6 Ways a Doula Can Transform the Birthing Process for Moms-to-Be

Since Prince Harry and Meghan Markle initially announced they were expecting their first child together, anticipation has mounted around the details of Markle’s birth plan. Amidst all the talk of how the announcement will be made and whether the nursery will be eco-friendly, the alleged detail that the Duchess of Sussex is working with a doula is perhaps the most intriguing. And that’s because many are still asking: What is a doula? From comprehensive coaching to emotional, physical, and educational support, here, three doulas spell out what, exactly, they do to help mothers-to-be.

Coaching Throughout the Birth Process
A doula is a non-medically trained professional who supports, educates, advocates, coaches, and nurtures a mom-to-be throughout the pregnancy, birth, and postpartum journey. “We work as a team alongside midwives, doctors, and nurses as we all have our own parts to play,” explains Lori Bregman, doula and author of Mamaste. “Nurses will come and go, doctors and midwives come towards the end to catch the baby, but a doula is a familiar, trusted person that can help you birth your baby.” According to Bregman, a mother-to-be can start with a doula as early or as late in the pre- or post-natal journey as desired. “Most people I work with start the second they take a pregnancy test,” says Bregman. “I personally like when I start early because I have a lot of time to build a solid relationship with my clients and really get to know them and understand the way they operate.”

A recent report, Cochrane Review’s “Continuous Support for Women During Childbirth,” found there were many positive birth outcomes when a doula was present. Women reported having a more positive childbirth experience with the support of a doula, as well as being less likely to take pain-relief medications. “Having a multi-pronged approach to service is critical to reduce poor maternal-health outcomes,” says Latham Thomas, doula and founder of Mama Glow. “When we are talking about 700 women dying during childbirth annually in the United States, we are in a crisis. For black women, who are [nearly] four times more likely than white women to die during childbirth or due to childbirth-related causes, having doula support can be life-saving.”

Education on the Intricacies of Giving Birth
“A big part of what we do is educate mothers-to-be on the process so that they understand the options are available depending on how and where they’re birthing,” explains Erica Chidi Cohen, doula, author, and cofounder and CEO of Loom. “Normalizing what to expect can deescalate a lot of the anxiety and help turn the situation from foreign into something that feels a little bit more understandable.” The unfortunate truth is that many women who are navigating the birth process find that the modern health-care system falls short on providing comprehensive information. “Women are in and out of doctor appointments so fast that they feel rushed, so fears, worries, questions, or concerns go unanswered,” adds Bregman. “When you work with a doula, you can always reach out with questions or concerns.” And to make education more available to the masses, Cohen has created Nurture: The Online Birth Course, which includes highlights from her book, Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood—and Trusting Yourself and Your Body.

Emotional Reinforcement
“Multifaceted support is necessary to meet a multifaceted experience,” explains Cohen. “We typically have looked at pregnancy as a very linear experience, and it’s not. It’s very emotional, and a doula can bring some coherence to the entire experience.” She also points out that modern pregnancy is a far cry from the sacred traditions of our ancestors, who typically had a much more communal experience. “In our modern culture, there’s a lot of isolation that happens,” adds Cohen. “A big part of what doulas do is normalize a lot of the feelings and bodily sensations that happen during pregnancy, which can feel very scary and unnerving for a first-time mother.” Emotionally, Cohen is what she likes to call “a really good vacuum,” allowing her clients to call and vent about any bad feelings or nervousness they’re having, knowing they have a space where they don’t have to give anything back. Thomas takes a similar approach, priding herself on being a profound listener, offering sessions that are multidisciplinary in approach, helping the mother-to-be connect deeper with her intuition and her baby while soothing the nervous system. Many doulas can also make referrals to medically trained professionals. “When there are needs that move into perinatal mood disorders, like postpartum depression and anxiety, I usually send those mothers to one of our partner providers to handle with care alongside the work I am doing,” explains Thomas.

Soothing Physical Touch—Especially During Labor
During the birth process, and particularly in labor, physical-touch therapy is incredibly beneficial in helping the mother-to-be maintain a sense of comfort and control. “When a pregnant person is having a contraction, their natural inclination is going to be to stiffen because the pain is uncomfortable,” explains Cohen. “A tense muscle responds to movement, so a massage is an effective way to keep a mother-to-be in the flow of moving through labor.” Similarly, a healthy breathing pattern, which can get stifled during labor, is a critical component. “It’s very hard to be conscious of these things—especially if it’s your first time,” explains Cohen. “That’s where we come in—like cheerleaders, helping to bring you back in the moment.” As Thomas points out, physical touch is an area where a partner can be of service. “When using massage techniques, I’ll enlist the help of the partner, if there is one, to participate at their level of comfort,” she says. “Touch transmits intention. Touch heals. I am big on mothers getting comfortable with touch.”

Support for a Mother-to-Be’s Partner
Thomas strongly believes that a partner should stay within their comfort zone while aiding the mother-to-be, but she encourages them to lean into their strengths and acknowledge their vulnerabilities to elevate their support. In that sense, knowledge is power. “While working with couples before birth, I teach the anatomy of labor and birth, comfort techniques, pressure points, and aromatherapy,” explains Thomas, who also sends videos, assigns reading, and does a lot of hands-on practicum with the partner so that they can better understand what they’re experiencing. Lastly, Thomas will assign tasks to the partner to help empower them with the tools they need to feel prepared for the process, including packing the birth bag, creating a “push” playlist, or timing the contractions.

Postpartum Care and Recovery
“Post-birth, you barely see your doctor until your six-week checkup,” Bregman points out. “There’s [necessary] support and nurturing that doctors and caregivers don’t have time for, or is outside the scope of practice.” And that’s where a postpartum doula, or the doula the mom-to-be has consulted throughout the birth process, comes into play—not only offering healing and holistic remedies, but also a nonjudgemental, reassuring ear. As Bregman puts it, “We take care of you so you can take better care of your baby.”