When to Call the Doula

In the movies, it usually happens like this: a pregnant woman is out at a restaurant or walking along the street with friends, when her water breaks with a gush. Immediately she must find a cab or get a ride to the hospital because the baby’s birth is imminent. (You wouldn’t know it, but I wrote this paragraph BEFORE looking up these sample clips.)

If life was like Hollywood, doulas might just be out of a job.

In real life, however, labour doesn’t start like a motorcycle, and it usually doesn’t take off like a rocket. Some women have their babies very quickly, but a majority of women will have several hours of labour, and it’s a good thing! Not only does it give you time to go to the hospital (if that’s where you’re having your baby), but it helps your body keep pace with the changes that need to happen in order for a baby to come earthside. The changes your body goes through in labour are vast and amazing, and condensing those changes into one or two hours as opposed to five or ten or twenty can be very intense.

Unfortunately, nobody knows how long a labour will be until it’s done, and those early contractions, or the gush/trickle of waters breaking can tell us things are starting, but not how they will proceed.

Your care provider will usually give concrete instructions about when to call or go to the hospital. Some use the 5-1-1 rule, some use 4-1-1 or when waters break. You should be clear with them when they want to hear from you, but a doula is different. Labour moves along best when mom feels safe, secure, and relaxed, and her response to early labour (even “false” labour which can begin days/weeks before baby’s birthday) will greatly affect how active labour and birth play out.

In my view, if you have hired a doula, call as soon as you want support. A doula will not judge you or be mad if you call while your contractions are ten minutes apart, or if you think it’s false labour, or if your water just broke but your care provider said to wait the night and hope contractions begin on their own. Doulas know birth is unpredictable, and they want to be there for you as this birth unfolds. Calling doesn’t mean she has to drop everything and come – maybe you just need reassurance that things are normal, or you want to vent without triggering a cascade of phone calls asking if you’ve had the baby yet! (Tip for loved ones anxiously waiting on that wonderful news: don’t call!! You will be informed when the parents are ready, and you don’t want to be the person who interrupted labour or early bonding with a pushy phone call.) Staying in communication with your doula near the end of your pregnancy will help both of you sense when it’s time for her to come – even just send a text if it’s not urgent, but you want to make contact.

A woman who spends a whole day feeling nervous and excited while she times her contractions ten minutes apart, just waiting for them to get closer so she can go to the hospital may still go too early and be more tired when labour gets challenging. Many women are so afraid they’ll call too early they actually wait far too long and shortchange themselves of a doula’s support in the early part of labour. I know one woman whose husband snuck to the bathroom to call their doula while she insisted “it wasn’t time” and in fact she was close to transition!

The beauty of a doula’s role is that she is there simply to support you. She will not chastise you for calling when you need the very support she is trained and eager to provide.