Birth doulas, quite simply, provide emotional, physical and informational support for women in labor. Doulas have a professional knowledge of labor and birth that complements the parents' own knowledge, and their wisdom and experience are of great help at an often stressful time. Massage, positive affirmations, position changes and other physical comfort measures, and lots of encouragement are in the doula's bag of tricks for birth.
Doulas stay with the mother throughout the labor, beginning whenever she calls, and ending after the mother and baby are settled from birth. Nurses and other medical staff have shift changes and need to split their time with other patients.
Some doulas act as an advocate for the mother during hospital birth, helping the mother to express her needs to the medical staff, and helping to mediate should any problems arise.
A good doula brings both professionalism and compassion into the labor room. Often, hospital staff have time only for their clinical duties, while partners and friends bring love and shared emotion but little knowledge of birth. The doula can "fill in the blanks" to give the laboring woman what she most needs.
Doulas also meet with women and their partners prenatally, building a relationship before the labor and helping to answer any questions about pregnancy and birth. A postpartum visit is usually included, with a chance to talk about how the birth went and make sure that life with the baby is off to a good start.
Doulas do not perform vaginal exams, check fetal heart tones, administer medications, or perform other clinical duties. They do not catch babies or act as midwives (except in the event that the baby comes faster than the care provider!), and they are not nurses, working on doctors' orders.
Doulas do not replace partners! The woman's partner or support person is vitally important, and knows the mother far better than the doula does. Doulas can also help partners by giving them a rest and making suggestions if the partner is at a loss for how to best support the mother.