Featured Guest Post: To Doula or Not to Doula?

This is a guest post from Kara, author of the charming blog Notes from the Nest which she writes as part of the team from Magnet Street Baby. When I learned she had used a doula for the birth of her son, I asked her to write a post about it and share her experiences with you. When you finish reading this informative post, head on over to the Notes from the Nest and check out her other many words of wisdom! Thanks, Kara, for writing such a great post for EHParenting’s readers!

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“Doula” is not a term that comes up in conversation a whole lot. In fact, one of my favorite memories from our birthing class was one of the dads asking about a “moolo” over and over again until someone finally realized that he meant “doula” – ha! Kudos to him, though, for bringing up the topic. At that point in my pregnancy, I had only recently learned about them myself. In case anyone else needs a little more formal definition, here’s the word from Wikipedia:

“A doula is an assistant who provides various forms of non-medical support (physical, emotional and informed choice) in the childbirth process. Based on a particular doula’s training and background, the doula may offer support during prenatal care, during childbirth and/or during the postpartum period.”

The following information is based on our experience with a doula. Obviously every doula, every couple and every birth experience is unique. I hope our story will help you in the decision-making process.

Childbirth Choices: After becoming pregnant, my husband and I had determined that we wanted to strive for childbirth without the use of pain medications. Being that I don’t have the highest pain tolerance, I knew that additional support would be needed to achieve this goal. This included attending childbirth classes in the Bradley Method and seeing a chiropractor that specializes in pregnancy. We had also decided to use my regular obstetrician at the hospital, rather than a midwife and/or a home birth.

Another big decision was whether or not to use a doula. I had a rosy vision of labor and delivery with my husband at my side, and feared that a doula’s presence would be awkward and intrusive. Yet the more realistic side of me protested: my wonderful baby-daddy will do nearly anything I ask of him, but he isn’t great at perceiving my needs on his own. And having never given birth, I didn’t even know what would be most helpful, so how could he know? We decided to at least meet with some doulas, to get more information.

Finding a Doula: Our Bradley teacher recommended The Childbirth Collective, which provides an opportunity to meet with doulas as part of their monthly classes. I’m sure other states have similar groups, or the DONA website has a “find a doula” search feature. Our doula actually works at a hospital, and then takes private clients like us on the side. When researching hospitals, check to see if they offer doula services.

Based on her online profile, we chose to meet with Dawn. Her down-to-earth personality and vast experience immediately put us at ease. I shared my concerns, and she pointed out that with her knowledge, she would be able to draw my husband into the support process. For example, she could show him how to do a lower back massage, and tell him when to do it. As she put it, there’s plenty of work for two people to do in assisting a laboring woman. After discussing a bit more on our own, we let Dawn know that we would like to hire her.

Cost: Our doula’s standard fee was $600, average for our area, but she is willing to adjust that price based on her clients’ ability to pay. Her services included two prenatal visits, her presence during all stages of labor and delivery, a postnatal visit and general availability via phone or email for questions. Especially when you consider that labor could last a day or two, we considered this price to be more than reasonable. I was able to use pre-tax flex spending dollars for this, and some insurance plans will even cover doula services.

Misperceptions: Sadly, there’s a video used in some childbirth classes that paints a negative picture of doulas- several of our friends were surprised to hear that we wanted one, after watching it. The doula in this video is apparently very in-your-face, hovering over the laboring mother in an annoying way. This was not our experience at all.

Our Experience: At our first prenatal visit, our doula asked lots of questions to get to know both my husband and me, such as:
-Fears during pregnancy and childbirth
-Prenatal information such as allergies, flexibility, body reactions to no food and sleep, modesty level etc.
-Review of labor process, expectations and support roles
-Induction alternatives
-Techniques that help and hinder labor progress
-Medications and interventions
-What happens after the baby is born?
-Baby Blues/depression/postpartum psychosis and what to look for

At the second prenatal visit, we discussed more topics:
-Baby positioning (by feeling my stomach, she could tell that the baby was lying across my middle, and gave my husband and me a partner exercise to move the baby into a head-down position)
-Pain medication preference scale
-Labor and birth positioning
-Comfort measures (relaxation, breathing, massage, hydrotherapy, mental activity, body positions/movement, hot/cold packs, backache measures, etc.
-Discussion of possible medical interventions and procedures

Birth-Day: As both our doula and OB had predicted, I didn’t make it to my due date, but went into labor four days early. We had expected that Dawn would come to our house for some of the early labor. After a few phone calls back and forth, however, we realized that mine was not going to be the all-day variety of labor, and we would instead meet at the hospital.

When we pulled up in the car, our doula was waiting with a wheelchair. I was in the final stages of labor at this point (trust me, it was not our plan to have this happening in the car!), and had trouble getting into the wheelchair, much less walking on my own. Unfortunately, the nurse assumed that I was an over-eager first-time mother, and was taking her sweet time checking me in, asking for insurance info, etc. Dawn was able to ask me a few key questions, loud enough for the nurse to hear and thus realize that I needed to get into a room immediately.

After a quick examination, I was moved to the nearest delivery room and pretty much went right into pushing. It was so reassuring to have a familiar, confident voice giving me encouragement and direction. My husband appreciated her presence as well. With everything happening so quickly, she was calmer than either of us, and was able to communicate some of our preferences to the hospital staff.

Post-Partum Visit: Dawn came to our house a few days after we’d returned home with our son. We talked about the birth process and how we felt about it. She brought pictures that she had taken for us. I thought I wouldn’t want to see any photos or video of the delivery itself, but I’m so thankful that she took them! She also gave some tips on breastfeeding, baby massage techniques, and caring for myself.

Based on our wonderful experience, I would whole-heartedly recommend the services provided by a doula. If you want to go the drug-free route, they can make that goal more attainable. Since this was our first child, and neither of us had any experience with a birth, we especially appreciated her knowledge and resources. Some people choose a midwife instead of an OB/GYN because a midwife is with you through the entire labor process, not just the final crowning stage. Because we used a doctor, our doula met that need of a constant support companion. Definitely interview as many doulas as necessary to find one whose personality meshes well with yours, and who will listen to and honor your choices in the birth process.

Kara
www.NotesFromTheNest.com

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