May 27th, 2021

Expecting a baby? Doulas support your comfort, safety and health

You’re having a baby — fantastic! Your pregnancy is one of the most important times in your life, and you’ll want all the help you can get to make sure the experience is as healthy and rewarding as possible.

A doula can help with that. Doulas are trained maternal health professionals who serve as pregnancy coaches before, during and after childbirth.

A doula or a midwife?

Doulas are sometimes confused with midwives, but there are major differences. Certified nurse midwives have extensive medical training. They provide clinical care to parents and babies before, during and after labor and delivery. Midwives may offer primary health care services to women from adolescence to menopause.

Doulas, on the other hand, are non-medical professionals who focus on the needs of pregnant parents and help them have safe and memorable pregnancies.   

How a doula can help you

A doula focuses on your needs, coming alongside friends, family and anyone else who may be supporting you. Your doula can give you more experienced assistance than a spouse or partner may be able to offer.

A doula tailors services to your needs and the needs of your family. A doula can offer emotional support; share the latest information about pregnancy, labor, birth, breastfeeding, and self-care; and coach you and your family about caring for a newborn. A doula also can help you get the services you need, such as prenatal and postpartum appointments with your health care provider.   

Benefits of doula services

Working with a doula can help you in many ways depending on what you want and what you need.

Support, encouragement, relief

Doulas can provide the help that used to come from extended families who surrounded and supported pregnant family members.

For example, a doula can talk with you about what to expect during your pregnancy and help you plan your birth. The doula can give you advice about following your provider’s direction. During labor, a doula can be there to massage your body, help you with breathing, and give you emotional reassurance and encouragement.

Advocacy

At times it can be difficult to talk with your provider about your questions and concerns. Doulas have experience with mothers’ needs during pregnancy, and your doula will get to know you and your unique situation. Your doula can advovate for you and help you communicate clearly with your provider.

If you want a more natural birth, your doula can help you avoid unwanted interventions. If you have a history of trauma or are fearful about giving birth, a doula can stand by you and offer support without judgment or bias.

Better outcomes

Studies show that support from a doula is often associated with decreased use of pain relief medication during labor, reduced incidence of cesarean sections, decreased length of labor and a drop in negative childbirth experiences.

According to a study published in the Journal of Perinatal Education, complications to mother and child and low birth weight were reduced when a pregnant mother received doula services. A study in the journal Birth showed rates of preterm and cesarean births were lower in pregnant women who worked with a doula.

How doulas specialize

When you choose a doula, consider which type is best suited to your needs. Doulas are trained to guide you through pregnancy and childbirth. But a doula can’t and shouldn’t replace your primary care provider.

Doulas may specialize as birth doulas, assisting during and after childbirth, postpartum doulas, helping after childbirth, or antepartum doulas, focusing on high-risk and difficult pregnancies. They also may be certified in specific areas of expertise, including breastfeeding, childbirth support, birthing techniques, and pre- and post-natal care.

A birth doula provides emotional and physical support during pregnancy and birthing. These doulas work as part of the birth team, and are there to assist and support, but not to replace, helpers and partners.

A postpartum doula provides families information and support about infant feeding, emotional and physical recovery from childbirth, soothing infants and coping skills for new parents. A postpartum doula might help with housework, assist in preparing meals, and help involve older children in the pregnancy and childbirth.

An antepartum doula helps with high-risk or difficult pregnancies. Often this includes women who are on bed rest during their pregnancy. An antepartum doula will cook, get groceries, run errands and support the pregnant mother while she is on bed rest. Their care ranges from knowing what foods and diet the expecting mother needs to providing emotional support and reassurance.

How to hire a doula

If you’re interested in working with a doula, start with your health plan. Some plans, including Tufts Health Together (a MassHealth plan), provide doula programs to their members free of charge. Tufts Health Together members can work with a doula before, during and after delivery. If your plan covers doula services, it can tell you how to contact the doulas your plan covers.

If your health plan doesn’t cover doula services, you can hire a doula directly. Doulas charge either by the hour or by birth, and their rates vary.

To search for a doula in your area, you can:

• Ask your health care provider or friends who have worked with a doula for recommendations

• Search a doula directory, such as doulamatch.net

• Search dona.org for a list of doulas certified by Doulas of North America International, the largest doula training organization in the U.S.

• Do a Google search for local doulas

Once you find doulas near you, give them a call. Meet and talk to see if they are a good fit for you and your family. When you hire a doula, make sure the doula provides the type of services you want and charges a rate you feel comfortable with.

No matter how you find or hire your doula, the extra help and support during your pregnancy can help you have a healthy, happy and positive birth experience.

Tufts Health Plan is one of the few health plans in Massachusetts to offer coverage across the life span regardless of age or circumstance. This coverage includes Medicaid/subsidized, commercial and Medicare health plans. To learn more, visit tuftshealthplan.com.