A What-a?! A Doula!!

Have you considered using a doula for your birth?

 “A what-a?” you ask.

A doula!

“Is that the same thing as a midwife?” you wonder.

Nope!

DEFINING DOULA

A birth doula is a person (usually a woman) “who guides and supports women and their partners continuously through labor and birth.  The doula is on call for you, arrives at your home or the hospital when you need her, and remains with you continuously, with few or no breaks, until after the baby is born.  The doula is trained and experienced in providing emotional support, physical comfort, and nonclinical advice. She draws on her experience as she reassures, encourages, comforts, and empathizes with the mother. She advises the partner about how to help, suggesting when to use particular positions, the bath or shower, and specific comfort measures.”  The Birth Partner – 4th Edition by Penny Simkin (2013)

A doula “holds space” in the birth environment.   Holding space refers to releasing her personal baggage and prejudices and being fully present in your birth.  She acknowledges that the experience is about you as a family, that it is sacred, and that it is to be honored and respected.   There is no agenda. The birth belongs to the mother and partner, and a doula is there to provide support and encouragement.  She is someone there only for you – she’s on YOUR team.

Essentially, the difference between a doula and a midwife is this:  A midwife is a health care provider who provides medical care to the mother, while a doula is a labor support person and childbirth coach.  A doula cannot perform any medical care. Now, there is a blend of the two called a monitrice. A monitrice is a woman trained to provide support not only during childbirth but also throughout the course of your pregnancy.  A monitrice acts a doula but her services extend into clinical care. For instance, she is able to listen to fetal heart tones, check cervical dilation, and take blood pressure. 

Why Doulas are Helpful to First-time Parents

I’m going to be honest.  I wanted a doula with my first pregnancy but my husband wanted to be my “doula.”  Looking back on it, it seemed like it was a matter of my husband not wanting to feel like he was replaced and me not wanting to replace him. After all, he was the baby’s father, the man who knew me the best, and my partner through all my childbirth classes. Naturally, he should have supported me!  But what we didn't know was that there would be the nuances of birthing that we were not experienced in. We didn't fully understand our rights as patients. We lacked confidence as first-timers.  Our birth outcome was not what I wanted – I hoped for an intervention-free birth but ended up with a cesarean section. 

Doulas can help the birthing mother and her partner feel confident.  Doulas are not substitutes or replacements for the partner. Rather, they add value to both parents’ experience of the birth.  I’m paraphrasing another snippet from The Birth Partner about how a doula can help the partner: A doula can help the partner apply what he/she learned in the actual unpredictable labor situation; give the partner a break to get a meal or take a short nap during a long labor; bring the mother beverages, hot packs, or ice; reassure the partner if he/she is worried about the mother’s well-being;  help interpret the signs of labor progress to partner; address the parents’ priorities, fears, and concerns and help them develop strategies to deal with them; and possibly photograph or video record the birth and moments directly following.

HOW MUCH MOOLAH FOR A DOULA?  

The price for a doula can range based on your geographic location, the doula’s experience and certifications, and whether or not they offer sliding scale pricing or barter options.  Prices range from $300-$3,000 though I find that most fall within the $500-$1,200 range.  Doulas will often work with clients by creating payment plans, as the fees are typically out-of-pocket expenses for parents.

Watch this clip from the Suze Orman Show where she approves the expense of a doula; sharing that doula care is a need. This is awesome!  It’s great to hear about doulas in a such a mainstream setting! 

I don’t want to reinvent the wheel with this post.  There are SO many great articles with stats and arguments supporting how doulas can enhance the labor experience, such as this Evidence Based Birth article. http://evidencebasedbirth.com/the-evidence-for-doulas/  I just wanted to offer up the consideration of this option to first-time parents and 2nd+'ers. 

HOW DO I FIND A DOULA?

Lastly, I want to leave you with some resources for how to find a doula.  Referrals are great, too! You can ask mom friends, nurses, doctors, midwives, women at church, acupuncturists, chiropractors, and birth photographers!

http://www.dona.org/

http://doulamatch.net/

BIRTH CHOICE

And guess what?! While evidence supports that doula support can statistically increase your chances of a natural childbirth, a doula can support ANY type of birth - from home birth to c-section!  Clearly, I think doulas are great assets to the process of childbirth and this post sings them praise. After all, it is World Doula Week!  However, please don’t read this and think “well, shoot, the only way to have an ideal birth is to hire a doula” because that isn't the case. I encourage partners to discuss what their birth looks like. If you’re on the fence, you can always interview a few to get a feel for the role in your birth and go from there.  The choice is yours, and your feelings of comfort and safety in your birth space are most important.