Illustration of a pregnant woman in a hospital bed with another woman standing by her side, holding her hand.

When I gave birth to my son, my husband was right there next to me. We were joined by a couple of nurses and my ob-gyn, of course.

And there was one other important person in the delivery room: Brandi, my birth doula.

Some people are surprised to learn that I hired a doula. But as an ob-gyn, I have long appreciated how doulas can enhance the birth experience. Once I got pregnant myself, I started searching for a doula right away.

Now that I’ve seen the power of a doula from both sides, I wish more people would use them. Here’s what I tell my pregnant patients about doulas.

What is a doula?

A doula is a professional who is specifically trained in labor and childbirth support. Your doula is there alongside your doctor and nurses to help ensure your emotional and physical needs are being met. You hire a doula yourself and pay their fee (more on this below).

It’s just as important to understand what a doula is not. Doulas don’t replace the ob-gyn, nurses, and other trained health care professionals who care for you in the hospital. And doulas usually do not express their own opinions—instead, they act with your values, wishes, and best interests in mind.

What are the benefits of a doula?

Think of a doula as a resource you and your partner can rely on throughout pregnancy, labor, birth, and beyond. A doula can provide physical, emotional, and informational support in many ways:

  • More coping methods: Your doula can suggest ways to help ease the stress and pain of labor. For example, they can show you breathing techniques or help find a more comfortable position as you work through contractions. My doula helped me through my labor pain and supported my decision to get an epidural. She even brought aromatherapy and massaged my feet, which was wonderful.

  • Fewer interventions: Studies have shown that doulas can decrease the need for assisted vaginal delivery and lower the likelihood of cesarean birth. If you do end up needing a cesarean, a doula can still provide reassurance and support. Your birth doula may even be able to go with you to the operating room, if you wish, instead of a partner or other support person.

  • An unbiased resource: Doulas are trained to point you to evidence-based resources, so you can stay informed and empowered throughout your pregnancy and birth. They can also help you put together your birth plan by asking questions you may not have considered. Do you want the baby placed on your chest right after birth? Will you bank your baby’s umbilical cord blood? My own doula was great at this.

  • An advocate: Once you’re in labor, the doula can be a voice for your birth plan, helping to make your preferences known to your health care team. Your doula can also help you make decisions in the moment. (Sometimes surprises happen, and new choices need to be made.)

  • Another set of hands: A doula can take a little pressure off your partner, family members, and friends. When I was induced, my husband had just ended a 24-hour shift (he is also a doctor). Having Brandi with me meant that he could get some rest before the main event.

  • Better communication: Doulas can help navigate confusing situations. They can remind doctors and nurses to explain medical terms and help make sure you always know what is going on.

  • Extra attention: Your doctor and nurses can’t be in the room for every minute of your labor, as they need to tend to other patients. Having a doula there at all times can help you feel relaxed, calm, and fully supported.

  • Postpartum support: Some birth doulas continue working with their patients for up to 8 weeks after delivery, while others specialize in postpartum care. Either way, they can support your recovery process, from breastfeeding to managing sleep schedules.

  • A more satisfying birth experience: People who use birth doulas often report having a more positive childbirth experience. I know I was grateful to have a doula by my side that day, and I would definitely do it again.

How to find and hire a doula

If you’re interested in hiring a doula, it helps to start your search in your late first or early second trimester. The longer you wait, the greater chance a doula will be booked. (Doulas can’t work with too many patients who are due at the same time.)

Ask your ob-gyn, childbirth class instructor, or fellow moms for doula recommendations. You can also search DONA International’s database of certified doulas. Take time to interview one or more doulas to make sure it’s a good match and to clarify their role and expectations. My doula and I clicked right away.

Before you book, check your hospital or birth center’s doula policy. Some birth facilities admit doulas as staff. Others count them as visitors, just like family and friends. And most hospitals limit the number of people you can have in the labor and delivery room.

Talking about cost

It’s important to know that doulas are not covered by health insurance or Medicaid in most states. Depending on where you live, hiring a birth doula can cost between $500 and $2,000 out-of-pocket. If cost is an issue, you can ask about a payment plan. Another option is to hire a doula-in-training, who may offer their services for free or at a reduced rate.

Once you hire your doula, they should touch base with you throughout the rest of your pregnancy. You’ll want to tell them about any complications that could affect your labor and delivery, like gestational diabetes or high blood pressure. As your due date nears, they can be on call 24/7—and ready to show up for you once labor begins.

Support when you need it most

You’ve heard “it takes a village” to raise a child. In many ways, that’s true of labor and birth as well. You can have a team of people to support you on this journey, and a birth doula can absolutely be one of them. As an ob-gyn, I welcome my patients to include doulas in their birth experience.

Published: July 2023

Last reviewed: July 2023

Copyright 2023 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

About the Author
Dr. Denise De Los Santos.
Dr. Denise De Los Santos

Dr. De Los Santos is a board-certified obstetrician–gynecologist in Edinburg, Texas. She is an assistant professor of obstetrics and gynecology, a module director for second-year medical students, and medical director of the ob-gyn faculty practice for the University of Texas Rio Grande Valley School of Medicine. She is an ACOG fellow.