Doula 101: What They Are & Why You Might Want One

Whether you’re expecting your first child or your fifth, you might be curious about all of the options for your care team, including a doula. While you’re not required to have a doula assist with your pregnancy, labor and/or delivery, there are plenty of reasons why you might want to look into it.

Here are the basics about doulas and how they can help you make the best decisions for your care team.

What is a doula?

Birth doulas are typically non-medical professionals trained to help support you throughout your pregnancy and during your birth. Doulas focus on the emotional and educational experience of your journey toward parenthood by providing resources that can help improve your pregnancy and birth experience.

What doulas do

Put simply: Doulas can do a lot. Here are some ways to incorporate a doula into your birth.

Doulas can work in any birthing environment. You don’t need to birth your baby at home to work with a doula. In fact, doulas actually serve a great function in a hospital setting because the hospital staff (including your nurse) will change shifts every seven to ten hours. Since most labors last longer than 12 hours, you’ll end up working with a variety of different nurses and doctors during your labor. A doula, however, will stay with you throughout. Research also shows that working with a doula can improve your labor and reduce the need for interventions.

Doulas can help your partner or chosen support person. People sometimes think that working with a doula will mean your partner, family or friends are excluded from the birthing experience. Nope. In fact, your doula is there to empower your birth partner with skills to help them support your pregnancy and labor. Think of the doula as a coach for the whole family, someone who’s there to make everyone feel supported through the process.

Doulas are your emotional support. Besides the physical support aspects like pain management, doulas are also there to help you through whatever you might be feeling. Doulas provide a space for you to ask any and all questions about your pregnancy and labor experience, and they positively reinforce and normalize symptoms, feelings and fears. They offer support without you having to worry you’re dumping on anyone.

You don’t have to have an unmedicated birth to work with a doula. In an unmedicated birth, a doula will help you with other pain management options like breathing techniques, laboring positions and movements to help labor along. All of these can improve contractions and keep you motivated as you move through your labor.

That said, if you have a medicated birth, doulas can still be helpful. They help you find positions that are hospital-bed friendly and can potentially reduce the length of your labor. Doulas can also help in a cesarean birth, mostly working as a support person in the room to help keep you and your support person calm.

A doula is not just for labor. Enlisting the help of a doula earlier in your pregnancy can help make you feel less nervous about the birth and can provide a safe space to share about the pregnancy, ask questions and feel supported. As we mentioned above, there are postpartum doulas to help you through all parts of the fourth trimester.

Doulas are resource banks, especially if it’s your first pregnancy. Working with a doula can help connect you to care providers that you really vibe with. Your doula will assist you with finding your OB or your midwife, and they can even recommend specialists like acupuncturists and massage therapists. And since they work locally and have other doula and parent connections in the area, they can introduce you to other new parents in your neighborhood.

You don’t have to be a first-time parent to work with a doula. There’s no rule that says only first-time parents deserve support! Especially if you had a previous birth experience that was challenging, working with a doula can help reframe the experience.

Keeping this long list of capabilities in mind, it’s important to know that, while doulas are expected to receive training for all types of birth scenarios, that training can vary, says Dr. Suzanne Mungalez, doula and licensed perinatal psychologist. Unlike the formalized education and certification that midwives, nurses and doctors have to go through, there’s no centralized training program for doulas.

In fact, many doulas receive their training through an apprenticeship model and on-the-job learning instead of in a formal classroom or certification program, Mungalez says. “Certification is not necessary to become a practicing doula or even to be a good one,” she says. If you keep this in mind as you start your search, it can really help broaden your list of potential doulas.

The difference between doulas and midwives

Doulas and midwives can sometimes be mistakenly roped together since they’re different from ob-gyns, but they’re also distinctly different from each other. In fact, midwives and OBs are actually more similar to each other than midwives and doulas. “It can be helpful to think of midwives and OBs as being under the same umbrella, and doulas under a completely different umbrella,” Mungalez says. One key example is that midwives can deliver babies—so if you work with a midwife, you don’t need an obstetrician as well. Doulas, on the other hand, can’t deliver babies, so you’ll need to make sure you also have a doctor or midwife as well. Here’s how Mungalez breaks down all the differences.

Midwives:

• Are licensed professionals

• Can assist with births in hospitals and birthing centers as well as home births

• Support patients medically and can perform much of the same gynecologic, reproductive and medical intervention care as obstetricians

• Don’t perform surgical or high-risk births

• Can be used in place of an OB in low-risk births 

Doulas:

• Are not medical professionals and can’t perform medical interventions

• Are trained to support people physically, emotionally, and through advocacy

• Can work with people through pregnancy, labor, delivery, postpartum and more

• Can help with non-medicated pain management

• Act as a bridge between birthing people and medical professionals

The difference between birth doulas and postpartum doulas

There are doulas for just about every major part of life (including death doulas), and there are several distinctions between birth doulas and postpartum doulas. As their titles suggest, birth doulas work with pregnant patients during the later stages of pregnancy and through labor and childbirth, while postpartum doulas help new parents with everything from baby care and feeding to light chores and meal prep during the newborn days.

Birth doulas and postpartum doulas require different training, especially since postpartum doulas need to specialize in infant care, but there are some doulas who are trained in both.

How to find a doula

There are lots of doulas out there, and some may be a better fit for you than others. Just like when you were searching for your OB or midwife, finding the right doula is going to take a bit of research on your end. But luckily, there are several places you can start your search.

The first place to start is Google—just search for “doulas near me,” and it will bring up all the applicable businesses in your area. Then it’s just a matter of scanning through each individual website, reading bios and creating a short list of doulas you’d like to reach out to. 

Another option that Mungalez recommends is to contact local doula training organizations since they often keep alumni directories and can make specific doula recommendations based on your unique wants and needs. Hospitals and birth centers also sometimes keep records of doulas they’ve worked with, “which can be nice if there are certain doulas who are already familiar with your birthing location or provider,” Mungalez says.

And if you’re looking for a doula who connects with your personal identity, there are directories for that, too. As an example, “the National Black Doulas Association is a great place to go for a Black birthing person looking for racially concordant care,” Mungalez says. There’s also the Queer Doula Network and the Asian Birth Collective. 

And sometimes, the best recommendations don’t come from an internet search. “I wouldn't neglect finding a doula through word of mouth,” Mungalez says. “You'd be surprised how many of your friends or family members have actually worked with a doula themselves!”

Interview questions to ask a doula

Finding the right doula for you is a personal experience. You’ll want someone who you feel really comfortable with. When you’re interviewing doulas, these questions can help you decide if they’re right fit for you and your family.

• Why did you become a doula?

• What sort of training have you had?

• How many births have you attended?

• Do you generally work with home births or hospital births? Which hospitals are you most comfortable with? Why? 

• Are you part of a doula collective? Do you have a go-to backup in case you’re unavailable?

• How many clients do you take per month?

• How much do you charge? What services does that include?

• What kind of specialized services do you offer?

• Do you have experience in high-risk pregnancies like mine? (If applicable)

• Are you supportive of both medicated and unmedicated birth? If not, why?

• Would you be open to supporting a cesarean birth?

• Will you support me through any decision?

For even more questions to ask potential doulas, check out our complete guide to interviewing doulas.

How much do doulas cost?

If you’re thinking that hiring a doula might be the right choice for your birth experience, your next question is probably “How much do they cost?” The answer to that may not be as straightforward as you’re hoping, since the cost of a doula depends on a few things, mainly your location and what services the doula offers. 

Doulas in larger cities are going to cost more than doulas in smaller towns. Labor doula services at Golden Gate Doula Associates in San Francisco, for example, can cost up to $3,600, whereas a doula in Carson City, NV, charges between $750 and $1,000 for birth packages.

Speaking of birth packages, since doulas work independently from any overseeing organization, the packages and services they offer can vary. Some doulas might offer one virtual or in-home visit while others might offer two or three. Some doulas may have additional training in massage therapy or acupressure or may have additional labor tools for you to use, all of which can increase the overall price. Some birth doulas will even schedule a visit or two with you when you’re postpartum. 

Most doulas will have set packages at set prices, so you’ll need to discuss with them what services they offer and what’s in the best interest of your ideal birth (and your wallet).

How to pay for a doula

Since doulas operate independently, you’ll need to pay for services out of your own pocket. If you’re looking to reduce the cost a bit, there are a couple of things you can do:

Check your health insurance coverage. Different insurance plans allow for different medical and birthing services, and some may cover some or all of the cost of a doula. Contact your insurance rep to see if your plan includes birth doula services—if it does, you’ll need to submit an out-of-network claim, since doulas don’t work directly with insurance providers.

Register for a doula fund. You can ask your friends and family to pitch in for the cost of a doula with a Babylist cash fund! These cash funds allow you to link your Venmo or PayPal account to receive money directly from your loved ones, or let them know you’d rather have cash or checks. Then you can put the money toward whatever you need—including a doula.

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