While each pregnant woman will give birth in a way that is uniquely personal, there are clear benefits to having support from a caring and knowledgeable person throughout labor. Studies have shown that women continuously attended during labor are likely to have shorter labors with fewer complications than women who labor alone. While hiring a doula or labor coach may seem like an expensive luxury, having an experienced coach can provide a number of advantages. A talented doula will enhance your labor experience: she can provide emotional support to you and your partner, physical support such as a soothing massage, practical help, and tremendous encouragement during a lengthy labor.

Most doulas will begin their relationship with you well before labor begins. You may discuss your desires for labor and delivery, and review your birth plan preferences. Doulas often play an educational role, and some act as healthcare advocates during the hospital experience, acting as a liaison between hospital staff and your family. For many couples, the simple fact that a familiar face will be continuously available throughout labor and delivery can be very reassuring.

Fathers often appreciate the role of the doula because coaching is demanding and exhausting. A doula can guide a father during labor, showing him ways to support his wife and become an active participant during labor. A doula can also support the new father, giving him opportunities to take small breaks, relax in the midst of a stressful situation, and get in touch with his own feelings about becoming a father.

As a doctor, I have generally found doulas to be an asset in the delivery room. However, there have been occasions when doulas present a barrier in communication between doctors and patients. Because all labors are unpredictable, it is important for a doula to be flexible about the birth plan. If you plan to have “natural” labor and then find that an epidural is preferable, your doula should play a supportive role rather than chastising you for letting go of prior expectations.

If you decide to hire a doula or labor coach, here are some areas to discuss before you make your choice:

• Find out if she is certified, and ask about her training. Find out if she has attended births in the hospital you will use, and whether she is familiar with your health care provider.
• Ask how many births she has attended and find out if she has witnessed various kinds of births including cesarean sections, and births with interventions. Asking for references is reasonable.
• Find out her fees, and whether prenatal and post-partum visits are included in her fee. Sometimes doulas who are still in training will be willing to work for considerably less than experienced doulas.
• Ask how she defines her role during labor and delivery. Ask whether she will come to your home during early labor and whether a post-partum visit is included.

If you choose to work with
a doula or labor coach, choose someone who puts you at ease, reflects your own values, and is someone you would be eager to include as part of your birth team.