What does a doula do during childbirth?

I get asked this question very often. And I keep reading answers to it – in articles, on websites, or on social media. For a long time, I thought I didn't need to answer this question again. But honestly, I don't like many of these answers. Not because they're wrong – but because they often fall short. They only describe a small part of what doula work is really about.

"Friend for a limited time"?

I, too, described my work for a while as being like a "friend for a limited time." And to a certain extent, that's true. A very close relationship often develops during the support period. Many women feel so comfortable over time that the connection actually feels a bit like a friendship.

The difference is this: being a doula is my job. It's my profession to support births. This gives me experience, knowledge, and a level of professionalism that goes beyond what a friend can offer.

The idea behind the "friend for a limited time" is still important: a person with whom you feel comfortable and with whom you can be exactly as you are. Without having to explain yourself, without having to meet expectations. This feeling of security and trust can have an enormously positive influence on the course of labor.

What's missing from this description, however, is the professional aspect. As a doula, I'm not just someone you can feel comfortable with. I'm also someone who sometimes asks uncomfortable, but important questions.

For example:

Have you already considered the possibility of a cesarean section?

What would help you if a home birth resulted in a transfer to the hospital?

Many female friends probably wouldn't ask such questions. Partly because they might not realize how important it can be to address these issues. And partly because they don't want to make you feel insecure or uncomfortable.

Furthermore, most friends have no experience in a birth setting. This experience, however, can be crucial – especially for the atmosphere in the room. Birth can be intense, loud, and sometimes frightening when you don't know what's happening. As a doula, it's important to me to make you feel safe and secure, especially in these moments. Someone who is frightened themselves will find it difficult to do so.

The doula as a space holder

One of the central tasks of a doula during childbirth is to hold space. But what does that actually mean?

Every person brings feelings, experiences, and predispositions to birth. Some of these we are aware of, others less so – yet they all influence us. Especially in such an intense situation as childbirth.

If feelings such as fear, insecurity, anger, or helplessness arise during childbirth, it is important to acknowledge them. At the same time, one should not allow them to take complete control.

I am not a therapist or a coach. With me, you can simply be yourself. I don't judge, and I don't try to "treat" you. My role is to help you manage these feelings so they don't overwhelm you and you can remain empowered.

And I am not only holding the space for you – but also for your partner, the midwife, possibly a midwifery student and all other people who are in the room during the birth.

For me, holding space means above all creating an atmosphere where everyone can feel safe. An atmosphere where feelings are allowed to exist. Because if we ignore or suppress feelings, they don't disappear – they usually just become stronger.

I often recognize anxiety early on in the women I work with. Sometimes they can't even pinpoint its source themselves. When we talk about it, it often diminishes – sometimes it even disappears completely.

And sometimes she just stays there. In those moments, I'm simply present. Not intrusive, but noticeable. Calmly and confidently by your side.

An addition to the birth team

Why are doulas needed in the birthing room?

One important reason lies in the system in which birth often takes place today. Particularly in clinical settings, midwives are frequently forced to leave the room intermittently – for example, to document or to attend to other women in labor.

This doesn't mean you'll be left alone. There are emergency buttons, CTG monitoring, and midwives keeping an eye on the situation. Nevertheless, it can be unsettling, especially for first-time mothers or women with previous traumatic birth experiences, when suddenly no one is directly in the room.

This is precisely where a doula can be a valuable addition to the birth team.

The well-known Cochrane Review by Hodnett et al. (2017) shows that continuous 1:1 support during childbirth is associated with better outcomes: more vaginal births, fewer cesarean sections and medical interventions, and overall more positive birth experiences.

Particularly interesting: The effect was strongest when the accompanying person had no medical role – exactly the role of a doula during childbirth.

Support also for partners:

It's not just the woman giving birth who benefits from doula support. Partners often experience the birth in a more relaxed and positive way as well.

Many partners want to help but don't know exactly how. In my support, I show them which touches, positions, or words can be helpful. This empowers them to become active and important companions during childbirth.

This makes the birth an intense and often very bonding experience for both.

Midwives also often appreciate my presence. As a doula, I take on tasks during childbirth that can complement their work, allowing them to concentrate even better on providing medical support – whether at home or in a hospital.

What a doula doesn't do

It's important to know: You always need a midwife for childbirth.

The difference between a midwife and a doula: a midwife is a medical professional and focuses on the physical health of mother and child. A doula, on the other hand, does not perform any medical tasks.

I do not make diagnoses, perform medical treatments, or replace a midwife. My role lies in the emotional, practical, and supportive realm.

Every doula works differently.

When I say that a doula "per se" doesn't have medical training, that doesn't mean she lacks knowledge. Many doulas have various advanced training courses and additional qualifications.

In my case, birth photography is also an important part of my work. Furthermore, over the years I have completed various advanced training courses – including relaxation techniques, rebozo, nuad, Ayurvedic treatments, essential oils, pelvic floor knowledge, birthing positions and breastfeeding support.

Therefore, my birth bag always contains things like a TENS unit, a birthing comb, various essential oils, a rebozo, a peanut ball and some other small helpers.

I bring these items to every birth – even to births where I'm only photographing. (Just let me know if you 'd like them! ) That way you don't have to get them yourself and can still benefit from them.

"Do I need a doula?"

No. You don't need a doula for the birth of your child.

But if you want more emotional support, continuity, and someone by your side during pregnancy and childbirth, a doula can be a very valuable addition to your birth team.

If you have any questions after reading, feel free to contact me – or book a no-obligation introductory meeting directly.