We know labor can feel daunting and overwhelming long before you ever feel a contraction.

Even after making the big decisions — Hospital or birth center? Obstetrician or midwife? — there are dozens of other details and potential scenarios to consider when making a birth plan.

For a growing number of women, the process involves deciding to work with a doula, who can then serve as an invaluable resource throughout the rest of pregnancy and as a knowledgeable support person when the big day comes.

According to a 2013 report from Listening To Mothers, six percent of mothers used a doula. Although that still represents a small minority of women, it had notably doubled from the three percent of women who reported using a doula during a similar 2006 report from Listening To Mothers.


That rise coincided with a 2012 study from Nursing for Women’s Health that found women who used doulas typically experienced shorter labors, had fewer unplanned cesarean sections and reported higher levels of satisfaction with their births.

And even the American College of Obstetricians and Gynecologists (ACOG) have recently noted that “published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.” ACOG also found that doulas are largely “underutilized” in birth settings.

So, why use a doula? 


Because “it is the team philosophy of support and encouragement that lift women up during a time of vulnerability and change,” Staci Caspers, co-owner of Midwest Doulas in Minnesota, said.

Caspers emphasizes that doulas help partners rather than serve as replacements for them.

She explains, “Many times the families have not been through a birth, or even seen a birth, we are there to ensure that ‘this is normal’ the sound you hear is ‘normal’ your wife or partner is safe, the smells are ‘normal, the monitor is ‘normal.’”

The support a doula provides typically begins the moment you agree to work together, with most being available to field questions throughout pregnancy and help with birth plans.

However, Caspers notes the type of assistance offered by doulas “stops at the medical practices.”

She adds, “It is our job to physically and emotional lift up the client and let the medical professionals do their job.”

A 2013 study published in The Cochrane Review that involved 15,000 women found those who received continuous support during labor from a person such as a doula were less likely to get an epidural or get a c-section.

However, Jenn Leonard, co-owner of Colorado Mountain Doulas in Colorado, says doulas can assist in whatever type of labor the mother-to-be wishes to have — or ultimately has.

“There are only two times a family should not use a doula. The first is if they do not want one,” Leonard says.

“The only other reason that a family should not use a doula is if that doula is unprofessional, judgmental, or tells the family she will speak for them. These situations should not be tolerated by a family. Their birth is theirs alone and they get to make all of the decisions.”

If you are considering using a doula or just want to learn more, contact one in your area to schedule a meeting.

Leonard suggests asking about the doula’s certifications and training, what would happen in the case of an emergency and whether the doula is receptive to your birth plan.

Above all else, remember a doula should be an advocate, not an intruder — so try to get a sense of whether you would be comfortable working together.

As Leonard puts it, you deserve to “own” your birth and the purpose of a doula is to help you do that.