As I was making my second cup of coffee around 10 a.m. one Friday morning, I received a text from a client that her water had broken. She had lost her mucus plug, and was experiencing mild contractions — all signs of early labor. After chatting on the phone, we agreed that her partner would call me as soon as her contractions became more intense and started occurring at regular intervals. Around 3 p.m., I was on my way to support her throughout the remainder of labor, using the birth techniques we had been practicing for the past month. After an intense and emotional labor, we welcomed baby Julia at 11:29 p.m.

This is what my days and nights as a doula often look like.

In March, I completed a 35-hour doula training at Natural Resources in San Francisco. Since finishing my training, I’ve been serving as an emotional, physical, and informational resource to women before, during, and after labor. I have the privilege of witnessing newborns’ first breaths of life and women’s innate strength on a regular basis. Here’s what my journey has been like.

Remind me, what’s a doula?
Doulas are companions who provide continuous care during pregnancy, birth, and the postpartum period. While OBGYNs and midwives are clinical providers, doulas are non-medical professionals who primarily focus on the emotional aspect of labor. Doulas serve as a constant throughout a woman’s pregnancy and postpartum period — something that’s rare in the fast-paced medical world where it’s normal to see a variety of professionals during prenatal, labor, and postpartum care.

Doulas can assist clients in developing a birth plan that aligns with that person’s unique preferences, like whether or not they want to use an epidural or circumcise their child. Doulas provide physical and emotional comfort during the birth itself by suggesting various labor positions, leading visualization or breathing techniques, using touch or massage to ease pain, and providing reassurance and motivational affirmations. When working with clients postpartum, doulas may even help parents navigate feeding and sleeping.

Ultimately, a doula’s goal is to offer the tools, guidance, and comfort to boost a client’s confidence, thus enabling them to have a positive experience, whether that’s birthing their child or adjusting to life as a new parent.

What scientific research has to say about doulas
Research shows that having doula support is more than just a nice-to-have — it can actually reduce birth complications and improve birth outcomes for mothers and babies. A 2013 study published in the Journal of Perinatal Education observed 226 expectant mothers of similar ages and races. Half the women were assigned a doula while the other half were not. The researchers discovered that the mothers matched with a doula were four times less likely to have a baby born at a low birthweight and two times less likely to experience a birth complication. Other recent studies (like this one and this one) arrived at similar conclusions.

Though only a small percentage of expecting mothers currently enlist doulas, the usage and profession are both growing in popularity thanks to research like this. Some hospitals now offer volunteer doula programs for patients, and in April 2018, the state of New York announced a pilot program that included expanded Medicaid coverage for doulas as part of an initiative to lower maternal mortality.

Training to become a doula
My training at Natural Resources took place for three to four hours weekly for a couple of months. Both of the instructors were former doulas with years of experience. One, who is now a homebirth midwife, had attended over 700 births.

As for the cost, I spent $800 on the training itself and about $200 for books, materials, group snack contributions (of course), and transportation. The training covered topics like a doula’s role, evidence supporting doulas, maternity care in the United States, the anatomy and physiology of pregnancy, fetal development, stages of labor, medical procedures, birth environments, how to interact with hospital staff, comfort measures, positions, and so much more.

The most surprising and valuable thing I gained in my training was 15 new sisters — a tribe of inspiring, compassionate, like-minded women. I keep in touch with many of them, and often reach out for support after a difficult birth or if I’m not quite sure how to handle a certain situation.

My reason for supporting mamas
While I’m undoubtedly motivated to improve maternal and infant outcomes in the United States through my work, my primary reason for becoming a doula is different. From my past and current experience of writing about pregnancy and birth, I’ve discovered that so many women feel overwhelmed by the entire process. Some even feel judged for their choices or pressure to make certain ones — like giving birth naturally, for example, because their best friend or mother refused pain medication.  

My goal is to deliver objective, research-backed information to my clients in a completely non-judgmental way, so they can make autonomous choices. In my opinion, it’s not about how a woman gives birth, as long as the path leads to a healthy and happy mother and child. Instead, it all comes down to making educated, informed, and intuitive decisions that won’t look the same for any two births.

English Taylor is a San Francisco-based women’s health and wellness writer and birth doula. Her work has been featured in The Atlantic, Healthline, Refinery29, NYLON, and Modern Fertility. Follow English and her work at https://medium.com/@englishtaylor or on Instagram at @englishtaylor.