Do I Need a Doula on My Birth Team?

If you are pregnant, it’s important to consider who will be in the delivery room with you when the time comes. Some people hire a doula to support their birth experience—but how do you know if that’s the right choice for you?

Rhonda Lanning, a certified nurse midwife and director of Birth Partners, the UNC Volunteer Doula Service Program, explains what doulas do and how to know if you need one.

What is a doula?

There are many types of doulas, but birth doulas are the most common. Birth doulas are trained to provide emotional and physical support and information to laboring parents and their partners before, during and shortly after the birth experience, Lanning says.

Doulas are not healthcare providers, like midwives and doctors, and they don’t provide clinical care. Doulas work with your healthcare team to help you have a positive birth experience.

“Birth doulas are unique members of the healthcare team,” Lanning says. “Their role is to be a continuous and supportive presence to the person having the baby and the people accompanying them.”

Birth doulas focus on helping people achieve whatever a “good birth” means to them, giving new parents a solid start on their parenting journey, Lanning says.

What do doulas do during labor and birth?

A birth doula offers the following types of support during labor and delivery:

  • Emotional support. This includes offering praise and encouragement and providing a listening ear.

“We share words like ‘you are so strong’ or ‘you are doing such a great job,’” Lanning says. “These simple words can truly make a difference for people who are feeling all of the many emotions that come with experiencing labor and giving birth.”

Doulas also help patients find their voice as they navigate the healthcare system, Lanning says. This is especially critical during the birthing process, when patients often hear a lot of information very quickly. Doulas can be a consistent presence in the delivery room and ensure that parents and clinicians are on the same page.

  • Physical support. This could include healing touch massage, coaching through breathing techniques, walking with the patient, helping with a bath or shower and creating a relaxing environment in the room (for example, dimmed lights and music).

“Labor is hard work and having someone by your side who can rub your back, put a cloth on your forehead or many other simple actions can ease pain and help people in labor feel cared for,” Lanning says.

It’s a common misconception that doulas are only for people who want to have unmedicated births—not so, says Lanning.

“People who plan to use medication for pain relief still have to push the baby out, and sometimes family members can be less attentive in that case because they think the laboring person is not in pain,” she says. Doulas are well-equipped to provide physical support to all laboring parents, epidural or not.

  • Partner support. Doulas can help reduce a partner’s stress and guide them in helping the laboring patient.

“Oftentimes, the partner may not feel like they have the information they need to support the person in labor,” Lanning says. Doulas can model helpful techniques—using massage during a contraction, for instance—and then encourage the partner to try. “It’s such a beautiful thing when we can step back and allow them to share in the experience together.”

Sometimes partner support is as simple as guiding them through how things work in the hospital, or making sure partners stay well-nourished so they have energy to support the person in labor.

“When I think back on my own experience with my first child, my partner was so sweet and attentive,” Lanning says. “But I labored for more than 24 hours, and he didn’t have much of anything to eat or drink during that time. After the birth, he got a terrible migraine, collapsed and was out of it for the first eight to 10 hours of our baby’s life. I ended up being up all night by myself falling in love with our baby. If partners are not taken care of during the labor, they won’t be able to enjoy the experience and provide support.”

What do doulas do after delivery?

A birth doula will provide support immediately after the baby is born, including:

  • Encouraging breast or chestfeeding
  • Providing emotional support for the parents
  • Initiating skin-to-skin contact with parents and the baby
  • Visiting with the family after the baby is born

There are also postpartum doulas who specialize in providing support services after families come home from the hospital or birth center.

What are the benefits of having a doula?

Research has shown that continuous support during labor and birth, like support from a doula, is associated with improved birth outcomes. These include lower risk of preterm birth, fewer cesarean deliveries and birth complications, shorter labor, reduced need for pain medication, and higher satisfaction with labor and delivery.

“It’s more than just a nice-to-have option. It can really make a difference in pregnancy outcomes and improve long-term health. Doula services could go a long way to help curb the high levels of mortality and morbidity we’re seeing in pregnancy now, especially among women of color,” Lanning says.

Research has also shown that having a doula during postpartum can help with breastfeeding success, Lanning says.

Who would benefit from having a doula?

Although having a doula could be helpful for any expectant parents, there are some situations where it is critical.

“If someone doesn’t have a partner or a support person for the birth, they would really benefit from having a doula,” Lanning says. “We also work closely with people who have complicated pregnancies or a fetal diagnosis that they know will be challenging.”

How much does it cost to have a doula?

The cost of having a doula varies based on where you live, the doula’s level of experience and the services provided. Some insurance companies may help cover doula services, but doula care is often paid for by parents.

If your insurance does not cover a doula’s services, ask if your hospital or birth center has a volunteer doula program such as UNC Health’s. Any pregnant person at UNC Medical Center can request a doula for free.

When should you hire a doula?

The best time to begin working with a birth doula would be around the middle of the pregnancy or early in the third trimester, Lanning says. If your hospital has a volunteer doula program, the doula would likely meet you at the hospital for labor and birth, even if you haven’t met with them before.

Are you pregnant and looking for a provider? Find one here.