What Is A Doula?

We’re Professionals
Birth doulas are professionals with training in how to support families during pregnancy, labor, birth, and immediate postpartum. Doulas do not perform any medical procedures but instead provide you with continuous emotional, physical, and informational support.

We’re Agenda Free
Birth doulas do not have an agenda, give advice, or assume there is a “right” way to give birth. Your goals are their goals, and they offer education and information so you can make informed decisions that are congruent with your family’s needs and values.

We’re Flexible
Birth doulas are flexible and know how to navigate birth’s unexpected twists and turns. If unforeseen circumstances should arise, your doula remains calm, keeps you informed on what is happening, and helps you adapt to changing circumstances. Doulas are attentive to your hopes and fears, respectful of your choices, and inspire confidence in your ability to labor and birth.

We Support Partners
Doulas do not replace the vital role of partners or other family members. Instead, they encourage partners to engage in the process with greater confidence and effectiveness and relieve them of the pressure to know and do everything.

We Work Collaboratively
Doulas know how to work collaboratively with medical staff even as they advocate for your needs and preferences during labor. Doulas work for you, not for the hospital, so their care can be individualized to fit your needs.

What Are The Benefits Of Hiring A Doula?

The many advantages of hiring a birth doula are recognized by the World Health Organization, the American College of Obstetricians and Gynecologists, and the National Institutes of Health. Current research consistently shows that women who receive continuous support during labor from a doula are less likely to need medical interventions and are more satisfied with their birth experience. These studies show that a doula’s continuous support, practical knowledge, and labor enhancing techniques help to reduce pain and anxiety in laboring people. When people are less frightened and feel less pain, labor is more likely to progress without the need for interventions.

Research shows that a doula’s presence during labor and birth results in the following positive outcomes:

  • reduction in the rate of cesareans
  • reduction in epidural requests
  • reduction in the use of Pitocin (a contraction induction method)
  • reduction in vacuum-assisted deliveries
  • shorter labors
  • an increase in successful breastfeeding and bonding
  • a reduction in “baby blues” and postpartum depression
Source: Rebecca L. Dekker, PhD, RN, APRN at evidencebasedbirth.com

What Do Doulas Actually Do At A Birth?

People frequently ask us what a birth doula actually does, and our answer goes something like, “Well, it depends. We tailor our services to each client’s particular needs, but basically, we offer families professional support during pregnancy, labor, and the postpartum.”

While this answer does faithfully represent our services and dedication to individualized care, it does not always satisfy the inquiring mind that asked. Often what the person is wondering about is the hands-on nitty-gritty of what we do when we’re at a birth.

So, in an attempt to make our doula skills more transparent and understandable, here’s a list of things we typically do for clients who are in labor (please note that this is not a complete list, nor does it include the types of support offered during pregnancy or in the immediate postpartum):

  • We answer questions and provide reassurance.
  • We show you all the ways a birth ball can be your friend.
  • We squeeze aching hips and apply counter-pressure to sore backs.
  • We encourage partners to bring on the love.
  • We help you stay in the moment and take it one contraction at a time.
  • We fill the tub and get the shower ready.
  • We laugh at your jokes and make some of our own.
  • We encourage, encourage, encourage.
  • We hold hands, ease fears, and normalize the birth process.
  • If you hit “a wall,” we help you climb right on over it.
  • We slow down communications with medical staff and ask important questions.
  • We respect any and all decisions you make (no judgment anywhere).
  • We remind the hospital staff of your hopes and preferences.
  • We guide you on how to use your breath during contractions.
  • We listen with compassion to what you and your partner are thinking and feeling.
  • We massage your shoulders and help you release tension.
  • We suggest positions that help labor progress.
  • We put heating pads and ice packs where you want them most.
  • We dig into acupressure points and give awesome foot rubs.
  • We check in with you to see what’s working and what’s not.
  • We help create a positive birth atmosphere.
  • We inform you about the risks and benefits of various medical procedures.
  • We provide evidence-based information so you can make informed choices.
  • We quench dry mouths and feed hungry tummies.
  • We strive to help you reach your childbirth goals.
  • We know our way around a hospital room and can find things quick.
  • If you’re using a particular childbirth preparation method, we use it, too.
  • We let you know about potential alternatives to medical interventions.
  • If something doesn’t go as planned, we help you ease into and accept this change.
  • We offer partners much-needed breaks.
  • We mop sweaty brows with cool wet towels.
  • We dim lights, get warm blankets, and hush beeping machines.
  • We use positions and rebozos to get babies in a good spot.
  • We offer soothing words and visualizations to help you sink in.
  • We suggest a variety of positions for the pushing phase.
  • We take photos to capture memories of this life-changing event.
  • We stay up all night until your baby is born.

How Do Doulas Work With Birth Partners & Family?

The role of the partner during labor is essential. Laboring people need to know that their partners are there for them and that they are on this journey together. Doulas encourage partners to be the primary source of emotional support and do not attempt to replace the partner’s role.

Most partners are inexperienced with childbirth and unsure of how to offer their loving support during this unique experience. Even the most attentive partner may be overwhelmed by the hospital environment, the changes unfolding in the laboring person, and the emotions that surface in anticipation of the baby’s arrival.

While childbirth educators do their best to equip partners with useful information and techniques, it is just too much to expect partners to remember everything and to know how to assist a person through labor instinctively.

A doula’s knowledge, skills, and expertise allow partners to be less pressured and more present. The doula will offer practical suggestions, information, and techniques as needed, which enables partners to be much more relaxed, loving, and emotionally present. A doula can provide partners with helpful tips along the way and make it possible for partners to take much-needed breaks.

There are also times when the labor or birth process can get intense or when things may take an unexpected turn. In these circumstances, partners may need as much emotional and informational support as the person in labor, and a doula can step in to reassure and care for the entire family.

How Do Doulas Work With Medical Providers?

Doulas do not perform any medical procedures, but they do work collaboratively with the hospital staff to create a supportive team atmosphere during your labor and birth.

An experienced doula knows how to create a good rapport with your nurses, midwives, and doctors while simultaneously advocating for your choices, needs, and desires.

Doulas help you to voice your needs and wishes without becoming confrontational or disrespectful, and they work to maintain the delicate balance between respecting hospital protocols and ensuring your autonomy.

Who Hires A Birth Doula?

Virtually anyone preparing for the experience of having a baby can benefit from the presence of a birth doula, including:

People Desiring A Unmedicated Childbirth

Doulas are well equipped to effectively support people’s efforts to avoid pain medications and interventions and to have unmedicated vaginal deliveries. A doula’s skill set is made up of emotional, physical, and informational tools designed to help you achieve the experience of natural childbirth within a hospital, birth center, or home setting.

People Striving For VBAC

A birth doula may be one of the most important and effective resources available to people striving for a VBAC. A doula can help you “leave no stone unturned” in your efforts to have a vaginal birth, and they can also help you to navigate the mental and emotional uncertainty that often accompanies this path. Doulas offer indispensable reassurance and encouragement as you strive for the VBAC experience.

People Wanting An Epidural Assisted Birth

Doulas can enhance the labor and birth experience of people who want to use pain relief medications. We can do this by providing useful information about epidural procedures, suggesting appropriate times to receive an epidural, recommending in-bed positions that enhance labor’s progression, offering advice on how to minimize the “cascade effect” leading to undesired interventions, and assisting with the critical transition into bonding and breastfeeding.

People With High-Risk Pregnancies or Births

Some pregnant people are considered to be in a higher risk category due to conditions such as IVF, advanced maternal age, hypertension, pre-eclampsia, diabetes, etc. Doulas can help relieve some of the anxiety and tension generated by these conditions by offering clear information and explanations and ensuring that you have continuous support throughout your pregnancy, labor, and postpartum.

People Planning A Home Or Birth Center Birth

In a home or birth center setting, doulas offer an additional layer of ongoing emotional and physical support while your midwife focuses on your medical care and the health of your baby. In an out-of-hospital setting, doulas focus in on comfort techniques, labor progression, optimal fetal positioning, and help with tasks such as setting up the birthing tub, preparing food, and cleaning up after the birth.

People Desiring A Unmedicated Childbirth

Doulas are well equipped to effectively support people’s efforts to avoid pain medications and interventions and to have unmedicated vaginal deliveries. A doula’s skill set is made up of emotional, physical, and informational tools designed to help you achieve the experience of natural childbirth within a hospital, birth center, or home setting.

People Striving For VBAC

A birth doula may be one of the most important and effective resources available to people striving for a VBAC. A doula can help you “leave no stone unturned” in your efforts to have a vaginal birth, and they can also help you to navigate the mental and emotional uncertainty that often accompanies this path. Doulas offer indispensable reassurance and encouragement as you strive for the VBAC experience.

People Wanting An Epidural Assisted Birth

Doulas can enhance the labor and birth experience of people who want to use pain relief medications. We can do this by providing useful information about epidural procedures, suggesting appropriate times to receive an epidural, recommending in-bed positions that enhance labor’s progression, offering advice on how to minimize the “cascade effect” leading to undesired interventions, and assisting with the critical transition into bonding and breastfeeding.

People With High-Risk Pregnancies or Births

Some pregnant people are considered to be in a higher risk category due to conditions such as IVF, advanced maternal age, hypertension, pre-eclampsia, diabetes, etc. Doulas can help relieve some of the anxiety and tension generated by these conditions by offering clear information and explanations and ensuring that you have continuous support throughout your pregnancy, labor, and postpartum.

People Planning A Home Or Birth Center Birth

In a home or birth center setting, doulas offer an additional layer of ongoing emotional and physical support while your midwife focuses on your medical care and the health of your baby. In an out-of-hospital setting, doulas focus in on comfort techniques, labor progression, optimal fetal positioning, and help with tasks such as setting up the birthing tub, preparing food, and cleaning up after the birth.

What Is Continuity Of Care?

Continuity of care is a continuous caring relationship between a client and health care professional over time. For most people, continuity of care is valuable because it allows clients to build a relationship of trust and understanding with their provider.

However, in today’s fast-paced obstetric and nurse-midwifery models, continuity of care is often sacrificed to provide large-scale services to growing populations. This means that even if you’ve hired a doctor or midwife that you really connect with, that person is not usually present when it comes time to birth your baby. Instead, whichever doctor or midwife is working at the hospital when you go into labor is the one you get, and it’s often someone you’ve never met before. While this model may be effective at delivering services within a strained healthcare system, it does not always work well for individuals and families looking for a more personalized labor and birth experience.

This is where birth doulas can fill in the missing link! Having a doula ensures that there is at least one birth professional in the delivery room with whom you have a secure, comfortable, and trusting relationship.

This relationship is built during the prenatal months so that by the time you go into labor your doula is well versed in your family’s unique style, hopes, fears, and goals. A doula works just for you, which means your priorities are her priorities.

This trusted relationship helps families feel more secure, confident and respected within the hospital environment and at a time of significant transition and intensity. It also assures that there will be a familiar and understanding presence during the postpartum to review your birth story with, support breastfeeding, and provide newborn care information. If continuity of care is something you value or desire as a part of your childbirth experience, please contact us so we can discuss our services and begin the connection.

Supporting VBAC

Over the years, dozens of clients have hired us as part of their preparation for vaginal birth after cesarean (VBAC), and it’s some of the most rewarding work we do. These people usually arrive in our office with a complex combination of determination and anxious uncertainty.

They are hoping to birth differently this time and committed to doing what they can to deliver vaginally, but they are simultaneously anxious about the possibility of a repeat cesarean and uncertain of their body’s ability to birth vaginally. These emotions are normal and reflect the multifaceted experience of people who have had a cesarean birth.

As doulas, we support VBAC families in all the same ways we support other clients, but we also attend to some of the unique concerns and considerations. We spend time talking about evidence-based research on VBAC, we discuss care providers and their VBAC success rates, we go over the importance of optimal fetal positioning, we explore alternatives to medical induction, and we dig up the seeds of doubt planted by extra prenatal testing and try to blow them into the wind.

In addition to these kinds of preparations, we also spend a good deal of time on emotional preparations. Each person and family approaching VBAC has a unique and often difficult previous birth story that has brought them to this crossroads. Some people are at peace with this story, while others are still tender and feeling varying degrees of sadness, disappointment, fear, confusion, guilt, and anger. Either way, we make plenty of space to hear the details of your birth story, to help you process it at your comfort level, and to identify parts that were particularly difficult or frightening so that we can offer extra support and advocacy in those sensitive or vulnerable areas.

And, even though we will bend ourselves into pretzels to help you realize your hope of having a vaginal birth, in our heart of hearts we want everyone to feel empowered by their birth experience regardless of how it happens. No matter how your baby is born, it takes strength and courage, and every type of birth experience deserves recognition and admiration. We love that line in Roanna Rosewood’s popular book on VBAC: “Birth isn’t a battle to win or lose. It’s the result of delving into your vulnerability and finding your power.” Our goal is to help you find your power in whatever way, shape, or form that happens.

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Areas We Serve: NW Portland, NE Portland, N Portland, SW Portland, SE Portland, Sellwood, Beaverton, Hillsdale, Tigard, West Slope, Gresham, Tualatin, Milwaukie, West Lynn, Happy Valley, Oregon City, Wilsonville, Vancouver, Camas, Washougal

Hospitals & Birth Centers We Serve: Kaiser Sunnyside, Kaiser Westside, OHSU, Legacy Good Samaritan, Legacy Emanuel, Legacy Meridian Park, Legacy Salmon Creek, PeaceHealth, Providence Portland, Providence St. Vincent’s, Adventist, WHA Midwifery Birth Center, Andaluz Waterbirth Center, Alma Birth Center, Canyon Birth Center, Home Birth

Our Specialities: natural birth, unmedicated birth, vaginal birth, water birth, epidural assisted birth, cesarean birth, vaginal birth after cesarean (VBAC), high risk birth, induction, twins and multiples, previous miscarriage and loss, LGBTQ+ families, single parents, surrogacy, hospital birth, birth center birth, home birth