Understanding the Role of Doulas: From Pregnancy to Postpartum Care

Deciding to grow your family is a joyful and exciting step. You might find yourself imagining the cute little outfits your baby will wear or the sports you’ll teach them to play when they get older—there are so many memories to make! But along with the happiness and anticipation, there’s also uncertainty. Pregnancy and childbirth come with physical and emotional changes, and the thought of labor and delivery can feel overwhelming at times.

As couples begin planning to expand their family, they face several important decisions, including where to give birth and who will be there to support them. Typically, both parents are present in a hospital delivery room, possibly joined by a close family member, such as a future grandparent. More and more, expectant parents are also choosing to include a doula in their birth experience.

A doula is a trained professional who provides continual physical, emotional and informational support before, during and shortly after childbirth. Unlike midwives, doulas don’t provide medical care. Instead, they offer reassurance, comfort and advocacy for the non-medical aspects of childbirth to promote a positive experience.

While some doulas specialize in specific areas (labor/birth, pregnancy or postpartum), their services commonly include:

Supporting families mentally and emotionally for childbirth by helping create a birth plan, reviewing important decisions and setting expectations.

Advocating for the mother and communicating her birthing preferences to the medical team.

Providing emotional support and hands-on comfort during labor, including guidance on breathing techniques and labor positions.

Assisting in the postpartum period with light household tasks, newborn care and breastfeeding support.

Connecting families with helpful resources such as support groups, essential supplies, pelvic floor services and more.

Research shows that having continuous support from a doula can improve birth outcomes, often resulting in shorter labor times and fewer cesarean births, which carry risks like infections and prolonged recovery. The emotional support doulas provide is also linked to lower anxiety and stress levels in birthing mothers. This kind of support is especially critical in the U.S., where maternal mortality rates are among the highest of developed nations at 18.6 deaths per 100,000 live births. Among minorities, black women have significantly higher rates at 50.3 deaths per 100,000 live births. Indiana ranks in the top 10 states with the highest maternal mortality, reporting 30.9 deaths per 100,000—just behind Virginia (32.7), Kentucky (34.6) and Tennessee (41.1).

One of the reasons this type of care may not be widely used is that most private insurance companies don’t cover the cost for doula services. However, employers, such as Walmart, have recently expanded their family-planning benefits to cover doula support. Additionally, certain hospital systems offer in-house doula programs designed to improve maternal care during and after pregnancy.

If you think a doula would be helpful to you, start by asking your health care provider for more information.