Cesarean births can be full of intention, beauty, and connection, and doulas absolutely have a role to play. Whether you’re supporting a repeat cesarean, a planned first-time surgical birth, or a cesarean scheduled after a long decision-making process, you can provide meaningful support. Here’s what new doulas need to know about supporting clients through scheduled cesareans, from what’s usually allowed to what’s often misunderstood.

Understanding Hospital Policies

Hospitals vary widely in what they allow when it comes to support people in the operating room (OR):

• Full access: Some hospitals allow a doula to accompany the client through prep, spinal anesthesia, and the surgery itself. Sometimes, this is based on the doula being viewed as “staff” or already holding OR credentials from hospital-based certification programs for doulas to be allowed in the OR.
• Limited access: Others allow doulas to be present for spinal placement or pre-op but ask them to step out for the actual surgery.
• No access: In some facilities, only one support person is allowed in the OR, often defaulting to the partner.
• Special requirements: A few hospitals offer an OR certification course or require a pre-approval process for doulas.

It’s essential not to assume access. Instead, prepare your clients to ask clear questions about what support is allowed, and be ready to support them fully within those boundaries.

What You Can Do as a Doula

Before the Birth:

• Help your client process emotions around a surgical birth.
• Walk through what the cesarean process will look like.
• Assist with writing a “gentle” cesarean birth plan (e.g., clear drape, skin-to-skin, music, delayed cord clamping).
• Encourage proactive conversations with their provider and hospital.

During the Birth:

If you are allowed in the OR:

• Offer calm, grounding support during spinal placement.
• Stay by your client’s head to provide reassurance and gentle reminders of their wishes.
• Take photos (if permitted) to help document the birth.

If you are not allowed in the OR:

• Stay with the partner, prepping them emotionally and logistically.
• Be present in recovery to assist with positioning, lactation, pumping (if needed), and early bonding.

After the Birth:

• Help your client process their experience.
• Provide information on cesarean recovery and emotional healing.
• Support feeding goals, physical comfort, and adjusting to parenthood.

What You Can’t Do

• You can’t enter the sterile field. Don’t touch anyone or anything.
• You can’t speak for your client or override hospital staff.
• You can’t assume you’ll be allowed in the OR—even if you’ve been allowed before.

You can, however, advocate. Advocacy starts with planning and communication. Work with your client ahead of time to help them understand their options, phrase their requests clearly, and navigate restrictions with calm clarity.

Myths and Misunderstandings

• “You can’t doula a cesarean.” False. You absolutely can. Your support may look different, but it matters just as much.
• “Doulas aren’t allowed in the OR.” Not always true. Some hospitals welcome doulas, and policies can shift. Always ask.
• “If I can’t be in the OR, I’m useless.” Not at all. Your presence before and after may be the most grounding support your client receives.

Real Story: A Doula in the OR

“I had the honor of attending a planned cesarean today as a doula! I was certain I would just be kept in the recovery room to wait out the process, but the hospital was fantastic and said I would be considered ‘staff’ and allowed in the OR for the procedure. The anesthesiologist was so kind to allow me in for mom’s prep and spinal, so mom had support even when dad had to wait outside.” — Darian Minzenmayer, Birth Doula

Including a doula in the OR isn’t just a courtesy—it can make a lasting impact.

Tips for Supporting the Partner

• Prep them for what to expect visually and emotionally.
• Help them know what their role will be during the birth.
• If both are allowed in the OR, coordinate who does what. You might focus on the birthing person while they focus on the baby.

Trauma-Informed Cesarean Support

Cesareans can feel vulnerable. Your role is to:

• Ask for consent before touch.
• Use calm, clear language.
• Remind clients of what’s happening when the moment feels overwhelming.
• Debrief afterwards with compassion.

Contract and Intake Tips

• Include a section in your intake form asking if a cesarean is planned or a distinct possibility.
• Clarify in your contract what happens if you’re not allowed in the OR. (My fees remain the same.)
• Offer postpartum support or a check-in call if you can’t be present at the birth itself.

Marketing Tip: Talk About Your Cesarean Support

Many doulas support surgical births—some exclusively! But if you don’t talk about it, potential clients may assume you don’t. Include cesarean-specific support in your website copy, social media posts, and elevator pitch. You never know who’s quietly scrolling and self-selecting out because they don’t realize that your support includes them.

It Matters

Your presence matters. Whether you’re by your client’s side in the OR or waiting just outside to welcome them into recovery. Scheduled cesareans still deserve preparation, presence, and postpartum care. With clear expectations and thoughtful support, you can make a big difference.

Want to learn more about situations like this? Join us in Doula Office Hours to talk through real-life experiences, business questions, and how to adapt your support for every kind of birth.