Understanding the Types of Doulas: Fertility, Birth, and Postpartum

Doulas are companions and space-holders with vast experience in helping others navigate essential transitions. While not medical professionals, they can be a crucial support tool for families from all walks of life. In addition, a doula occupies a role in the community. Doula care includes helping with communication and personal relationships, resource-finding, and advocacy. Doula care usually involves practical support, such as helping you move safely during labor. 

Birth doulas are the most commonly known, but many types are out there—and the profession is growing! Other kinds of doulas include loss doulas who support families through miscarriage or stillbirth, adoption doulas, gender transition doulas, and more. Full-spectrum doulas support people throughout the entire reproductive cycle, specializing in all transitions related to the conception journey, pregnancy, and navigating life postpartum. 

Read on to learn more about the three most common types of doulas and some tips on choosing one that’s right for you! (We are thrilled to bring you our upcoming clinical directory to make finding and building your care team even easier… stay tuned!)

Doula Training and Certification

Independent organizations train doulas, and while there is currently no national regulation of doulas in the United States, some of the best-known, most reputable doula organizations are: 

• DONA International
• CAPPA
• Birthing Advocacy
• Childbirth International
• HealthConnectOne

A doula may be both trained and certified or only trained. It’s up to the doula whether they choose to become certified or not. Additionally, some doulas work by themselves and own their own businesses, while others may work as part of an agency, co-op, collective, group, or even a non-profit. 

Many doulas might specialize in a specific stage throughout their training and/or certification.

Fertility Doulas

Fertility doulas provide care to people and families in the preconception stage. This can include informational, mental, physical, and emotional support for people who are trying to conceive through sexual intercourse, as well as those who are using assisted reproductive technology (ART) like fertility medication, IVF, IUIs, and other forms of medical fertility help. Fertility doulas are not as well-known as other types of doulas, but they are a growing group of support professionals.

Fertility doulas also connect with you to help you through the conception process. The support a fertility doula provides is wide-ranging and can look many different ways—from reading recommendations and nutrition advice to care navigation and more. A fertility doula may help you track and chart your menstrual cycle. They may help you: 

• Connect to holistic resources like acupuncture or herbal medicine
• Guide you through movements and exercises like fertility yoga or specific types of training for fertility
• Recommend a therapist who specializes in perinatal issues
• Accompany you to medical appointments

They are there to support you in a way that you request and need. Fertility doulas may work on an hourly, flat fee, or package structure. 

Trying to conceive can be difficult, especially if you’ve experienced previous pregnancy losses, have been trying for a long time, or are using ART on your journey. A fertility doula doesn’t replace a medical provider or your family and friends, but having one on your team can make the entire experience more manageable and less stressful. 

Birth Doulas

The most common type of doula in the US, a birth doula accompanies you through pregnancy, labor, and birth, providing emotional, mental, physical, and informational support. There is strong evidence for the benefits of birth doulas, including a lower chance of Cesarean birth, shorter labor, and even a lower chance of having a baby admitted to the NICU (1).

When you hire a birth doula, they will often help guide you throughout your pregnancy, providing movement, nutrition, and lifestyle recommendations specific to you. Most importantly, they will help you plan and prepare for your birth and postpartum experience and be physically present during your labor and delivery. Birth doulas usually work under a flat-fee system, which varies widely depending on your local area and the doula’s experience level. 

Usually, parents meet with a birth doula several times prenatally to learn and plan. A birth doula can provide provider recommendations based on your goals and personality and direct you to resources to help you learn more about your pregnancy. Generally, birth doulas also have strong knowledge of the birth options in your local area. Think of them as your own personal pregnancy Google (without the weird ads and off-base results!). Doulas are also trained to provide non-medical comfort measures during labor, like massage and position changes.

It’s a common misconception that doulas are only for parents planning to give birth without pain medication or other medical interventions. The truth is, doulas support all parents and all deliveries (and yes, that includes planned Cesarean births!) A birth doula’s mission is to help you regardless of your goals or the path your birth takes. Anywhere you’re planning to birth - in the hospital, at a birth center, or at home - a doula can be present and provide tremendous physical and emotional support to help you have a positive birth experience. 

Postpartum Doulas 

Postpartum doulas specialize in the time after giving birth, often called the fourth trimester (aka the first three months of your baby’s life). These doulas are trained in baby care, lactation, birth recovery, and perinatal mental health. In addition, they often have significant experience with newborns and will be well-versed in helping you with breastfeeding and/or bottle feeding your baby. Overall, a postpartum doula is focused on helping you recover from pregnancy and birth and thrive in early parenthood.

Postpartum doulas are also well-versed in practical support skills, like cooking, laundry, and other household tasks. Postpartum doulas usually work hourly in packages and may do both daytime and overnight shifts. 

Finding and choosing a doula

Increasingly, doulas are available to support people virtually, although most still work in person in their communities. There is also a growing movement in the United States to ensure that Medicaid and other forms of health insurance cover doula services. Still, most parents pay for doulas themselves (which means that doula care can be hard to access for many families). 

If you know you want a doula in your corner as you become a parent, start looking in your local area. Ask friends and family for recommendations, source referrals in local parenting groups, or use national directories like DoulaMatch. Then, identify a few doulas you like and make an appointment to chat with them directly, either in person, over video chat, or on the phone. Ask questions about their training, experience, philosophy, and other aspects of your own care or personal situation that are important to you. Above all, you should truly like and connect with your chosen doula.