I understand because I have been there. It is challenging to sift through the overwhelming amount of information regarding health during pregnancy and delivery, sorting trends and fads aside from important information and fact. If you haven't heard of a doula before, the topic might be easily seen as belonging in the "trends and fads" pile. Again, I have been there. The term 'doula' certainly never came up in conversation in the circles I was a part of, either as a young woman learning about reproductive health in school nor when I was an adult discussing pregnancy and childbirth with friends. However if you have dismissed the idea of hiring a doula out of hand because of stereotypes or preconceived notions about who they are and what they do, you may want to take a moment to learn about some of the proven benefits of having the support of a doula during your pregnancy, labor and delivery.
The fact is, birth culture in the United States doesn't really foster the idea of hiring someone to attend your birth for emotional support. We have been brought up believing that birth is risky and laboring women are best left in the hands of highly trained physicians and nurses. Hiring a doula, in most people's limited knowledge of the word, might require you to have a full-on-all-natural labor and forgo that epidural you have been considering. Some of you may even think hiring a doula means you have to commit to a home birth. These ideas couldn't be farther from the truth.
Perhaps you are struggling to sift through the myriad of information and options for care during your pregnancy and your delivery. Doulas can be very helpful in narrowing down what it most important to you and your individual needs and wishes in regards to care. During their time spent with you before your labor, your doula will discuss all of your options and help answer any questions you have about common procedures and interventions that might be offered or necessary during labor. Or perhaps the hospital or practice you are delivering with have certain interventions that they use routinely and you want to become more informed about them. Doulas provide a completely nonjudgmental space for you to ask questions and discuss concerns, something you may not be comfortable doing with your physician. Let me be clear though, a doula should never offer medical advice or suggest you forgo the advice of a care provider. Her role is to provide information and resources that go over the pros and the cons of each choice you get to make for your care, not to steer you one way or the other.
What about your spouse or your partner? How can a doula help emotionally support a laboring mother without pushing their most important emotional bond to the side? It's simple, really. A doula is not there to replace anyone or to take over your labor. She is there to reassure you and your partner that everything is fine - that everything you are experiencing and feeling are normal. She may help your partner support you by guiding their hands to your hips to do compressions or showing them how to 'talk' you through a contraction. Her presence allows your partner to focus on you while she gets you water or a cool cloth for your forehead or any number of other, minor things that would otherwise draw them away from your side. She gives your partner the opportunity to take quick breaks for food or to sneak off to the restroom without the fear or guilt of leaving you alone. She can also relieve a lot of your partner's anxieties about how and what they are supposed to do when you are in labor - knowing that someone is there to help can be just as big of a relief for them as it is beneficial to you.
Many women and their partners struggle to justify the added expense of a doula during their labor. While some FlexSpending accounts allow you to use them for doula services, as of now no health insurances cover the cost of hiring a doula. For families that have little or no exposure to doulas or the benefits of having one attend your birth, this alone can be reason not to pursue the matter. You are not splurging on a luxury when you are hiring a doula, you are paying for a trained professional to assist you with one of the most important events in your life. If you have looked into hiring a doula and it is truly something outside of your family's means, it never hurts to contact a few doulas in your area and see if they are willing to work out a payment plan or if they offer a sliding scale where they charge families what they can afford. Some metro areas also have community doula programs, like Urban Baby Beginnings based out of Richmond, VA, for at-risk or economically vulnerable families.
Lastly, having a doula present at your birth can empower you to advocate for yourself while in labor. During the end stages of labor a mother is 100% focused on one thing: her body. The late stages of labor require an intense amount of concentration and focus, and most women are simply unaware of their surroundings once they reach this point. Having a doula present can help ensure there is someone there able to see and asses what is happening in the delivery room. Perhaps it is important to you that you be able to labor in the position of your choice. The staff at the hospital may not be aware of this and could try and encourage you to lie on your back in the bed. While your doula cannot intervene with any medical staff she can gently remind you or your partner that you did not want to labor that way, and ask if you are alright with being moved. This allows you to make the choice; lie down or let the staff know you prefer to labor as you are. Keep in mind, birth does not have to be something that happens to you. Birth can be an incredibly empowering and spiritual event that you are an active and joyful participant of, and a doula can help you achieve that!
So while you are sifting through your options for labor, keep an open mind about hiring a doula. Ask friends and family if they have had a doula attend one of their births or if they know anyone who has. Reach out to local mom groups and talk to other mothers like you who may have used a doula and see if hiring one is right for you. You won't regret it.
If you have questions or would like to share your birth experience with a doula please do so in the comments below!
* Impact of Doulas On Healthy Birth Outcomes; Kenneth J. Gruber, PhD, Susan H. Cupito, MA, and Christina F. Dobson, MEd and Doula Care, Early Breastfeeding Outcomes and Breastfeeding Status at 6 Weeks Among Low Income Primiparae: Laurie A. Nommsen-Rivers, Ann M. Mastergeorge, Robin L. Hansen, Arlene S. Cullum, Kathryn G. Dewey
** Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries; Katy Backes Kozhimannil PhD, MPA, Rachel R. Hardeman MPH, Laura B. Attanasio BA, Cori Blauer-Peterson MPH, and Michelle O’Brien MD, MPH
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Interested in meeting with a doula in your area? Doulamatch.net is a searchable database for birth and postpartum doulas using your city and state or your zipcode.
DONA.org also provides a nationwide searchable database for doulas that have been certified through their organization.