Friday, June 22, 2012

So who do you REALLY want to hire? A doula or a monitrice?

What a doula provides:

Continuity of care:*

Once the doula comes to your side in labor, she is there for the duration of your labor, birth and immediate postpartum period. Nurses have other patients to care for and will be in and out during labor. Your OB may only show up for the delivery and then again, you may end up with a completely different OB. If you have a hospital birth with midwives, there is a great chance that the midwife will have other patients as well and will be in and out. You get to know your doula at several visits before the birth, and she gets to know you and your hopes and concerns regarding your upcoming birth experience. She will also see you after the birth. Some doulas are also postpartum doulas, and if you desire, your postpartum doula can help you during the postpartum period with breastfeeding and parenting issues.

Support for the birth parter:

Doulas do not just help the mother! I have seen a very visible sigh of relief from fathers when I have entered the room. Just knowing that there is someone else available to help their partners seems to put them at ease. If they forget something they learned in their childbirth education class, even if they forget everything they ever knew, having the doula there to provide loving encouragement to the birth partners to participate as much as they are comfortable is a huge relief to dads to be.

Wealth of knowledge:

Doulas know all about birth and the birth process. Many have given birth themselves. Even if they have not given birth themselves, they have supported women in the process and know what a laboring woman looks like. They know the birth environment of local hospitals and practitioners. Even if they do not have experience at that particular location themselves, most doulas network with other doulas and can always find out. If a doula doesn't know the answer to your question off the top of her head, she knows where to go to find the answer.

Another pair of hands:

It gets tiring to massage a laboring mom sometimes, so if the labor is very long, the birth partner and the doula can take turns.


The doula knows how hard labor can be and what needs to be done to get through it. Many times the labor doula has given birth herself, and if she hasn't, she is experienced with supporting mothers through labor. A laboring mom and her partner can rest assured that their doula truly "gets it."


The doula is there for the parents. She is hired by the parents and has loyalty to only the parents. She can help remind you to make informed decisions and can help explain what hospital staff are saying when you are in the middle of concentrating on labor.

Reduced rates of medical procedures and complications:

Studies have shown that a woman can have another woman sitting in the room doing absolutely nothing, and her presence alone will improve the outcome of a woman's labor and birth. Imagine if a trained doula is in the room. In summary the benefits of a doula are:

Source: Unknown. If this is yours, please let me know.

What a monitrice provides:

All of the above plus:

A monitrice is able to provide clinical skills such as checking fetal heart tones, taking blood pressure, and assessing cervical dilation through pelvic exams. 

Do you want someone who can provide some medical skills? Do you want someone who can help you decide when to go to the hospital by assessing cervical dilation through a pelvic exam? 

Then you want a monitrice

About both doulas and monitrices:

There is a wide spectrum of what services doulas and monitrices are comfortable providing. Some doulas are certified and some choose not to certify. It is up to the expectant families to do research to determine what type of doula they want and/or need at their births, and if they want a doula at all. Maybe what a mama really needs is not a doula at all but a monitrice. 

If you decide that a monitrice is what you really need, I am happy to provide a few referrals to some doulas who also have been trained as monitrices. 


The list of services that doulas typically provide comes from Henci Goer's The Thinking Woman's Guide to a Better Birth, pages 182-183. The elaboration of services provided are my own clumsily written thoughts. 

Because I like to give credit where credit is due, a local doula who wrote an article about the scope of practice of doulas, sparked this entire thought process of mine. 

1 comment:

  1. Kristi,
    The oft quoted stats you show in the pic above came from the original study on doulas, which was actually done here in Houston. I used to have a link to the full article, but I can't find it now. Here is the citation:
    Continuous Emotional Support During Labor in a US Hospital: A Randomized Controlled Trial

    John Kennell, MD; Marshall Klaus, MD; Susan McGrath, PhD; Steven Robertson, PhD; Clark Hinkley, MD
    JAMA. 1991;265(17):2197-2201.