Doulas are trained professionals who provide emotional, physical, and informational support before, during, and after labor and birth. Unlike medical providers, doulas do not perform clinical tasks. Instead, they offer continuous, nonjudgmental support, honoring each birthing person’s values and preferences—whether they choose an unmedicated or medicated birth, at home, in a hospital, or in a birth center (Dekker, 2019).
The Madriella Doula Code of Ethics
Doulas are held to a high standard of professionalism and integrity. According to the Madriella Doula Code of Ethics, a doula will:
- Provide emotional support, physical comfort, advocacy, and evidence-based information throughout pregnancy, labor, and the postpartum period.
- Assist in developing a birth plan and support communication between the birthing person, their family, and the medical care team.
- Offer postpartum support, including emotional debriefing, recovery support, and basic lactation guidance such as positioning and timing (Kozhimannil et al., 2013).
- Always act with professionalism, respect, and compassion.
A doula will never:
- Make medical decisions for the client or their family.
- Offer medical advice, diagnose medical conditions, or perform clinical procedures.
- Interfere with the decisions of medical professionals or confront healthcare staff.
The Role of the Doula in the Birth Team
Each member of the birth team plays a unique and essential role:
- Doctor or Midwife: Provides medical care to ensure the safety of the birthing person and baby.
- Partner or Support Person: Offers emotional connection and physical presence.
- Doula: Delivers continuous, nonclinical support including:
- Encouragement and reassurance
- Comfort measures such as massage, counterpressure, and labor positioning
- Breathing and relaxation techniques
- Advocacy to ensure the birthing person’s preferences are respected
- Support in the immediate postpartum period, including assistance with infant feeding (Bohren et al., 2017)
Basic Doula Services
While services vary by training and experience, most doulas offer:
- Initial Consultation: An introductory meeting to ask questions, discuss expectations, and assess compatibility.
- Prenatal Visits: One or two sessions to review the birth plan, practice comfort techniques, and prepare for labor.
- Ongoing Communication: Phone, text, and email access throughout pregnancy, usually beginning in the third trimester.
- Labor and Delivery Support: Continuous in-person support beginning at 37 weeks or once active labor begins.
- Postpartum Visit: Occurs within a few days after birth to support recovery and newborn care.
- Educational Resources: Access to childbirth education materials, referrals, and informational guides on labor, breastfeeding, and postpartum wellness.
Evidence Behind Doula Support
A growing body of research affirms the value of continuous labor support. A landmark systematic review found that individuals supported by doulas experienced the following outcomes:
- 39% decrease in the likelihood of cesarean birth
- 15% increase in the likelihood of spontaneous vaginal birth
- 10% decrease in the use of pain medication
- 31% decrease in the likelihood of reporting a negative birth experience (Bohren et al., 2017)
Additional studies have demonstrated that doula support contributes to shorter labor durations, lower maternal stress, and greater satisfaction with the birth experience (Dekker, 2019; Kozhimannil et al., 2013).
Learn More
If you’re considering hiring a doula, exploring reliable resources and speaking with others who have experienced doula-supported births may help you decide.
Visit the following articles for more information:
- The Value of Labor Support
- Reasons You Need a Doula
- Affording a Doula: Is It Possible?
- Are Doulas Covered by Insurance?
- When to Call Your Doula
References
Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, 7, CD003766. https://doi.org/10.1002/14651858.CD003766.pub6
Dekker, R. (2019). Evidence on: Doulas. Evidence Based Birth. https://evidencebasedbirth.com
Kozhimannil, K. B., Hardeman, R. R., Alarid-Escudero, F., Vogelsang, C. A., Blauer-Peterson, C., & Howell, E. A. (2013). Doula care, birth outcomes, and costs among Medicaid beneficiaries. American Journal of Public Health, 103(4), e113–e121. https://doi.org/10.2105/AJPH.2012.301201
