What is a Doula?

By Mel Haley

Full Spectrum Doula at Wyld Garden Doula Services

Many people confuse doulas and midwives, or just have no idea what a doula does. Others think that doulas are just for home births or crunchy granola types. I am here to tell you that doulas are for everyone! Midwives are medical providers, while doulas are non-medical support. If a doula isn't catching the baby, what are we doing? The work that a doula does can be summarized into a few different areas of expertise: 

• Physical support

• Emotional support

• Education

• Advocacy

Physical Support

Doulas provide physical support during labor through hands-on techniques, maintaining the environment, and suggesting different positions. When I walk into a labor room, I do a quick scan of the space to see what I can do to make it more conducive to birth. We know that dim lighting is essential for labor, so I will often close shades or turn off overhead lighting. While that may seem like a small thing - and it is easy to forget about - dilated pupils make for a dilated cervix! I carry a whole big bag of tools and tricks to help people through every sort of labor and birth. Other examples of physical support that doulas provide: 

• Hip squeezes and massage

• Suggesting position changes, such as walking, showering and using a birth ball 

• Aromatherapy to help with relaxation and energy levels 

• Usings a TENS machine for pain relief

• Acupressure points to help with pain and progress 

• Keeping track of hydration, nourishment, and bathroom breaks

Emotional Support

One of the most important things that a doula does is support the entire birthing team emotionally. Partners are often worried that a doula will replace them, but we never could. Partners are the experts in the birthing person, and the most essential person in the room who can provide comfort. At the same time, partners are going through their own intense experience and need support, too. Watching someone that you love go through labor is tough. Doulas help by contextualizing what is happening and helping both the laboring person and the partner understand what is normal. Doulas also: 

• Providing a calm grounding presence

• Breathing with the birthing person

• Help decide when it makes sense to leave home and head to the birth location 

• Offer encouragement 

• Coaching through difficult or intense moments 

• Checking on you in postpartum during hormone drops

Education

Our health education in the U.S. leaves a lot to be desired, so many people become pregnant without knowing a whole lot about birth. Yes, you can read all the books and watch all the YouTube videos, but often the sort of learning that is most crucial is the learning that you do as unexpected concerns come up. Doulas offer something called "anticipatory guidance." For example, perhaps your water breaks at home before any contractions start. You call your doula. The doula can help you do all the non-medical things to test if your water really did break (spoiler: people pee themselves often in the ninth month), and then also walk you through what a call to your provider will likely sound like. I regularly feed my clients possible questions that they might want to ask so that they aren't getting flustered and missing out on an opportunity for true informed consent. Other ways a doula can educate you: 

• Providing trusted, evidence-based resources 

• Teaching childbirth education

• Helping you go through the pros and cons of an induction

• Watching for signs of postpartum mood and anxiety disorders and connecting you to resources - like Jen!

Advocacy

Perhaps one of the most important things that a doula does is advocate for clients. Every doula does this very differently, so as you are considering who is the right fit be sure to ask each candidate about their approach. Some organizations teach doulas that they should never even address medical staff, let alone advocate. Other doula trainings focus on the challenges of the healthcare system and encourage doulas to go in ready to "fight." I personally find that I am somewhere in the middle. I approach each situation with humility and humanity, but if I see my clients being ignored (especially if they are in pain) I will amplify their voice. I am a queer doula serving many LGBTQ families, so I also help with things like staff addressing everyone correctly. Some of the ways that I help advocate: 

• Asking if you need time to think and helping you communicate that to medical staff

• Making a plan for position changes and rest during a longer induction

• Repeating what you said if no one answers or reacts to you 

• Gently correcting pronouns 

• Helping you remember your questions when medical staff walks in 

I've had many clients hug me and say, "We couldn't have done this without you!" It is truly an honor to usher people through the event that transforms them into a parent. Sometimes people feel that the cost of a doula is too much, and to those folks I usually ask: how much did you spend on your wedding? Having a guide and an expert in your corner on the most important day of your life is priceless. If you would like to learn more about me and why I became a doula, you can find me over at Wyld Garden. 

Mel Haley is a full spectrum doula serving people from fertility to pregnancy to birth. You can find more information about them at www.wyld-garden.com or reach out to them directly by email at melissaf.haley@gmail.com.