What do Doulas really do?

Throughout and beyond the nine months of pregnancy, doulas aid women by offering emotional, physical, and informational support. There are multiple proven health benefits to using a doula and yet the use of doulas is limited in the US, particularly amongst Black mothers.

Women often hire a doula during their pregnancy as a personal resource guide and to discuss birth plans. With the help of a doula, mothers can prepare for whichever form of birthing experience they prefer and receive emotional support throughout the process. Various studies confirm the clinical benefits of using a doula for both the mother and child. In one study, doula-assisted mothers were shown to be four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding.(1) While doulas are non-clinical professionals, their work has a tangible clinical impact.

Beyond just the benefits to the mother and child, doulas provide partner support to ensure the co-parent and family members are also involved in the birthing process. Doulas are invaluable for their ability to assuage the usual stress felt by both the mother and the family during a pregnancy.

Despite being non-medical professionals, their role in healthcare spaces is also important. Doctors and nurses commonly appreciate including doulas as a part of the healthcare team because it offers a holistic approach to care -- the clinicians can focus on providing medical support and the doula can provide emotional and informational support. Additionally, doulas help advocate for their clients who may not know how to approach health professionals.

Given the evidence of positive benefits from utilizing a doula, why do only roughly six percent of women in America use doulas? One possible reason is because of the cost. On average, employing a doula can cost anywhere from $500 to $3,500 or more -- an expense typically not covered by medical insurance. Moreover, many women are unfamiliar with the work and benefits of doulas. Women from low-income backgrounds, therefore, would be unlikely to use a doula during their pregnancy yet at the same time would be a demographic that would greatly benefit from the services doulas provide.

Hopefully, with time, the evidence for doulas will prove their value -- particularly how their utilization can decrease healthcare costs through improved health outcomes. In this future, their services would thus be covered by insurance companies and be readily accessible for all.

References: 1. Gruber, K. J., Cupito, S. H., & Dobson, C. F. (2013). Impact of doulas on healthy birth outcomes. The Journal of perinatal education, 22(1), 49–58. https://doi.org/10.1891/1058-1243.22.1.49”