Is a Doula Worth It? What the Research Says (and Does Virginia Medicaid Cover Doulas?)
Short answer: for many families, yes. A doula gives continuous, non-medical support (emotional, physical and informational) before, during and after birth. A Cochrane review of 26 trials with more than 15,000 women (Bohren et al., 2017) found that continuous one-on-one labor support was linked to more spontaneous vaginal births, fewer cesarean births, less use of pain medication, shorter labors and fewer negative birth experiences. A doula doesn't replace your midwife or OB, and in Virginia, Medicaid covers services from state-certified community doulas.
I'm Asia Rideout, a birth and postpartum doula, student midwife and pregnancy & postpartum strength coach in Alexandria, VA (formerly Graceful Doula Birth).
What a doula does
Before birth: prenatal visits, help understanding your options, a birth plan, and practicing positions, breathing and comfort measures
During labor: continuous presence, reassurance, counter pressure, massage, position changes, and helping you communicate your wishes
For your partner: showing them how to support you, and giving them breaks
After birth: help with the first feeds, postpartum visits and emotional support
What a doula doesn't do
A doula doesn't do medical tasks such as checking your cervix, monitoring your baby's heart rate or giving medication, and doesn't make medical decisions for you. Your midwife or OB provides medical care; your doula supports you and helps you feel informed and heard.
What the research shows
The Cochrane review by Bohren and colleagues (2017) compared continuous one-on-one labor support with usual care. People with continuous support were:
More likely to have a spontaneous vaginal birth
About 25% less likely to have a cesarean birth
Less likely to use pain medication, including epidurals
About 31% less likely to report a negative birth experience
Likely to have a shorter labor (about 40 minutes on average)
Less likely to have a baby with a low 5-minute Apgar score
The authors noted that some of the clearest benefits were seen when support came from a trained person who was there only to support the laboring person and wasn't part of the hospital staff, which describes a doula.
Birth doula vs. postpartum doula
A birth doula supports you in late pregnancy, through labor and birth, and in the first days after.
A postpartum doula supports you at home in the weeks after birth with feeding, newborn care, meals, light housework, sibling care, and rest for you.
Many families choose one, and some choose both. See what's included in each on our doula page.
Does Virginia Medicaid cover doulas?
Yes. Virginia Medicaid has a Community Doula benefit that covers up to 8 prenatal and postpartum visits plus support during labor and delivery, from pregnancy through about six months after birth, as long as you keep Medicaid coverage. Services must come from a doula who is state-certified and enrolled with Medicaid. Ask any doula you're interviewing whether they're certified and accept your plan, and see the Virginia Medicaid Community Doula Program for details.
Questions to ask when you interview a doula
What training and certifications do you have?
How many births have you supported, and in which hospitals or birth centers?
What's included (prenatal visits, labor support, postpartum visits)?
When are you on call, and who is your backup?
How do you support partners?
How do you work with my midwife or OB?
How do you support people who want an epidural, or a cesarean?
Frequently asked questions
Is a doula only for unmedicated births?
No. Doulas support all kinds of births, including births with epidurals, inductions and cesareans.
Will a doula replace my partner?
No. A good doula helps your partner take an active, confident role.
When should I hire a doula?
Anytime in pregnancy. Earlier gives you more time to build trust and plan, and prenatal visits often happen in the last weeks of pregnancy.
Birth and postpartum doula support in Alexandria, VA
Graceful Doula Birth is now part of MotherMade Strong. Asia offers birth and postpartum doula support to families in Alexandria, Northern Virginia and the DMV, and consultations are free.
Learn about doula support · Book a free consultation
Related: How to Prepare Your Body for Labor · MotherMade Strong Resources
Sources: Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A, "Continuous support for women during childbirth," Cochrane Database of Systematic Reviews (2017); Virginia Department of Medical Assistance Services, "Community Doula Program."
This article is general education, not medical advice. Please talk with your OB or midwife about your pregnancy and birth plans.
Written by Asia Rideout, birth and postpartum doula, student midwife, Certified Personal Trainer and Pregnancy & Postpartum Athleticism Coach, founder of MotherMade Strong in Alexandria, VA.
