By Ann Grauer, President, DONA International

It’s no secret that doctors and nurses are overworked, particularly those in the baby business.

Even if other patients, shift changes, paperwork, blood pressure checks and fetal heart rate monitoring don’t get in the way, doctors and nurses—even midwives—must focus on the healthand well-being of mother and baby. The emotional and non-medical needs of the woman in labor come second. Sometimes they don’t get much attention at all.

And while most women are surrounded by their partners, families or friends during labor, this good intentioned group can only do so much.

That’s where doulas come in. They have surged in popularity over the past decade. Most likely you know someone who has worked with one. But if you’re like many expecting families, questions remain: What exactly are doulas? How do they help? And how can you find the right one?

A doula is a woman who provides support before, during, and after childbirth. Unlike a doctor, midwife or nurse, she is not a medical practitioner. Instead, her job is to focus entirely on the non-clinical side of childbirth. She provides educational, emotional and physical support for the mom. There are two kinds of doulas: birth and postpartum. Some women hire both, and some just hire one, depending on individual needs.

During labor, birth doulas provide around the clock care, comfort measures such as breathing, relaxation, massage and positioning, and an objective, calm perspective. They also help educate families about their options during labor, guide partners to participate with confidence and at their own comfort levels, and enhance communication between the laboring mother and her medical professional. She will typically meet with the family one or two times prior to the woman’s due date and will be available to answer questions by phone.

Postpartum doulas, on the other hand, make life easier for the new mother and family in the first weeks after childbirth. In addition to providing emotional support, they help new parents become comfortable with newborn care and infant feeding. They can also lend a hand by cooking a meal, throwing in a load of laundry, spending time with siblings, and performing other household organization tasks.

Aside from helping to make childbirth and its aftermath as positive as possible, doulas have been proven to improve obstetric outcomes. Studies show that when they assist with childbirth, women have shorter labors, fewer complications, require less pain medication, and have lower incidences of cesarean sections. As a result, women are more satisfied with their birth experiences, suffer less from postpartum depression, and have a stronger bond with their partners and babies.

Babies also benefit. In fact, fewer babies are admitted to special care nurseries, evaluated for infection, or have longer than normal hospital stays when doulas are involved.

So how can you find the right one for you?

Some work for hospitals or serve as community or hospital volunteers, so it’s worth checking with your doctor. For the most part, though, expecting families hire them privately.

Hiring a doula is very personal. While there are a number to choose from, they don’t all have equal qualifications. So it’s important to ensure that your’s has received formal training and/or certification.

Ask the questions when interviewing any doula:

• What training have you had? (You should verify certification with the organization.)
• Do you have one or more backup doulas for times when you are not available? May we meet her/them?
• What is your fee, what does it include, and what are your refund policies?

Specific questions for interviewing a birth doula:

• Tell me/us about your philosophy about childbirth and supporting women and their partners through labor.
• May we meet to discuss our birth plans and the role you will play in supporting me/us through childbirth?
• May we call you with questions or concerns before and after the birth?
• When do you try to join women in labor? Do you come to our home or meet us at the place of birth?
• Do you meet with me/us after the birth to review the labor and answer questions?

Questions when interviewing a postpartum doula:

• Tell me about your experience as a postpartum doula.
• What is your philosophy about parenting and supporting women and their families during postpartum?
• May we meet to discuss our needs and the role you will play?
• What different types of services do you offer?
• When do your services begin postpartum?
• What is your experience in breast-feeding support?
• Have you had a criminal background check, a recent TB test? Do you have current CPR certification?