What is a doula, and what role do they play during pregnancy and birth?

If you are thinking about hiring a doula, or just want to know more about what they do, make sure you read our latest post

For our penultimate post in Midwife Month, we take a look at the role of doulas in pregnancy. If you're pregnant and thinking about hiring a doula for your own pregnancy and birth, or are just curious about what their role entails, read on.

We’ll look at what doulas are, what they can and can’t do and reasons for and against hiring one.

Firstly, what is a doula?

Doulas are individuals who support women and families to try and help them have a positive experience of pregnancy, birth and the first few weeks or even months of newborn life.

They can support women in all kinds of situations and different kinds of births, from home deliveries to c-sections, and help support them in their parenting choices. The various services offered by a doula differ according to the needs of the women, couple or family that she is working with.

Doulas offer emotional and practical support, but they do not replace the role of doctors or midwives, assist in medical procedures or help in delivering the baby.

While there are a small number of NHS-employed doulas, usually offered to women in need through community schemes, doulas are mainly employed privately by families to work with them before, during and potentially after the birth.

What can doulas do?

Birth doulas provide ongoing support, for women and couples, through pregnancy, labour and birth and the immediate postnatal time. They will usually meet you a few times before the birth to get to know you, can help you write a birth plan or go over previous birth experiences. They are then on alert for the birth, and will come out to you when you call them. They will offer emotional support while you deliver the baby, and can act as your advocate with medical professionals if you wish.

Postnatal doulas provide practical and emotional support for new mothers and families in their own homes, in the post-natal period. Help can range from assistance in the home (such as cooking dinners) through to listening and chatting. Doulas may also be qualified in breastfeeding and able to give help support and advice with baby feeding if needed.

Some doulas work as both birth and postnatal doulas, while others work only as birth doulas or postnatal doulas.

What can’t they do?

Doulas do not take a clinical role or work alongside midwives and doctors. While they may have medical training, this is not something that’s used to help deliver the baby. They only offer emotional or moral support.

They are not supposed to offer medical advice, but they can support you to find balanced information to make informed decisions about maternity care.

They do not take the place of a midwife or doctor as you will still have your regular, scheduled appointments.

Why hire a doula?

Support. There are many emotional and psychological aspects involved in giving birth so they can help with this before, during and after. As a second-time mum, they could help you understand why things happened as they did with your first birth, help you relax about your upcoming birth and decide on the choices you want to make second-time-round.

Doulas can also help ensure you have the type of birth you want while it’s taking place, when it’s easy to be overwhelmed by everything that’s going on – for you and your partner – and hospitals can be busy and staff stretched.

If you won’t have a birth partner with you at the time – for example, if you’re a single parent, your partner is away or will be needed to look after the other children – then this is a guaranteed way of having someone constantly at your side throughout the entire birth.

They can also help take the load off at home when you’re recovering, which can be useful if you have other children or have had a traumatic birth.

What reasons are there for not hiring a doula?

It’s another person in the room. Giving birth is an intensely personal experience and you might want as few as people as possible around you to feel as relaxed as possible.

While you can pick and chose the doula you like, if you don’t ‘click’ with them or feel you get on well, it might make the experience uncomfortable.

They’re not a must-have, the NHS provides a detailed schedule of appointments and care during pregnancy and midwives and / or doctors will deliver your baby.

The expense, at what’s potentially already an expensive time.

How much do doulas cost and where can I find one?

While it depends on what services you ask for, how long you employ them for and where in the UK you are, doulas tend to cost from around £200 upwards. Search for a doula on the Doula UK  website. Alternatively ask around, read experiences on sites like Mumsnet, or contacts at places like the NCT might be able to help.