Most people do not fully appreciate the impact a doula has throughout pregnancy to postpartum. A doula can work with you as early as preconception, throughout pregnancy, and for a year after delivery. A doula teaches and advises on self-care support, nutrition, and partner suggestions, as well as assisting parents through the journey of in-vitro fertilization (IVF) and intrauterine insemination (IUI) support.

Doulas for pregnancy

Some doulas specialize in preconception, others in labor and delivery, while others for the entire pregnancy, labor, birth and postpartum (see more on when to call a doula). Doulas with a full scope of training can help with childbirth education, birth planning, exercise and nutrition, as well as enhance labor and improve recovery. By the time you feel your first contraction, you will have had good information and emotional support before active labor begins.

Doulas for labor and delivery

Doulas are with you constantly through labor and the immediate stages of postpartum. With a doula to coach and support you during the labor and birth, you won’t have rotating shift changes or any distracting transitions in your labor and delivery support team. They are there to answer questions, help move the labor along, and help you feel safe and comfortable.

      And, because a doula is with you the entire time, there is a greater feeling of safety and support. Studies show that women who use doulas report a much more favorable birth experience, including:

        1. Significantly less epidural use
        2. Less likely to have cesarean birth when a doula and midwife are present
        3. More likely to rate the birth experience as good
        4. Feel they coped very well with labor
        5. Reported that labor had a very positive effect on their feelings as women
        6. Perceived that they were stronger and had better stamina
        7. Lowered odds of postpartum depression and anxiety

      Doulas for support and advocacy

      The scientific data supports reduced fear when a doula is present, which is essential in allowing the body to relax. A doula assists with relaxation techniques to reduce pain. They work in ways that enhance breathing, which allows individuals to sink into their bodies. When the body is relaxed, fear is dissolved and oxytocin increases and labor progresses more easily.

      We see this improvement in overall birth experiences no matter if there are interventions, if the birth is unmedicated or medicated birth, or if it's spontaneous or induced. The overall experience is still improved because with the presence of a doula there is a greater feeling of body autonomy.

      We help mothers understand that they have choice in every single situation by helping them to advocate. This process starts from the doula’s first day with the mom. When your voice is amplified, when you feel heard, you feel like the situation is yours. This also improves oxytocin levels and the process of labor.

      Doulas for postpartum support

      Typically, your physicians will not see the baby for about 30-45 days after birth, which can seem like a long time. A doula can be available to help with breastfeeding assistance and look at signs or any issues that might be missed before seeing your physician. The doula can be there in your home to provide good quality care, lactation guidance, nutrition advice, assistance in healing, and support planning for the months to come. Most people plan for their birth, but they do not plan well for postpartum care.

      Doulas understand and recognize mood changes and more serious episodes that may occur from hormonal changes. Doulas are not therapists or doctors, but they can recognize the signs when you and your family need to seek assistance.

      Doulas help parents and infants throughout the birth journey by providing understanding, high levels of emotional, physical, and mental support, and teaching parents how to advocate their desires and wishes throughout all stages of the pregnancy and afterwards. 

      To learn more about when to contact a doula and how to use a doula for preconception, click through to these other articles:

      Doulas and the Preconception Experience 

      When Should You Call a Doula? 

       

      Michelle Gabriel-Caldwell, CD, PPD, CBE and CLE

      Michelle Gabriel-Caldwell, CD, PPD, CBE and CLE

      Michelle is the owner of Baby, Please Birth Services Agency LLC. She is a certified Birth Doula with Bradley, NBDA, and DONA, in addition to being a certified Postpartum Doula with NBDA. Likewise, she is a certified Childbirth Educator teaching the Bradley Method®, Evidence-Based Birth® Childbirth Class and her own Holistic Childbirth Course for The Birth Center of NJ. Michelle is a Breastfeeding Peer Counselor, soon to be a CLE.

      Michelle serves on the National Black Doula Association (NBDA) Advisory Board, as well as  NBDA® Certified Doula Instructor and Doula Mentor. Michelle is a mother of two and has been married for 25 years. She is also a full-time Chemical Engineer and Technical Editor. 

       

      References

      1. Gordon NP, Walton D, McAdam E, Derman J, Gallitero G, Garrett L. Effects of providing hospital-based doulas in health maintenance organization hospitals. Obstet Gynecol. 1999 Mar;93(3):422-6. doi: 10.1016/s0029-7844(98)00430-x.

      2. Falconi AM, Bromfield SG, Tang T, Malloy D, Blanco D, Disciglio RS, Chi RW. Doula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching. EClinicalMedicine. 2022 Jul 1;50:101531. doi: 10.1016/j.eclinm.2022.101531.