MyChart®
Pregnancy and childbirth can be a stressful process, including before, during, and after that bundle of joy comes into your life. The baby may decide to arrive sooner or later than expected. Complications can arise that affect the delivery. The birthing person may have different ideas about the delivery process than the attending obstetrician. There are times when expectant parents, especially those delivering a child for the first time, can use the help and support of someone to guide them through the long and sometimes difficult birthing experience.
A doula is a multifaceted professional who works with expectant persons and their partners, with a focus on a family’s life during the sensitive period when support makes the most difference and creates long-term positive experiences. Trained and experienced in providing emotional support, physical comfort, and non-clinical advice, doula’s act as a coach and confidante before, during, and after childbirth to help achieve a healthy and satisfying birthing experience.
What is the Difference Between a Doula and a Midwife?
Midwives are health care providers who are trained to oversee low-risk pregnancies, labor, and birth. As registered nurses, they can provide obstetric and gynecological services, conduct exams, and help with common gynecological concerns such as sexually transmitted infections, urinary tract infections, or yeast infections. Midwives also support birthing people during labor and in the postpartum period with breastfeeding and birth control.
A doula is not the same as a midwife. Doulas typically do not have formal training in the medical field and are not medical providers. The doula is a professional labor and birth attendant who is specifically trained to provide the birthing person and any associated family, if participating, with education, physical comfort, emotional reassurance and encouragement throughout the labor, birth, and postpartum process. They are not trained to deliver babies or care for the birthing family in any medical capacity.
Does a Doula Give Medical Advice?
Doulas do not perform medical tasks, give medical advice, or make decisions for the family as they are not trained medical professionals. The doula acts as a companion, coach, and provider of objective information to help the expectant parent make informed decisions in conjunction with their healthcare providers.
The doula further breaks down and explains information provided by the hospital and clinic staff into terms that the birth person and family can understand. Doulas encourage the birthing person to ask the provider questions about any information they do not understand. For example, the doula may describe a procedure and why it is done, clarify the procedure’s risks and benefits, and identify alternatives. A doula will not try to influence the mother’s decision regarding the birthing procedure. A doula never contradicts a health care provider but ensures the parent-to-be fully understands the medical direction being given and offers guidance on the birth plan if there are personal expectations about what will happen.
What Does a Doula Do?
Doulas guide expectant persons through the intimate and transformative experience of having a baby. If a partner is involved, that support person is included in the process. Doulas serve as an unbiased, nonjudgmental resource, pointing pregnant persons toward evidence-based information to help them stay informed and empowered throughout pregnancy and birth. In addition, doulas offer guidance and community resources regarding maternal self-care, lactation, and other issues pertinent to healthy parenting through the first six weeks postpartum.
In general, doulas focus on four primary areas:
- Information – Providing prenatal and postpartum resources and referrals related to labor and birth.
- Communication – Fostering positive communication with doctors, midwives and nurses, supporting informed decision making, and helping women advocate for themselves.
- Emotional Support – Using relaxation techniques and encouragement to create a calm birth environment.
- Hands-on Support – Assisting with walking, breathing and position changes, providing breastfeeding support, and utilizing natural options, such as massage, to relieve stress and anxiety.
Some doulas focus on specific areas and can perform different roles depending on your needs. “Full spectrum” doulas can provide support to people during the entire pregnancy, from birth to abortion or miscarriage or adoption. This concept highlights how doulas provide support regardless of pregnancy outcome. Full spectrum doulas have knowledge and training and can take on diverse client needs.
Antepartum doulas offer professional, compassionate doula support to families that are experiencing a difficult pregnancy, an otherwise healthy pregnancy with overwhelming variables, or one that comes with medically directed limitations. Doula support can include assistance with daily household tasks.
Labor or birth doulas provide continuous care during labor and act as advocates for the family. They may assist in communicating with medical staff for the patient to make informed decisions.
Postpartum doulas support new parents during the first few weeks after birth by caring for and feeding the baby and performing household tasks. A postpartum doula is not a nanny or a baby nurse. They have knowledge about postpartum recovery, breastfeeding, and newborn care.
When Should I Use a Doula?
Enlisting a doula is a personal choice that depends on your birth plan, prenatal education, and medical birth team. There is no wrong time to enlist a doula, as they can be helpful at any stage of pregnancy!
In the prenatal stage, doulas can:
- Meet with you during the second or third trimester to get acquainted.
- Teach relaxation and breathing skills.
- Answer questions about the birthing process.
- Explain labor and delivery procedures and possible complications.
- Help you develop a birth plan.
During labor, some doulas can stay by your side to provide comfort and support while involving and reassuring the partner, if present. The doula will also help with:
- Relaxing and resting using gentle massage and touch.
- Getting into comfortable positions.
- Getting sufficient nutrition and fluids.
- Communicating your preferences to the medical staff.
In the postpartum stage, a doula can provide support, education, and encouragement through:
- Teaching you how to care for the new baby, including the partner, if involved.
- Providing breastfeeding education.
- Ensuring you get plenty of rest.
- Making sure you eat regularly, stay hydrated, and are comfortable.
- Teaching older siblings how they can help you.
Your doula will also make sure you think of post-delivery considerations, such as creating a postpartum plan and discussing feeding goals for the infant.
What Are the Benefits of a Doula?
Research conducted over 20 years shows that doulas can positively impact many areas of the birth process, especially for women in in the most vulnerable populations and respecting communities.
Clinical Benefits can include:
- 50% reduction in the cesarean rate
- 25% shorter labor
- 60% reduction in epidural requests
- 40% reduction in Pitocin (synthetic oxytocin) use
- 30% reduction in analgesia use
- 40% reduction in forceps delivery
- 9% decrease in pain medication use
- 34% less likely to rate their childbirth experience negatively
- Better APGAR scores for baby
The benefits of a doula go far beyond what happens before or during delivery.
Doulas help pregnant women:
- Understand medical information from their provider
- Communicate better with the medical team
- Adhere to medication and crucial lifestyle changes for preventative measures
- Adopt healthy coping mechanisms
- Feel empowered to ask questions and self-advocate for their care and their babies care
Doulas provide emotional support:
- Decreased anxiety
- Increased confidence
- Boosted self-esteem
- Improved postpartum mental health
- Family bonding and support for partners and siblings
- Offers relaxation techniques, encouragement, and a calm environment.
Doulas provide physical support:
- Increased movement
- Improved relaxation
- Comfort and reassurance
- Lactation support
How to Find a Doula
Doulas usually aren’t members of a hospital staff. Asking your doctor, friends, and family members for recommendations can usually provide good sources to choose from. Before selecting a doula, meet with the candidate to ask questions such as:
- What is your training, certification, and experience?
- How many clients do you take a month?
- What does prenatal and postpartum doula care look like for you?
- How many births have you attended?
- Do you have a backup or mentor that supports you?
- How much do you charge?
As of January 1, 2023, doula services were added as a Medi-Cal benefit to members on Medi-Cal insurance.
TrueCare offers doula services to Medi-Cal patients. For more information, call (760) 932-4891. Current patients can ask the front desk or their prenatal coordinator.
Most private insurance plans don’t cover doula services, so you may have to pay out of pocket. Choose a doula who’s knowledgeable, whose rates you can afford, and whom you like and trust.
TrueCare Doula Services
Doulas have typically been accessible only to women who can afford the additional out-of-pocket cost. However, a growing body of evidence has highlighted the value that doulas bring to care teams and care coordination.
As part of TrueCare’s commitment to reducing maternal and infant mortality rates, TrueCare received a $2 million dollar grant to provide doula services to build a doula program for San Diego communities. TrueCare is the only health center in Southern California to receive this grant, reinforcing the organization’s mission of providing comprehensive, affordable, and culturally sensitive health care options.
“As a person-focused health center with integrated women’s health services and a comprehensive offering for quality physical and mental health care, we are excited to be a systemic force in bettering pregnancy experiences and health outcomes for both moms and babies,” said TrueCare Chief Medical Officer / Chief Operations Marie Russell, MD.
TrueCare’s doula services put community at the center. Individuals that represent the populations we serve are trained to become doulas and provide pregnancy, birth and postpartum support to individuals and families from their community. Our model is designed to connect pregnant families to dignified doulas in their community who are trained and financially compensated to provide doula support. In addition to providing support, doulas are also supported by mentors who offer guidance as needed and organize ongoing training development tailored to serve their needs. TrueCare’s doula model encourages compassion, cultural and linguistic understanding, and community support.
Doula services at TrueCare can include:
- Creating a birth plan and postpartum plan
- Outlining birthing experience wishes
- Alleviating fears and concerns about pregnancy, labor and delivery, and beyondv
- Providing support through the postpartum transition
- Teaching birthing persons and their support team (if involved) coping techniques
- Having dedicated visits to offer tools and techniques for the birth support person to empower them for the big event!
- Providing emotional support at every stage of pregnancy and after
- Discussing feeding goals and ways to attain them
- Discussing nutrition for mom and baby
To enjoy a special kind of prenatal and postpartum comfort and guidance, ask about TrueCare’s doula services. TrueCare offers a wide-range of health care services, including dedicated Women’s Health centers and comprehensive Pediatric Care for a healthy start to life.
Additional Resources:
Dona International
International Childbirth Education Association
What To Expect.com
International Doula Institute
Cochrane
DISCLAIMER: THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE
The information, including but not limited to, text, graphics, images, and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you read on this website.
