My first baby was born in Germany. Before the birth I interviewed several midwives and chose a birth centre, and I gave birth without pain medication. What stayed with me afterwards was one feeling: so this is what birth can be — supported, intense, and beautiful.
My second baby was born at home in Taiwan. That was when I realised how many women here have never heard of having someone whose whole job is to be with them through birth. And how much harder it is if you are also navigating a language and a medical system that aren't your own.
First: what a doula is — and isn't
A doula is a trained companion who gives continuous emotional, physical and informational support through pregnancy, birth and the early postpartum weeks.
- Not a medical provider. I don't do cervical checks, read the fetal monitor, catch babies or make medical decisions for you. That is the work of your doctor and midwife.
- Not a replacement for your partner. A doula is there so your partner is supported too, and doesn't have to carry the panic of "what should I be doing?" alone.
- Not only for unmedicated birth. Hospital births, epidurals and caesareans can all have a doula.
What the research says
The strongest evidence on continuous support in labour is a Cochrane systematic review last updated in 2017 (Bohren et al.), pooling 26 randomised trials, 15,858 women, in 17 countries. Compared with usual care, women who had someone with them continuously were:
No harms were found. And in the subgroup analysis, the benefits were largest when the support person was a trained doula rather than hospital staff or a friend — a roughly 39% lower risk of caesarean.
A second, often-quoted figure comes from the US: among mothers covered by Medicaid, those supported by a doula had a clearly lower caesarean rate. It is an observational study, not a trial, but it points the same way as the Cochrane review.
Caesarean rate: with a doula vs national
US Medicaid births; n = 1,079 with doula support
Data: Kozhimannil et al. (2013) Am J Public Health, PMID 23409910
This is why the World Health Organization's 2018 guideline on intrapartum care recommends that every woman can have a companion of her choice throughout labour and birth — a partner, relative, friend, or doula.
You may read that doulas prevent postpartum depression. There are early, encouraging signals, but they come from observational studies and small pilot trials. There is no large randomised trial yet. I'd rather tell you "we don't know yet" than sell you hope as a conclusion.
The four things a doula actually does
A 2019 Cochrane qualitative review (51 studies, in women's and companions' own words) groups what companions do into four kinds of support:
Information
Where labour is now, what the staff just said, and the non-drug ways to cope with pain.
Advocacy
Not fighting the staff on your behalf, but helping the wishes you planned get said out loud when you can't speak.
Practical
Walking, changing positions, counter-pressure, warmth, holding your hand, reminding you to drink and eat.
Emotional
Being there, the whole time. Reassurance that what you feel is normal, and that you can do this.
Why it matters even more when you give birth in Taiwan
The same 2019 review found that women giving birth in a country that isn't their own may benefit from a companion who understands the local culture. For foreign families in Taiwan, that is exactly where a bilingual doula adds the most.
- Mandarin, in the room. Many delivery rooms run in Mandarin, and some staff are reluctant to speak English. I speak Mandarin, English and Japanese, so I can tell you what is being said and help your questions reach the right person. (For major medical decisions and consent, it is still worth asking the hospital for its own explanation too — I am your companion, not a certified medical interpreter.)
- Knowing the system's defaults. Taiwan's caesarean rate is around 36–38%, and in a 2023 survey about 70% of hospital births involved an episiotomy. Many of these are standard procedures (SOPs). If you want something different, it needs to be said early, in writing, and agreed with your doctor before labour — I help you prepare that.
- Reading the culture. Doctors here often tell you only your next appointment; family may expect a month of 坐月子 (postpartum confinement). I can explain what is normal here, what is negotiable, and what to ask.
- Someone who stays. Your partner can be fully with you instead of searching for words in a translation app.
Whether a doula may enter the delivery room is decided by each hospital — there is no national rule — so ask when you choose where to give birth. My guide Giving birth in Taiwan as a foreigner covers the rest of the system in detail.
Honestly: not everyone needs one
Parents' own accounts online are mixed, and I think you deserve both sides:
- Those who found it worth it describe the doula as a bridge with the medical team, and say their partner could focus on them. One wrote that, knowing what she knew afterwards, she would have paid double.
- Those who didn't often had an epidural, a wonderful nurse and a steady partner, and felt the doula mainly gave the partner a break — at a real cost. Some put their budget into postpartum support instead.
Nearly everyone agrees on one thing: it depends on the person, and on the fit. Meet a few doulas and choose the one you relax around. If that isn't me, that's completely fine.
What I'd add
The numbers are the foundation. But I'm never really accompanying a statistic — I'm accompanying you.
Years from now, you may not remember how many hours labour took. You will remember whether someone saw you — your fear and your strength. Far from home, that matters even more.
Questions people ask
My partner will be at the birth. Do I still need a doula?
The two work together. Partners tend to have a more positive experience when a doula or midwife is with them — someone explains what is happening, shows them what helps, and lets them take a break. A doula supports your partner too; she doesn't replace him.
Is a doula useful if I plan an epidural or a caesarean?
Yes. With an epidural you still need help with positions and someone to explain labour; a planned caesarean still benefits from preparation and someone to help you process it afterwards.
Can you interpret for me in a Taiwanese hospital?
I speak Mandarin, English and Japanese and can help you understand and be understood throughout labour. I'm not a certified medical interpreter, so for major decisions and consent, also ask the hospital for its own explanation.
How much does doula support with you cost?
My support plans start from NT$21,000 (online support from pregnancy to 6 weeks postpartum). Adding a birth course or in-person birth support changes the price, so I send a full quotation after we talk. See the three plans →
Sources
- Bohren MA et al. (2017) Continuous support for women during childbirth. Cochrane Database Syst Rev, CD003766 (Cochrane Library · PMID 28681500)
- Bohren MA et al. (2019) Perceptions and experiences of labour companionship. Cochrane, CD012449 (summary)
- World Health Organization (2018) WHO recommendations: intrapartum care for a positive childbirth experience (WHO)
- Dekker R et al. Evidence on: Doulas, Evidence Based Birth, updated April 2024 (link) — source of the doula-subgroup figures
- Postpartum depression: Gjerdingen DK et al. (2013) pilot RCT (link)
- Taiwan caesarean rate: Ministry of Health and Welfare statistics (link); episiotomy: Taiwan Birth Reform Alliance 2023 survey (link)
- Parents' views: discussions on Hellobee, The Bump and Berkeley Parents Network (example)
This article is for information only and is not medical advice. It cannot replace direct conversations with your doctor or midwife.