In your research you've probably read a ton about what a doula is, or what a doula does. And it sounds great... if a little vague? So let's take a brief look at "Sarah's" birth and postpartum period and see how her doula actually supports her.

What is a birth doula?

Sarah wakes up with mild cramping.  She wakes her partner and they soon call their doula.  While Sarah's partner times contractions her doula listens to Sarah during a contraction, assessing how Sarah is coping with the contraction; can she talk through a contraction, does she gasp or moan, how is her breathing? These cues will tell the doula, along with Sarah's own wishes, whether it is time for her to join them.

When the doula joins them at their home she again observes Sarah during a contraction before determining what Sarah might need.  As Sarah is coping well the doula busies herself gathering cloths, heating pad, birth ball, massage oil etc. After a contraction the doula encourages Sarah to pee and have a light snack. Soon the contractions are such that Sarah has to stop what she's doing and focus through each one. As she leans into her partner's shoulder and sways her hips Sarah's doula encourages her to take full deep inhales and begin to deeply moan on the exhales. As Sarah struggles to find a rhythm the doula helps by modeling this for her. 

After a few hours of steady progress the trio decide to head to the hospital. Once in their room Sarah's doula lowers the blinds and grabs Sarah a drink of water. When Sarah complains of being hot and nauseous, her doula grabs the nearest basin and helps her over to the bed, where she can rest her upper body. She then grabs Sarah a cold cloth and holds it to the back of her neck while Sarah’s partner squeezes her hips and encourages her. Once they are settled their doula checks if Sarah’s partner needs anything; a drink, snack, a bathroom break perhaps?

As labour progresses Sarah's doula follows her lead when she can see Sarah has found a movement/vocalization/position that is working for her. When Sarah struggles the doula suggests position changes to manage Sarah's pain and provides firm pressure to her sacrum every contraction for the next few hours. Their doula continues to pay close attention to Sarah and her partner, anticipating what they may need or want, perhaps before they realize it themselves. When Sarah decides to climb into the shower, her partner sprays hot water on her back while the doula gets them both a cold drink, clips Sarah's bangs out of her face, and gives the couple a few minutes alone.

When Sarah feels the urge to push, their doula encourages her to take whatever positions feel natural, and physically assists Sarah into positions that she may find comfortable. As the room fills with nurses and the doctor the doula stays by Sarah's side, gently praising her and encouraging her efforts. She communicates what the nurses/doctor are telling Sarah if Sarah hasn't heard something and wipes Sarah's forehead with a cool cloth. 

When baby's cries finally fill the room their doula tearfully congratulates them both (well this doula is tearful anyway!). She takes photos with dad's phone while the nurses attend to the placenta and post-partum checks. When the checks are done babe begins bobbing her tiny head around, searching for the breast. With a few suggestions from their doula Sarah's baby is soon latched and briefly nurses. Their doula makes Sarah some toast, grabs dad a snack from the cafeteria and takes a few more pictures, and with joy in her heart hugs them all before leaving the new family to become acquainted.

What is a postpartum doula?

A few days after Sarah’s baby is born, their doula arrives for her first postpartum visit. After washing her hands she finds mom and baby cuddled on the couch. Sarah accepts her doula’s offer of some tea and soup. While Sarah is eating, her doula settles herself on the living room floor to fold the pile of laundry she’s found there. Once Sarah has eaten, it’s baby’s turn. Nursing has been going well for Sarah but her doula notices one or two ways she can make herself more comfortable while nursing and asks Sarah if she can add a pillow under her arm so Sarah can be more relaxed.

While Sarah nurses the two chat about how Sarah has been adjusting. Her doula reassures her that what she is feeling is normal and common and they share a laugh about that hilarious nurse from her birth! At the same time Sarah has asked her doula if she can cut some veggies for dinner and cook a pot of rice. Miraculously baby has fallen asleep and Sarah is able to leave her in the safe spot she has set up. She wisely takes advantage and heads upstairs to nap while her doula works in the kitchen and keeps one eye on baby.

After an hour or so Sarah finishes prepping dinner, cleaning the kitchen and tidying the living room just in time to hear baby waking. She holds and snuggles baby until she sees nursing cues at which point she gently wakes Sarah and delivers baby to be fed. They take advantage of the fact that Sarah is reclined in bed and baby is calm to play around a bit with nursing positions. Sarah sees that side-lying nursing, while awkward at first, is a position she would like to practice more, in order to make nighttime nursing a little more restful. As Sarah’s partner arrives home from work with their preschooler, their doula says goodbye to the family and confirms their next visit later that week.

This relationship continues and evolves as baby grows. Sarah asks their doula for a few overnight visits when her preschooler gets sick and they are all stretched to their limit as well as when her partner goes away for the weekend. Sarah looks forward to chatting to her doula as she always leaves these conversations feeling calmed and reassured as well as validated and confident! Being a mother of two now Sarah experiments with a few different baby carriers so she can have her hands free more often. Having two sets of hands (mom and doula) makes babywearing easier those first few times until she has the hang of it. When baby is three months old their doula comes for her final visit with the family. Sarah is a confident mother of two now and knows she has made a friend she can always reach out to when or if she encounters struggles in the future.