While a doula is well versed in the anatomy and physiology of labor and birth, they do not give medical advice, diagnose conditions, or prescribe treatments. While doulas are always advocates for their clients, and will ensure the family has the opportunity to have all their questions answered and take part in medical decisions during their care, they do not speak to care providers on behalf of their clients. Rather, they coach their clients on informed medical decision making during prenatal visits, so that in the moment, the family is able to recognize when more questions should be asked before a medical procedure. Finally, a doula’s role does not replace that of a loving, supportive partner. Rather, doulas support and empower both parents during the birth experience. Doulas can encourage partners to better support the birthing person by teaching them many of the comfort measures doulas use. They can also ensure that a partner is able to participate in the birth by informing them of the many options they have, such as supporting the birther as they push, assisting in catching the baby, cutting the umbilical cord, announcing the sex of the baby if it isn’t known, etc.
There is often a misconception that doulas only support “natural” childbirth (a problematic phrase in itself) or that doulas are anti medicine. This is not the case for the majority of doulas. Most training organizations teach doulas to look to their clients needs and preferences as a guide for how to best support them. There are many concerns, wishes or desired outcomes that may lead a family to choose to hire a doula. For example, many first time parents wish to have a more experienced support person with them, but live far away from family and friends who might fill this role. Some birthers have experienced trauma in the past and fear that labor and birth might be triggering for them. A doula can help them prepare for what to expect during labor and birth, and encourage them to communicate their needs openly with their partner and care provider. Birthers also might wish to have a different birth experience than their previous birth(s). A doula can help them identify what options they have and how they can find a supportive provider for a new kind of experience, for example, an OB with a great track record of successful VBACs (vagnial birth after ceserean).
For many years, researchers have been documenting the effect that continuous labor support has on birth outcomes.The data is highly supportive of doulas having a beneficial impact on not only the physical outcomes of birth, but also the psychological impact on the family in their care. Hiring a doula has been shown to increase the likelihood of vaginal birth, decrease the rate of medically unnecessary cesarean birth, and decrease the use of episiotomy, forceps and vacuum assistance during the pushing stage. Hiring a doula also correlates with higher APGAR scores in newborn babies, and a decrease in postpartum mood disorders in the new parents. Families who hire doulas also report having a more positive experience, and happier memories when they look back on the birth of their baby.
In a time when science and technology are increasingly present in pregnancy and childbirth, doulas have a crucial role in modern maternity care, empowering people to have positive birth experiences through education, companionship, and advocacy.