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Common Misconceptions About Doulas

  • Posted on February 25, 2016 at 12:23 am

Often times, people who have never experienced doula support have differing ideas about what it is that a doula actually does.  Sometimes, inaccurate media portrayal of doulas or other misinformation can leave people with major misconceptions about doulas and doula support.  Here are a few of those misconceptions, along with some clarification:

  • Doulas are for people who want to have un-medicated births
    False.  While many mothers-to-be who desire to have un-medicated births often look to doula support to help them accomplish their goal, this is not the primary function of a doula.  The role of a doula is to meet with mom and her birth team to learn about mom’s desires for labor, birth, and postpartum, and to help her and the birth team come up with a realistic plan to achieve her goals.  This could include discussing nutrition for a mom  who is concerned about blood pressure, discussing labor management techniques for a mom who is concerned about an impending induction, giving information about  what to expect in the event of a cesarean section, or helping the birth partner learn techniques to help mom cope in early labor.  It can also include techniques to manage labor with an epidural, as well as educating mom and her birth team about alternative options for pain management, both medically and non-medically (such as morphine, fentanyl, showering, massage, etc.).
  • Doulas mainly attend / promote homebirth
    Homebirth can be a great option for some, and as doulas, we are thrilled to attend ANY birth with a mama who is being supported completely in any birth setting – whether at home, in a free-standing birth center, or in a hospital.  For most doulas, however, the vast majority of our clientele (depending on the area and demographics of that area) are planning to deliver in a hospital.  Doulas in your area will likely have broad knowledge of the labor & delivery policies in most of the local hospitals and may take time to discuss those with you, or can give you ideas of questions to ask your provider in order to learn more about the policies of your chosen birth location.
  • Doulas are basically like a midwife, right? 
    Doulas and midwives may be similar in that they both understand birth to be a natural body process, however they have very different roles.  Unlike midwives, doulas are not medical professionals.  We offer prenatal, labor/birth, and postpartum support in non-medical ways only (most of us.  There are doulas who are also Registered Nurses, and may offer limited clinical support because of their medical authorization to do so, however most doulas DON’T. Clinical support would be outside our scope of practice).  A doula may offer massage in labor, or teach your partner a technique like using a rebozo, or perhaps a suggest something like a miles circuit for a longer labor, but they will not give medical advice, nor will they perform any clinical tasks.

    • So then, what does a midwife do?
      Similar to an OB, a midwife is a medical professional.  A midwife would be your primary care provider, like an OB would, and would be the person you would see for regular prenatal checks.  During your pregnancy, they will monitor baby’s heart rate, take your vitals; they may prescribe supplements, give you dietary information, answer your medical questions about your pregnancy, etc.  During labor and birth, the midwife manages your labor.  They may monitor baby’s heart rate and other signs in labor, and they are the medical professionals responsible for suggestions such as IV or any medications/herbs/supplements if necessary, pitocin administration in postpartum (if necessary), cord clamping, APGAR scores, etc. Your midwife keeps your medical records throughout your care (which is typically through pregnancy, birth, and around 6 weeks postpartum) and also carries liability for the safety of mom and baby.  If you are seeking medical advice during pregnancy/labor/postpartum, you would typically ask your midwife or your ob (whoever your primary care provider is for your pregnancy), and most doulas would point you in that direction.
  • Doulas are an advocate for moms
    Actually, doulas will help to empower moms to advocate for themselves.  While it would be outside the scope of practice for a doula to make decisions for a client, or to argue with anyone on the birth team, we may ask mom “do you have any questions?” or “how do you feel about what is being suggested?” “Would you like your provider to explain alternatives to you?” or something along those lines.  These kinds of questions help mom to find her voice and help her to feel more in control of her own labor.  It is, afterall, her birth experience.  In addition, doulas are birth professionals who  may be asked to leave by hospital staff for any reason.  We  are there, not to interfere, but to enhance mom and partner’s experience.  Mom’s may choose to ask their birth partner to advocate for them, however, which is perfectly acceptable.  The doula then can also empower the birth partner as well as the mom with questions and information to help them better communicate with their birth team.
  • I have my husband/partner, so we don’t need a doulaThat’s great!  Moms who are supported well in labor often have better postpartum outcomes and have happier birth experiences overall.  Sometime it is the birth partner who benefits the most from hiring a doula.  Here are a few reasons from the perspectives of some birth partners:
    – “I appreciated the knowledge base that our doula brought to our team.  I learned so much in our pre-birth meetings, and even learned about things I wouldn’t have known to ask about.”
    – “Having a second person who was available to support my wife took a lot of pressure off of me.  When she had to go in for testing and I was stuck at work, I was relieved when our doula offered to meet her there so I could finish my work and my wife was still supported.”
    – “We had induced labor with pitocin, and we were concerned with our baby’s heart rate while the pitocin was running.  When we were both too tired to stay up and watch the monitor (so that my wife could re-position if  baby’s heart rate looked off), our doula took over and woke her only when she needed to change positions.  It allowed us to  take shifts so that I could be rested, and that made it possible for me to be more of the support person that she needed me to be when we were awake.”
    – “There were a couple times where I felt overwhelmed, both during the end of the pregnancy, and during labor.  The support of our doula was so awesome, because she gave me the room to take a step back when I needed to.  She completed our team, and we both felt more secure having her with us.”
    – “From the first prenatal appointment, I felt like a huge weight had been lifted from my shoulders thanks to our doula providing encouragement and knowledge about what we were preparing for. She quickly became a vital part of the pregnancy, answering all of our “first timers” questions at all hours of the night and day and always helped us feel more comfortable.”
    – “In the delivery room, our doula was awesome; helping with managing family and friends, assisting us in communicating with the nurses, and most importantly helping me figure out how to help my wife. She reassured me when I would get worried about my wife or wondering what was “normal”. All in all, she was a huge part of our pregnancy and birth and we didn’t even have to question hiring her for our second pregnancy.”

Do you have more questions about doulas?  Visit the “Questions?” section of this site for more information.