What is a Doula?

The Doula Difference

When Claudia Bermudez had her second child nine months ago, she decided to hire a doula, someone who would help mother her during the birth. Her own mother was dead, and having a nurturing woman at her side gave her extra strength, confidence and calm.

"When the going got tough and I became scared, I could look in her eyes and she held my hand so tight that I didn't feel alone," says Bermudez, of Lincoln, Mass. "My husband was there and could offer his love, but for me there was something about the female support that was crucial. She was a mother. She had actually birthed children."

A growing number of women like Bermudez are finding that a professional doula (which is the Greek word for "woman caregiver") can be a valuable source of support. Not that they take the place of a partner, doctor or midwife -- they just fill in the gaps, providing continuous support from early labor until after the birth.

Besides making a woman feel more relaxed and confident, doulas can actually help make the labor progress easier and faster. Studies have indicated that the use of doulas can result in labors that are 25 percent shorter. Also, requests for epidurals drop by 60 percent, and women are half as likely to undergo a Caesarean section.

"Mothers who labor alone or don't have a doula may have a great deal of anxiety, which produces substances like epinephrine and neurepinephrine," says Dr. John Kennell, a leading researcher on doulas and professor of pediatrics at Case Western Reserve University in Cleveland. "When levels are high, labor contractions become much less efficient or may even stop."

What each couple needs or wants from a doula will vary.

The doula might be running for ice chips and heat packs so that the partner can stay close by. She might be offering encouragement or explanations about the birth process as questions arise. Or she might be giving a massage to help ease labor pains -- and, yes, even a quick rub for your partner when hours of exhaustion set in.

"I always recommend to partners that they consider having extra support people there like a doula, particularly if they're first-time dads, because oftentimes they're not quite sure what's supposed to happen," says Lyon. "A doula can give him little suggestions and help him feel more effective in what he can do to help."

Women might need the extra emotional support, too, Lyon says. "Sometimes the partner will have a hard time seeing her in pain, or just isn't going to come through for her emotionally, and women tend to know if this is the case in their relationship. Then the doula helps her."

Ideally, couples should hire a doula during the second trimester so that they can meet at least once or twice to get to know each other and the type of birth they're envisioning. When the woman goes into labor, the doula goes to the house and helps support the couple until it's time to go to the hospital, then accompanies them there.

The cost, which is sometimes, but not typically, covered by insurance, can range anywhere from $400 to $1,200, says Condon. Some doulas charge by an hourly or flat rate, others on a sliding scale. Condon's group has a flat rate of $900 for up to 12 hours, then $30 an hour afterward. The fee includes prenatal and postpartum visits, and phone calls are free.

To find a certified doula in your area, several groups provide referrals, including Doulas of North America, (206) 324-5440; the International Childbirth Education Association, (612) 854-8660; or the National Association of Postpartum Care Services, (800) 45-DOULA.

Courtesy of WebMD Corporation