I often get asked “What is a Doula, and why did you choose to hire one?”
If you’ve ever given birth before in a traditional medical setting [ie: a hospital, labor and delivery suite, or operating room] then you know some of the protocols and procedures can feel a bit well.. cold. Sometimes you have a choice, but the way medical staff might phrase a comment and / or question leads you to believe you don’t have a say in the topic of discussion.
Maybe you’ve given birth and you felt like you wish you had someone on your side that assisted in carrying out your wishes. Or, maybe you’ll be giving birth soon and aren’t sure how to navigate the process.
For us, our twin pregnancy was long and hard. Nearing the end, I was at the doctor’s office four days a week for growth studies, BP checks, NST’s [non-stress tests for the babies], and blood flow studies. It was a lot. Even though I am a Registered Nurse [yes, that’s my former career] and spent 5 years of my time as an RN in the ICU setting before leaving the hospital life behind, it was still tricky to navigate what was truly necessary for the safety of the babies and myself, versus what was excess. Did I really need all of those studies? Did I really need all of this blood work? Was it really necessary to induce early, or was that just common practice?
We hired a Doula with the intent of having her help us navigate some of those big questions, as well as to have her help us through labor. Essentially to have someone on our side that wasn’t zipping from patient to patient checking off boxes. Don’t get me wrong, our OB’s and High Risk Physician’s were incredible. We also believe in making educated decisions and did not want to agree to something simply because we didn’t know any better. We wanted to be informed patients for both myself and our children.
Additionally, I wanted to understand what was being done to my body and my children’s bodies to be able to decide what was right for us as a family. Hiring a Doula gave us that extra voice of reason that allowed us to process questions as we were faced with them throughout pregnancy and delivery. She also provided us with resources so that we could make our own informed decisions.
Okay, so – what is a Doula and what is her role you ask?
The role of the Doula is to serve the laboring woman. Her biggest goal is to help the laboring mother reach her desired birth outcome. This could mean anything from a first-time successful vaginal delivery, to a non-medicated vaginal delivery, or to a laboring woman who feels like she needs extra support by her side.
In our case, I felt as if I did not have much of a voice during the delivery of my daughter 8 years ago. I was given medication to speed up my labor, told I needed to remain in bed and labor on my back – despite there being zero complications with myself or my daughter, ended up receiving a non-functioning epidural, and had a fourth degree tear [ouch ouch ouch].
All of this could have been prevented if I had not been afraid to speak up, or if I would have had an advocate *cough cough – a Doula* by my side during labor. I didn’t know any better, and I certainly didn’t want to question the people who were telling me I “had” to do certain things. Needless to say, I did nottt want the delivery of our twins to end up going the same way where I felt like I had a total loss of control – so we hired a Doula!
What does a Doula do for me?
- A Doula provides continuous emotional and physical support throughout pregnancy and labor.
- Provides information and resources to you during pregnancy that will help you learn about all of the options you have during your birth.
- While you are still pregnant, your Doula will encourage you to communicate with your OBGYN / Midwife in order to be an informed patient regarding any interventions, procedures, etc. that may be recommended to you.
- The Doula will assist your birth partner [whether this is your husband, mother, etc] during labor in ways that will help them support you as the laboring mother.
- During labor, the Doula will help ensure your wishes for the birth environment are maintained [low lights, soft music, no visitors, etc] to the best of their ability.
- One of my personal favorites, is the Doula will assist with comfort measures during labor such as massage, pressure point techniques, different laboring positions, and assisting with relaxation breathing.
What does a Doula not do?
This is equally as important as what a Doula will do for you. It’s important to mention that a Doula does not replace your healthcare provider [OBGYN or Midwife]. Doula’s do not perform tasks like blood pressure checks, monitoring baby’s heart rate, etc. Additionally, they do not make decisions for you. They translate information from your doctor so that you can understand it and make an informed decision for yourself and your baby.
Another motivating factor for us was the statistical evidence in better birth outcomes from mothers who used Doulas during their pregnancy and labor. Factors such as reduced usage of Pitocin [which can increase your chances of ending up with a c-section or tearing], decrease use of pain medication during labor, less requests for epidurals, higher chance of a successful spontaneous vaginal delivery, and higher satisfaction with birth outcomes*.
If you’re interested in hiring a Doula, here are some important questions to ask whomever you might be considering to fulfill that role for you. Also, we met with our Doula for breakfast and coffee prior to hiring her to make sure we were all a great fit! You want to make sure your personalities mesh, because again – they are going to be there for you during one of the most important days of your lives.
- What is your training, what organization are you certified through?
- How many births have you attended?
- Are you available around my due date? How many births do you take on per month?
- Do you have a backup Doula, and will I [or can I] meet her?
- Please share with me your philosophy about birth.
- Are you available to us during pregnancy?
- At what point in labor do you come to us?
- At what point during our pregnancy do you become “on call”?
- What types of coping techniques do you primarily utilize during labor?
- Have you ever worked with our OBGYN / Midwife?
- What are your fees and what is your booking process?
Let’s talk cost!
You will find some insurance companies cover the cost of a Doula; however, most do not in the United States. After researching Doulas, I have found that most range from $400-$800. Upfront, this may seem like a lot. However, think about what they do! They are on-call for you, remain by your side during your entire labor, and assist you bringing your baby into this world! That is a BIG job! Also, the presence of a Doula can often help you prevent costly expenses such as a c-section or a vaginal tear. Many Doulas are willing to work out payment plans to help you budget for the cost. For us, this was something we were very passionate about so we chose to pay out of pocket for ours. She was worth every cent, and I would easily pay twice over to have her there for us during future pregnancies.
To find a Doula in your area, DONA International provides a service that allows you to search your zip code and find certified Doulas in your area. Here is a link to their page: DONA International
*Data and statistics received from americanpregnancy.org // The American Journal of Managed Care, 2014