Britt Fohrman, doula, birth educator, photographer and yoga teacher, @brittfohto

No matter the type of birth you envision (or the one you end up having), doulas are invaluable advocates who can help you make educated and informed decisions during pregnancy, birth, and the postpartum period. 

We sat down with Britt Fohrman, SF-based doula, to chat about the benefits of engaging one during your pregnancy, birth, and early postpartum. 

What is a birth doula?

Regardless of the type of birth you envision (anywhere from an all-natural home birth to a planned cesarean and everywhere in between), birth doulas provide the continuity of personalized care throughout your pregnancy, birth, and into your early weeks as a new parent. They’re there to emotionally support you (and your partner if you have one), partnering with you through any decision-making that might come up unexpectedly. A doula does not replace your doctor, midwife, or partner. 

Your doula will get to know you deeply, providing guidance and resources grounded in experience and based on your specific needs. They will also provide support for partners, helping them remain calm, engaged, and empowered throughout the process. 

During labor and birth they will:

Support you at the beginning of your labor. A birth doula will help you understand where you are in the process of your labor and what can be done safely to allow the labor to progress naturally before you rush off to the hospital. You'd be surprised how many people go to the hospital when they aren’t very far along - and by the cascade of interventions that can ensue when women are at the hospital for too much time. A doula can be an invaluable resource to bring relaxation to all stages of labor so that you can be fully connected to your body and your baby. 

Help you advocate for yourself and bridge the gap between you and your care team. If you birth at a hospital, most of your labor will be in the company of a rotating cast of nurses. The doctor or midwife who arrives may not be the person you’ve been seeing throughout your pregnancy. So what happens if you need to make a decision quickly? A doula’s job is to listen to your provider alongside you and can translate that information, slow things down, and help you make a well-informed choice from a calm and clear place. 

Support your ease, confidence, and efficiency in labor. Doulas are there to help you connect with your breath, provide recommendations for labor positions and offer general encouragement.  They may also utilize aromatherapy and massage. By this stage, your doula will know you well enough to know what modalities will be most effective in maintaining or transitioning you back to calmness, confidence, and energy throughout your labor.

Remind you that you have options. Your doula may, for example, remind you that you have the option to give birth in the position that feels best for your body and your baby. Whatever situation arises during your labor, a trained and experienced doula will share options so that you can proceed safely through your labor.  

Help get breastfeeding off to a positive start if that is your intention. If you choose to breastfeed, you’ll likely find that it takes commitment and a whole lot of patience, especially in the beginning. Some support and guidance can be really helpful in those first few moments and hours after birth.

Having a doula has been directly correlated with decreasing the number of birth interventions. For more information about the effectiveness of birth doulas, explore one of our favorite resources.

When should I start looking for a doula, how would I go about finding one, and how much do they cost?

There are no national qualifying standards for doulas. It is, however, ideal to have a doula who has been professionally trained. There are proven benefits to having a professionally trained doula as opposed to a family member or a friend. Professional doulas often have a variety of other skill sets and qualifications which can be helpful when deciding you want to work with; some are massage therapists, experts in postpartum support, nutritionists, yoga instructors, birth educators, or herbalists. You can use these qualifiers to find someone who has the attributes and skill sets that are important to you. 

To find a doula in your area, it can be helpful to tap into community resources, reaching out to others who work in pregnancy and birth in your community. 

Tip: Try to find someone who has experience and knowledge of the birth community in your area  - ie knows the space, providers and any pertinent information of where you’re giving birth and what you can expect when you walk in the door. 

We recommend engaging a doula as early in your pregnancy as possible. as you’ll want to be sure you have the time and opportunities to get to know one another in a meaningful way before you give birth. However, sometimes people realize they want a doula the day before they give birth - it’s never too late to add one to your care team. 

Doula services range from around $500-$5,000 depending on level of experience and where you live. Some doulas will work on a voluntary or sliding scale based on need. There are some insurance companies that cover doula services and in most cases you can pay through your FSA or HSA.