emotional support, physical comfort, and assistance in obtaining
information before, during and just after childbirth.
A "Postpartum Doula" provides care to a family with a newborn baby.
A "Birth Doula" recognizes birth as a key life experience that the
mother will remember all of her life. The doula understands the
physiology of birth, the emotional needs of a woman in labor. She
assists the woman and her partner in preparing for and carrying out
their plans for the birth. She stays by the side of the laboring woman
throughout the entire labor. She provides emotional support, physical
comfort measures, an objective viewpoint, and assistance to the
woman in getting the information she needs to make good decisions.
She facilitates communication between the laboring woman, her
partner, and clinical care providers. She perceives her role as one who
nurtures and protects the woman's memory of her birth experience.
Doulas do not normally do any kind of medical assessments or
advising, but she is able to educate the family by explaining the various
choices they will face during the birthing process. A doula advocates
for the mother and her family by providing childbirth education and
discussion, before and during the birth. In this way a doula helps a
mother find her own voice without speaking for her.
Up until relatively recent, women all over the world have given birth
with the help of other experienced women present. Even with the
increased safety of hospital birth, and homebirth with trained midwives,
we must not disregard the important ingredient of a doula. We can
A doula will come to you in your home, and meet with you several
times during the prenatal period. You will spend some time getting to
know each other during that time. She will listen to your needs,
wants, fears and birth goals. She will make sure you understand the
labor and birth process. She will teach you pain relief measures that
are natural and drug-free. She will go over relaxation skills, and
exercises you can practice to allow you to have the best fetal
positioning at birth. She will discuss breastfeeding issues if need be.
When your labor starts, she will join you in your location of preference,
either at home, or at the hospital, and stay with you throughout your
entire labor and delivery, and even for a short while
Doulas don't have shift changes, as nurses do, and doesn't need to
follow hospital protocol and leave to update records, or attend to
another patient. She will be your familiar voice during labor,
encouraging, suggesting, and reminding of labor positions and comfort
measures. She works as a member of your health care team.
Following your birth, your doula will stay with you until both you and
baby are all settled in. And will meet with you once or twice
postpartum to go over your birth experience, and talk about any
concerns you might have. If you have hired her to stay postpartum,
she will attend to your every need, and do her best to help you adjust
to your new role as parent, or as parent again!
Experience has shown that doulas do not "take over" the job of the
partner, but enhance their participation by modeling behavior, drawing
them closer, and assuring them that the process of birth is normal and
desirable. Our society has gone quickly from barring partners from
birth rooms, to relying on them to participate at their comfort level in
birthings. Fathers and partners usually end up being our best
Studies on doulas have shown improved outcomes in many areas, from
reduction in cesarean birth and other surgical procedures, shorter
labors, less use of medication, to improved satisfaction with your baby
and an improved relationship to your partner, and your medical
Every birth is unique, and individualized. Doulas strive to help each
mother and her family to have the experience that they feel is
We are there to witness and acknowledge, encourage and support. We
are there to let you know that you CAN do birth the way you want to.
We can't guarantee a short labor, or an absolutely perfect outcome.
But a doula's job is to care for you before, during and after your birth,
and to help each family have a "Treasured Birth".
website for more information
on finding a Doula in your area:
or call me at:
For more information on
Doulas, please see DONA's
Doula's of North America:
Marshall H. Klaus, M.D.;
John Kennell, M.D.; and
Phyllis H. Klaus, C.S.W., M.F.
THE BENEFITS OF HAVING A
Researchers Kennell and Klaus et. al.
found among six studies:
- Cesareans down 50%;
- Length of Labor down 25%;
- Pitocin down 40%;
- Forceps down 40%;
- Requests for Epidurals down
THE IMPACT OF A DOULA ON
LABOR AND EARLY PARENTING:
(Adapted by Penny Simkin from a
handout used by Sandy Arpen in
- Increases positive feelings about
- Decreases interventions;
- Decreases cesareans;
- Decreases anxiety;
- Decreases tension;
- Shortens labor.
SUPPORT IN LABOR FROM A
- Increases acceptance of the baby;
- Enhancement of maternal/infant
- Decreases neonatal problems;
- Increases self-esteem;
- Increases feelings of control;
- Increases mother's cooperation
- Decreases postpartum
needs are met, clinical outcomes are
improved for mother and baby. In
addition, the long-term impact may
be enhanced self-confidence and self-
esteem in the mother.
(See References Below for Sources.)
1. Hodnett, Ellen D., and Richard W. Osborne. "A Randomized Trial of the Effects of Monitrice Support during labor:
Mothers' Views of Two to Four Weeks Postpartum". Birth. 16:4, December 1989.
2. Hofmyer, G. J. et al. "Companionship to Modify the Clinical Birth Environment: Effects on Progress and Perceptions of
Labor and Breastfeeding". British Journal of Obstetrics and Gyn. 98: 756-764, 1991.
3. Kennell, J. Klaus, M., et al. "Continuous Emotional Support During Labor in a US Hospital". Journal of the American
Medical Association. 265: 2197-2201, May 1, 1990.
4. Simkin, P. "Just Another Day in a Woman's Life? Women's Long-Term Perceptions of Their First Birth Experience, Part
5. Birth 18:4, December 1991 and "Part 2", Birth, 19:2, June 1992.
6. Sosa, Klaus, Kennell, et al. "The Effects of a Supportive Companion on Perinatal Problems, Length of Labor and
Mother-Infant Interaction". New England Journal of Medicine 303: 597-600, 1980.
7. Wolman, Wendy-Lynne, et al. "Postpartum Depression and Companionship in the Clinical Birth Environment: A
Randomized Controlled Study". Am. Journal of Obstetrics and Gynecology, May 1993.
QUESTIONS TO ASK A DOULA
When you are looking to ask someone to attend your birth, there are several questions that you should ask
the way a doula approaches a birth. This is your birth and you are looking for a woman who will serve you in
accordance with your specific needs. Doulas want to be hired by someone who is confident in our abilities and
experience. Because each doula brings into birth their own experiences and philosophies, we are usually asked
to serve the women we are most compatible with. And many times become long-time friends with these
women. A good match is almost always mutual!
Question 1: What is the doula's philosophy of birth? Will she support your goals and beliefs about
My philosophy of birth is that birth is a natural process. That interfering with that process through un-
necessary interventions, augmentation can be detrimental to both the mother and the baby; both physically
I support natural unmedicated birth. However, I have attended many births, and I also support each
mother's right to experience birth the way she is comfortable. If pain medication, an epidural, or other
methods of pain relief are part of a woman's birth plan, I am there to support, and advocate for her choices.
Question 2: What is her scope of practice? What are the limits to her practice? What will she do,
and not do to assist you?
This is what the DONA (Doulas of North America), through which I am trained and certified, says a doula's
"Scope of Practice" is. As a DONA Certified Doula, I must adhere to this Scope.
- Services Rendered: The doula accompanies the woman in labor, provides emotional and physical
support, suggests comfort measures, and provides support and suggestions for the partner. Whenever
possible, the doula provides pre- and post-partum emotional support, including explanation and dis-
cussion of practices and procedures, and assistance in acquiring the knowledge necessary to make
informed decisions about her care. Additionally, as doulas do not "prescribe" treatment, any suggestions
or information provided within the role of doula must be done with the proviso that the doula advise her
client to check with her primary care provider before using any application.
- Limits of Practice: DONA standards and Certification apply to emotional and physical support only. The
DONA Certified Doula does not perform clinical or medical tasks such as taking blood pressure, or
temperature, fetal heart tone checks, vaginal examinations, or postpartum clinical care.
- Advocacy: The doula advocates for the client's wishes as expressed in her birth plan, in prenatal
conversations, and intrapartum discussion, by encouraging her client to ask questions of her caregiver
and to express her preferences and concerns. The doula helps the mother incorporate changes in plans
if and when the need arises, and enhances the communication between client and caregiver. Clients and
doulas must recognize that the advocacy role does not include the doula speaking, instead of the client,
or making decisions for the client. The advocacy role is best described as support, information, and
medication or negotiation.
- Referrals: For client needs beyond the scope of the doula's training, referrals are made to appropriate
Question 4: What is the doula's experience? How long has she been a doula?
I have been a birth doula for eleven years and as such, I have been primary doula for many couples, and single
women, some of which were teen moms. I have supported birthing parent's from many different cultures and
backgrounds. I have done both home births and hospital births.
Question 5: Can the doula provide you with references?
I do have several references from happy new parents that have used my doula services recently. They are
available for you to contact upon your request.
Question 6: What are the doula's fees?
I charge $600.00 a birth. With every 30 births I attend my fee will increase as my experience and expertise
Question 7: Does your doula work with a partner or student? Can you request or reject that she
work with another doula?
I am happy to work with a mother and her partner to hire two doula's, however, I will still charge my full fee. I
always welcome another experienced doula's help because it is always a positive experience to work with
Question 8: What is your doula's availability? For how long before and after your due date will she
I will inform you of my availabilty for your due date when I receive first contact with you. If I commit to attend
your birth I will be available to you 24 hours a day, 7 days a week. I will not leave town when it is close to your
due date. You can reach me preferably at home, and if not at home, on my cell phone, which I will be happy to
provide you with telephone numbers for. I usually allow ten days between client's due dates. I have never had
an issue with overlapping births, however, I do have another certified doula available for backup from a group
of doulas for your due date. If for some unforeseen reason I cannot attend your birth, I would provide you with
a back-up doula. At that time you would pay me and I would be responsible for paying the back-up doula.
Question 9: How many prenatal visits does she provide? How many postnatal visits?
I usually try to provide three to four prenatal visits to allow us time to get to know each other better. During
those visits I will listen to your expectations for your birth, and discuss your birth plans. I am able to provide
you with prenatal education through the my Natural Childbirth series if desired. If you are interested in taking
Childbirth classes, please reference that information page for more details. I will visit you one or two times
postnatally. Usually the day after the birth in the hospital, and once in your home to talk about the events of the
birth. If you desire further postpartum support, I do offer that at an additional fee.
Question 10: What is the doula's role during early labor? Will she come to your home? When?
The doula's role in early labor is emotional support. Unless a mom requests that I attend that phase of her
labor, I usually require telephone contact, until your labor is well established. When you can no longer speak
through your contractions, that is when I prefer to come and assist you. I will come to your home when this
time arrives. My goal in aiding laboring moms is to keep mom at home for as long as it is safe for both mom and
baby. The longer you can stay at home, the healthier it is for both you and baby. Staying home will help to
discourage interventions and augmentations at the hospital for as long as possible, or even allow you to
accomplish a natural birth. It is necessary for you to be in contact with your care provider during this time. For
most normal labors, it is safe to stay home for a great deal of time. It is beneficial to mom to labor in a familiar
and comfortable environment for as long as it is possible.
Question 11: How will the doula work with your partner in birth?
It is extremely important for a partner to be incorporated actively in the labor and delivery process. I encourage
partners to be hands-on, and I will give suggestions throughout labor to them in how to help. There are some
dad's who don't want to be hands-on, and I respect that also. Labor and birth for each person, brings with it
previous life experience, and how you participate in your birth will be greatly influenced by those experiences.
I am not there to take the place of a partner during labor and birth. I am there to enhance the experience in any
way that is comfortable to both of you.
Question 12: How will the doula work with your primary care provider and with the nurses and other
Hospitals have "protocols" that they need to follow, and I respect those protocols. Your care provider provides
you with medical support, which I do not provide. It is important for you to follow your care provider's advice.
I am there to compliment your birth experience, and work with any professionals involved in your care. It is
your responsibility to advocate for the desires in your birth plan. I can educate, and inform you of choices, and
empower you with information thereby giving you the tools you need to make decisions. However, I can not
make medical decisions or speak for you. As a doula I am there to support you emotionally, physically, and to
help with natural methods of pain relief. I will do my best to help you have the birth experience that you would
like to have. I will help you find your voice, and help you advocate for yourself, and help you stay as close to
your birth plan as is possible.
Question 13: Will your doula attend a prenatal appointment with you to meet your caregiver?
I would enjoy accompanying you to one of your prenatal appointments to meet a caregiver. However, please
keep in mind that most medical providers work in groups. The chances of having one particular caregiver on
the day of your birth is very rare, unless you are having a midwife and a home birth experience.
Consistency of care is always the goal, and having a doula attend your birth will help you maintain that
consistency. During nursing staff changes, doctor/midwife changes, etc. I will strive to be one of the consistent
care giver throughout your labor and birth.
Question 14: Please tell your doula any special concerns you have regarding your birth.
I am happy to discuss any other information, or details that would be relevant to your birth. Physical concerns,
psychological concerns, past birth issues. All of these will be discussed during the prenatal visits. It helps to
write down your questions as they come up, and present them to me either through email, or a telephone call.
I am happy to speak with you any time prior, or after your birth!
I am listed on the following
- Childbirth Collective
Please visit my blog at: