If you’re pregnant or family planning, there’s a lot to think about—including the benefits and costs of a doula and if you should hire one. In a 2013 survey, only about 6% of women in the U.S. reported using a doula. But that number is rising as women recognize the value of doulas’ involvement in any and every type of birth plan. With help from doula and chiropractor Dr. Tijana, we explain why having one by your side ranges from a good thing to absolutely necessary.
What is a doula? Is it the same as a midwife?
While some doulas are also midwives, there are some key differences. Midwives are able to provide medical care—not just during pregnancy but also throughout labor and delivery and postpartum. Unless they also have a midwife certifications, doulas do not give medical care. Doulas are trained to offer vital information and physical and emotional support throughout your birthing experience. Some doulas also have additional training to help during your pregnancy and postpartum too.
So what exactly does having a doula look like? Does the support and care have to end right after delivery or can the relationship keep on going? “Childbirth support and education encompass continuous emotional and physical support throughout the pregnancy, labor, and postpartum period,” Dr. Tijana explains. “Doulas work to merge practical guidance with compassion for the birthing parent, their partner, and their whole family.”
What are the major benefits of a doula?
Whether they’ve had a home birth, water birth, or were at a hospital, many women believe the benefits and costs of a doula are well worth it. But word of mouth isn’t the only way the value of doulas are being recognized; there are also many proven benefits to a doula’s one-on-one care.
Fewer complications for mama and baby
Quite a few studies point out that women who have the support of a doula actually have better birth outcomes. Doula support is tied to fewer complications for both mom and baby—including lower rates of preterm birth and reduced risk of c-sections. In fact, research shows that mamas who hire doulas are two times less likely to have a birth complication and their babies were four times less likely to have low birth weight. They’re also more likely to try and breastfeed.
Certified postpartum doulas give tremendous emotional support. It comes at a time when most moms are exhausted, sore, and learning a lot about newborn care. Having someone in your corner 24/7 for advice or to vent to can make all the difference when you’re overwhelmed. In a judgment-filled world, postpartum doulas help with what you want for your breastfeeding experience. (Lactation consultants are a fantastic resource to add to your team too!) They can show you how to use a pump and give guidance on sore nipples, how to hold your baby, and more.
Most articles and advertisements paint a rosy picture of a woman in pregnancy—calm, optimistic, happy, and even minimal swelling right up to her due date. But the reality is that pregnancy can bring up a wide range of emotions. You may notice an increase in the amount of stress you feel and a difference in how you cope.
More than 30% of moms say their birth experience was traumatic. Overall, women who work with a doula report more satisfaction with their birth experience than women who don’t. Also, something amazing: the reduction in pre-term births that we see with doulas may be, in large part, due to how helpful they are at lowering stress in mamas-to-be.
Connections to other resources
Recommendations from family and friends are great. Experienced doulas usually have an extensive list of resources they’ve worked with and are happy to share those with you.
Can a doula help advocate for me with my birth?
Advocacy is such a big and important topic when it comes to your healthcare. It’s an important one to talk about with anyone who will be with you during labor, including your doula.
Why advocacy needs to be discussed as part of your birth plan
It’s a sad truth that women, especially women of color, encounter barriers within our medical system that feel insurmountable. Even in emergency rooms, women tend to wait more than 30% longer to receive care. They’re less likely to receive effective pain medication than men. Unfortunately, many women can recall a time when they were discriminated against by a provider. Bias in medicine is dangerous regardless of what situation or symptoms a woman is experiencing. And that’s true during pregnancy, labor and delivery, and postpartum too.
Despite all of our country’s resources, out of all industrialized nations the U.S. has the worst maternal mortality ratio. (The maternal mortality ratio is the number of maternal deaths per 100,000 pregnancies. To be included, a death must have occurred while pregnant or within 42 days of the end of pregnancy.) This is sad news for absolutely every American woman and her family. But for black women and their families? It’s especially tragic. The Hispanic maternal mortality ratio was 11.8 in 2018. For white women, it was 14.7. That ratio was 37.1 deaths per every 100,000 pregnancies.
How a doula helps advocate for you
Our healthcare system needs work to better serve and support pregnant women and their care. A huge way doulas are important is that they’re another person advocating for the patient—you.
At a time when you (and your partner or family) are stressed, you may feel like you don’t have a choice in some of the decisions presented to you by a physician or nurse. Doulas can remind you that you do. Because they are intimately familiar with your wishes, they can be an added voice in the room that’s there to communicate your desires and requests and support you through medically necessary changes to your birth plan. “We work on creating an environment of collaboration between the birthing families and the care providers,” Dr. Tijana says. “That way, you can achieve an informed and supported birth experience.”
I love the benefits. But how much does a doula cost?
Before you ask a doula about cost, double check with your insurance provider about coverage. Some insurance plans cover part or all of the cost of a doula—but many still do not. Then, reach out to several new and experienced doulas to get a sense of cost. Here in Florida, the Magnolia Birth House says newly certified doulas are usually about $500. Highly experienced doulas may be $2,000 to $3,000 and have concierge-level services. Postpartum doulas won’t have the same fee structure. Usually, you’ll pay about $45 per hour.
Are there any options if the cost of a doula is too much for me right now?
Adding up the benefits and costs of a doula are something every woman should do. But not everyone will feel like they’re in a financial position to shell out the full cost. If you feel strongly about having a doula to support you, you do still have some options. First, go ahead and reach out to doulas and let them know your situation. Some may offer reduced rates in certain situations. Another option is to look for a doula who has completed a lot of their training but isn’t quite certified yet. Students need hands-on experience, and they are generally much more affordable.
How can I make the most out of my relationship with my doula?
Picking the right doula for you can seem overwhelming. But the best thing to do is to go with someone qualified, reliable, and who you get a good feeling from and connect with. “Choosing a doula is a very personal experience for each birthing family,” Dr. Tijana adds. “It goes beyond advice and support. You and your doula should align on a human level, so you can be met with compassion as you approach you journey into parenthood.”
Are there rules on doulas being present in the delivery room during COVID?
COVID has affected so much, and it’s changed some aspects of labor and delivery too. If you’re giving birth in a healthcare facility, you’ll want to ask who can be in the room with you during labor and delivery. Many hospitals are allowing one or two individuals for each mama, but some aren’t allowing any. Make sure to find out how they notify you or post changes to their visitation policy. You’ll also want to check on a few other things, so there are no unwanted surprises:
- Does my doula need to bring any proof of vaccination or of her credentials as a doula to be allowed in the room?
- Will my doula and/or designated family member or partner be able to come and go from the hospital once I am admitted? Or should they come prepared to stay in my room the entire time?
- If I need a c-section, are both my doula and/or family member allowed to be with me?
- Where should my doula and/or family member wait while I am being admitted?
Now that you know the benefits and costs of a doula, check out these other pregnancy articles: COVID vaccination during pregnancy, breastfeeding after COVID vaccination, FAQs with a lactation consultant, and info on the Delta COVID variant and pregnancy. Also, connect with Dr. Tijana at healthybeingwellness.com.