Rhea Dempsey
Birthing Wisdom

What is a Doula and Why Do I Need One?

Modified and previously Published on Kidspot – 20/3/18

The call came through at 1.55 in the morning, ‘We’re heading to the hospital’, explained the soon-to-be-father of baby number four. ‘Great’, I replied, ‘I’ll meet you there’.

The early morning call is the easiest to respond to – no other commitments to juggle, no traffic snarls, no parking challenges. Easy.

Room three, the same room as last time. I’d been with this couple for the beautiful birth of their third baby two years ago. We had a warm, easy connection that came from sharing the potency, beauty, grace and bonding of birth.

Before entering I was delighted to hear the familiar spontaneous, instinctive sounds of a woman working through a building contraction, mmm … sounds like seven to eight centimetres to me, well into active labour – perfect timing for arriving at the hospital.

The room was still being set up for the work of birthing – lights dimmed, mat and physio-ball, music, shower available, bed raised high for standing and leaning support, ice water and face cloths to cool a striving body.

The birthing mother dropping into deeper instinctive responses, using gravity, working into the contractions, swaying and rocking to the internal rhythm of her body and baby’s birth dance, her sounds matching the opening of her body, with a respectful midwife watching over. There is a harmony of purpose in the birthing room, I know it well; it’s orchestrated by the oxytocin flooding this birth space.

And so begins another birth adventure in my work as a Doula.

I’ll offer this mother a small measure of suggestion and guidance; a large measure of presence and reassurance; a soft voice murmuring encouragement; eye contact, gentle touch, breathing with, hand squeezing, sips of water, cold cloth; and an endless measure of awe, respect and unconditional love. And soon, into this love circle, a baby boy emerges into arms and hearts, creating tears of delight and gratitude all round.

Later, I make my way home and back to bed for another hour or so sleep before a busy day. Perfect.

So what is a Doula?

Doula is a Greek word that has come to mean a woman who helps other women. In contemporary times, the word has evolved to mean a woman experienced in childbirth who provides continuous physical, emotional and informational support to the mother, before, during and after childbirth. (Doula work also continues to evolve to encompass support across other life transitions).

The birth doula’s role covers physical, emotional and partner support, as well as sharing evidence-based resources. But at its heart it’s really an intense nurturing role often described as ‘mothering the mother.’

‘Queen oxytocin’, as I call the naturally occurring hormone that drives normal birth and bonding physiology, is optimally released in mothers in birth situations where birthing women feel emotionally and relationally safe. Helping them feel this way is the true essence of the doula’s role. So actually, we could simply describe the doula’s role as an ‘oxytocin multiplier’, and research shows that doulas do this very well.

Why you need a Doula?

The research shows the presence of a doula results in ‘improved physical and psychological outcomes for both mother and baby; reduced risk of caesarean section; reduced rates of interventions like synthetic oxytocin, vacuum and forceps deliveries; increased satisfaction with the birth experience; better APGAR scores for baby; increased breastfeeding and bonding and reduced rates of postpartum depression and other mood disorders.’ (DONA International: 2014)

In fact, the American College of Obstetricians and Gynaecologists and the Society for Maternal-Fetal Medicine, in a joint paper report that ‘one of the most effective tools to improve labour and delivery outcomes is the continuous presence of support personnel, such as a doula. Given that there are no associated measurable harms, this resource is probably underutilized.’


And given that, in Australia the statistics for interventions are well above the World Health Organizations recommendations and the rates of birth trauma, ante and postnatal anxiety and depression are all high and rising, the doula research is entirely relevant here as well.

The kind of ‘with woman’ continuity care that doulas provide now, has traditionally been part of the midwife’s role. However, in Australia only eight percent of women get to access midwifery ‘continuity of care’ programs – the gold standard in maternity care. As a result, doulas are ‘filling the gap’ by providing continuity of care, advocating for women, protecting normal birth and providing breastfeeding and emotional support.’

It seems that, until the midwifery ‘continuity gap’ is filled, including a doula in your birth team is a no-brainer.


Rhea Dempsey

Independent Birth Educator, Doula, Counsellor, Trainer, Presenter on birth issues, Author of Birth with Confidence: savvy choices for normal birth


Rhea Dempsey

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