What a Doula Actually Does During a Birth

When a woman is in labor, so many thoughts, feelings, and sensations course through her. Labor usually starts out slow and steadily becomes more intense. She and her partner work through each contraction together. 

The intensity of labor is something many people fear. But this couple is not frightened. Because they’ve been well prepared and supported by a childbirth expert…their doula. 

Pregnancy

Long before Baby Day, the couple meets multiple times with their doula to prepare for birth. She comes to their home, and they are able to discuss all their concerns and fears ahead of time. She gives them tips on how to prepare. And demonstrates comfort techniques they can use once labor begins. 

Their doula also tells them about things they never thought about. Like informed consent, evidence-based care, and the importance of fetal positioning. With all this preparation, they’re able to approach labor with confidence. 

Labor at Home

During early labor, the woman calls and talks to her doula on the phone multiple times. Her doula encourages her to rest and reminds her to eat nourishing meals throughout the day. 

When the contractions grow more intense, her doula comes over to the woman’s house. She helps her breath through each contraction like they’d practiced. The doula has a whispered conversation with the woman’s partner, easing a few of his worries and giving him suggestions on how he can best help.  

The doula holds a heating pad on the woman’s back while timing a few contractions. Since the woman is having back labor, she guides her through some Spinning Babies activities. These help ease the pain in her back, and her labor falls into a better pattern.

The woman’s contractions get more intense, and her doula asks her if she’d rather be here or the hospital. She definitely wants to be at the hospital. Her doula agrees that it’s probably time. While her partner helps her into the car, her doula carries their bags out. She reminds the partner that they’ll need the infant car seat—he runs back in for it. Then it’s off to the hospital, the doula following behind in her own vehicle. 

Labor at the Hospital

Pulling into the hospital, the woman decides to wait until her doula has parked and meets them at the front door. She grabs one of their bags and helps the woman through the hospital doors, while her partner parks the car. 

While checking into the front desk, a contraction hits. The doula quickly gets behind the woman, applying counter pressure on her hips, which eases the pain greatly. The doula gently tells the staff person to wait for this contraction to end before asking their next question. During the confusion of checking it, the doula helps the woman remember what she wanted to ask for—a room with a tub and a nurse who loves natural birth. 

Once in their labor room, the doula helps the woman get in a comfortable position. She reminds her partner how to do the hip squeezes she showed them at their last meeting. While he does that, the doula busies herself preparing the room. 

She hangs twinkle lights in the bathroom. She starts filling the tub and turns on the woman’s preselected relaxation music. She hangs up the woman’s affirmation cards and covers the clock on the wall. She runs out to ask the nurse for a birth ball and a bucket for ice water. Before she knows it, the woman’s labor room has transformed from a cold hospital room into a peaceful, cozy haven. 

By this time, the woman’s partner is getting tired, so the doula takes over doing the hip squeezes. She also massages the woman’s back in-between contractions with her favorite massage oil. Since the contractions seem even more intense now, the doula suggests it’s time to labor in the tub. 

The woman lets out a sigh of relief as she sinks into the warm water. The doula makes sure the water is at a safe yet comfortable temperature with her tub thermometer. She holds cold washcloths to the woman’s face as her partner continues doing counter pressure from in the tub. 

The Birth 

The woman starts to feel the urge to push slightly. Her doula asks if she wants her to get the nurse. “Not yet,” she says, listening to her intuition. The doula respects her wish—an important part of having a doula is knowing she works for the client, not the hospital. 

Another hour passes, and the woman now tells them to get the nurse. The doula steps out to fetch the nurse and gives her a quick recap of the woman’s birth plan. The nurse does a cervical check in the tub and tells the woman she’s complete and ready to have her baby. She instructs her to get out of the tub and into the bed while she calls the doctor. 

After she leaves, the doula reminds the woman that she only has to follow the hospital’s policies if she wants to. The woman agrees. She says she will get out of the tub but wants to give birth in the shower instead of the bed. Once she’s settled there, the doula again steps out to update the nurse on the woman’s wishes. 

The woman gives birth to a beautiful baby shortly after her doctor arrives. Thankfully, her doula had told to discuss this option with her doctor ahead of time, so there was no confusion in the moment. 

The doula helps the woman dry off, and she and her partner slowly help the woman and her baby into the bed. The doula gets several sweet photos of the three of them as the new parents meet their baby for the first time. 

The doula helps the woman notice the first feeding cues from Baby. She reminds her the best way to hold Baby for their first feeding session. Afterwards, they snuggle and settle down for a rest. 

Postpartum

The doula’s work isn’t done with the birth. She also meets with the woman one more time several days after the birth. This is an important meeting where they talk about the entire labor and birth experience—sometimes called “Birth Story Processing”. 

The doula listens with an empathic ear as the woman tells her about all the feelings she had during the process and since coming home with the baby. She fills in details that the woman missed while in the more intense parts of labor. This process helps her move forward with the birth experience safely tucked away inside her—close to her heart. And she’ll be forever thankful for her doula’s love, teachings, and support throughout the entire experience. 

St. Louis Birth Doula, Alysha Collins, uses a Rebozo during a birth.