Birth is a normal and natural process for which a woman's body is perfectly designed. A laboring woman intuitively and instinctively knows how to birth her baby. Given the right environment and support around her she will be able to birth her baby with the knowledge and wisdom of the millions of women who came before her.

Laboring women experience a unique set of emotions and are at the precipice of an incredibly transformative time in their journey to motherhood. Supporting laboring and birthing women at this juncture in their lives is essential. A woman experienced in childbirth who provides emotional, physical and informational support has proven to be of utmost value to the laboring women, her partner and the team of people that surround her at the birth of her baby.

The scientific value of professional labor support by a doula has been proven in a meta-analysis of six major studies. A doula supported birth boasts a 25% shorter labor, a 50% drop in cesarean rates, 40% drop in the use of oxytocin, 30% reduction in the use of pain medication, 40% reduction in the need for forceps or vacuum assisted deliveries and a 60% drop in the request for epidurals. Clearly doula attended births are safer for both mothers and babies.

As a doula providing continuous physical, emotional and informational support, I feel that my role as part of the birth team, which includes a medical caregiver, labor nurse, partner of the laboring women, and perhaps a family member, is a vital and important one. At a time of great psychological stress and many unknown factors for the laboring couple a doula can remain an objective helpful supporter allowing the birth partner an opportunity to experience the birth at his or her own comfort level. Without a doula present the birth partner has the sole responsibility of all the laboring woman's needs. When a doula is present she can relieve the partner of some of those duties and let the birth partner be present and attentive as he or she sees fit. This allows the partner to be fully and emotionally connected to the birthing mom and the baby without the worry of meeting her every physical or emotional need. In no way does the doula interfere with the relationship between the laboring woman and her partner. No one can replace that sacred relationship. As the doula stands apart in support of the mother and her partner, she also does not interfere with the medical caregivers. She can act as an advocate for the couple but the advocacy role does not include the doula speaking for the couple or making decisions on their behalf. Her primary focus is attending to the laboring woman's emotional and physical needs, respecting the birth space and providing information so that the mother and father can fully participate in critical decisions during the course of the labor and birth.

Birth quite often is a very intense and emotional time for a laboring couple. Even the best-laid plans can take quite a different turn during the course of a labor. Because of the unpredictable nature of the birth process, a couple can feel like their labor is getting out of their control and range of comfort. An experienced labor professional can help put things in perspective and support the laboring couple during a time of stress, confusion and self-doubt all the while validating their feelings and emotions. She is there to reassure the couple that birth is a normal, natural process. A doula is there to navigate the sometimes rough and rocky waters of childbirth and to make sure a laboring couple is armed with information in order to make informed choices and educated decisions. With her background of knowledge and experience at birth a doula is present to provide informational support to the birthing couple in new and unfamiliar surroundings. She provide alternatives to pain medication, if desired by the birthing couple. By employing a number of different and effective comfort measures to a laboring woman, a doula truly provides a mother with real options to medication in labor. A woman who is only offered pain medication may not be aware of other options thereby limiting her power to choose.

The responsibility of the doula is primarily to ensure that the wishes of the birthing couple are heard and respected. A doula supports the birthing couple in their decisions regarding the birth of their baby and protects the sacred birth space. Generally a doula meets with a couple several times during the course of the pregnancy. She listens to the couples plans and preferences for the birth of their baby and when necessary she educates and informs the couple of practices and procedures beneficial to mothers and babies. If necessary a doula helps a couple draft a birth plan and informs them of local hospital and birthing center practices.

When labor starts, a doula is available to assist with continuous physical and emotional comfort measures during the entire course of the labor until the birth of the baby. In early labor this might mean frequent phone contact. The doula may provide suggestions for food, drink, rest or activity. In active labor a doula is present continuously providing physical and emotional comfort to the laboring couple. She is the one consistent caregiver who is committed to being present for the whole labor. A doula stays with the new family for several hours after birth. She can assist with early breast-feeding and bonding by making sure the parents are comfortable in their surroundings and with hospital procedures and protocol. When the new family needs some time alone to get to know their new baby the doula quietly leaves. A doula is in contact with the couple by phone for the days immediately following birth and generally visits with the new family within a week of the baby's birth. At this visit the doula may provide information and assistance with breast feeding and infant care if the new family requests this support. The doula and parents have an opportunity to talk about and process the birth and the doula gets a chance to hold and admire the new baby. In some circumstances a birth doula is needed for more than one or two post-partum visits with the new family. At this point a postpartum doula takes over care for the new family. She is there to care for, support, and listen to the emotional and physical needs of the family she is serving.

Finally a doula has a responsibility to the organization that certifies her. It is her responsibility to adhere to the code of ethics and standards of practice of the organizing body.