What’s a doula? What do – and don’t – they do during childbirth?

A doula is a professional who offers non-medical support and guidance to women during childbirth and the postpartum period. The term "doula" stems from ancient Greek, meaning female servant or slave. However, modern doulas run their own businesses and charge for their services. The word doula gained prominence in the US during the 1970s, when Dana Raphael revived it to describe women who supported breastfeeding mothers.

Studies by Marshall Klaus and John Kennell in Guatemala revealed that the presence of a supportive female companion during labor resulted in shorter labor times and reduced chances of cesarean sections.

The first official use of the word "doula" in a dictionary occurred in 2003. In Australia, demand for doulas started increasing in the early 2000s, though data on their exact numbers is scarce. A 2018 survey in California indicated that around 9% of women in that state employed a doula during labor, with higher rates among Latina and Black women.

Doulas' fees vary widely, depending on their level of training, experience, and the range of services they offer. Trainee doulas may charge as little as A$500, while highly experienced doulas can cost over $5,000. It is important to note that while non-clinical childbirth support has been present in Australia for many years, the need for doulas surged in recent years due to perceived inadequacies in the current maternity system.

Midwives and doulas generally agree that the current system fails to meet women's needs, with midwives struggling to cope with clinical workloads and lack of continuity of care, while doulas step in to fill this gap. However, conflicts can arise when doulas overstep their role and provide medical advice or decisions.

Doulas do not provide clinical care, such as performing vaginal examinations or monitoring the baby's heart, nor do they make decisions for the client or pressure them into making specific choices. The lack of a national body to oversee and regulate doulas in Australia means that there are limited options for addressing concerns or complaints.

However, state-based health complaints commissioners, the Health Ombudsman, or Fair Trading and Consumer Affairs can be approached in case of issues. Cases where mothers or babies have died due to the absence of midwives or obstetricians have highlighted the potential dangers of doulas attending "freebirths" without proper medical supervision.