There are many people who can be involved in your baby’s birth, from your partner, friends and family to dozens of care team members who are with you every step of the way. But there is another person you can choose to support you: a doula.
Below we explain the role of a doula, the common types of doulas, the benefits of their services in and out of the delivery room, and how to find one if you’re interested.
What is a doula?
A doula is someone trained to provide physical, emotional, and informational support before, during, and after a one-on-one health event. Most often, doulas help expectant parents prepare for and transition to childbirth.
What does a doula do?
What a doula does can vary. Many fertility members describe their services as “full spectrum,” meaning they can help with everything from conception and pregnancy to labor, delivery, and the postpartum period. Other doulas specialize in certain parts of that spectrum.
It is important to note that although doulas are professionally trained, they are not licensed medical professionals; they cannot give a diagnosis, second opinion or medical advice. Instead, their focus is helping you get as much information as possible, then supporting and advocating for the choices you make using that information.
Types of doulas
Prenatal (pregnancy) doulas
Prenatal doulas work with people who need extra help during pregnancy, mostly because of pregnancy complications. Antepartum doulas specialize in providing emotional and educational support to help manage the stress of a high-risk pregnancy. For those with Medicaid coverage, prenatal doula support is covered.
Birth doulas are what most people think of when they hear the word “doula.” Birth certificates are usually covered by Medicaid insurance and some private insurances. For those without insurance coverage, the cost is negotiated directly with the doula or their organization.
Birth doulas help people prepare for labor and provide ongoing support throughout the labor and delivery process. If you choose to work with a birth doula, you’ll generally meet with them before your due date to create your birth plan, which is a written document detailing all of your preferences for the big day. You can provide your birth plan to your care team as soon as it is ready, and during labor your doula will help ensure it is followed as closely as possible.
This is one of the main forms of support a birth doula provides: communication. As your personal advocate, it’s their job to make sure everyone in the room is on the same page as you and that you have all the information you need to make informed decisions about your job.
The rest of the support that a birth doula provides is mostly emotional and physical. They will of course encourage you, but they can also help you manage your labor with non-medical pain relief techniques such as guided breathing, massage and position changes.
Doulas who specialize in the postpartum period can be especially valuable to new parents. Like fertility doulas, they can help you with relevant, evidence-based information. During the postpartum period, a doula can be helpful in navigating topics such as postpartum recovery and bonding with your baby. Many postpartum doulas are also lactation consultants, so they can help you get started with breastfeeding. Again, postpartum doula support is covered for those with Medicaid coverage.
Other types of doulas
While doulas are most often part of the pregnancy, labor and delivery and postpartum experience, some help people when they are trying to conceive or after a loss.
For example, fertility doulas support people in the process of trying to conceive and can be especially helpful for those who may be experiencing signs of infertility, and miscarriage doulas help women and their partners through pregnancy loss.
The cost of these other types of doula services are not covered by Medicaid and are usually not covered by private insurance.
What is the difference between a doula and a midwife?
There is a big difference between a doula and a midwife. Doulas can provide many different forms of support, but again, they are not licensed health care professionals. So they can’t actually deliver your baby or provide other direct forms of care, but a certified nurse-midwife can.
Research shows that ongoing support during labor and delivery, such as that provided by a doula, can have positive effects for mother and baby. They can include:
- Higher rates of birth satisfaction – A large part of a doula’s job is to make sure that your wishes and feelings are respected during labor and birth. This type of advocacy and support often leads to a happier, more fulfilling birth experience.
- Lower rates of medical intervention – For some women, a doula’s presence, support, and focus on non-medical pain management reduces the need for pain medication. In some cases, pain medications can interfere with contractions, so using less can reduce the chance of needing a medically assisted vaginal delivery (such as a vacuum or forceps) or a C-section.
- Lower maternal mortality rates – Studies show that women of color in the US, especially black women, have a higher risk of pregnancy complications than white women. Meanwhile, women of color are also less likely to receive all the care they need from their care team. Having a doula present during labor and delivery can help offset these factors.
How to find a doula?
Many doula certification organizations have tools on their websites that allow you to search for doulas by location, specialty, and other filters.
But depending on your insurance plan, your provider may specify which doula services are covered. For those with Medicaid in Minnesota, for example, the state health department maintains the Minnesota Doula Registrywhich includes lists of Medicaid-enrolled doulas in the state and their national certifying organizations.
Healthcare companies often work with local doula organizations. At HealthPartners, we connect our Minnesota program members with Doulas through everyday miracleswhich is headquartered in Minneapolis.
Is a doula covered by insurance?
As we mentioned earlier, some insurance plans cover doula services. Coverage often includes emotional and physical support before the birth, during labor and delivery, and the postpartum period.
HealthPartners MinnesotaCare and Medicaid members can work with a birth doula for free. If you are a member of HealthPartners MinnesotaCare or Medicaid, you can call 866-885-8880 (TTY 711) to start your free doula process. Volunteer doulas are also available at some of our birth centers.
In cases where insurance does not cover the services of a doula, it is still possible to have one involved in your pregnancy, labor and delivery. You can make support and payment arrangements directly with the doula or team of your choice.
Your birth, your path
A doula is much more than a breathing coach and another source of encouragement for your big day. A doula can help you manage your pregnancy’s health, ensure your birth experience is as close to your ideal as possible, and support you through the first few weeks postpartum.