A doula is a non-medical support figure who can accompany a woman and her family during pregnancy, labor, birth, and the postpartum period. Her role primarily involves listening, providing presence, and offering practical and emotional support. She does not replace a midwife, gynecologist, or other healthcare professionals and does not perform diagnoses, clinical check-ups, or treatments.
In recent years, there has been increasing talk about doulas in Italy as well. But what does she actually do? What is the difference compared to a midwife? Can she be present during birth? And how can you understand if this type of accompaniment might be useful during your maternity journey?
In this guide, we aim to clarify things by distinguishing the doula's support from healthcare and exploring her potential role from pregnancy to the first days after birth.
What is a doula?
A doula is a person who offers accompaniment and support to a woman and her family throughout the maternity journey. Her intervention is primarily emotional, relational, and practical and can involve different moments: pregnancy, birth preparation, labor, birth, and the postpartum period.
The type of accompaniment can change based on the individual doula's training and experience, the family's needs, and the agreed-upon service. Some focus primarily on birth, while others work more in the postpartum period.
However, it is important to clarify a fundamental distinction from the beginning: a doula does not replace the healthcare professionals who oversee the pregnancy, birth, or puerperium.
What does a doula do?
The common thread of a doula's work is generally continuous presence. She can listen to doubts and concerns, help future parents navigate available information and services, and offer practical support whenever the family feels the need for it.
The doula during pregnancy
During pregnancy, a doula can offer a space for listening and discussion to the expectant mother, partner, or couple. She can help organize practical aspects of the baby's arrival, share information about local services, and accompany the family in preparing for the period after birth.
Conversely, she does not perform pregnancy check-ups and does not assess the health status of the mother or the baby: these aspects fall under the purview of healthcare professionals.
The doula during labor and birth
Some doulas also offer accompaniment during labor and birth, when the expectant mother desires it and the regulations of the facility where the birth takes place allow for her presence.
Support can consist of continuous presence, listening, encouragement, and practical help to make the labor process more comfortable. However, the doula remains a figure distinct from medical staff and does not intervene in clinical decisions or procedures.
The World Health Organization recognizes the importance of a woman having a person of her choice by her side during labor and birth. This person can be a partner, a family member, a friend, a doula, or another figure chosen by the woman.
A Cochrane review also studied the effects of continuous support during labor, noting potential benefits for the birth experience and certain outcomes. It is important to specify, however, that these studies do not concern doulas exclusively: support can be provided by professionals, trained individuals, or family members and people chosen by the woman.
If you want to know more about what might happen from your arrival at the ward to the birth, you can also read the MYSANITY guide on hospital birth.
The doula in the postpartum period
The postpartum period is one of the times when practical support can be particularly appreciated. Coming home with a newborn means facing new rhythms, fatigue, intense emotions, and a completely different daily routine.
Depending on the agreed-upon service, a postpartum doula can offer listening, help organize daily life, facilitate moments of rest for the mother, support the couple in the first days at home, or offer a presence during the hours when the family feels the greatest need for support.
Some doulas may also offer practical support with household management or the daily care of the newborn, always within the scope of agreed-upon activities and without substituting for medical figures.
The postpartum period indeed includes clinical aspects that require specific expertise. To understand what might happen immediately after birth, you can delve deeper into the MYSANITY guide on the first 48 hours after childbirth.
What does a doula not do?
Understanding the boundaries of her role is just as important as knowing what she can do.
A doula does not perform exams or diagnoses, does not measure vital signs, does not prescribe medications or treatments, does not clinically assess the progress of a pregnancy, does not monitor fetal well-being, and does not assist with birth from a medical perspective.
Therefore, she does not replace the midwife, gynecologist, pediatrician, doctor, or other healthcare professionals. If symptoms, pain, health problems, or clinical doubts arise during pregnancy, birth, or the postpartum period, the point of reference must be an appropriate healthcare professional.
Doula and midwife: what is the difference?
Doulas and midwives can both be present during the maternity journey, but they have profoundly different roles.
| Doula | Midwife | |
|---|---|---|
| Practical and emotional support | Yes | Can be part of the care |
| Healthcare profession in Italy | No | Yes |
| Clinical exams and assessments | No | Yes, within their expertise |
| Medical care during pregnancy | No | Yes |
| Medical assistance during birth | No | Yes |
| Continuous presence and accompaniment | Can be the focus of the service | Depends on the care model |
In Italy, the midwife is a healthcare professional. She possesses a university education and specific competencies in assisting with pregnancy, birth, the puerperium, and women's health.
The doula, conversely, has a non-medical function of accompaniment. For this reason, it does not make much sense to consider doulas and midwives as two alternatives to choose between: they can address different needs.
Can a doula and a midwife work together?
Yes, the two roles can be complementary when clear boundaries are maintained and respective competencies are respected.
The midwife oversees the medical aspects within her expertise; the doula can offer continuous presence and additional practical or emotional support, if the woman desires.
The most important thing is that the expectant mother always knows who to turn to for each need and that no non-medical figure replaces the professionals responsible for clinical care.
When might it be useful to consider a doula?
There is no single situation in which a doula is necessary for everyone. The choice depends on personal preferences, one's family network, and the type of support desired.
It may be an option to consider, for example, when one desires non-medical continuous presence, when living far from one's family, when the partner has limited availability, or when one feels the need for greater practical and emotional support before or after birth.
For some families, the most useful time may be pregnancy; for others, labor; and for others still, it is the weeks following birth that require extra help.
How much does a doula cost?
There is no single price. The cost can change significantly based on the city, the doula's experience, the duration of the accompaniment, and the type of service requested.
A meeting during pregnancy, a path that includes multiple appointments, availability during the birth period, or a postpartum support service can have very different formats and costs.
Before choosing, it is therefore useful to ask for a clear quote and verify what the service includes: the number and duration of meetings, phone availability, potential presence during labor, postpartum assistance, travel, and conditions in case of schedule changes.
How to choose a doula?
The relationship with a doula is very personal. Beyond training and experience, it is important to feel comfortable in the relationship and to be able to talk openly about one's expectations.
During the first meeting, it may be useful to ask what training she has completed, how long she has been practicing, which phases of maternity she works with most, what the service includes, what availability she offers, and above all, which activities she considers outside her expertise.
Clarity regarding professional boundaries is a good element to evaluate. A doula should be able to explain simply when she can offer support and when it is necessary to turn to a midwife, doctor, or other healthcare professional.
How to find a doula near you
There are professional associations and networks that collect the names of doulas active in various cities and provinces. In Italy, for example, Associazione Doule Italia has a directory through which it is possible to search for professionals by geographical area.
Presence in a directory can be a starting point, but it does not replace a personal interview. Before choosing, it is always useful to directly verify training, experience, working methods, availability, costs, and compatibility with your own needs.
When is it necessary to consult a healthcare professional?
Every issue related to the health of the mother or the baby must be evaluated by qualified healthcare professionals.
During pregnancy and the postpartum period, significant or persistent symptoms, pain, bleeding, fever, problems related to a C-section wound, respiratory difficulties, major breastfeeding problems, or any concern about the health of the mother or the newborn must not be managed by relying on a doula.
In these cases, it is necessary to contact a midwife, gynecologist, doctor, pediatrician, or the healthcare services indicated for the situation.
For example, if significant pain, redness, fever, or other symptoms appear during breastfeeding, you can also explore the MYSANITY guide on breastfeeding mastitis, remembering that an informational article does not replace professional assessment.
Frequently asked questions about doulas
Is a doula a midwife?
No. A doula primarily offers practical and emotional support and does not provide medical assistance. A midwife, conversely, is a healthcare professional with specific competencies in assisting women with pregnancy, birth, and the puerperium.
Is a doula a healthcare professional?
In Italy, being a doula is not a healthcare profession. The classification and methods of practice may, however, be different in other countries.
Can a doula be present during birth?
She can accompany the woman during labor and birth when the woman desires it and when the facility's rules allow it. Her presence, however, does not replace that of the healthcare professionals responsible for care.
Can a doula help after birth too?
Yes. Many doulas offer specific services for the postpartum period, with listening and practical support for the mother, partner, and family in the first days or weeks after birth.
How do I know if a doula is right for me?
It is useful to have an initial meeting, ask for information about training and experience, clarify what the service includes, and determine if you feel free to express your expectations, doubts, and needs. An important element is also the clarity with which the doula distinguishes her role from that of healthcare professionals.
In conclusion
A doula can represent a form of additional support during pregnancy, birth, and the postpartum period for those who desire a continuous, practical, and emotional presence alongside medical care.
Not all women feel the need for one, and there is no "one-size-fits-all" choice. Understanding her role well, her limitations, and the difference compared to a midwife allows you to decide with greater awareness whether this type of accompaniment might be suitable for your own maternity experience.
To learn more about the phases immediately following birth, you can also read First 48 hours after birth: what to expect and First breastfeeding: practical tips to get started.
Sources and references
World Health Organization — Companion of choice during labour and childbirth for improved quality of care.
Cochrane — Continuous support for women during childbirth.
Ministry of Health — information and recognition of the healthcare profession of midwifery.
Associazione Doule Italia — description of services offered by doulas and directory of participating professionals.
This article is for informational purposes and does not replace the advice, diagnosis, or recommendations of a healthcare professional.