As a doula, I want nothing more than for you to have the birth of your dreams. I want you to feel confident, positive, and like your birth is nothing but a happy memory. I wish I could promise you a specific birth, but I cannot.
However, as a doula, I do promise you this: continuous support without judgement.
When we read websites, see reels, and even read peer reviewed studies, the message tells us that doulas improve birth outcomes, and they can even reduce the length of labor.
As a doula, I need you to know that there are population level statistics and then there are individual experiences. I will do my best to help you have a safe, empowering, and positive birth. But the truth is, the only thing I can truly promise is continuous support and no judgement.
What Are The Benefits of a Doula?
The evidence is pretty clear: doulas offer measurable benefits. When we look at a group of people birthing with doulas and a group birthing without, we see statistically significant differences in outcomes.
A 2023 meta-analysis found that doulas were associated with:
- Reduced c-section births
- Lower rates of preterm birth
- Increased initiation and duration of breastfeeding
- Shorter duration of labor
- Less use of pain medication
- Improved emotional wellbeing
This means that when researchers looked at the data from multiple studies, we saw an increased likelihood of vaginal birth, higher rates of breastfeeding, less medication use, and overall better outcomes.
However, what this does not tell us is what type of birth you will have. Remember, a risk is not a guarantee, and unfortunately neither are benefits.
What CAN a Doula Promise?
As a doula, I want nothing more than to promise you a positive, happy, easy, and safe birth experience. However, there are so many variables when it comes to labor.
What position does baby settle into? How does your uterus respond to contractions and oxytocin? When does your water break? How does baby tolerate contractions? Low lying placenta and bleeding? What interventions do you choose or become necessary? Is preeclampsia involved? Infection?
Overall, birth often unfolds really well. But the reality is, there are variables we cannot control and thus, we cannot guarantee certain outcomes.
However, we can promise to provide continuous labor support from when you request us in labor until after baby is born.
Our continuous presence can mean that if your labor pattern is showing signs of baby not being in the best position, we can help you find different positions, stretches, exercises, rebozo techniques, etc., to facilitate space for baby to move.
Our hands on comfort techniques can mean not using medication which allows you more freedom of movement which is shown to help labor progress.
We can support you in making the decisions that feel right for you, so you do not feel pressured into any unnecessary interventions you do not want (not to be confused with medically necessary).
Being there means having someone reminding you of your voice so you feel like an active participant in the decision-making process. This means that regardless of how birth unfolds, you were involved in decisions, and you did not feel as if things were simply being done to you. When you have a voice, when you are involved, even the most difficult birth can be empowering and positive.
Why Have a Doula If There’s No Guarantees?
As mentioned, while we cannot guarantee an outcome, we can guarantee continuous support.
Wearing a seatbelt when you drive does not guarantee you won’t experience an injury in the event of an accident. However, we still wear it because we know that without the seatbelt, our risk of injury is significantly higher in the event of an accident.
And beyond the practical aspect of doula support, you simply deserve someone in your birth space solely to support you. Someone whose only job is to help you feel safe, heard, respected, and supported.
The nurses are incredible, but their number one priority is clinical safety. They’re also at the mercy of how busy a shift is. Your partner can be an incredible support, but they are also experiencing a big and life impacting day. They deserve support too.
Your midwife, you OB/GYN, they are rarely able to provide in room support for the entirety of your active labor.
Your doula is there to guide, support, and ensure there’s someone with you at home in early labor, through shift changes at the hospital, and regardless of how your birth unfolds.
What Can I Do To Increase The Likelihood of The Birth I Want?
What every doula is likely to tell you is this, we cannot do all the work for you. We WILL be there with you, but there are many things you can do to increase the likelihood of the birth you desire.
If you are hoping for a physiological birth, unmedicated, then where you give birth and the provider you choose has a big role in the likelihood of that happening.
Laboring in a tub or shower, having freedom of movement without having to explicitly request, these things are often impacted on the hospital, birth center, or homebirth midwife you choose.
We recognize that risk level, insurance, options in your area, etc., impact your options. However, when it is possible to choose, be mindful of the location and providers you choose based on what you hope for in your birth.
Understanding fear, tension, pain cycle is important. We tend to fear what we do not know. We cannot teach everything one should learn about birth in a two-hour prenatal visit. Taking a comprehensive childbirth class, reading evidence-based books, and being active in learning about your options are all important. When you know what to expect, there is less fear.
I wish I could promise a smooth, shorter than average, spontaneous vaginal birth, but I cannot. So I promise you this, whenever you request I join you during labor, I’m there. When you need support, you’ve got my words and my hands. When you have questions, I’m ready with evidence-based information. And regardless of how your birth unfolds, I’m with you, I’m supporting you, and I think you are incredibly brave and strong.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...