Doulas are non-medical birth coaches or guides that help women and their partners achieve the kinds of births they desire, and follow up during the postpartum period. A 2016 study in the journal Birth found that having a doula can reduce your chances of preterm birth and caesarean section

I absolutely credit my birth doulas with helping me achieve two natural, unmedicated births. But whether you want a natural birth, or you want the epidural started at the first hint of contractions, doulas are necessary because of the unexpected things that happen before, during and immediately after birth. Here’s a list of the real reasons you need a doula.

Medical issues during pregnancy

Pregnancy is difficult enough if everything goes according to plan, add in health complications and it can be even more challenging. Whether you struggle with debilitating morning sickness, hernias or preterm labor, doulas are a good source of information for coping with these challenges and creating a plan to help get you to term.  

Not only do they have practical experience with these pregnancy complications, but they are in touch with multiple providers in your community who can help alleviate symptoms. Midwives, chiropractors, acupuncturists, OB-GYNs and other specialists can all help you cope with pregnancy complications. Having an experienced guide can also help you make difficult decisions when you aren’t at your best.

Overdue pregnancy

My first son arrived two days after my due date, thus providing a timely ending to a relatively uncomplicated pregnancy. My daughter, however, was a different story. At 36 weeks I was one centimeter dilated and began having consistently spaced, intense contractions every day. This went on, and on, and on some more.  

At 41 weeks I was emotionally and physically exhausted and ready to throw in the towel. I had tried every conceivable trick to induce labor: pineapple, spicy food, evening primrose oil, yoga and all to no avail. The only thing more scary to me than a medical induction was continuing to labor for a good part of every day with no baby to show for it. My doula suggested I see a chiropractor she’d worked with for years just in case my daughter was in an awkward position that was preventing birth.  

Intensely skeptical, I booked an appointment for 10:00 a.m. the following day. The session lasted about thirty minutes and my daughter was born five hours later. Without my doula’s suggestion, I feel confident I would have ended up having a medically induced birth and very likely a C-section, both things I fought hard to avoid.

Your birth plan doesn’t work out

As scary as having the birth you planned can be, having the birth you didn’t plan is even more frightening. Women who hoped for C-sections but end up with unmedicated births because of a determined baby or delayed surgeon can be left feeling overwhelmed by the sensations of a birth they had not anticipated.  

Similarly, women desiring natural births who end up having emergency C-sections can feel totally terrified as they undergo a major surgical procedure with very little preparation. This is when a doula steps in to offer her expertise with managing fear, pain, disappointment and unrealized expectations. Having a guide to explain the process in real time can give you the information and emotional support you need to quickly adjust to changes in your birth plan.

Birth injuries

Whether you experience a severe tear during vaginal birth, have an episiotomy, or undergo a C-section, the recovery process can be painful and confusing after a birth injury or surgical procedure. Your doula can offer you information about healing and managing pain.  

The herbal sitz baths my doula recommended were crucial when I experienced a third-degree tear during my first birth. Doulas are also masters of various breastfeeding positions that can take the pressure off a C-section incision. If you find yourself really struggling, a postpartum doula can help with daily household chores and caring for your baby.

Postpartum depression

Whether your birth went according to plan or not, whether you’re a first-time mom or experienced mama, an estimated 11 to 20% of women who give birth will experience postpartum depression according to the Centers for Disease Control. Pediatricians sometimes include a screening during your baby’s well-child visits, but most women are discharged from the hospital with no follow-up until their six-week post birth check at the OB-GYN.  

If you feel yourself struggling once the week or so of baby blues has passed, your doula is an excellent resource. Once you’ve found a mental health professional to address the postpartum depression, a doula can help get you back on track. Sleep and self-care are major factors in postpartum depression, and both are in short supply after giving birth. Having someone to take the night-shift so you can get solid, uninterrupted sleep or to make a healthy dinner while you get a shower can be huge factors in relieving your depression.  

Breastfeeding support

I have yet to encounter a woman who felt breastfeeding was simple or intuitive. That’s where a doula comes in. If you’re able to successfully breastfeed there will be endless questions about milk supply, nipple pain, breast infections and healthy weight gain. Doulas can help with all these issues, and if the problem requires more expertise, they often have close working relationships with lactation consultants who can help.  

When you are unable to breastfeed, doulas can be just as important.  After giving birth to my son I struggled to breastfeed for weeks. I tried every position possible, used nipple shields, pumped before feedings, did skin-to-skin, all without success. As days turned to weeks without any improvement, my mood started to seriously deteriorate.

Operating on very little sleep and surging with hormones, all I wanted was to feed my baby. It took a long, tearful conversation with my doula to acknowledge that breastfeeding wasn’t going to work out before I could give myself permission to stop trying. She went on to help me work out a pumping schedule that allowed me to give my son breastmilk while saving my sanity and ending a frustrating cycle.

For more information on finding a birth or postpartum doula go to https://www.dona.org/what-is-a-doula/find-a-doula/.

To find out more about postpartum depression and treatment visit http://www.postpartumprogress.com/.