The childbearing age and beyond brings with it many changes whether emotionally, mentally, or physically. The presence of support is vital while navigating the various milestones. That’s where the word and existence of a doula come into play. Being well-informed through evidence-based teachings provided by a doula encourages you to advocate for yourself, thereby making strides to change the meaning of support.

What is doula care?

A full spectrum doula does what the name says. This is a doula certified to assist and provide evidence-based care through the entire spectrum of reproductive needs from fertility, pregnancy, birth, postpartum, and loss. There has been growth in the full spectrum area as the medical world realizes that support doesn’t start at pregnancy or stop at birth.

People ask several questions when looking for a doula at any stage of their reproductive journey. Questions of cost, availability, what each job entails, and the client’s benefits are the usual ones. As a full-spectrum doula, I’ll address each of the questions and hopefully help you make informed choices in your quest for one.

How do you find a doula?

Doulas can work as a private business for themselves but sometimes centers or hospitals employ them. For private doulas, there’s always a matter of where to find them. Your local mom group is a great place to start, but if that doesn’t exist and all else fails, some training agencies have built databases just for clients to find their closest doula!

My own training agency, Doula Training International (DIT), Doulas of North America (DONA) International, and Birthing Advocacy Doula Trainings (BADT) are the 3 big-name agencies that have directories separated by cities or states with contact information. Give their databases a quick search to check your options; you might even run across me!

How much do doula services cost?

The big question is always about money. Insurance coverage is a case-by-case basis, but as more research becomes available on the necessity of doula services, more and more insurance carriers include these services as a part of pregnancy and birth coverage. For example, Medicaid and now Tricare cover doulas.

There’s no set cost for doula services. Each doula chooses what they feel their services are worth, and rightfully so. The reality is accessibility can be a hurdle when combating economic disparities. The fear of accessibility and cost can be debilitating when seeking services, but it doesn’t have to be.

The good news is that many doulas have sliding scales, grants, and even take on free clients regularly. Don’t be afraid to reach out and be upfront. Many of us aren’t in this for the money. We want to support you and we’ll work with you.

What is the role of a doula?

There seems to be a doula for every moment you may need support. Exploring doulas’ existence in fertility, birth, postpartum, and loss can genuinely help you better understand how their presence and roles are invaluable.

1. Fertility journey

You may have watched on TV or heard stories of how getting pregnant is as easy as just laying down and doing the do. That may be the case for some, but it’s not that simple for many. The first step in the reproductive cycle that leads to childbearing is conception, and that’s where a fertility doula becomes of service. The journey to conceive is different for several bodies. Whether you’re just a healthy heterosexual couple going the old school way, an LGBTQIA+ couple using artificial insemination, or a loving single woman who struggles with fertility, a doula has the tools to support you.

The benefits that a full spectrum doula can provide during the fertility journey include but are not limited to:

• Nutrition assistance, for example, in creating food plans.
• Preconception health and wellness education in the form of herbs, herbal teas, physical activity, and lifestyle changes.
• Emotional support during in vitro fertilization (IVF) and intrauterine insemination (IUI).

Fertility is one of the few taboo topics that isn’t talked about enough. The struggle is so private that the need for support outside family members and spouses is rarely considered. We need to break this stigma. As more women become upfront about their fertility journey, the walls begin to disintegrate. For every conception path, you have the option to maximize your support with the addition of a birth worker.

2. Pregnancy and childbirth

Most people think of pregnancy and childbirth when they hear the word doula or birth worker. Pregnancy is such a long journey where your body is consistently changing along with your growing baby. Physical, emotional, and psychological changes together with prenatal visits occur at different levels for different people.

For some, a doula is the only support through their pregnancy while for others, a doula is a form of added support. A doula doesn’t take the spot of a medical professional or a spouse during pregnancy but instead fills the emotional, mental, and physical gap between them. The need for a support person has grown due to the increased maternal mortality rates across the globe. Studies report that the presence of a support person has reduced C-section rates by 50%, length of labor by 25%, use of oxytocin by 40%, and requests for an epidural by 60.2%.

The roles and benefits of a doula during pregnancy, labor, and at birth are to:

• Assist with comfort measures.
• Answer those nitty-gritty texted questions that pop in your head at midnight.
• Join you at doctors’ appointments.
• Help you advocate for your choices while giving birth.
• Help you build and achieve your birth plan.
• Reassure you when the birth plan goes out the window, and your birth process starts to look a little different.
• Guide you through early labor using breathing, conversation or varying labor positions.

As much as it’s assumed, doulas cannot deliver babies, but we don’t need to. The role of a birth worker in pregnancy and birth is truly pivotal in such a sparkling moment.

3. Postpartum period

All too often, we overlook postpartum support. With effects of the 4th trimester such as postpartum mood swings, depression, psychosis, and changes brought by adding a new family member, the extra support a trained doula brings is invaluable. The perinatal mental health gap is all too real.

Benefits of a postpartum doula are to:

• Provide information on the importance of bonding time between you and your newborn.
• Provide lactation support within their scope of practice.
• Provide a simple meal, light cleaning, and a breath of fresh air.
• Maximize your healing emotionally, mentally, and physically.

4. Loss

My first experience with a doula was actually during a time of loss. It was my first miscarriage ever, and I’d just moved to a new city with no family other than my husband and 2 children. I was in pain, in shock, and somehow felt alone.

Loss is a period some of us may go through that’s often overlooked or not talked about due to its dark nature. The amount of support that a full spectrum doula provides during this challenging time is immense.

The role of a full spectrum doula in loss includes:

• Providing herbal baths and herbal teas.
• Providing emotional support.
• Offer grief guidance to support you through this transitional time.

Don’t underestimate the kindness, compassion, and support of a stranger in such a seemingly dark time of reproductive nature.

5. Abortion

Abortion doula work is so important as it’s part of your reproductive care. Having an abortion can be emotionally and physically challenging, thus abortion support is needed. Abortion doulas or full spectrum doulas ensure emotional, physical, and informational support is available in such a pivotal moment.

Their role entails providing:

• Herbal teas before and after the procedure.
• Evidence-based information on what to expect before, during, and after the procedure.
• A hand to hold during the procedure (depending on your office’s regulation).
• Care packages for after the procedure.
• In-home care after the procedure.

Conclusion

As much it’s assumed, doulas don’t just help with pregnancy and childbirth. There are many stages where you can utilize a doula’s services. Accessibility and cost of a doula are factors when seeking medical/holistic services, but it shouldn’t be the main deciding factor.

A doula’s role at each stage of the reproductive spectrum offers you such a wide range of benefits. It will make a difference in the standard of care and the value of your experience. A doula’s presence will make you heard throughout your reproductive journey and feel empowered to advocate for yourself.

Find and support your local doulas to continue making waves in reproductive justice.