What does a birth doula do? A birth doula provides physical, emotional, and informational support to women and their partners during pregnancy, labour and birth. She offers help and advice on comfort measures such as breathing, relaxation, massage and positioning. She provides assistance to families in gathering information about the course of their labour and their options, both prior to and during labour and delivery. During labour and delivery the birth doula is a source of continuous emotional reassurance and comfort and can help explain medical procedures and their usefulness. In hospital births nursing staff often attend to more than one mother in labour at a time, and therefore is often absent for long periods of time. A birth doula supports the mother (and birth partner) through the entire labour and delivery.

During labour and delivery birth doulas offer non-medical skills such as massage, counterpressure and other comfort and pain relief measures. The birth doula works with the mother and birth partner, using numerous proven breathing, positioning and movement techniques. A birth doula is also trained to provide any needed assistance to partners who want to play an active support role.

Why should I hire a doula?  Almost every woman can benefit from the special attention and continuity of care that a doula can give. Statistics repeatedly show that doulas can make a difference in the outcome of your birth. Here are a few examples taken from the book "Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth" by Klaus, Kennell, and Klaus (1993):

50% reduction in the caesarean rate
25% shorter labour
60% reduction in epidural requests
40% reduction in oxytocin use
30% reduction in analgesia use
40% reduction in forceps delivery

Must I have a non-medicated birth with a birth doula? A birth doula can provide support for any type of birth: medicated or unmedicated, vaginal or c-section. Your doula is comfortable working in any setting: in a hospital along side your regular doctor or midwife, or at a home birth. A birth doula can help the couple navigate any unforeseen events and support the mother in deviating from her birth plan when necessary. A birth doula never imposes her own beliefs.

Your birth doula recognizes that this is not just another day, but one that you will remember for the rest of your life. All said and done, the birth doula’s charter is to support you in experiencing a safe and satisfying birth so you retain a sense of accomplishment and fulfillment from your birthing experience.

What if I have already decided to get an epidural? Many women assume that having an epidural means that you just sit back and enjoy your labour. Even though you lose mobility with most epidurals, you still need to change positions frequently to help move the baby down the birth canal. You will also experience the emotional impact of the labour as your body moves through the process. You may get discouraged, fearful, tired or weepy, and sometimes you have to wait to reach the appropriate dilation (usually 4-5cm which can take many hours). Once you request the epidural it may take time for an anesthesiologist to become available. Your doula will be there to give emotional and physical support and to help explain the procedures that go along with an epidural (IV,catheter, monitors, etc.). An epidural may slow your progress, and the doula can stay with you while other family members or support persons take a break or catch a nap.

Is a doula a midwife? While some doulas are also certified midwives, as a doula I do not perform any medical tasks. We don't take blood pressure, monitor the baby's heartbeat, do vaginal exams or administer medication. Most doulas are from non-medical backgrounds, but are highly trained and experienced in the mechanics of labour and in comfort techniques. We may use massage, counter pressure, position changes, hot or cold packs, aromatherapy and visualization to help you deal with the pain and discomfort of labour.

Do you come to my home when I'm in labour? Depending on your own birth plans, you may spend early labour at home with your doula or you might meet the doula at the hospital. You may also plan to have your baby at home with midwives.  If you do plan to stay at home for any length of time, your doula can help make you comfortable and be an attentive companion. You simply request your doula's presence when you feel you need her.

How much do doulas charge? In Toronto the price can vary from $400 to $1200. Most packages include prenatal visits, labour and birth, and a postpartum visit. While some people may think it's expensive, consider the service: as your doula we agree to reserve the weeks around the mother's due date and are on call 24 hours a day during that time.  This in itself is a significant commitment.  We often stay up all night with women in labour and leave our families for extended periods - for many doulas this necessitates hiring a babysitter; and we perform physically demanding tasks during labour such as massage and counter pressure and are often on our feet for hours at a time.

Are doulas covered by insurance? While there are certain insurance plans that do cover the expense of hiriing a doula, most do not.  Please check with your insurance company.

My husband will be with me - isn't that enough? We can never replace the support and encouragement of your husband or partner, and a doula can actually help make the experience much more positive for them by offering suggestions as to how they can better assist you during labour. They may not feel the pain that you're feeling, but they often feel anguish and a sense of helplessness while watching you go through the birth process. Some men deal with this emotional upheaval by "checking out." They may sleep, watch a football game, or just seem to withdraw from you. We try to pull them back into the process by showing them how they can make you more comfortable and be there for you emotionally. Please see the "links" section for more information on "dads and doulas".

What if I end up having a c-section? To quote Forrest Gump, "Life is like a box of chocolates...you never know what you're gonna get." Childbirth can and does take some unexpected turns, and a doula will be there to help you navigate through what may be a very stressful time. Depending on the situation and the hospital your doula may or may not be allowed into the operating room with you.  If we are not allowed to go with you, we can use the time while you're in surgery to move your belongings to the postpartum area or we can stay with friends and family members and give them emotional support while they wait for news. We are often allowed into recovery - that way the father can be with the baby in the nursery and you won't be left alone. Some women hire doulas even when they are having a scheduled Cesarean because they know the value of having the prenatal and postpartum visits as well as someone to answer their questions and give emotional support before and after the birth.