Doulas 101

What do these advocates do for parents during birth?


Meg Shreve


Sarah Rountree wasn’t sure what to expect with her first delivery. "I was a nervous mom," she says, recalling the birth of her son, Brody.

Since she had few family members in town, the 35-year-old Lincoln Park mom hired a doula.

"Doula" is an ancient Greek word now meaning a profession of women helping women. Part midwife, part nanny, part your-mother-without-the-nagging, doulas help women through their delivery and the transition into motherhood.

While only 5 percent of women used a doula during delivery in 2002, doulas are gaining more members, more acceptance from doctors and medical proof that they are helpful during the delivery.

After an emergency Caesarean section, Rountree ended up using several rotating postpartum doulas during her six-week recovery. The doulas helped care for Brody and did household chores, allowing Rountree and her husband to sleep.

"They just came in and whipped everything into shape, but not in an intrusive way," Rountree says.

Some describe a doula as an experienced set of hands, someone to be there when the doctors and nurses can’t be.

Karen Laing, president and founder of Birthways, which helps expectant moms find doulas, says doulas are professionally trained women who provide emotional support for families.

There are two types of doulas—labor and postpartum. Labor doulas help women plan for their delivery, find answers to questions and are present for the delivery.

Postpartum doulas help new moms adjust to their new lifestyle. They guide them through breastfeeding and lighten the workload by running errands or doing chores.

Laing says it’s important to remember the role of the doula is support, not expert advice. Doulas aren’t there to teach parents how to be parents.

The cost of a doula depends on experience. Laing says labor doulas charge $350 to $1,000, while postpartum doulas run $23 to $30 an hour. Often, medical insurance does not cover these costs.

But that could all be money well spent. According to a University of Michigan study, labor doulas not only calm women, but also shorten the duration of labor. A shorter labor means less need for medical interventions such as forceps, vacuums and episiotomies. The study also showed a decrease in Caesarean sections.

Dr. Xavier Pombar, director of obstetrics at Rush University Medical Center, says he works with a doula almost every other month. Pombar sees them as valuable emotional support. His office even provides a list of doulas to patients.

"For the most part I welcome doulas," Pombar says. "Doulas can be [in the delivery room] the entire time. It can be hard for doctors and nurses to be constantly present."

Charity Cooper, a certified nurse midwife at the University of Illinois Medical Center in Chicago, agrees. Doulas’ nonmedical support does not overlap with the doctors and midwives. "We’re all here for the same purpose," Cooper says. "Women in labor need people around them and I think that’s the role the doula is now filling."

Support during delivery

"[It’s] a mixed bag of when women will call seeking a doula," says Natalie Evans, a Rogers Park resident who has been a trained labor doula for three years. Most seek a doula in the final trimester.

Addison resident Rachel Dolan Wickersham has been a certified doula for 12 years. She typically meets two to three times with a mom and dad before a baby is born.

"It’s really more of a chance to get to know each other," says Natasha Gittings of Forest Park, who has been a labor doula for eight years and a postpartum doula for seven.

Jen Small, who lives in Chicago’s Andersonville neighborhood, wanted a doula during her first pregnancy when her son, Alec, was born. The 33-year-old mom hired Gittings. "It was like having the perfect mom there. It felt like there was someone there just looking out for me," says Small.

As the due date approaches, the doula is on call until the mother goes into labor. Sometimes a doula will join the mother at her home to help her through contractions or meet her at the hospital, says Gittings.

Creating a comfortable setting is vital. "I do whatever I can do to make it not seem like a big hospital," she adds.

Finding the right one

Certification isn’t necessary to become a doula, and there are no governing bodies or licensing standards.

"It’s a buyer be aware situation," says Laing. "That being said, in my experience these are very committed women who are dedicated to and fascinated by birth."

But doulas can get formal training. The most common is certification through DONA International. Other organizations, such as the Association of Labor Assistants & Childbirth Educators and the Childbirth and Postpartum Professional Association, also offer certification.

Ask your doctor or hospital for a list of doulas. DONA’s Web site offers a checklist of questions. In general, parents should interview several doulas, ask how many births they’ve attended, what their birthing philosophy is and how long they stay after the birth.

Pombar stresses that expectant moms should make sure their doula is sensitive to their wishes. "I think the one thing [doctors] look for is that patients understand they make the decisions," he says.

Wickersham shares Pombar’s concerns.

"Ten to 20 years ago [doctors] had no idea what I was doing," Wickersham says. "Now most have a pretty good understanding that a doula is there to support the family and not to step into the caregiver’s role. A good doula learns how to do her work without interfering."

Meg Shreve is a graduate student at Northwestern University’s Medill School of Journalism and a former Chicago Parent intern. Chicago Parent intern Dani Litt and managing intern Graham Johnston contributed to this story.

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