Doulas, Deliveries & Decisions

I gotta be honest here for a minute… This post isn’t just written for you readers. That’s right, I got selfish. As a women’s health therapist I work with pregnant clients all the time and the first time I heard of doulas I had absolutely no idea what that meant. So when I had the opportunity to meet a doula and learn about them, I jumped at the chance! Emily Potter Wannenburg and I were introduced through a mutual friend who knew we would nerd out and bond over our love of helping women. For this interview, Emily and I grabbed lunch to discuss all things Doula. 

First things first. What in the world is a doula? 

A doula is a layperson who lends support to an expectant mother and/or a couple from the time the contract is signed, through pregnancy, labor & delivery, and into postpartum period. 

In Emily’s words, “A doula is your personal 411 of pregnancy and delivery. As a doula, you’re the tour guide or the flight attendant at birth. The dads are often watching to see my response and so my goal during labor and birth is to keep it calm and keep the energy low and then I’m a source of information, of what’s happening and what’s going to happen next. If things divert from the original plan then I can be the source of information for the partner who might be left standing there. “Ok Joe Shmoe, this is what’s happening with mom, this is where she is going, this is where you’re going to go.” 

What's the difference between a doula, midwife, and OB?

The most important differences to keep in mind are:
 - an “OB” (i.e. obstetrician) is a medical doctor who is trained to care for a woman throughout her pregnancy and to deliver the baby
 - a midwife is a medical professional (who may or may not be a nurse) who is trained to deliver the baby
 - a doula is a lay person there to support you, who does not deliver. This person may have a medical background but they do not act as a medical health care provider when they are a doula. 

Well if a doula isn’t going to actually deliver your baby then what do they do? 

A doula provides a momma to be (and her family!) with emotional, physical, and informational support throughout pregnancy. They help you to understand the changes your body is going through. When it comes time for the big day they are there to help you make the best decisions for you and your growing family. After delivery, they can help you better bond with baby, such as assisting with breastfeeding and by making sure you are cared for. 

Essentially they help you to be more confident throughout the whole process by supporting and educating you - which is no joke because confidence going into birth is a strong predictor of having a positive birth experience! 

Research has actually identified that "Women who report confidence during labor have a greater sense of control, feel more informed in making choices, and perceive their labor and delivery as less painful and more positive. Conversely, fear and anxiety during labor and childbirth are associated with increased feelings of pain and need for medical pain relief, prolonged labor, and possibly an increased risk of emergency cesarean section."(

Research has shown that a woman’s involvement in decision making during childbirth, having information about available options, feeling supported by caregivers, and fulfillment of expectations all contribute to confidence and positive birth experiences. Doulas can help with that, and working with a doula has actually been shown to decrease rates of C-section and use of pain relief medication.

A doula is not going to tell you how you must have your baby. “A great doula has experience but realizes that it’s not about her, it’s about the mother and their birth focus.” Their role is to help you to have the best birth experience possible, whether that’s through a scheduled C-section or an unmedicated home water birth, and everything in between. They will spend time talking about what you would like for your birth because this is a day you’re going to remember. 

Emily and I both hear lots of birth stories - both good and bad. I can tell you that every time I ask a woman about her pregnancies and deliveries I hear purely about the experience. Rarely does anyone remember what degree of tearing she had or how many stitches they required. But you can hear it in the way a woman describes her births whether she felt supported or pushed around. 

A doula may be as involved or not-involved throughout the pregnancy as you decide. For example, Emily’s “mommas” (she doesn’t call them clients!) have 24/7 access to her via calls, texts, and email from the time they sign the contract, usually 6-8 weeks pregnant, up till after the birth. She also attends at least one care provider appointment with her mommas. Her mommas get access not only to a support person but with her almost 30 years of experience and community network she knows who in Jacksonville will help make your VBAC (vaginal birth after cesarean) dream much more likely. 

One huge benefit of working with an experienced doula in your community is that they have the connections. They know which midwives will drive out for a natural water birth at home, who will honor your intention to have a vaginal delivery after a c-section, and who might NOT be a great match for your birth plan. Currently, in healthcare, it’s tough to choose a qualified health care professional based on objective measures and numbers… it’s mostly done through word of mouth. Unlike Gossip Girl, your OB should not be picked just because your best girlfriend used them. That’s a whole topic on its own (I’ll post it next!).

Ok, that’s nice but what if you have a partner/spouse/best friend/mom who’s going to be there for you during the delivery?

Well, let’s hope this doesn’t happen… 

Or this… 

All kidding aside though, Emily actually brought up this difference saying “A doula does not replace a partner or family. Those people know you better than anyone else in the world. But a doula knows labor and delivery better than your partner, so together we can make an amazing team to help you through this.” 

In fact, there’s been plenty of times where she actually “doulas” the partner, reminding them to eat, drink, use the bathroom, and even rest. “I’ll tell them right up front that if there’s a long labor, I will send off the dad to rest, because after the delivery you’re going to need to rest and he’s going to be with the baby.” Not only does she make sure that everyone is at their best, but she is there to be helpful and work together as a team with your family and care providers. When that happens, the moms leave feeling good about the choices they make regardless of what happens during that birth. You want to make educated decisions and not to have regrets. 

What kind of training does a doula have?

Doulas are not licensed nor degreed professionals. Training typically consists of a long weekend. In the training, you learn the physiological progression of pregnancy, birth, and postpartum. You’ll touch on things like coping mechanisms, breastfeeding, childbirth education, pain control, and what your role is as a doula. After the course, there are a certain number of births which a doula needs to “attend” to before becoming certified. There are a number of different certifying bodies such as DONA which run the courses, certify, and offer continuing education for doulas.

Emily goes on to say that “To remain certified you have to recertify every few years, but you don’t have to be certified to work as a doula. It shows another level of commitment and of holding yourself to another standard. It also keeps you accountable. Information is always changing so you need to find someone who is always studying and is a lifelong learner.”

How do you find the right Doula for you? 

Doulas come in all levels of experience, just like in any profession. 

1. Start by finding doulas in your area. A couple links which may help you:
   - Google Yes that’s right, Google and FB can help you find doulas in your area! 

2. Call and talk with this doula. The two most important questions to start with:

  • Are they available when you are due? It doesn’t matter how amazing the doula is, if they are already booked with clients or can’t be there, then you need to find someone else
  • Price: doulas can set their own prices, which most often vary on the amount of experience they have and what they include in their services. Remember, a doula with 30+ years of experience who is available 24/7 is probably going to charge differently than someone with 5+ years of experience. Emily knows many doulas in the area and will happily refer a momma over to a fabulous doula within her price point.

3. If availability and price both work for you then the next biggest question to answer is: Do you like this person? Seriously ladies, this person is going to probably be in your home at some point, they will meet your family, and they are going to be present for one of the most memorable moments of your life. It’s best to speak with a few different doulas (within your budget and who are available!) to see who you have the best connection with.

4. And finally, meet with this person! Before you sign the contract be sure to get some face to face time, ideally with you, the doula, and feel free to bring along your partner, friend, or mom. If the birth doesn’t go according to plan you could be spending quite a bit of time with these people - make sure you are comfortable with that! This is also the time to discuss any questions you may have about the contract.

It was an absolute pleasure to chat with Emily. I left with a much better understanding of how doulas can support expecting mothers. Do you have any other questions about doulas? Comment below!