Doulas 101:

The Evolution Of The Doula Profession

What Does The Word “Doula” Mean?

The term “doula” is a Greek word that refers to “a person of service” and it was popularized in the 1970s by the American anthropologist Dana Raphael, who was a strong proponent of breastfeeding. Raphael used the term “doula” in her book, The Tender Gift: Breastfeeding, to describe the vital role of non-medical care-givers who support breastfeeding parents during the postpartum.

Not long after, Dr. Marshall Klaus and Dr. John Kennell began conducting research on the medical outcomes of childbirth when continuous care is provided throughout labor by a non-medical support person. Klaus and Kennel also adopted the term “doula” to refer to these birth companions and their research revealed significant medical benefits to doula-assisted births.

The term doula was still relatively unknown in the 70s and 80s but started to gain greater recognition by the 1990s and was finally accepted into dictionaries in the early 2000s. Today the word “doula” is synonymous with birth and postpartum support.

About Doulas, Portland OR

The History Of Doulas

There are records of childbirth companions that date back to prehistoric times and up until the last century birthing people traditionally had midwives, family, or community members to support and guide them through childbirth. However, as birth moved out of the home and into the hospital, the role of labor support was abandoned during the medicalization of childbirth. To fulfill people’s continued need for birth support in more modern times, professional doulas arose in the 1970s as a part of the natural childbirth movement and they have been gaining in numbers, professionalism, and recognition ever since.

In 1989, Penny Simkin wrote her seminal book, The Birth Partner: Everything You Need To Know To Help A Woman Through Childbirth, which helped to popularize doulas and their important role in the birth room. A few years later in 1992, Doulas Of North America (DONA International) was founded and it was the first organization to train and certify birth and postpartum doulas. Then in 1993, Klaus, Klaus, and Kennel published their landmark book, Mothering The Mother: How A Doula Can Help You Have A Shorter, Easier, and Healthier Birth, which is still essential reading for anyone training to be a doula.

Today there are multiple organizations all over the world training birth and postpartum doulas, and more and more families are searching out doula care to fill in the gaps created by large-scale, depersonalized medical care.

Types Of Doulas

If you type in the term “doula” on a search engine, you might be surprised by some of the information that comes up. That’s because there are several different types of doulas out there all offering specific kinds of support services. Here is an overview on the most common types of doulas:

What Is A Birth Doula?

A birth doula is professionally trained in how to provide client-centered support to families during pregnancy, childbirth, and the immediate postpartum. This type of doula offers a variety of services, but most importantly they provide a trusted, ongoing relationship so that families feel well supported and well informed throughout their entire childbirth experience.

A birth doula meets with clients several times during pregnancy and takes the time to learn about their hopes and preferences and how to best support them. This type of doula is on-call for when labor begins and joins the family in their home or at the hospital or birth center to provide emotional support, evidence based information, practical hands-on comfort measures and physical positioning, and advocacy to help navigate medical systems and ensure the client’s autonomy is respected.

A birth doula stays with clients until the baby is born and for the first couple of hours after delivery to support family bonding and breastfeeding. The doula tends to stay in contact in the days after birth and offers at least one home visit in the week or two after birth to talk about the birth experience, answer questions about newborn care and feeding, and provide resources. The Birth First Doulas agency is committed to providing high quality birth doula services, and our birth doulas are some of the best in the Portland metro area.

What Is An Antepartum Doula?

The word “antepartum” means before birth, so an antepartum doula is specifically for supporting people during their pregnancy and are most commonly used during difficult or high-risk pregnancies. This type of doula builds a trusting relationship with the client and provides emotional and informational support in an effort to lower the levels of stress and anxiety that the pregnant person is experiencing and increase their sense of calm and preparedness.

An antepartum doula helps clients to better understand what to expect, to generate questions to ask their OB or perinatologist, to prepare a birth plan appropriate to their unique circumstances, to find resources that may be needed, to design a postpartum care plan, and to encourage clients to find ways to still find joy in their pregnancy and the baby.

Antepartum doulas do not join people in labor but they usually provide at least one postpartum visit to wrap up their care after the baby is born. Birth First Doulas is proud to offer antepartum doula services in the form of our Half Doula Package.

What Is A Bereavement Doula?

A bereavement doula provides support to families who anticipate the loss of their baby in cases of miscarriage, stillbirth, or a diagnosis in which the baby is not likely to live long after birth.

A bereavement doula offers a lot of emotional support during pregnancy by walking with families on their journey through loss and offering a safe space to grieve and talk through the choices available them.

Bereavement doulas can provide information on what to expect, gently encourage parents to bond with their baby and create meaningful memories, and offer resources for families experiencing loss.

Different Types Of Doulas, Portland OR

What Is A Postpartum Doula?

A postpartum doula is professionally trained in the needs of the family in the days, weeks, and months after birth or the addition of a new baby. A postpartum doula offers non-judgmental support and guidance during the tender postpartum as the family adjusts to the stressors of caring for a newborn, breastfeeding and bottle feeding, sleepless nights, recovery from labor and delivery, and baby blues.

A postpartum doula’s role may include emotional support, newborn care during the day or night, evidence based information on the range of normal, feeding support, babywearing support, and physical support including meal preparation, laundry, light housekeeping, running errands, and child care for older children. Sometimes a labor doula and postpartum doula are the same person and can provide ongoing care throughout the entire childbearing year for those who want it.

While Birth First Doulas does not offer postpartum doula services directly through our agency, many of our birth doulas also offer postpartum doula services, and we are proud to be in partnership with Bridgetown Baby, the premiere postpartum doula agency in Portland.

What Is A Sibling Doula?

When people are having their second, third, or fourth baby, one question they face is who will take care of the older children when labor begins and it’s time to go to the hospital or birthing center? If family doesn’t live nearby, figuring out who will be with your kids can be stressful, especially since the start of labor is unpredictable and can be in the middle of the night.

A sibling doula provides on-call child care for the siblings of the new baby, and they can be called in night or day to step in and keep the home fires burning while you and your partner are busy with labor and birth. A sibling doula comes to the house several times during pregnancy to spend time with the children, learn about their schedules and activities, and get a tour of your home. Some sibling doulas are even open to transporting children to daycare, to school, or to the hospital to meet the baby is that’s what the parents desire.

A sibling doula can provide peace of mind knowing that your children are well cared for as you welcome the newest family member into your loving arms. Birth First Doulas does not offer sibling doula services directly through our agency but some of our wonderful doulas do offer it as an addition service.

What Is A Full Spectrum Doula?

A full spectrum doula provides nonjudgemental client-centered support services for a variety of reproductive circumstances including fertility, antepartum, birth, postpartum, miscarriage, abortion, stillbirth, surrogacy, and adoption.

What Does A Doula Do?, Portland

What Is The Difference Between A Doula And Midwife?

Doulas and midwives both believe that birth is a normal physiological process and work to improve people’s childbirth experiences, but their roles are quite distinct.

Midwives are medially trained professionals who are responsible for the physical health and safety of the birthing person and baby. Like doctors, midwives order medical tests, draw labs, take measurements, assess fetal heart tones, catch babies, and perform a wide range of clinical exams and procedures. Midwives also provide clients with information and emotional support, but their top priority is to ensure medical safety.

Doulas, on the other hand, do not give medical advice or perform any clinical tasks. They are free of medical responsibilities and therefore able to focus entirely on improving the overall experience of birthing people and their partners. Doulas focus on the emotional, mental, and physical needs of their clients by taking the time to really listen and validate people’s feelings and experiences. Doulas provide comfort and guidance by offering understanding, evidence based information, and a wide variety of hands-on physical techniques that reduce discomfort and help labor to progress.

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Many of the photographs on this site were taken by Portland Birth Photographer: Natalie Broders and She Saw Things

Birth First Doulas is proud to be in alliance with Bridgetown Baby & Community Doula Alliance

Doula Service Locations: NW Portland, NE Portland, N Portland, SW Portland, SE Portland, Sellwood, Beaverton, Hillsdale, Tigard, West Slope, Sherwood, Hillsboro, Gresham, Tualatin, Milwaukie, Lake Oswego, West Lynn, Happy Valley, Oregon City, Wilsonville, Oregon, and Vancouver, Camas, Washougal, Washington

Hospitals & Birth Centers We Serve: Kaiser Sunnyside, Kaiser Westside, OHSU, Legacy Good Samaritan, Legacy Emanuel, Legacy Meridian Park, Legacy Salmon Creek, PeaceHealth, Providence Portland, Providence St. Vincent’s, Adventist, Hillsboro Medical Center, WHA Midwifery Birth Center, Andaluz Waterbirth Center, Alma Birth Center, Canyon Birth Center, and Home Births in Portland, Oregon

Doula Service Specialities:  birth doula service, childbirth & parenting classes, newborn classes, certified doulas, natural birth, unmedicated birth, vaginal birth, water birth, epidural assisted birth, birth advocacy, cesarean birth, vaginal birth after cesarean (VBAC), high risk birth, induction, twins and multiples, previous miscarriage and loss, LGBTQ+ families, body positive, single parents, surrogacy, hospital birth, birth center birth, home birth, and a variety of additional doula services in Portland, Oregon

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