I am certified by two different organizations, however, this will include as many options
available to you as I can find to list. If anyone has more numbers available, please feel
free to contact me.
Robin Elise Weiss, ICCE, CD(DONA), NACA, BCCE
The term doula is Greek for slave or servant. Doulas provide emotional and physical
support during pregnancy, labor, birth and postpartum. (NOTE: In some areas, the term
doula only refers to postpartum help, in this FAQ I am dealing only with Labor support.).
They call themselves many things including: Childbirth Assistant, Labor Support
Professional, Birth Assistant, Birth Companion, etc.
A doula does not speak for a couple, provide medical or clinical skills (See Question #2
on Monitrices.), or act in any unprofessional manner (Most organizations have Policies
that each doula must follow.).
A doula provides:
- explanations of medical procedures
- emotional support
- advice during pregnancy
- exercise and physical suggestions to make pregnancy more
- help with preparation of a birth plan
- massage and other non-pharmacological
pain relief measures
- positioning suggestions during labor and birth
- helps support the
partner so that they can love and encourage the laboring woman
- avoid unnecessary interventions
- help with breastfeeding preparation and beginnings,
- written record of the birth
- many other possibilities that vary from doula to doula
A monitrice is sometimes a nurse or a midwife, or someone who is professionally trained to provide
clinical skills to a couple (fetal heart tones, blood pressure checks, and vaginal exams).
There is some debate over monitrice versus doula. This basically states that the
careprovider (CNM, OB, or DEM) should be providing the clinical skills freeing the
doula or monitrice to provide the emotional support that the client needs.
This also varies from area to area and doula to doula. Some of this is based on the
experience your doula has, some is based on the going rate in your area. the basic range
would be from $200-$800. However, most doulas will barter, set up a sliding scale, or
payment plans to help those who can't afford a doula. So, do not let this keep you from
hiring a doula.
I am going to give basic suggestions and then list the organizations that I am aware of.
Places you can try to find a doula: organizations dealing with childbirth, your birth place
(hospital or birth center), your childbirth educator, your care provider, lactation consultants,
La Leche members, anyone who has recently had a baby or works in the field.
Doulas of North America (DONA)
1-206-324-5440 will put you in contact with members in your area.
AskDONA@aol.com is the e-mail address.
snail mail address:
1100-23rd Ave. East
Seattle, WA 98112
ALACEHQ@aol.com for e-mail
snail mail address:
PO Box 382724
Cambridge, MA 02074
National Association of Childbirth Assistants (NACA)
snail mail address:
219 Meridian Ave.
San Jose, CA 95167
The Bradley Method®
According to Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier
and Healthier Birth, by Kennell, Klaus, and Kennell (1993), having a doula can give you a:
- 50% reduction in cesarean rates
- 25% shorter labor
- 60% reduction in epidural requests
- 40% reduction in oxytocin (pitocin) use
- 30% reduction in analgesia use
- 40% reduction in forceps delivery
- The Birth Partner by Penny Simkin, PT, CD(DONA)
- The Birth Book by Dr. William and Martha Sears, RN IBCLC
- Special Women, Polly Perez
- Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier & Healthier Birth by John H. Kennell , Phyllis H. Klaus , Marshall H. Klaus
- "The Whole Nine Months," Parenting, Gayle Pryor, May 1992, p34.
- Active Birth by Janet Balaskas
- Good Birth, Safe Birth by Diana Korte and Roberta Scaer
- Natural Childbirth the Bradley Way by Susan McCuthcheon
- Silent Knife: Cesarean Prevention & VBAC by Nancy Wainer Cohen & Lois Estner
- Open Season: A Survival Guide for Natural Birth and VBAC in the 90's by Nancy Wainer Cohen
- Obstetric Myths Versus Research Realities by Henci Goer
- Natural Birth After Cesarean: A Practical Guide by Johanne C. Walters , Karis Crawford
- Easing Labor Pain by Adrienne Lieberman
- Rebounding From Childbirth: Towards Emotional Recovery by Lynn Madsen
- Is she certified?
- Does she provide prenatal and/or postpartum visits?
- What can you expect during these visits, if offered?
- How many births has she attended?
- Can she provide references?
- What form of training has she had?
- What types of births has she witnessed (Cesarean, epidural, intervention free, VBAC,
teen birth, etc.)?
- Her fee? And does she have a sliding scale or other arrangements available?
- Has she ever worked with your care provider or at your place of birth?
- Does she has back-up arrangements available?
- What will her role be in early labor?
- Will she provide labor support at your home prior to going to the place of birth?
- Is she familiar with many methods of childbirth?
- How does she define her role during labor and birth?
The bottom line is do you and your partner like her.
The best way for doulas to work with providers (at least me and the other
midwives I know), is to attend a visit with the client to meet the provider.
This provides a way to ask questions of the provider. Granted, physicians
might not like this, but it is worth a shot, especially if the doula and
client are not confrontational.
From: Sheri Payne
My husband was against it at first. My reasoning which finally got him to agree was that I
had never been through a birth before ( although I had witnessed my
friend's home birth) and he had never been through one even though he's
been trained, so let's have someone with experience on our side.
April's right, the nurses leave you alone most of the time. It was nice
to have someone nearby who was sympathetic and who could tell me if what
I was experiencing was normal. Since we were trying to go as natural as
possible, I liked having her around to tell me what she thought about the
doctor's suggestions. I'm sure the nurses would have rather given me an
epidural than sit through the tough contractions, helping me to work
through it. My husband was a great help, but when things got very scary
near the end and I was in a lot of pain, he fount it very comforting that
Paula (doula) was there to help him, too. Even the toughest of men come apart
when their wives are in pain.
From: Rachel :
I had two doulas during labor (not planned that way, the
back-up doula came : first, and then decided not to leave
when my primary doula arrived.) It was : wonderful. They
waited on me, brought me drinks, massaged my back, gave me
encouragement, etc. It was even OK with me that my
husband took a half-hour : cat-nap in the middle of it
all, so he was more able to assist when it came : time to
push. They also helped clean up the mess afterward (this
was a home : birth), which was very nice.
Why Use a Doula?
In order to have a positive birth experience,
most women need continuous labor support.
Although Obstetrical Nurses are experienced
in dealing with a laboring woman's emotional
and physical needs, they can seldom
guarantee the support they provide will last
throughout the labor - especially in hospital
settings where shift changes, coffee breaks,
heavy paperwork and busy nights regularly
occur. Some OB nurses handle up to six
laboring couples at a time. Midwives may be
able to offer more labor support, but they
too have clinical duties to which they must
The father or partner, may be better able to
provide continuous support but has little
actual experience in dealing with the forces
of labor. Even fathers who have had
intensive preparation are often surprised at
the amount of work involved (more than
enough for two people). Even more
important, many fathers experience the birth
as an emotional journey of their own and find
it hard to be objective in such a situation.
Will the Doula replace the father?
Some fathers or partners are concerned they
may be sidelined or replaced by the Doula
during labor. Although individual situations
vary, and one should question a prospective
doula about her philosophy, generally the
answer to this question is no - she will not
replace him. Studies have shown that fathers
usually participate more actively during labor
in the presence of a Doula than without one.
A responsible Doula supports and
encourages the father and enhances his
support style rather than replaces him.
I have been to six births thus far, and I love it as much as I thought I would.
It's very hard, emotionally taxing work, but it's so satisfying. I still feel
little unsure because I'm so new, but as my wise boss told me, "When I think
the people who trusted me with their births 20 years ago, I shudder. But the
line is, they didn't care about how many "tricks" I knew, all they cared about
that I was there for them and I cared."
From: Kate Hallberg
We met our 'doula in training' or childbirth assistant at our childbirth
education class- a lot like Bradley but not really. The two women
teaching the class also were childbirth assistants. My husband was
initially more interested in the idea than I was, but I had no objections.
Leigh met with us on and off before I went into labor and was on call for
when I did. She also went to one or two of our obstetrician appointments
as well as a hospital tour where we were to give birth. Before the birth
she discussed herbal method of inducing labor- See Susan Weed's "Herbal
for the Childbearing Year". She also listened when I needed to complain as
the due date came and went.
The morning I went into labor she came over and hung out with me for a long
time. I had been monitoring my blood pressure as I was borderline toxemic
and it was Leigh who noticed I was 'pitting' which is a sign of toxemia
after I had been in labor for 12 hours without a whole lot of progress.
She also had a fetoscope and was monitoring my daughter and showed my
friend and husband how to do it. We ended up going to the hospital Monday
night and discovering that I had low fluid volume and my daughter was having heart rate decelerations with every contraction. That's when the
fun began. I took black and blue cohosh tinctures all night- administered
by Leigh to try and get some progress and avoid pitocin. Leigh was helpful
the next day in providing encouragement and suggesting to my husband and my
friend what I would like in terms of support. (None of us other than Leigh
had been to a birth before.)
After laboring all day Monday and Tuesday I was finally fully dilated
Wednesday morning. In the meantime I had an IV painkiller at 30 hours and
two walking epidurals following that. Leigh helped the rest of the team
support me physically during contractions and finally during pushing. At
57 hours of labor we concluded that Ursula wasn't coming out and we decided
to do a c-section. Leigh and my husband were in surgery and then was there
to provide a little breastfeeding support and take pictures after the
birth. For a week or two afterwards she came over and helped a little and
checked on our breastfeeding progress.
I've written this with the doula in the starring role- but what was really
more important was the presence of my husband and friend. The doula helps.
From: Sabrina Cuddy
She was wonderful - gave great backrubs in just the right place,
helped me get comfortable, made great suggestions, came in when I
needed a c-section and made sure we got what we needed to bond,
went to the nursery with the baby for a short battery of routine
Q. If you did it, would you do it again?
From: Trish Jalbert
We met with our new doula, and she is fabulous! She's as if we made
her to order.
My doula really helped me through the rough spots. She gave me the encouragement I needed. I have never felt so empowered. My partner was thrilled that she kept explaining everything to him. I liked the way she pulled him into the birth rather than exclude him as he originally thought.
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