As a physical therapist specializing in women’s health and someone currently pregnant, I’ve been reflecting a lot on my upcoming labor and delivery. One question I find myself considering, both personally and professionally, is whether hiring a doula is worth it.
There’s no shortage of opinions on the topic, but I want to provide insight from my clinical experience, published research, and my own pregnancy journey.
What is a Doula?
For those who might not be familiar, a doula is a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth. Doulas are not medical professionals but can be a crucial part of a birth support team, focusing on non-clinical aspects of care to help achieve the healthiest and most satisfying birth experience possible.
As a physical therapist, I’m all about optimizing the body’s function, especially during times of stress—like labor. Doulas can complement this work, ensuring that laboring moms feel supported, empowered, and able to make informed decisions in a high-pressure environment.
The Physical Therapist Perspective
As someone professionally involved in biomechanics of pregnancy and childbirth, I see a lot of overlap between what I do as a PT and what doulas offer. Doulas are trained in techniques to help with labor progression, pain management, and body positioning—skills that are often overlooked in the medical side of labor and delivery. In fact, many of the strategies that physical therapists recommend, such as optimal positioning to reduce pelvic floor, hip and sacrum strain, align with the support doulas provide.
For example, when it comes to pelvic alignment and maintaining proper posture during contractions, doulas can assist with positioning, ensuring that both the baby and mom are in the most favorable positions for labor. They’re also skilled in hands-on comfort measures like counter-pressure, massage, and breathing techniques that align with physical therapy principles of pain relief and muscle relaxation.
Emotional Support is Just as Important
While my work as a PT focuses a lot on the physical aspects of labor, I know firsthand from my own pregnancy how important emotional support is. Doulas are not just there for physical help—they also provide continuous emotional and mental support, which can be vital in reducing stress hormones like cortisol, helping labor progress more smoothly.
In the Literature
According to various published studies, the presence of a trained doula significantly decreases the rates of cesarean sections or the need for instruments during vaginal birth when compared to those that had standard care without a doula. Further, labor duration is shortened. If this isn’t convincing, let’s look at what it does for your baby. Evidence also shows that the presence of a trained doula leads to decreased episodes of low birth weight and premature labor. Further, rates of breastfeeding and skin-to-skin contact are increased. Finally, for both the mother and child, reduced rates of PTSD or anxiety were noted in women with a support system, creating a more calm environment for all those involved!
Professional Insight, Personal Reflection
Now that I’m on this journey myself, I find it comforting to know that I could benefit from the presence of a doula during my own labor. Physical therapists often focus on the mechanics and optimization of the human body, but we also know the importance of feeling supported emotionally. Additionally, as this is our first baby, I can sense that my husband may be (and I say this with all the love in the world) - freaking out. I take comfort in knowing that he is also supported, or at least will have guidance on how to support me during the process. The holistic support a doula provides can help reduce the physical toll of labor and promote a more positive experience overall.
Is it Worth It?
In my view, hiring a doula can be an incredibly worthwhile investment, especially if you value a well-rounded, supportive birth experience. As someone who understands the physical demands of labor and the value of non-medical interventions, I see doulas as an excellent complement to both medical professionals and physical therapists alike.
While each person’s birth journey is unique, I believe that having a doula can optimize the experience—both physically and emotionally. Whether you want extra guidance, hands-on support, or someone to advocate for your birth plan, a doula offers value that goes beyond what medical providers or even PTs can offer alone.
If you’re considering whether or not to hire a doula for your labor and delivery, my advice is to reflect on what kind of support you need. From my perspective as a physical therapist and mom-to-be, I would say yes—it’s worth it.
~Dr. Alina Wright, PT, DPT
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Works Cited:
Shahbazi Sighaldeh, Shirin, et al. “Comparison of maternal outcomes in caring by Doula, trained lay companion and routine midwifery care.” BMC Pregnancy and Childbirth, vol. 23, no. 1, 31 Oct. 2023, https://doi.org/10.1186/s12884-023-05987-7.
Sobczak, Alexandria, et al. “The effect of doulas on maternal and birth outcomes: A scoping review.” Cureus, 24 May 2023, https://doi.org/10.7759/cureus.39451.