While midwives and doulas often work in tandem as part of a woman’s birth team, they perform separate roles. A doula provides physical, emotional and informational support to a mother and her family before, during and after childbirth.
Doula care has been shown to provide such benefit and improved outcomes to both mothers and babies that Vanderbilt offers doula services free of charge to its nurse-midwifery practice clients.
“Initially, when I became a doula it was to get my foot in the door, raise my kids, then get midwifery training,” says Joy Shaw, a childbirth and post-natal facilitator (doula) who has assisted in more than 150 births since she began her career nine years ago.
“My goal was eventually to become a midwife. But I feel like I’m filling a real gap in supporting what midwives and doctors do.”
Doulas provide physical, emotional and informational support during pregnancy, developing a birth plan, childbirth and after the baby is delivered. They may specialize in birth or postpartum care.
Shaw, one of Nashville’s most in-demand doulas, has helped women through childbirth in almost every possible setting: birth centers, hospitals, her own home.
“I felt a doula was really essential in the hospital setting because I wanted an advocate for me,” says Zoe Jamail, who hired Shaw for her first birth in a hospital and is working with her again through the second, which will take place at home.
“I knew that everyone else’s concern was getting the baby out, and I wanted someone who was there to make sure that, barring any extreme danger, my birth plan would be respected.”
A doula can make as much as $45K a year according to healthcaresalaries.com
Shaw says the advocacy role is especially important in a hospital, where emotional support is often lacking.
“They’re lost, they’re alone in the room, they don’t know what’s going on. You’re like a tour guide through the birth experience; you can tell them what’s normal and alert them of their choices because, even though they have options, often they’re not told they have options.
“If a woman is delivering in the hospital, I want her to carry that memory as being empowering and conscious, and that even if everything goes completely different than she was hoping, she still feels like she got to make choices, and it was her birth and she got to call the shots.”
The life of a doula is often intense, especially with multiple patients.
“My longest birth was 56 hours and I also had another couple the other part of the time,” Shaw adds.
“I left the house Monday and came back Thursday, and I got an hour and a-half nap between the two. You start learning how to manage your energy in that environment. When I train doulas I give them a personality test because certain temperaments can’t adjust and aren’t suited to the work, I’ve found.”
Those who want to explore the field can find training and certification through organizations such as DONA International.
Shaw, who has three children of her own, apprentices doulas to give them more real-world birth experience. She has written a training manual for childbirth and post-natal facilitators who wish to follow in her footsteps and has advised a local hospital on setting up and staffing their own birth center.
Her services also now include pre-conception consulting and counseling and support for couples experiencing the changing dynamics of starting a family. Sometimes all parents need is an outside voice to reassure them what they’re going through is normal, she points out.
“I love birth, but I don’t do what I do because I’m obsessed with birth. I do it because I feel like where we’re weakest as a culture is with families,” Shaw says.
“If I can support families through the most difficult transition they go through, and offer that support even in little ways as I need to, they’re probably going to stay more cohesive. Down the road, I see these families thriving and I’m so happy I got to play a part in helping them make it through.”