I am a doula. I am called to serve.

“Doula” is a Greek word that literally translates to “a woman who serves.” In ancient Greek households, a doula was a woman in the highest level of servitude to women in the home, and she assisted with childbirth and childrearing.

Throughout history, women have provided other women with support during childbirth, when mothers often gave birth at home. The majority of Western women now give birth in hospitals, where labor and delivery are treated as medical events, and mothers are treated as patients.

In recent years, social movements have called for treating childbirth as a more natural experience, and for bringing back continuous one-to-one support for women, by women, during labor.

Maybe you, like many others, are thinking that’s what the mother’s partner is for.

The partner can, and should, be prepared to support the laboring mother with gentle touch and encouraging words.

Partners, however, are not professionally trained in labor support, and can become nervous and hesitant when faced with the pain and uncertainty the person they love may feel during childbirth. Partners can be left feeling helpless in the process, wanting to do more but not quite knowing how.

A modern doula cares for a woman throughout labor, knowing what the mother wants giving birth to be like and doing everything she can to guide her to an empowering experience; she also guides the partner in helping the laboring woman.

Many women who become doulas are called to the role after experiencing childbirth themselves. Some want to provide other women with something they felt was lacking. Some had such a positive and empowering experience that they want to provide the same for others.

Still other doulas, myself included, do not have their own children, but instinctively feel drawn to nurture women during their transitions into motherhood.

There is no licensing for a doula, but there is a certification process. Doulas can become certified through any number of well-respected organizations.

Certification typically includes attending childbirth-education and breastfeeding classes; a hands-on workshop with professional trainers; working with a mentor; required reading; writing assignments; and, most importantly, attending a certain number of births.

A doula does not provide any medical care and does not make any decisions for the mother or her partner — she simply provides non-judgmental support for medical decisions the couple does make and gives them the information and feedback to guide the decision-making process.

Even though a doula does not provide medical care, there is evidence that using a doula has medical implications. According to a study by the Cochrane Collaboration in 2013, women who had a doula present during labor were more likely to have a vaginal birth without the use of vacuum or forceps extraction, less likely to have a caesarean section, less likely to use pain medications, more likely to have shorter labors, and more likely to be satisfied with the experience.

Birth is a key event a woman will remember all her life. Whether it’s positive, negative, scary, fearless, difficult, effortless, uncomplicated, or problematic, a woman will always remember.

Pregnancy and childbirth are both ordinary and extraordinary. They are both common and unique. As a doula, I treat them as such.

Many options

A pregnant woman has many options and will often feel overwhelmed and bombarded by information, confused about which choices may be right for her. She will receive advice from friends, family, and even strangers. It might seem like everyone has an opinion on what she should or shouldn’t do.

Most of the opinions and advice are focused on what people think is best for the baby. Certainly, a healthy and happy baby is the end goal, but the mother’s wants, needs, expectations, and emotions shouldn’t be ignored.

The popular adage is “A healthy baby is all that matters,” but, in reality, it’s not all that matters. Why should the mother’s experience and feelings be minimized?

A doula often views her role as “mothering the mother” because she certainly deserves nurturing during such an important time in her life.

During pregnancy, a doula helps a woman prepare for the birth she desires, and then stays with the woman throughout labor to help her achieve that birth. A doula provides emotional and physical comfort measures and facilitates communication between the laboring woman, her partner, and her care providers.

When I meet with a woman during her pregnancy, the first thing I do is ask questions to get a feel for what type of birth she envisions — her dream birth, regardless of feasibility. I want to know what kind of birth she would have in a perfect world.

From there, we talk about the options she has to get as close as she can to that experience in the real world.

There are so many things to take into consideration. Does she want to use an obstetrician or a midwife? Does she want to give birth at home or at the hospital? Does she want chemical pain relief or to use natural pain relief techniques?

Does she want to push lying on her back or squatting or on her hands and knees? Does she want to give birth in the water? Does she want to bring the baby to her chest immediately to breastfeed? Does she want to keep her placenta?

Maybe she didn’t even know she had some of these options. Maybe she’d never even heard of some of them. Maybe, after that initial meeting, she still doesn’t quite know what she wants, but she’s armed with information she didn’t have before, and ready to do her own research and consult with her medical care providers.

Providing resources

I also provide mothers with a list of resources they may find useful, including various doctors, midwives, and hospitals; prenatal fitness classes; pregnancy, childbirth, and breastfeeding education classes; lactation consultants; support groups; and more.

I am available to mothers any time of day or night via phone call, text message, or e-mail.

I am happy to loan clients any of the books in my personal library if there is a topic they want to research.

After the initial consultation, I meet with the expectant mother and her partner two or three more times.

At those meetings, I address any questions they have come up with in their research.

I show them the contents of what I call my “doula bag” and demonstrate how they can be used during labor. The bag includes some basic things, like non-latex gloves, absorbent pads, and hygiene items, as well as things like massage tools, essential oils, a heat-able rice pack, snacks, and water.

We also go over what might happen during labor and delivery — both the expected and the unexpected, because, as nice as it is to have a birth plan, sometimes things are unpredictable, especially during birth.

We talk about what comfort measures the woman might like to try based on how she manages pain at other times in her life. Does she like massages or are there places she doesn’t like to be touched? Does she like aromatherapy, and are there particular scents she finds relaxing or offensive? Does she find warm water soothing?

I also demonstrate some of the positions I might encourage her to try during labor, both for pain relief and to help things progress — hands and knees, squatting, lunging, bouncing on an exercise ball, leaning against a wall or her partner and swaying, and more.

When it comes time for the actual birth, I encourage the client to call me the moment she feels things are starting to happen — even if she’s not entirely sure. We can talk through what she’s feeling and she can rely on me for phone support until she decides she either wants me to attend to her at her home, or she wants to go to the hospital and have me meet her there.

I will be there, from the moment she decides that she needs me, until the baby has been born, the mother is settled, and my presence is no longer required.

At the hospital or birth center, I try to be as unobtrusive as possible to the medical professionals, while attentively serving the needs of the mother.

Whatever she needs, whenever she needs it, I am there. I will rub her back; hold her arm as she walks laps around the maternity unit’s floor; massage her feet; feed her ice chips; fetch her water; and help her move herself into new, more comfortable positions.

I will play her music, diffuse essential oils, hold a bucket while she vomits, and wipe her brow. I will talk to her about what her body is doing and what it means. If the birth plan changes, by choice or by circumstance, I will talk it through with her, and reassure her.

When she’s ready to push, I will hold her leg, hold her hand, and hold her gaze. When she says she can’t, I will tell her that she can, that she will, and that she is.

When the baby is out, I will tell her that she did. I will tell her she is strong, that she’s amazing, and that she should be proud.

In the minutes following the birth, I try to make myself scarce, so that the parents and baby can bond, though I am still there in the background should anybody need me.

When the new mother is comfortable, the baby has been checked out, and everyone is settled, I will leave. Whether it is four hours or 24 hours, I will not leave before then.

Though the birth is, of course, the climax of the whole experience, a doula does continue in her role after it is over.

I continue to be available by phone and e-mail for several weeks, and try to drop off postpartum healing aids after everyone is home from the hospital. I schedule a postpartum meeting several weeks out so we can process the birth and how it went — whether the birth plan was adhered to or deviated from, whether the mother felt supported, and whether she has positive memories or wishes it had gone differently.

Finally, I write up a birth story, from my perspective, to remember the details, and share any photographs I may have been able to capture.

It is bittersweet when my time with a client has come to an end. I am thrilled to have helped a woman through pregnancy and into motherhood, but, after having been allowed to be part of such an intimate process, it can be hard to let go. I keep a log of all of the birthdays so I can make sure to acknowledge them and send a card in the future.

Not every woman wants a doula, but every woman deserves one. Every mother deserves to feel wholeheartedly supported, encouraged, and, most importantly, not judged during the most emotional, vulnerable, and transformational experience of her life.