What is a Doula? Here is What A Doula Is & What We Do

What is a doula?

It’s a funny-sounding word that means so much!

One of the top questions I get is: “well, what is a doula?” And I’m always happy to answer that question because I think more folks should know what a doula is and what we do. Our jobs are truly to make your birth and postpartum time less scary and confusing, and to make you feel more prepared, empowered and supported. Everyone can benefit from a doula!

Here’s the doula definition for you: a doula is a trained professional who provides physical, emotional, and informational support to families during their pregnancy, birth, and postpartum time. We are not medically-trained, so we do not give advice in that realm. Some doulas are for pregnancy and birth, and some doulas support you in the time directly after birth (otherwise known as your postpartum time or sometimes called “the 4th trimester”). 

Let’s take a look at these two types of doulas:

Birth doulas

Birth doulas will start working with you anytime during your pregnancy. Honestly, we get hired for this service from as soon as someone gets a positive pregnancy test all the way up until a few weeks before someone’s estimated due date. However, my advice is to hire your birth doulas as soon as you can for two reasons:

1. You get more value out of your doula the sooner you hire us.

2. You get to build a deeper relationship with your doula if you have longer to work with us. Relationship-building is a key component to how we do our work, and it’s so lovely to have that rich connection with your doula before your birth.

Birth doulas bring so much support to your pregnancy and birth, so let’s look at how they do that:

1. Birth doulas are educators: while we encourage all families to take a comprehensive childbirth class in addition to hiring a doula, your doula will also be an invaluable source of evidence-based information for you. If you are looking for more info on any topic, your doula can provide that for you!

2. Birth doulas are facilitators: we love facilitating good conversations between you and your partner, between you and your care provider, and on the day of your birth, between you and your care team at your birth place. We know that birth works best when everyone is communicating well and on the same page. We help you to think through those conversations ahead of time, and in the moment, we help you remember the right questions to ask.

3. Birth doulas are advocates: we are really great at advocating for our clients’ needs in their birth spaces. We will never speak for you, yet we will make sure your voice is heard. Noticing and naming are two of the ways we do this, and we will always check in with you to make sure your wishes are being carried out. Sometimes our doulas will see things that you don’t see, and we will make sure to bring them to your attention.

4. Birth doulas have resources: we have So. Many. Resources! From local resources for pelvic floor physical therapy to great chiropractors to the best lactation specialists, we’ve got you covered. Your doula will also be a fantastic resource for any birth, pregnancy or baby topic you can think of, and can help you decide on things like what goes on your baby registry to what items you really need in your postpartum recovery time. I like to say that we are better than Google, and I stand by that!

5. Birth doulas have knowledge about birth: this seems like a no-brainer, but it’s true! When everything you learned in your childbirth class goes out to the window, your doula will be right there with their knowledge of comfort measures, positions changes, when is the best time for pain medication, what is this intervention that my care provider is suggesting, etc. Having a birth doula in the room is an invaluable support for partners and family members, too.

One of our amazing birth doulas, Elizabeth McGuire with a happy client!

Now, let’s look at what postpartum doulas do:

Postpartum doulas

1. Postpartum doulas are helpers: Right after you have a baby, what you need most is to rest, feed yourself and feed your baby. Postpartum doulas can help with all of that! They can also tidy up your house, do a load of baby laundry, and be a great listening ear for you if you want.

2. Postpartum doulas are baby whisperers: Postpartum doulas know all the tips to help your baby with sleeping, expelling gas/pooping, and soothing. Let them teach you their ways! They are happy to do it.

3. Postpartum doulas are educators: Want to know how to do baby-wearing? Want to learn how to set up your pump? Postpartum doulas know all of this and more! They are happy to educate you on all things baby like: when can you expect that first growth spurt? What is tummy time and when should I start it? They are also knowledgeable about the basics of breastfeeding/chestfeeding, and can be an invaluable help to you with that.

4. Postpartum doulas have resources: So. Many. Resources! Just like birth doulas, postpartum doulas have all of the evidence-based resources for you and can get you connected with all of our favorite local resources and services. Remember, we are better than Google! (still standing by that!)

5. Postpartum doulas have knowledge about babies and recently-postpartum folks: Having a postpartum doula in your house is like having your own expert to answer all of your questions. The number one question we get is: “Is this normal?” They are happy to tell you when it is normal and will be the first to suggest you call your care provider if they think it’s needed.

Click to learn more about EJ Jones, one of our fantastic doulas!

And I want to point out some advantages to having our postpartum doulas come support you at night:

overnight postpartum doulas

1. Night nanny/night nurse/postpartum doula: what’s the difference? Well, it’s 3 names for the same thing. Our overnight postpartum doulas will be happy to take care of your baby through the night while you catch up on some much-needed sleep.

2. Your overnight postpartum doula can do a few of those household tasks I mentioned above at the start of their shift, but once everyone is in bed, they will be keeping the house quiet so that everyone can sleep.

3. Your overnight postpartum doula will be feeding and taking care of your baby through the night. If you are nursing, you will come up with a feeding plan that maximizes your sleep. Let the doula take care of burping, changing and getting your baby back to sleep for you!

4. Overnight postpartum doulas are magic! If you don’t believe me, look at our testimonies from rested & happy clients!

I hope you now have a clearer sense of what a doula is and what we do. If you are ready to hire a birth doula or postpartum doula in the Nashville area, fill out our intake form and schedule a call with me today. Our service area extends about 30 miles in all directions from downtown Nashville, but we do make exceptions sometimes if you live a bit farther out. Give us a call and let’s chat soon!

Click the photo to learn more about hiring the amazing Kelsie Craig as your doula!

We would love to help support you in your birthing year! I think we have the best birth doulas and postpartum doulas in Nashville, but I’m biased :-) Check out our Google reviews to see what our clients are saying about our services and the value we bring to your experience.

Pregnancy, postpartum and COVID-19

East Nashville Doulas upholds the highest standards of care for our clients and their families. In the midst of an ever-changing landscape brought on by the emergence of COVID-19 in Tennessee and beyond, I wanted to let you know what our agency is doing to stay informed and to keep our clients and doulas safe.

1. Following CDC & ACOG Guidelines

We are staying up-to-date with the Centers for Disease Control & Prevention (CDC) and American College of Obstetrics & Gynecologists (ACOG)’s COVID-19 safety guidelines for pregnant people and care providers. You can find them here:

Guidelines issued by the CDC for pregnant people and breast/chestfeeding people

Guidelines to protect yourself and your family

ACOG practice advisory

2. Safety Measures

East Nashville Doulas is monitoring regional guidelines (Tennessee Department of Health info) and hospital policies where our clients are giving birth to ensure that we have the most up-to-date information for our families. Our doulas also continue to follow and share best practices for cold & flu season with our client families and our own families. These safety measures from the CDC include:

• Washing hands frequently for at least 20 seconds with soap and water. If soap and water is not available, we will use a hand sanitizer that contains at least 60% alcohol.

• Avoiding touching eyes, nose or mouth with unwashed hands.

• Avoiding close contact with people who are sick.

• Covering mouth and nose with a tissue when you cough or sneeze (or use the inside of elbow) and dispose of the tissue in the trash immediately. Wash hands immediately afterwards according to the protocol above.

• Cleaning and disinfecting frequently touched objects and surfaces.

• Staying home when we are sick (this is when it’s great that we work with a team!).

• Staying home for at least 24 hours after a fever is gone (without the use of fever-reducing medicines).

3. Extra precautions

In addition to the above safety measures, we take the following precautions to keep our client families healthy:

• Notifying you if anyone in a doula’s family is experiencing cold or flu symptoms so that you can decide if you’d like a backup doula instead.

• Washing our hands first thing when we come into your home or birthing space. Continuing to wash hands frequently as needed.

• Wearing gloves in the birthing room when possible to avoid skin-to-skin contact.

• Washing our clothes in hot water and disinfecting our shoes after a birth.

• Cleaning any birth supplies used with disinfectant wipes between births (massage tools, etc.)

• Removing our shoes at the entrance of your home when visiting or starting a postpartum shift.

Since there have been confirmed COVID-19 cases in the greater Nashville area, our doulas will add the extra precaution of taking their temperature before attending each birth and postpartum shift, and will report any symptoms to our team.

Of course, we will follow all hospital policies and guidelines in place, and will keep you updated as we get new information. All medical questions should be directed to your care provider.

Know that we are doing all we can to stay healthy & well so that we can support you!

Again, your health and safety is of utmost importance to the East Nashville Doulas team, and we are happy to answer any questions you might have. Feel free to give us a call at: 615-957-5871 or email me at: andrea@eastnashvilledoulas.com

Why Inclusion Matters

Here’s one thing I know about life...inclusion matters. Representation matters. Love is love.

I think it’s important to share the values that led me to start this agency. As one of the L’s in LGBTQ+, it’s crucial to me that my agency serve all people and all families. And to say it proudly & loudly.

When I first jumped into birth work, I worried for a bit that I wouldn’t be hired as a doula because I am a lesbian. I live in Tennessee, and while Nashville is a pretty progressive place, Tennessee is most definitely not. In my first few years working as a doula, I saw the discrimination first hand. Doulas who told me point blank that they refused to work with gay couples. Midwives who would take a meeting for a consult, but when they realized the family was not straight, they’d leave the consult.

But I also saw something else. I saw my business flourish. I was out & open about my relationship with my partner—now my wife—on my website because I wanted potential client families to know up front where I stood. And I just got busier & busier. This is how I know living your authentic truth is the only way to go. This is why inclusive care for all is the only way for  me to run a business. This is why you will never be turned away at East Nashville Doulas simply because of who you love & how you make a family.

Thank you for supporting this LGBTQ+-owned business. I’m in awe every day of the trust our client families put in us to walk with them at their most vulnerable time. We see you, we honor you, and we support you.  All of you.

How Late is Too Late to Switch Care Providers?

Today's blog was written by birth doula Amy Reitz. She is tackling the hot topic of when, why, how you can change care providers in your pregnancy. Read on to find out more!

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Second opinions. Switching providers. Change. SCARY….Our minds can jump to an anxious place so quickly when we are considering the health and safety of ourselves and our babies. I have seen quite a bit of activity in online groups lately related to switching providers. Sometimes people are looking for recommendations for a new provider, but a lot of the time their questions signal to me that people are looking for validation. They want to know if they are warranted in even considering making a change. Part of this is obviously because the thought of making the wrong decision can be overwhelming. Realistically though, making a change is entirely up to you.

A positive outcome is all about making informed choices with regard to your needs and the needs of your child(ren). So, how do you do it? Where do you even start? Let’s talk about what the process looks like when it becomes necessary to explore alternate care options during pregnancy.

How does the need to look for alternate care come about in the first place? Nashville has a constant influx of people, but switching providers because of relocation is not exactly what I’m talking about here.

We’re talking getting a second opinion or electively switching providers because of one of the following reasons:

• a need to elevate your overall experience
• a difference of opinion between you and your provider
• your preference regarding location of delivery has changed
• any other reason that does not fall in the medically necessary category.

Most often there is something brewing long before someone decides to take action. In my opinion, no one other than you needs to want a second opinion or change of scenery in order to explore it further. Trust your gut!

The most common misconception about switching providers is when someone believes it is too late to make a change. Preferably, a care provider does want to begin the process as soon as possible, but that still does not mean that a first trimester switch is the only time to change things up. I’ve seen a pregnant person reference 20 weeks as being “too late in the game”. My heart sank when I read it! I could sense the mix of feelings inside this person. Halfway through a pregnancy is absolutely not too late to make a change. Eventually the visits to the office/care provider are going to become more frequent, and if you already know halfway through that something isn’t clicking, go ahead and investigate making a change prior to the frequency of your visits increasing.

As the Office Manager of a home birth midwifery practice, I see people switch providers at various points throughout their pregnancy fairly often. I asked my boss and all around badass midwife Jennifer Vines for her thoughts on this topic:

“As a home birth midwife, we are open to transfers at any time. A pregnant person can change their mind about their birthing options for a number of reasons.  When we have inquiries of late transfers we sit down and talk about what they are looking for that is different than what they are currently receiving in care.

The biggest reasons we take late transfers are:

• A provider indicating their discomfort with things on the birth plan that they previously agreed to earlier in the pregnancy.

• The pregnant person learning that the facility she is planning to birth at does not support her birth plan. The provider may have indicated they approved but the facility will not support the parents wishes.

• Deciding they really want a water birth.”

See?! Not too late. Theoretically, you could walk into any hospital you want in labor regardless of whether your provider delivers there. While I do not recommend doing this unless you are going to the closest hospital out of necessity/emergency, that doesn’t make it any less true. You could also potentially find a midwife with availability to be on call for a home birth. You never know unless you ask! Instincts and gut feelings are real things. Listen to them! Don’t know where to start? Ask a doula! For real. We’re well connected, we give great references, and we are always down to talk all things birth.

The East Nashville Doulas Birth Story

Welcome to the newest doula agency in Nashville—East Nashville Doulas! We are so excited to offer professional labor support and education to families in the greater Nashville metro area. We are a group of dedicated and compassionate doulas who believe that all pregnant people and their families deserve to be supported no matter where or how they choose to give birth. 

I’m Andrea, and I’m the owner and founder of East Nashville Doulas. I chose the name because this is where I live—in this vibrant, progressive, expanding part of town. East Nashville draws people from all over the world to its fabulous restaurants, funky shops, famous music venues, and busy coffee shops. While we serve families all over the metro Nashville area, we carry the East Nashville spirit with us, and the heart of our work reflects these values—diversity, inclusivity, and support for all families.

Today, I thought I would share our East Nashville Doulas birth story with you! Like any parent, I’m very proud of the work that went into “birthing” this agency, but the story of its conception starts long ago.

I began my journey to birth work as a first-time mom searching for birth options over 25 years ago when I was pregnant with my daughter. Back then, I had never heard of the word "doula," but I knew that I wanted my birth to be the transformative experience I knew it could be. I also knew I wanted to birth my way on my terms. I chose a great OB who reflected my values, and I had an uncomplicated (and very fast!) hospital birth. Still, I was left wanting more for any subsequent births.

Fast forward to right after the birth of my second child at home, I had a much more empowering experience this time around as I felt more involved in the choices around this birth. It was in my research for my second birth that I heard the term “doula” for the first time. Aha! This was what was missing with my birth experiences—continuous and professional labor support. I decided that this was what I wanted to do with my life. I wanted to support families welcoming babies into their lives in a way that I had not been supported. 

I took a DONA-approved training around 1999, and ended up supporting the births of a few friends. I loved doing this work, but couldn’t figure out how to make it a sustainable career at that time.

I continued to work as a teacher and university administrator, eventually landing at Vanderbilt University in Nashville, TN. After working there for 12 years and raising my two children, I came back to the idea of returning to birth work when I was ready to make a change in my life. In 2015, I attended another DONA-approved training (with the fabulous Jessica English of Birth Kalamazoo), quit my job at Vanderbilt, and began my full-time solo doula practice. Within a few years, I built up my practice to become one of the busiest and most sought-after doulas in Nashville. I also mentored many new doulas by sharing my expertise with them.

In 2017, I became a certified Lamaze childbirth educator, and I’ve taught more than 100 couples in my classes over these last few years. With my lifelong background in education, I know how important solid, evidence-based information is for families as they navigate their birth choices. Knowledge is empowering, and it also reduces fears. 

In 2018, I decided that in order to serve even more families, I would open a doula agency. But I knew that I wanted to adopt a different agency model--one that provided the security families wanted by knowing who would be showing up for their birth. I had many families come to me because they wanted to know who their doula would be--they wanted a familiar face in their birth space. With us, you will know your doula, and that’s who will be at your birth.

I assembled a team of fabulous doulas who I met through networking and our mutual love of all things birth. They each bring amazing skills and talents to this work, and I'm so lucky to call them colleagues and friends! They are compassionate professionals who are eager to talk with you about how they can support your family during this transformational time.

And this is the East Nashville Doula difference! With our agency, our 3 foundational principles are: 

- It’s your birth (we provide nonjudgmental support)

- You create your birth vision (we are happy to provide great resources if you need them!)

- Your doula will be there supporting your birth and your vision every step of the way

I also hold a very strong belief that since no one can determine how long their labor will last, no East Nashville Doula family will ever be charged extra for a longer labor. Our agency has a structure in place to make sure that our families are well-supported, and our doulas are compensated for longer births. That’s just a no-brainer for us! Making our families and doulas happy is our number one priority.

I also believe in the power of education to transform people's lives. That's why we recommend childbirth education classes to all of our clients, and we offer both group and private classes to meet every family's schedule. Having the knowledge and tools you need for your birth can only lead to better outcomes.

Finally, what makes East Nashville great is community--diverse, inclusive, & accepting. I moved to East Nashville with my partner 5 years ago to find that accepting community, and it was the best decision ever! At East Nashville Doulas, we honor that spirit by proudly supporting all families who seek our services.

Support, education, community...these are the values that gave birth to East Nashville Doulas. Give us a call today if you’d like to find out more about how we can help you with your own birth story!

Talking about...water breaking

Did you know that your water can break at any point in labor? It can happen before labor starts, during labor itself, or your baby can be born with the waters intact (called being born “en caul”). 

If we look at births on TV or in the movies, virtually 100% start with the water breaking. But that does not mirror reality! Research tells us that only about 8-10% of people (about 1 in 10) will have their waters break before labor starts. 

Many people report that they notice a difference in the strength of their contractions after the water breaks. In many cases, the water has been acting as a cushion for baby’s head, and with it gone, now the baby’s head is directly on your cervix. This is a good thing and helps your labor progress!

Did you notice a difference in your contractions before & after your water broke? Were you in the 10% of people whose labor started with waters breaking? Was your baby born “en caul?” Let me know in the comments!

Talking about...early labor!

My number one suggestion for my clients in early labor? R • E • S • T & IGNORE!

It’s the opposite of what you want to do, I know! “OMG, I’ve been waiting for labor to start FOREVER! Let’s start doing All The Things!” I get it. Really, I do!

Seriously, here are the facts to support this advice:

1. Early labor is the most variable part of labor, and can last hours or days. Yes, days. So, saving up your energy is KEY to getting through this part of labor. 
2. Like preparing for an endurance event, going out too hard & fast will trip you up later on when you need that energy for the super physical stages like pushing. Pace yourself well and it will pay off in the end!
3. Distraction with an easy labor project like making a freezer meal for your postpartum time, or watching your favorite show on Netflix can help you to ignore your early labor until it becomes active. When you can no longer rest & ignore, THAT’S when it’s time to start your labor coping & comfort measures!

What did your early labor look like? Did you rest & ignore, or did you do something different? Let us know in the comments!

Why you don't need a doula (but you should want one!)

You may be asking, "Why is a doula telling me that I don't need her services??" 

Well, the operative word there is "need." Women have been having babies since the dawn of time, and for 99% of that time, they've been giving birth with no medical help. Even if they had a midwife or other birth helper in the past, the real work of birthing a baby was done by the mama herself, in most cases.

No one "needs" a doula to have a baby. But here are 6 results from a 2012 study drawn from over 15,000 births that illustrate why you should definitely want one:

• 31% decrease in the use of Pitocin
• 28% decrease in the risk of C-section
• 12% increase in the likelihood of a spontaneous vaginal birth
• 9% decrease in the use of any medications for pain relief
• 14% decrease in the risk of newborns being admitted to a special care nursery
• 34% decrease in the risk of being dissatisfied with the birth experience

Did those numbers catch your eye? They definitely caught mine! In today's hospital birth setting especially, the doula plays an important role of holding space and empowering families to create the births they want.

Doulas provide the support, experience, and non-judgmental compassion that birthing families need.

Your birth story is something you will remember for the rest of your life! If you want to increase the likelihood of being satisfied with your birth experience, then you want to hire a doula. And this doula will look forward to hearing from you soon.