What Does a Doula Actually Do During Labor?
So, what exactly do you do in there?
Hi, I'm Jessica Ruscetta, founder of Rooted In Birth and Heart of Maine Doula, and I get asked this question constantly. At consultations. At family reunions. Once, memorably, by a guy at the Poland transfer station while I was holding a bag of recycling.
I've been a doula since 2013. That's over a decade of births, more hours in hospital rooms and living rooms than I can count, and an embarrassing number of gas station coffees consumed at 3 a.m. somewhere between Lewiston and Portland. And still, most people picture one of two things: a woman in flowing linen chanting over a candle, or a very expensive person who stands in the corner and says "breathe."
The truth is somewhere in between, and it's a lot sweatier. So let me pull back the hospital curtain (the one that never fully closes) and tell you what a doula actually does during labor.
A doula's labor job description (unofficial, mostly accurate)
1. I answer the phone at 2:47 a.m. like I've been awake for hours. From 38weeks until your baby arrives, I'm on call 24 hours a day, 7 days a week. My phone is always charged. My car always has half a tank. My birth bag is always packed. My hair is a separate issue we will not be discussing. When you call and say "I think this might be it, but maybe it's gas?" I will say, calmly and lovingly, "Let's time a few and see." Sometimes it is gas. No judgment. Gas is part of the journey.
2. I become a professional hip squeezer. If you've never had someone press your hips together with the force of a hydraulic car jack during a contraction, you have not truly lived. Counterpressure is one of my love languages. My forearms by hour 14 could open any pickle jar in Androscoggin County.
3. I rearrange your body like a very gentle game of Tetris. Hands and knees. Side-lying with a peanut ball. Slow dancing with your partner. Sitting backwards on the toilet (yes, really, it's a classic). Positions help with comfort and can help labor progress, and I carry a mental Rolodex of about forty of them. You'll try one, hate it, and I'll have three more ready before the next contraction.
4. I am the keeper of the snacks, straws, and cold washcloths. I will hold a cup with a bendy straw to your lips between every contraction like it's my sacred calling. Because it is. I've also refilled the ice chips so many times the nurses think I work there.
5. I coach your partner, too. Partners are wonderful. Partners are also sometimes standing in the corner holding a phone charger, looking like they just wandered into the wrong movie. I like to think of myself as a tour guide who has been there before and can point out the good sights. I'll show your partner exactly where to push on your back, remind them to eat something, and send them for a bathroom break before they start swaying. Then I hand them right back to you, more confident and only slightly less pale.
6. I translate hospital into English. When someone says "we're going to check your cervix, then maybe talk about Pit," I'm the one who makes sure you understand your options, the risks and benefits, and that you have time to ask questions. I don't make medical decisions, and I don't give medical advice. I just make sure you're never nodding along to something you didn't understand.
7. I support every kind of birth. Every single one. Want an unmedicated water birth? I'm there. Want an epidural the second you hit the triage door? I'm there, and I'll help you breathe through the contractions until the anesthesiologist arrives. Planned cesarean? Still there, offering reassurance and helping with skin-to-skin and that first feed. My job isn't to steer your birth. My job is to help you feel informed and supported in each moment.
8. I say "you're doing it" approximately 900 times. And I mean it every time. Somewhere around transition, many people announce they can't do this anymore. In my experience, that's usually a sign you're getting close. I will not say that to you in a smug way. I'll say it with my hand on your back and my face very close to yours, because you ARE doing it.
9. I stay. Shift change? I stay. Long night turns into a long morning? I stay. Labor stalls and everyone is tired, and the vending machine ate my last dollar? I stay. Continuous support means I'm there through labor and into the first hours after baby arrives, including helping you get started with breast or chestfeeding.
10. I take the photos (and quietly delete the unflattering ones). You're welcome.
Things I do NOT do (despite occasional requests)
Catch the baby. That's your midwife or doctor. Doulas are trained, non-medical support people. Midwives and OBs are the licensed clinicians who do the exams, monitor health, and deliver babies. Together, we make a pretty great team. Separately, I am just a woman with strong forearms and a bag full of snacks.
Check your cervix. I know you want a number. I also want you to have a number. I am not the one who gets to find it.
Promise you a perfect birth. Nobody can honestly promise that. Birth is unpredictable, and anyone who guarantees otherwise is selling something. What I can promise is support, no matter which way the road turns.
Judge your birth plan. Or your playlist. Okay, I might judge the playlist a little, but only internally.
Replace your partner. I'm the backup singer, not the lead. Your partner knows you. I know birth. That combo is hard to beat.
Take it personally when you tell me to stop touching you. Sixty seconds ago you needed my hand. Now you'd like me to leave the state. Both are completely valid, and I've heard far worse.
What a doula is like, according to the experts (my clients)
One of my favorite compliments came secondhand. A former client told me the labor and delivery nurse commented on how laid back she seemed for a first-time mom. That's the whole goal. Not a doula who looks impressive, but a birthing person who feels calm, informed, and ready.
It's the same thing they emphasize in Maine doula training programs like the Heart of Maine Doula Program: evidence-based knowledge, hands-on skills, and real compassion for the families in our own communities. Basically, know your stuff, use your hands, and love your people.
The short version
So what does a doula do during labor? I squeeze, I fetch, I translate, I cheerlead, I coach partners, I hold straws, I hold space, and I hold the line on your wishes. Then, when your baby is finally on your chest, and the room goes quiet and soft, I step back, wipe my eyes (every time, I'm not even sorry), and let you have your moment.
And then I go, eat an entire sleeve of crackers in my car, and sleep for eleven hours.
It's the best job in the world.