A size-friendly doula, also called a fat-friendly doula, provides compassionate and nonjudgmental support to individuals of all sizes throughout pregnancy, birth, and postpartum.
Their expertise and support can make a significant difference in helping you have a positive and empowering birth and postpartum experience.
If you're considering hiring a doula, we'll explore what a size-friendly doula is and what they do. And we'll start by answering commonly asked questions about doulas and the benefits they provide.
What is the difference between a care provider and a doula?
Care providers, like OBGYNs and midwives, provide clinical care during pregnancy, childbirth, and postpartum.
Doulas do not provide medical care or clinical interventions but rather provide non-medical support.
So, care providers focus on the clinical aspects of care, while doulas provide emotional and physical support, advocacy, and guidance.
While care providers and doulas have different roles and responsibilities, they can work together to provide comprehensive support.
If you're searching for a size-friendly care provider, we have you covered, too!
How is having a doula different from relying on my loved ones for support?
The presence of a partner, family member, or friend can provide comfort and reassurance during the often-intense experience of labor and delivery.
Loved ones can offer encouragement and motivation, help with relaxation techniques or breathing exercises, and advocate for someone's wishes and needs with healthcare providers. They can also provide practical assistance with tasks such as feeding, changing, and holding the baby after birth.
Let's see some fun examples.
Grandparents can rock a customized t-shirt, cheer you on, and hold your leg while you give birth.
Loved ones can even sometimes help catch the baby when they are born, as this Dad did!
A doula doesn't replace your loved one!
Instead, they complement and enhance the support your loved ones provide.
Doulas are skilled birth professionals; most have received specialized training and certification to provide this support. They can help answer questions, provide evidence-based information on childbirth options, and offer guidance on newborn care and lactation.
They can help the person giving birth, and their partner or support person navigate difficult decisions or situations with objectivity and support.
From their deep connections in the birth community, doulas have insights into what medical facilities best align with your birth preferences. Or if you're planning a home birth, they can help you to connect with size-friendly home birth midwives to interview. In addition, they have local resources they recommend from lactation consultants or chiropractors.
Doulas also help support and engage your loved ones, but again, they aren't a replacement for your partner or support person.
And for those who don't have a partner or a support person available, doulas are an invaluable resource!
What are the different types of doulas?
While this resource primarily focuses on birth doulas, many different types exist. And all doulas can be size-friendly (many are)!
1. Abortion Doula
Abortion doulas provide emotional and practical support to individuals before, during, and after an abortion. They offer guidance on navigating the abortion process, emotional support, and help with self-care practices.
2. Adoption Doula
An adoption doula can support the birth parents, adoptive parents, and adoptees during adoption. They offer help with decision-making, emotional support, and post-adoption adjustment.
3. Antepartum Doula
An antepartum doula provides emotional, physical, and informational support during a high-risk pregnancy, bedrest, or other challenging situations during pregnancy.
4. Bereavement Doula
A bereavement doula provides emotional and physical support to families who experience a miscarriage, stillbirth, or infant loss.
5. Birth Doula
A birth doula provides emotional, physical, and informational support during labor, childbirth, and immediately after birth. They can help the person giving birth and their partner or support person to create a birth plan, provide comfort measures during labor, help with advocacy, and offer emotional support during the birthing and postpartum process.
Birth doulas aren't just for people wanting a “natural birth.” They work with people who want an epidural or other pain management during labor as well as those who prefer to go unmedicated. They also provide support for those having a cesarean birth or Vaginal Birth After Cesarean (VBAC).
6. Cultural Doula
A cultural doula supports clients from specific cultural backgrounds or communities. They may offer culturally-specific practices and traditions, education and resources, and emotional support.
7. End-of-Life Doula
An end-of-life doula provides support to individuals and families navigating the end-of-life process, offering compassionate care and support during and after the dying process.
8. Fertility Doula
A fertility doula provides emotional and practical support to individuals or couples trying to conceive, including those undergoing fertility treatments.
9. Full-Spectrum Doula
Full-Specturm doulas support people during all stages of the reproductive journey, including birth, postpartum, abortion, miscarriage, stillbirth, and adoption. Full-spectrum doulas recognize that reproductive experiences can vary widely and aim to provide compassionate and nonjudgmental support to individuals and families throughout these experiences.
10. Lactation Doula
A lactation doula supports new parents who are breastfeeding, chestfeeding, or pumping. They may offer education on feeding positions and techniques, help with latching, and provide emotional support.
11. LGBTQ+ Doula
An LGBTQ+ doula provides support to LGBTQ+ families, offering specialized care that takes into account their unique needs and experiences. In addition, they may provide guidance on finding LGBTQ+-friendly healthcare providers, education and resources, and emotional support.
12. Montrice
The term “Montrice” is a combination of the words “monitor” and “doula,” reflecting the dual focus of this role. A Montrice typically has a background in nursing or another medical field and may also be trained as a doula. A Montrice can be especially helpful for clients who have medical complications or are planning a hospital birth and want extra clinical support and monitoring.
13. Postpartum Doula
Postpartum doulas provide support to the person and their family after the birth of a baby. They can help with lactation, newborn care, meal preparation, light housekeeping, and emotional support during postpartum.
14. Sibling Doula
Sibling doulas help older siblings during the birth of a new baby. They provide age-appropriate education about the birth process and emotional support, allowing siblings to feel included and involved.
15. Size-Friendly Doula
A size-friendly doula is a birth professional who supports and advocates for individuals of all sizes during pregnancy, childbirth, and postpartum. They know people's unique needs and experiences during a plus size pregnancy and provide compassionate support free from judgment or bias. A size-friendly doula helps clients feel empowered and can play a valuable role in improving birth outcomes.
16. Surrogacy Doula
Surrogacy doulas provide support to intended parents and surrogates during the surrogacy process. They may offer guidance on navigating the legal and emotional aspects of surrogacy, provide support during medical appointments and procedures, and offer emotional support throughout the process.
17. Teen Doula
Teen doulas support and guide young parents, typically those under 20. They offer education on pregnancy and childbirth, provide emotional support, and help with decision-making and advocacy.
18. Trauma-Informed Doula
A trauma-informed doula supports clients who have experienced trauma in the past, including sexual abuse, domestic violence, or birth trauma. They offer specialized care that considers their client's history and provides a safe and supportive environment for their perinatal journey.
It's important to note that not all doulas specialize in a particular area, and some may offer a combination of services. Additionally, some doulas specialize in specific types of births, such as home births or VBACs, or have experience working with particular populations, like people with disabilities.
While many people undergo specialized training to become a doula and often receive certification, some learn at the bedside. So, as you go through the hiring process, you can decide what level of training or experience matters to you when finding the right fit.
What are the benefits of hiring a doula?
Hiring a doula can help provide personalized, compassionate support, improving physical and emotional outcomes for the person giving birth and their family.
According to the American Congress of Obstetricians and Gynecologists, one of the most effective ways to improve labor and delivery outcomes is to have continuous support from a doula.
Studies show that having a doula present during childbirth can lead to a 50% reduction in the cesarean rate and a 25% shorter labor.
In addition, there is a 60% reduction in epidural requests, a 40% reduction in oxytocin use, a 30% reduction in analgesia use (pain medication), and a 40% reduction in forceps delivery. These statistics highlight the potential benefits of having a doula present during childbirth, including improved birth outcomes and reduced medical interventions.
We'll share even more benefits below as we look at all a fat-friendly doula provides.
What is a size-friendly doula?
A size-friendly doula is a birth professional committed to body positivity and inclusivity. They have worked on their biases and understand the unique challenges and needs that may arise for higher-weight people during pregnancy, birth, and postpartum.
Here are the unique ways size-friendly doulas support their plus size clients and families.
Specialized Size-Friendly Support
Size-friendly doulas are knowledgeable about the physical challenges that may come with a larger body and can offer personalized support to help you find comfortable positions during labor and feeding your baby, access necessary equipment, and feel more at ease throughout labor, delivery, and postpartum.
For example, monitoring, especially continuous fetal monitoring, can be more challenging for plus size individuals. However, most birth doulas are skilled at helping to keep the monitors in place. They can also assist you with decision-making if your care team makes recommendations like internal fetal monitoring.
Emotional Support
Having a doula who truly understands and validates your experience can be incredibly empowering. Size-friendly doulas are there to listen and empathize without judgment as they've worked on their biases.
Celebrate Your Body
Fat-friendly doulas believe all bodies are beautiful and worthy of celebration. These doulas help you feel confident, empowered, and supported throughout your birth journey.
Advocacy
Studies show that plus size women can face bias and discrimination from healthcare providers during pregnancy. And weight bias can impact the quality of care they receive. So, a size-friendly doula can help people navigate the healthcare system and advocate for their rights and choices.
How can I connect with a size-friendly doula?
1. Get Referrals
Ask your plus size friends, co-workers, care provider, and online local community groups for recommendations. Also, some medical facilities and birth centers have doula programs, so be sure to inquire.
2. Search Online
There are directories of doulas who specialize in supporting plus size pregnancy, like sizefriendly.com. Or you can search for “size-friendly doulas” in your city.
3. Look for Size-Friendly Language and Images on their Website
Check a prospective doula's website and social media for language and photos that suggest they are size-friendly. For example, they may use inclusive language such as “every body” or have images of people of all sizes.
4. Ask Questions
When interviewing prospective doulas, inquire about their experience working with plus size clients. Ask how they will support you, what accommodations they will make to ensure your comfort, and how they will help you advocate for your birth preferences. You can even ask for references.
If you feel comfortable, be specific! Communicate your needs and preferences, including any concerns about your size and how they can support you. A size-friendly doula will work with you to create a personalized support plan that meets your unique needs.
5. Trust Your Gut
When you meet with a potential doula, consider how they make you feel. Do you feel heard, respected, and supported? Do they seem knowledgeable and compassionate?
Choosing a size-friendly doula who makes you feel comfortable and confident is essential.
Questions to ask when hiring a size-friendly doula?
The number of doulas you should interview can vary depending on your preferences, the availability of doulas in your area, and your needs.
Meeting with several doulas allows you to compare their experience, style, and approach to supporting clients and choose the one that feels like the best fit for you. So, interview at least 2-3 doulas before deciding.
Here are some questions you may want to ask during the interview process.
- What experience do you have working with people of size?
- Do you consider yourself to be a size-friendly doula, and are you familiar with Health At Every Size®?
- Can you provide references from clients with large bodies that you have supported in the past?
- How do you approach supporting clients of different sizes during pregnancy, labor, and postpartum?
- How do you accommodate different body sizes and shapes during labor and delivery?
- How do you ensure that your clients of size feel comfortable and respected throughout the birth process?
- How do you ensure you provide inclusive and nonjudgmental care to clients of all sizes?
- Are you familiar with any special considerations or accommodations that may be needed for during labor and delivery?
- How do you support clients facing discrimination or bias regarding their size during their birth experience?
- Do you have additional training for supporting clients of size during pregnancy, childbirth, or postpartum?
These questions can help you evaluate the doula's experience and approach to supporting clients of size. Also, they help ensure that you feel comfortable and supported throughout your pregnancy and birth experience.
Don't feel pressured to ask all these questions – you can choose what matters most, and a conversation with your prospective doula will naturally unfold.
Questions to ask when hiring a birth doula?
Beyond questions related to being fat-friend, below are common questions you might consider asking when looking for a doula who is the right fit for you and your family.
- What inspired you to become a doula, and what is your birth philosophy? (great icebreaker to get the ball rolling)
- What is your experience and training as a doula?
- Are you certified, and if so, by which organization?
- How many clients do you take each month?
- What is your availability, and how do you handle being on call for clients?
- What is your backup plan if you cannot attend my birth?
- Can you provide references from past clients?
- What services do you provide as part of your doula support package, and what are your fees?
- What is your policy on communication and availability leading up to and after the birth?
- Do you have experience working with my healthcare provider or birthing location?
- How do you involve my partner or support person in the birth experience?
- How do you work with clients to create a birth plan, and what is your approach if the birth plan needs to change?
- How do you help clients manage pain during labor?
- What are your postpartum services, and how do you support clients during the postpartum period?
- How do you provide inclusive and nonjudgmental care to clients of different backgrounds and identities?
These questions will help you understand the doula's experience, qualifications, and approach to supporting families, as well as help you determine if they are a good fit for you and your birth preferences.
When should you hire a size-friendly doula?
There is no right or wrong time to hire a doula!
Starting your search early is recommended, especially if you have specific preferences for the type of doula you want to work with. Consider looking for a doula around the end of the first trimester or the beginning of the second trimester.
Should I hire a doula if I'm having a c-section?
This is a common question when people consider hiring a doula. The answer is yes! And since plus size people are at a greater risk of having a cesarean birth, let's dig into this a bit.
Here are some ways a doula can support you during a cesarean birth:
Provide Emotional Support
A doula can help you feel calmer and more relaxed during the c-section by providing emotional support and reassurance. In addition, they can offer encouragement and help you stay focused on your goals and preferences for your birth experience.
Help with Communication
A doula can help facilitate communication between you and your medical team, ensuring that you understand what's happening during the c-section and that your preferences are being taken into account. As well as helping you communicate your preferences for the c-section, such as having a clear drape or immediate skin-to-skin contact with your baby.
Take Photos
Your doula can help document when your baby is born, and you bond as a family. There are even specialized birth photographers!
Assist with Feeding Your Baby
Doulas can help with breastfeeding/chestfeeding immediately after the c-section, providing guidance and support to help you and your baby get started.
Provide Postpartum Support
A doula can provide postpartum support during your recovery from the c-section, helping with newborn care, offering emotional support, and providing resources and information. And there are some unique needs for plus size people during a c-section, like the need for larger belly bands and caring for your incision if you have an apron belly.
Some hospitals may have policies restricting the presence of a doula during a cesarean birth, so it's important to check with your care provider and hospital to determine if a doula will be allowed in the operating room. Usually, this decision is left to the anesthesiologist.
But even if they can't be in the operating room, they can still offer incredible support.
How much do size-friendly doulas cost?
The cost of hiring a doula can vary depending on several factors, such as their experience level, location, and the services they provide.
Typically the cost of a birth doula in the United States is between $800 and $2,500, while the average price of a postpartum doula is between $25 and $45 per hour. However, these costs can vary widely.
Some doulas offer a sliding fee scale or payment plans to help make their services more affordable. In addition, many communities have affordable doula programs.
In great news, some insurance companies cover some or all of the cost of doula services, so it's worth checking with your insurance provider to see if this is an option for you.
Remember that hiring a doula can be a valuable investment in your birth experience and postpartum recovery. You can encourage your loved ones to support your desire for doula support by setting up a doula fund along with your baby registry.
“Having a doula at all three of my births was the best investment. From our first conversation, I immediately felt more confident in my ability to have the birth I desired. I expressed my concern about being plus sized and wanting a low-intervention birth, and she didn't bat an eye, reassuring me that my body was more than capable if those were my birth goals.” – Kathryn
We hope you've learned a lot and are empowered to connect with a size-friendly doula who will help you to feel confident and capable as you bring your baby into the world.
If you're a size-friendly doula, see our resources for size-friendly birth professionals.
References
Campbell DA, Lake MF, Falk M, Backstrand JR. A randomized control trial of continuous support in labor by a lay doula. J Obstet Gynecol Neonatal Nurs. 2006 Jul-Aug;35(4):456-64. doi: 10.1111/j.1552-6909.2006.00067.x. PMID: 16881989.
AGOC Committee Opinion Approaches to Limit Intervention During Labor and Birth. Volume 133, No.2, February 2019.
Incollingo Rodriguez, A.C., Smieszek, S.M., Nippert, K.E. et al.Pregnant and postpartum women’s experiences of weight stigma in healthcare. BMC Pregnancy Childbirth 20, 499 (2020),
Cesarean Birth Statistics – Center for Disease Control and Prevention (National Vital Statistics System, natality file).
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