Types of Doulas and FAQ

By: Gloria Miles

You're pregnant and you've just heard someone ask if you are hiring a doula. But you're sort of confused about what a doula is, what she does, and what she doesn't do. And maybe there's more than one type? Is that true? It can get confusing! Hopefully this blog post will help differentiate between the types, figure out which kind you'd like and/or need.

[Note: I use the gender pronoun "she" throughout the post, though men and/or those who do not identify as female may also become doulas and midwives. This is for simplicity's sake and not to be exclusive.]

 

richmond doula member and birth doula heidi blanton-pohl at embrace birth center, photo by joy kraynak of joyful birth services

richmond doula member and birth doula heidi blanton-pohl at embrace birth center, photo by joy kraynak of joyful birth services

So let's get started!

First, let's talk definitions:

Doula: comes from the Greek word that means "a woman who serves." It is now used to refer to a person trained in providing emotional and physical support during a woman's pregnancy, labor, birth, or postpartum period. She may or may not be certified. She may work autonomously, as a part of a small group, or within a doula agency.

Midwife: A midwife is NOT a doula. She is a healthcare professional who provides actual medical care and gives medical advice to women during their pregnancy, labor, birth, and postpartum periods. She may work in a hospital, clinic, or home setting. Some midwives offer doula or monitrice services to women as well.

Monitrice: She blurs the line between doula and midwife. She provides emotional, informational, and physical support, but can also do certain tasks like monitor blood pressure or perform vaginal exams. She is NOT the pregnant mother's care provider.

On to some frequently asked questions about doulas: 

Is a doula like a midwife?

No. A doula only provides informational, physical, and emotional support. She does not give medical advice nor does she perform in any clinical capacity like take blood pressure, monitor fetal heart tones, do vaginal exams, etc.

When do I hire a doula?

That really depends on when you need help.

  • Doulas can be hired for the pregnancy. Typically, they charge an hourly rate. This option may not come to light as an option until she is needed.
     
  • Doulas can be hired for the birth. Most women wait until about the second trimester to hire a doula, but it's never too early to start forming a relationship! This kind of doula typically charges a flat rate.
     
  • Doulas can be hired for the postpartum period. She typically charges an hourly fee.

What does a doula do exactly?

  • She gives informational support. This is different than medical advice. She gives you lists of resources, shows you good books to read, points you into the right direction for childbirth education classes, etc. And she can point your partner to some great resources as well!
     
  • She provides emotional support. She is absolutely the person you call when you feel upset, scared, or anxious. She helps you with birth affirmations. She reminds you of how strong you are in labor. And she is the person giving you a break during the postpartum period. She is also emotional support to your partner by giving him or her plenty of affirmations, advice, and breaks when needed.
     
  • She provides physical support. She gives massages, foot rubs, provides counterpressure, and more during labor and delivery.

Postpartum and antepartum doulas provide emotional and informational support as well, and they also help with more "common" things like: laundry, dishes, meal prep.

 

Is she only for natural births/hospital births/home births?

Doulas can help in any type of birth. The beauty of a doula is she supports you in any way that you want.

I have a midwife/awesome partner/sister/friend...do I really need one?

I'm going to be slightly controversial and say, no...not everyone needs a doula. However, if you feel like you want one, a doula is a magnificent addition to your birth team. I have yet to hear a woman wish she hadn't hired a doula for her birth or postpartum period.

Also, you can have a doula and your amazing partner, midwife, sister, or friend with you. A good doula will only enhance your experience; she will never replace anyone on your birth team.

Aren't they expensive?

Yes and no. Doulas cost anywhere between free (some student doulas work for free until qualified. Or doulas who participate in special programs, like for military or low-income families) to $2,000. In Richmond, the range seems to be about $500-900 for a birth doula. Postpartum doulas seem to charge $20 to $35 an hour, with hourly packages available that can help with costs.

Some doulas charge extra should your birth exceed a certain amount of hours (for example, an extra $250 if your birth exceeds 18 hours). However, most doulas charge a flat fee for births.

Are they all certified?

No, plenty of wonderful doulas do not have certification for one reason or another. However, most are certified through an organization.

Who are the organizations?

There are so many! DONA, CAPPA, ToLabor, ProDoula, and plenty of smaller ones. Look them up, read their philosophies, and ask around. You may find some more compatible for you than others.

Richmond doula member and postpartum doula amy washington with a new family, photo by joy kraynak of joyful birth services

Richmond doula member and postpartum doula amy washington with a new family, photo by joy kraynak of joyful birth services

You said there were more than one type of doula. What kinds of doulas are there and what are they for?

  • Labor/Birth doula: She provides some support (usually through phone calls and emails) prenatally. There is a visit or two between both of you. She is there for you from the moment you call saying you think you're in labor, through the labor, and for a few hours postpartum. There is typically one or two postpartum visits
    .
  • Postpartum doula: She provides support during the postpartum period; usually within the first six to twelve weeks, but a lot of times beyond that. They provide care in an hourly fashion. Things within their scope is breastfeeding support, sibling care, light housework, quick errands, helping mom sleep, giving her time to bathe, caring for the newborn so that mom can get some time to sleep, etc. Postpartum doulas are available for day or overnight services. Overnights may include some quiet chores, feeding support, guidance on newborn care and helping everyone get a good night's sleep. 
     
  • Antepartum doula: She works for you, typically during high risk pregnancies. Besides emotional support, she works like a postpartum doula in that she can provide sibling care, light housework, meal prep, running quick errands, and more.
     
  • Bereavement doula: She provides support during the loss of a baby at any stage of pregnancy. She also supports the mother if the decision has been made to carry a baby with a fatal diagnosis to term, if there is any anticipated NICU stays, and understands how to support subsequent pregnancies after a loss.

    There is a doula for all of the stages and events within motherhood. Richmond Doulas proudly holds members of each type. Please contact us for more information on how to find the perfect doula for you and your family.

 

Gloria Miles is a Navy veteran and mother of 3. She wears many hats as a doula, certified aromatherapist, and student midwife. She is currently working towards obtaining a Bachelor's in Healthcare Management. When she is not blogging, she enjoys reading, knitting, hiking, and mud runs. 

A version of this blog post was originally posted on simplemiracles.org and is shared with permission of the author.

Edited to add: Bereavement doulas and fixed grammatical errors.

richmond doula member and postpartum doula, breastfeeding peer counselor and cpst, mcrae Brittingham with a new family, photo by joy kraynak of joyful birth services

richmond doula member and postpartum doula, breastfeeding peer counselor and cpst, mcrae Brittingham with a new family, photo by joy kraynak of joyful birth services