What Can a Doula Do?

Is it worth it to have a professional support person on hand for a birth?

Welcome to Did It Work?," a semi-regular feature where I discuss something we bought or did for the baby and whether or not it worked. Today: Hiring a doula.

Most of these features about whether baby-related things were worth it end with me shrugging and declaring that it’s hard to determine the efficacy of anything in an entropic universe. Right now, for example, we’re trying to figure out how to get the baby to sleep for longer periods of time and I have absolutely no idea if all of the energy we’re putting into it is making any difference at all or if she just naturally would have gotten slowly better at sleeping no matter what we did. Impossible to say. Are we making it worse? Probably not. Right?

However, today’s subject is easier for me to assess. We hired a doula to help us prepare for, get through, and recover from our daughter’s birth. There is no question in my mind that it was absolutely worth it, I’d do it again if I had the decision to make again.

For the unfamiliar: A doula is a “non-clinical birth professional”-- in practical terms, a person who provides emotional support and advocacy for the patient throughout the birth process. Doulas don’t perform or assist in medical procedures, they’re more like knowledgeable advocates.

I’d heard great things about doulas before thinking seriously about having a child, like this piece from 2018 that touched on how the presence of doulas led to dramatically better outcomes for Black mothers in the American South. This piece from the Washington Post from the following year mentions the correlation between doulas and lower rates of C-sections, shorter labor, and fewer birthing complications. The most recent numbers I could find on how many expecting mothers hire doulas are from 2012 and estimate that 6% of mothers use doula services; I am going to take an educated guess here that the number has grown since then, since as of last year, use of a doula is such a well-established good move that some advocates were fighting to get doula services covered under Medicaid.

Hiring a doula was one of the first decisions around the pregnancy that we made, after deciding that we were going to let the baby’s sex be a delivery room surprise.

I found our doula through the very scientific process of typing “doulas Los Angeles” into Google and finding one named Kayleigh who I liked and had good reviews from other mothers. (I later learned of other ways to look up available doulas, like through DONA and by asking for recommendations from your OB-GYN, but I lucked out with my throw a dart at a dartboard method. I also later learned that Kayleigh had worked closely with my doctor in the past and that the two got along like pals, which was also lucky.)

Kayleigh’s website and overall philosophy seemed in line with what I’d hoped for– earnest and reverent for the whole process in a way that’s sometimes difficult for me, slightly crunchy yet self-aware. I wanted somebody who could help me appreciate pregnancy and birth as a miracle who also understood that both were objectively insane. This was in early 2021 and thus still in the pre-vaccine phase of the COVID pandemic, and so our introductory conversation was to be held over the phone, shortly after having my pregnancy confirmed by my OB-GYN.

But on the day I was scheduled to have the preliminary call with our doula, I woke up pretty sure that I’d miscarried (everything was fine; sparing you the goriest of the details, it is possible to bleed during early pregnancy for reasons that are never explained and that apparently have no impact on the outcome of said pregnancy). I texted Kayleigh in tears to let her know what was going on and that we’d have to reschedule, and she called me to talk me through it. On the telephone! Like we were living in olden times.

We hadn’t signed anything, agreed to anything, or even really talked beyond email, and this person was taking valuable time out of her day to help a sobbing stranger work through her fear of pregnancy loss. It was such a meaningful act of kindness that I’m tearing up thinking about it. We hired her that day, after a nerve racking appointment at the doctor ended in good news.

The first thing she said to me when we met in person was “Here, I brought you a present for your taint.” It was a pack of Rachel’s Relief gel packs. She spoke frankly about everything that was probably about to happen to my body, refreshing honesty in the exhausting pregnancy discourse, a world of soft-focus obfuscation and gross out Just You Wait scares that often, for some reason, tried to be cutesy.

Our doula was a great resource throughout my pregnancy. She held a couple of three-hour in-person sessions where she walked us through what to expect during labor and the postpartum period, including holding up a model of the human pelvis that had little hinges in it so that she could show us how the pelvis adjusted to a baby passing through the birth canal and a tool that showed us exactly how much the human cervix dilated during labor (10 cm is a lot uh bigger than I thought it was). Both of those things were terrifying, but useful in driving home to a male partner how gnarly birth is. Did our in-person sessions contribute to my husband being more proactive than most about taking on more responsibilities after Juniper came along? I can’t say for sure that it did, but it certainly didn’t hurt.

She was there to text with whatever updates or questions I had. I’m sure there were moments when I was acting nuts, but always felt like she was on my side, even when she was talking me down. More broadly, it was useful to have a person so easily accessible who had up-to-date information about pregnancy and birth practices– experience that parents and other relatives simply don’t have. I don’t think breastfeeding would have gone as smoothly as it did if not for her.

Kayleigh helped us come up with a “birth plan,” and, when things weren’t going according to plan (because they never do), helped us adjust the plan. She showed up at the hospital with an armload of electric candles and a portable speaker and I think– although I’m not sure because the pain obscures my memory of the hours between 8 pm and 8 am the night before Juniper was born– I think she held me up while I was showering during labor? Maybe she handed me a towel?

We had her do some postpartum doula work for us, which involved her coming by the house and making sure I was as comfortable as I could be during a very uncomfortable time. We’re still in touch. I just sent her a photo of my daughter dressed in bunny ears, her little face in a dour expression reminiscent of a Civil War-era spinster, sitting on the lap of an adult dressed as the Easter rabbit.

Saying we hired a doula “for the baby” is a bit of an inaccurate characterization. Doulas are there to support the person giving birth, but a healthy mom means a healthy baby, so, in a way, those cooling pads for my ravaged taint indirectly benefited my child.

Doulas: do they work? Absolutely.

Image via Shutterstock