Is having a doula right for me?

Is having a doula right for me?

Written by Dr. Teng

When it comes to childbirth, the list of questions that will come up during your pregnancy may seem endless.  It is our job as the physician to do the best we can to answer these questions, and to make sure you are as prepared as possible for when the time comes to have your baby.  As much support as we hope to provide you during this experience, patients may need an extra source of support during the childbirth process.  I have had several patients ask me if I recommend getting a doula. 


So what is a doula?  The word doula (pronounced doo-la) stems from the Greek meaning “a woman who serves,” and refers to someone who provides emotional and physical support to a woman and her partner during the childbirth process.  Most often the term refers to a birth doula, although there are also antepartum and postpartum doulas.  Some patients may only want their partner in the room during the labor and delivery, while others may want someone else present as an extra source of encouragement and comfort.  Some may not have the support of a spouse or family member present.  Each patient has her individual needs.


While doulas can help support many aspects of the complex birthing process, including breathing and relaxation techniques, massage, and assistance with positioning, it is important to understand that they do not have any medical training nor do they provide medical care.  There is no universally accepted training program for doulas, and multiple organizations provide courses with varying requirements.  No academic credentials are required for someone to refer to him or herself as a doula. 


However, the value of labor support goes beyond credentials, and even patient satisfaction.  In March of 2014, ACOG, in conjunction with the Society for Maternal-Fetal Medicine issued a consensus on the safe prevention of the primary cesarean delivery highlighting the following:


“Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.  A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery.”

What we know already is that childbirth is an amazing, yet emotionally, physically, and mentally taxing process.  This analysis gives us tangible evidence of how important support personnel can be, whether it be a doula, spouse, family member, or friend.  If you do decide that a doula is right for you, it is important to find someone you are comfortable with who can provide support to meet your needs, and to recognize the boundaries and limitations of his or her role.  Our job as the physician is to make sure that you are well informed when making decisions during pregnancy and the childbirth process, and to provide the best medical care to ensure a healthy mom and healthy baby.   


All that being said, my experiences with doulas have been positive ones.  Would I recommend one if my patient felt she needed the added support?  Absolutely.