of having to do the medical stuff. This is why a doula is a great addition to your birth support team, even if you're birthing with a midwife. 

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How does a doula improve birth outcomes?

Because a doula's primary responsibility is the woman giving birth, they are focused solely on your agenda. Their physical support can help you maintain control, comfort, and confidence. Emotional support helps you feel cared for and helps you feel empowerment in your birth. Informational support helps keep you informed during labor and provides you with evidence-based information on your birth options. A doula's advocacy can help you be heard and supported in your right to make decisions for yourself and your baby. 

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In 2017, a study proved that a person having continuous support during labor experienced:

- 25% decreased risk of a c-section, the largest effect was seen with a doula (39% decrease)

- 8% increased likelihood of a spontaneous vaginal birth, the largest effect was seen with a doula (15% increase)

- 10% decreased use of any pain relief medications

- shorter labors by an average of 41 minutes 

- 38% decreased risk of low APGAR scores for baby 

- 31% decreased risk of being dissatisfied with the birth experience

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Can you receive doula support if you're planning on having a medicated birth or an epidural? Aren't doulas just for unmedicated births? What about if I'm planning a c-section or if I end up needing one?

 

A common misconception about doulas is that they are only for people who want an unmedicated birth. Doulas are for all births in all settings. You do not need to be the super crunchy person birthing alone in the woods with a baby deer to have a doula. The support a doula provides throughout pregnancy, labor, and immediate postpartum (discussed above) are beneficial regardless of the type of birth you have. While an epidural can relieve pain, it doesn't provide the type of support a doula does. Before, during, and after receiving pain medication, a doula can provide you with support and comfort measures. They can still help you with position changes and help you with feeling more comfortable. This support and comfort can also be more than just physical, since many times an epidural can take away the pain, but not the anxiety and other feelings that can come with bringing new life into the world. Informational support and advocacy are also always available regardless of the type of birth you have, and can be the bridge to communication between you and your provider. Being provided with that continuous support and encouragement has been proven to help with a positive birth experience in all birth settings.

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A cesarean is no different, planned or not. Doulas still provide physical, emotional, and informational support and advocacy before, during, and after. *Full disclosure, however, some hospitals do not allow doulas to be in the OR during surgery. This is up to the anesthesiologist, not your doctor, and also up to you and your partner to request that there be an extra person in the room. Even in this scenario, doulas still provide those same benefits before and especially after. A c-section is major surgery and being able to have that extra support during the immediate postpartum period is extremely beneficial.

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Does a doula replace a dad or partner?

My favorite thing about working with partners is that a doula has an intimate knowledge of birth, but your partner has an intimate knowledge of you. Because of this, we can work together to support you in the best way possible. By providing support for partners, doulas are also providing further support to you. Doulas bring a calming presence, which is great for reducing stress for both the woman giving birth and her partner. Partners feel more confident and relaxed when a doula is present since a doula helps to normalize birth and everything that comes with it. Partners can also be shown ways to further comfort you and can work with a doula to help utilize these. Studies have shown that doula support not only increases a birthing person's satisfaction with their partner's role at their birth, but partners also feel more enthusiastic and believe their contribution to the labor and birth was more helpful and meaningful. 

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Where do doulas attend births?

Doulas attend births anywhere a baby can be born, from hospitals to home to anywhere in between. 

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Does insurance pay for a doula?

This depends mostly on the insurance company, as well as the doula. Unfortunately, most insurance companies do not cover doulas at this time. There are, however, rare occasions where a person might be able to negotiate with their insurance company and get some of the cost reimbursed.