Preparing for childbirth, especially when aiming for a natural, low-intervention experience, involves building a strong and supportive team around you. Alongside your trusted medical professionals, many expectant parents in India are now exploring an additional layer of support: a birth doula. The idea of having a dedicated companion focused solely on your emotional and physical comfort throughout labour is appealing to many.
My name is Dr. Vrushali Pillai, and as a Senior Consultant in Obstetrics & Gynaecology at Borneo Hospital, Thane (part of the Borneo group serving Thane, Nashik, Chhatrapati Sambhaji Nagar, and Raipur), my priority is always a safe and positive birth experience for every mother and baby. We believe in supporting informed choices, and understanding the Role of Doulas can be a valuable part of your birth preparation.
This article aims to explain what a birth doula is, what they do, the potential benefits of their support (particularly for natural childbirth), how they work alongside your medical team, and how you might find and choose one in India. It’s crucial to understand from the outset that doulas provide non-medical support; they complement, and do not replace, the essential medical care provided by your obstetrician, midwives, and hospital staff like our team at Borneo Hospital.
What is a Birth Doula? (Defining the Role)
The word ‘doula’ comes from ancient Greek, meaning ‘a woman who serves’. Today, a birth doula is a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth.1
Key Distinctions:
- Non-Medical Professionals: This is a very important point. Doulas are not doctors, nurses, or midwives. They do not perform clinical tasks like vaginal examinations, foetal heart rate monitoring, give medical advice, diagnose conditions, or make medical decisions for you. Those responsibilities lie solely with your qualified medical team at Borneo Hospital.
- Focus on Support: A doula’s role is purely supportive. They are there to nurture and assist the labouring mother and her partner, helping them have the most positive and empowering birth experience possible, based on their preferences.
What Does a Doula Actually Do? (Scope of Support)
The Role of Doulas is multifaceted and spans the entire perinatal period:
Before Labour (Antenatal Period):
- Building Rapport: Most doulas meet with you several times during pregnancy to build a trusting relationship.
- Birth Preferences: They can help you explore your options, clarify your wishes, and create a birth plan or list of preferences to discuss with your doctor.
- Information & Education: They provide evidence-based information about the labour process, coping techniques, comfort measures, and common hospital procedures, helping you feel more prepared.
- Addressing Fears: A doula can provide a safe space to discuss any fears or anxieties you have about childbirth.
During Labour & Delivery:
This is where a doula’s continuous presence is most felt.
- Continuous Physical Support: Offering hands-on comfort measures such as:
- Massage and counter-pressure techniques to ease back pain.
- Suggesting and assisting with different labour positions to promote comfort and progress.
- Helping with relaxation using heat/cold packs.
- Supporting you if you choose to use water immersion (hydrotherapy), if available and appropriate.
- Emotional Support & Encouragement: This is a cornerstone of doula care.
- Providing a calm, reassuring presence throughout labour.
- Offering praise, encouragement, and positive affirmations.
- Helping you stay focused, positive, and work with your body’s rhythms.
- Simply being there consistently, which reduces feelings of being alone.
- Informational Support:
- Gently reminding you of coping techniques you learned.
- Providing simple explanations of what’s happening (if you request it, always complementing information from medical staff).
- Helping you gather information to make informed decisions about your care, if options arise.
- Advocacy (Facilitation, Not Decision-Making):
- Helping you articulate your preferences to the medical team. This does not mean overriding medical advice, but ensuring your voice is heard respectfully.
- Facilitating good communication between you, your partner, and the hospital staff.
- Partner Support: Doulas also support the birth partner (husband, mother, etc.), helping them feel more confident and involved in supporting the labouring woman. They can suggest ways for the partner to help and offer them breaks if needed.
Immediately Postpartum (The First Few Hours):
- Many doulas stay for an hour or two after birth to:
- Help with initial breastfeeding establishment, if desired.
- Provide comfort and support as you recover from delivery.
- Help you process the birth experience by talking through it.
(Some doulas also offer postpartum services at home, focusing on newborn care, maternal recovery, and household support, but this is typically a separate role from a birth doula).
The Evidence-Based Benefits of Doula Support
A growing body of research highlights the positive impact of continuous labour support, particularly from a doula. Studies, including Cochrane reviews (a highly respected source of medical evidence), suggest that women who have continuous support from a doula may experience:
- Shorter labours.
- Reduced need for medical pain relief, such as epidurals or narcotics.
- Lower rates of Caesarean sections and instrumental vaginal births (forceps/vacuum).
- Increased likelihood of a spontaneous vaginal birth.
- Higher reported satisfaction with their overall birth experience.
- Babies may have slightly better Apgar scores (a quick assessment of newborn well-being) at birth.
- Reduced maternal anxiety.
These benefits are particularly noted when the support person is not a member of the hospital staff or the woman’s social network, but a trained doula dedicated solely to her support.
How Doulas Complement Medical Care (Working with Doctors & Hospital Staff)
It’s essential to understand that a good doula aims to be an integral and respectful part of the entire birth team.
- Team Players: Professional doulas work collaboratively with your obstetrician (like myself, Dr. Pillai), midwives, and nurses at Borneo Hospital. They understand and respect the distinct roles.
- Different, Complementary Roles: Your medical team are responsible for the clinical safety and health of you and your baby – monitoring vital signs, assessing progress, diagnosing issues, and performing necessary medical procedures. The doula’s focus is entirely on providing continuous physical comfort, emotional reassurance, and informational support to you. They don’t get in the way of medical care; they support you through it.
- Enhancing Communication: A doula can sometimes help bridge communication by encouraging you to ask questions if you seem unsure, or by gently reminding the team of a preference noted in your birth plan (e.g., “She was hoping to try this position, is that okay now?”). They help you process information but do not give medical advice or make decisions.
- A Calmer Patient, An Easier Job: When a labouring woman feels continuously supported, calm, and well-coped, it can actually make the medical team’s job easier, allowing them to focus on clinical tasks knowing the mother’s emotional and comfort needs are being attended to. The Role of Doulas can facilitate a smoother interaction.
Is a Doula Right for You? (Considerations)
Hiring a doula is a personal choice. Consider these points:
- Your Birth Preferences: If you are aiming for a natural, low-intervention childbirth and desire robust, continuous support in using non-pharmacological coping techniques, a doula can be particularly beneficial.
- Your Existing Support System: Think about who will be with you. A doula provides professional, trained support. They don’t replace your partner or family but can help them support you more effectively and provide continuity if staff changes occur.
- Personality Fit: It’s vital to find a doula with whom you and your partner feel comfortable, respected, and completely at ease. Trust is paramount.
- Financial Investment: Professional doula services involve a fee. Consider this as part of your pregnancy and birth budget.
- Hospital Policies: Most hospitals in India, including Borneo Hospital, are increasingly supportive of women having doulas present, provided the doula understands and respects hospital guidelines and works collaboratively with the medical team. It’s always good to discuss your intention to have a doula with your doctor beforehand.
Finding and Choosing a Doula in India
While the professional doula movement is more established in some countries, it is steadily growing in India, especially in major cities like those near our Borneo Hospital branches in Thane and Nashik.
- Where to Look:
- Recommendations: Ask your obstetrician or midwife at Borneo Hospital if they have a list of doulas they have worked with and recommend.
- Online Directories: Search for Indian doula networks, or international organisations like DONA International or CAPPA which may have listings for certified doulas in India.
- Word-of-Mouth: Ask friends, family, or colleagues who have recently given birth if they used and would recommend a doula.
- Antenatal Classes: Some childbirth educators may also be doulas or can provide recommendations.
- Interviewing Doulas (Key Questions):
- What is your training and certification (from which organisation)?
- How many births have you attended? What is your experience with natural childbirth and hospital births?
- What is your philosophy on childbirth and the support you provide?
- What services are included in your fee (e.g., number of antenatal visits, on-call period, continuous labour support, a postnatal visit)?
- What are your backup arrangements if you are ill or at another birth when I go into labour?
- What are your fees and payment schedule?
- How do you see your role working alongside my doctor and the hospital staff?
- Crucially, after meeting them, ask yourself: Do I feel a good connection? Do I trust this person? Do I feel they will respect my wishes and support me effectively?
Borneo Hospital’s Perspective on Doulas & Labour Support
At Borneo Hospital, our primary goal is a safe and positive birth experience for every family.
- We are committed to supporting informed choices and patient-centred care. Our obstetricians, like myself, and our midwifery and nursing staff are dedicated to providing both excellent medical care and continuous emotional support throughout your labour and delivery.
- We are generally very supportive of patients choosing to have a doula attend their birth, provided the doula works professionally and respectfully within our hospital guidelines, focusing on their non-medical support role and complementing the care plan established by your medical team. Open communication between the doula, the parents, and hospital staff is key for a harmonious experience.
- We believe that a supported mother is an empowered mother, and the combined efforts of a loving partner, skilled medical professionals, and potentially a dedicated doula, can all contribute to this shared goal.
The Role of Doulas in childbirth is to provide dedicated, continuous physical, emotional, and informational support, acting as a steadfast companion for the labouring mother and her partner. The evidence suggests that this support can have numerous benefits, particularly for women aiming for a natural, low-intervention birth experience, including higher satisfaction and potentially reduced need for medical interventions.
A doula is a valuable part of a comprehensive support team, working alongside, not in place of, your trusted medical professionals. If you are considering hiring a doula for your birth at Borneo Hospital, do your research, interview candidates to find a good fit, and discuss your plans openly with your obstetrician. We support your desire for a positive and empowering birth.
