Doulas Are F*cking Awesome

Tracey O’Halloran had one C-section and didn’t want another, so she found a hospital that would respect her wishes — and a doula, Katie Prendergast.

Once labor began, Tracey says, “I was in full-blown freakout pain and fear … She encouraged me to get on top of the wave and ride it out and reminded me this was all normal and my body was designed to do this. I don’t know if the pain became more manageable or I became better at managing, but that was a game changer.” Katie rocked Tracey and her husband together in the midst of her contractions. She kept Tracey’s husband from chattering at her during contractions. “So many little and big moments, even to the gentle suggestion of using mineral oil when baby’s head got a little stuck,” Tracey tells Scary Mommy. “I am so, so so thankful.”

Tracey had it right: Doulas are amazing.

Sarah Breeden says her doula did all the running around so her husband could just be with her, then helped her with birth positions, and took pictures as her son emerged. “She put my mind at ease before, during, and after labor,” Sarah explains.

Nicole Fisk, totally nervous about her planned induction, says, “My doula, Judy, knew I was nervous about induction … and that I was hoping for a natural childbirth. Not only was Judy able to use acupressure points to help my labor along naturally, but she also reminded me, when I was considering the epidural, that I could turn off the pitocin drip for some relief … So thankful for her level head, knowledge, and kindness.” Nicole went on to have the natural birth she wanted.

Doula, according to Blissful Moments and several of the doulas I talked to, comes from Greek and means “a woman who serves.” Doula-in-training Rebecca Shelton, owner of Begin Beautifully Doula and Birth Services LLC, explains that doulas “provide emotional and physical support during pregnancy, labor, birth, and the immediate postpartum period.”

Bailey Gaddis, doula and author of Feng-Shui Mommy, agrees. A birth doula, she says, “supplies physiological and psychological support during and after birth. They’re so awesome because they act as the pregnant woman’s right-hand woman, or man, helping to make their experience happier and more stress-free.” But, Shelton says, because doulas aren’t medically trained, they can’t perform medical acts or give medical advice; instead, they rely on non-medical comfort measures to help the woman and her partner through the birth. These can include “movement, massage, acupressure, aromatherapy, and positioning.”

Anne Gulick talks about how her doula, Kristin DuBard, did much of this for her in a hospital situation. Dubard “made gentle suggestions for changing positions, getting in the shower, etc., once labor started for real … What I know for sure is that my husband was freaking the fuck out and was glad to have her in the room. I ended up having an unmedicated birth and minimal stitching afterwards.”

Gaddis also supplied plenty of scientific reasons for using a doula. According to the Cochrane Review, a meta-study that included more the 15,000 women, having a birth doula led to a higher likelihood of a vaginal birth without interventions; an average labor length 40 minutes shorter than unsupported women; less likelihood of a C-section and less likelihood that baby would be admitted to the NICU; plus a full 34% decrease in the chance that a mother will be dissatisfied with her birth experience.

Not everyone loves a doula, of course. Dr. Amy Tuteur, MD, mouthpiece behind The Skeptical OB and author of Push Back: Guilt in the Age of Natural Parenting, says “doula” was actually the Greek word for “female slave,” not “a woman who serves.” “Despite only 16 hours of training,” she says, “many doulas now represent themselves as childbirth advisers whose purpose is to facilitate unmedicated vaginal birth.” And all those studies that show doulas are good? They can be applied to any birth companion. She continues, “Doulas who try to give medical advice or to advise their patients behind their obstetricians’ backs (which is most doulas) put women and babies at risk.”

Dr. Amos Grunebaum, MD, of professor of clinical obstetrics and gynecology at Weill Cornell Medicine feels differently. “Doulas in general,” he says, “have been found to be helpful as long as they stay out of medical decision-making which should remain between the patient and the doctor.”

Shelton says a doula is there to provide information about labor interventions, not to push the mother to choose one or the other. “It’s important for the mother to make informed decisions,” she says, “and there’s no way for them to do that if they don’t get the information they need. I believe doulas are for all births, including planned cesareans (which many believe a doula would be useless for). The whole concept of being a doula is to mother the mother.”

Doulas can be pricey though. Shelton, who is only in training, charges $325 for her services; other women report paying $500 or more. In New York City, doulas who have attended more than 100 births go for $2,000–$4,000. However, a doula who’s attended only 1–10 births costs $360. While every woman who wants a doula deserves a doula, their cost can be prohibitive. Some hospitals offer them for free; other doulas, including Shelton, offer sliding fee scales (one upcoming birth, for example, will end up costing the mother only $50). But we’re a long way from a doula for every woman in every labor, and one of the major hurdles to that is cost.

If you can afford it, a doula is fantastic. I had an amazing one holding my leg during my first labor, a wonderful woman named Brigid who didn’t bat an eye at my consent to a cascade of needed interventions — when she knew I had planned a natural childbirth. Doulas have helped many women bring babies into the world by, as Shelton says, “mothering the mother,” freeing their partner to be there for her in a different capacity.

In fact, when I asked about doulas, I was inundated with stories about women who helped other women when they were in extremis. Of women who never left another woman’s side. Of women who, pregnant themselves, ended up with bruises from their hands being gripped so hard. Doulas are amazing. And maybe one day, every woman will have the chance to have one.