What is a Doula?

The term Doula is Greek for slave or servant. Doulas provide emotional and physical support during pregnancy, labor, birth, and postpartum.

A Doula provides:

• explanations of medical procedures
• emotional support
• advice during pregnancy
• exercise and physical suggestions to make pregnancy more comfortable
• massage and other non-pharmacological pain relief measures
• positioning suggestions during labor and birth
• help supporting the partner so that they can love and encourage the labouring woman
• avoidance of unnecessary interventions
• help with breastfeeding preparation and beginnings,
• written record of the birth

What is the difference between a Doula and a Midwife?

A Doula is an experienced professional who provides information and, when needed, physical and emotional support to you and your partner before, during, and after childbirth.  As a Doula, I am not trained nor do I participate in any of the medical elements of birth i.e. vaginal exams, taking blood pressure, etc.  A Midwife is a medically licensed individual who can provide support and can deliver babies.

Why should I have a Doula?

For many women, especially first time moms-to-be, childbirth can be a little uncertain. At times, there is even doubt or fear present. A Doula is a special support person who can make you aware of the stages of birth, teach you pain-coping practices, and objective emotional and physical support to you when you need it. If you have a birthing partner, a Doula is there to support both of you in achieving a happy, healthy birthing experience.

What are the benefits of using a Doula?

Studies have shown the following benefits of having a Doula present at birth:

• 50% reduction in c-section rates
• 25% shorter labour
• 60% reduction in epidural requests
• 40% reduction in Oxytocin use
• 30% reduction in analgesia use
• 40% reduction in forceps or vacuum deliveries

Women who have used a Doula are more satisfied with their birth experience, feel more confident in their ability to mother, bond faster with their newborn, are less likely to have post-partum depression, and are more likely to breastfeed. ~ Klaus, Kennel, and Klaus 2001

I have been through a prenatal class and my partner will be at my birth, what does a Doula do that my partner cannot?

Your partner plays an essential role in providing support. The actual birth process is usually as new to your partner as it is to you. As your Doula, I will work with your partner, explain what is happening, provide knowing comfort, be a liaison with the hospital staff, and do anything else that you desire to make the birth experience more comfortable. I am there in addition to, not instead of, your partner. Ideally, myself, your birth partner, and your caregiver make the perfect support team for you the new mother.

I want my birth to be a private, intimate event. Will having a Doula take away from this?

A Doula is aware of the changes that take place in a woman's body during birth and the stages of labor she must go through.  This experience can be invaluable, especially for first-time moms. A Doula doesn't replace your partner/labour coach or interfere or interrupt your experience, but is there instead to provide moral support for the both of you to help you along.

What does a Doula do for my partner?

My role as Doula is to support the entire family.  This means your partner can go to the bathroom, grab a bite to eat, or if labor is particularly long, even take a nap without worrying about leaving you laboring alone.  It means your partner can fully participate in the birth of your child at whatever level they are most comfortable.  If your partner would prefer to take pictures and leave things like massage up to me, they can.  If they would prefer to be the one massaging or holding your hand, I can take the pictures, fetch water, and deal with any other tasks that may come up.  Often, I am handing water to your partner to hand to you, or handing him/her chapstick to put on your lips etc. – making it easy for him/her to know what to do. As your Doula, I tend to the details, leaving your partner free to focus on what’s really important to you.

Will a Doula advise against an epidural even if I want one?

No, it is not a Doula's place to speak to medical professionals on your behalf.  My job is to provide you with resources, information, and moral support so you can make your own choices about your birth.  I act as an advocate on your behalf if you like, and encourage you to discuss all choices with your significant other, but again, it is not for me to make any medical decisions for you.

I am planning an Epidural for my Birth, Why Use a Doula?

Doulas first and foremost, help to give you the information you need to make informed decisions for your care and your babies care.  This doesn’t stop just because you decide on an epidural during birth.  There is no medication that is proven safe for your baby, including the epidural, so support becomes even more important in these situations.  As your Doula, I will do my best to help ensure that you understand the risks and benefits so you can make informed decisions.  With an epidural, you are often subject to much more intervention from medical procedures, such as the use of Oxytocin (a drug used to bring on or increase the strength of uterine contractions), vacuum or forceps extractions, episiotomies, and sometimes a cesarean birth.  Again, I will give you the information you need to make informed decisions and offer you alternatives and it is up to you to decide what you feel is best. After the birth I will help you with Breastfeeding, help you at home with recovery, and assist with incorporating this new tiny being into your life.

I really want a Doula at my birth, but my partner is still reluctant.

This is probably the most common reason that women are hesitant to hire a Doula.  It is natural for partners to be wary of inviting an outsider to the birth of their child.  Partners often feel their role is to protect the mother and baby, and minimizing outsiders is one way to do that.  Oftentimes, reluctant partners will feel more comfortable with the idea once they have met the Doula and had an opportunity to have their concerns and needs addressed.  I offer free, no-obligation consultations, and we can meet wherever you and your partner feel most comfortable - at home, at the coffee shop, or at my home office.  I encourage you to ask your most challenging questions at this consultation.  It is also notable that partners who were reluctant at first are often the biggest supporters of Doulas after benefiting from her presence at the birth of their child.

I think I want my older child to be present for the birth - can you come just to support him/her?

Absolutely!  I have attended several births with children present and have experience in preparing them for birth as well as providing them with support during the birth.  The benefit of hiring a Doula to support your child is that I will assist you in helping to prepare your child for the birth.  I can more readily answer any questions he/she may have during the birth, and anticipate any concerns that may arise.  I will willingly wait with him/her in the waiting room if things get intense, and then return when/if the child feels ready.

I am planning to have a homebirth - do I still need a Doula?

This depends on your preferences and on your midwife. Some midwives work with apprentices who will fill the role of a Doula.  Most midwives offer a very high level of emotional support, regardless of whether they work alone or with apprentices.  There are benefits to hiring a Doula separately, however.  You can interview several Doulas to ensure the best relationship.  Also, having a Doula at your homebirth ensures that the level of emotional support will be maintained even in the event of an emergency, during which the midwife and apprentice could be too busy to offer much emotional support.  As your Doula, I will also provide an increased level of postpartum support.

Are doulas covered by BC Medical?

No, unfortunately Doulas are not covered by BC Medical and are paid directly by the client. Some second party insurance companies have been know to cover Doula costs but it is rare, you may want to check with your extended health plan to see if they will cover it.

How much does a Doula cost?

The cost of a Doula varies from Doula to Doula. Since it is considered private health care there are no set guidelines for what doulas charge. Usually fees are based on the Doulas experience i.e. number of births attended as well as additional relevant education and experience. In Vancouver the fees generally range from $500-$800.

Do you have backup in case you cannot make it to the birth?

Yes, I do have  backup Doulas in case of emergencies.  It is important to note, however, that the backup Doula would only be called for a true emergency i.e. if I am at another birth or if I am teaching prenatal classes. I have very rarely had to use back-up as I schedule my clients in a way that I can attend all their births.