Hiring a doula (also referred to as a birth coach) for Liam’s birth was not something I ever gave any thought to. The reason is simple: I had a midwife who was hands on with me during every stage of labor, my husband is a firefighter, unaffected by blood and extreme pain, and my mother had three natural births (without a single tear, I must add.) All three of them were with me from my very first contraction. I felt extremely comfortable with my support team.
However, not every woman is in my position. Birth and delivery is not the easiest thing to stomach (or the most glamorous) and some partners might not cope well with seeing the women they love suffer, or the gallons of blood that follow, without being able to physically “help”. That’s where a doula can step in.
First, a quick definition a doula:
The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now known as a birth companion and post-birth supporter, a non-medical person who assists a woman before, during, and/or after childbirth, as well as her spouse and/or family, by providing physical assistance and emotional support. The number of certified birth doulas in the United States has exploded in recent years, with 2,636 practicing today (400 in NYC!), up from only 31 in 1994 (according to DONA International).
“Why do I need a doula if I have a doctor that I trust?”
As much as a doctor cares for your health and the baby, he or she will be in and out of the room. You will spend more time with the nurses than with your beloved doctor. A doula on the other hand will not leave your side — not until your baby is born, the placenta is delivered, and the first latch is established. If you want her to, she can also come to your home early, before you go to the hospital; she might massage key pressure points, apply warm compresses to your aching lower back or run a hot bath or shower to ease the pain of your contractions. She will help you decide when it is the right time to go to the hospital, something that, believe it or not, is harder to decide than you think. Too early may lead to more interventions, too late may, well, be very stressful for you. Think of your doula as your one woman team: her job is to support you and your partner through every stage of labor, through the fear, chaos, and exhaustion. She is a woman who you will not only know on a personal level, but who will also do anything she can to give you the stress-free, positive environment you need in order to deliver in. She will remind you why you don’t want an epidural, or speak to your doctor when you can’t do so yourself.
In the unfortunate case an intervention is recommended by your doctor, a doula can help you decide what is right for you and your baby and even have your back. She will help you stick to your birth plan, but also reassure you about the choices you make in the labor room. According to a study of 15,000 women conducted in 2012, those who received continuous support were “more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth” (evidencebasedbirth.com).
“My partner will be there, I don’t need a doula.”
As I mentioned earlier, this was my thinking. I felt confident about my support team. However, a doula’s job is also to guide your partner, showing him/her how he/she can be involved, whether that means rubbing your feet or whispering some reassuring phrases every now and then. She will also come ready to teach you both some positions to help alleviate the pain. She might bring a rebozo, a long flat garment used by most doulas (see the positions here), or have you lie in a tub or on a mat. Unlike your partner/mother, a doula is experienced and familiar with common labor room fears and the obstacles to natural birth; she will know how to advocate for you if you want her to. Nonetheless, a doula will never interfere or take the place of your partner; she is positive and supportive, but knows when to step back.
Luckily for me, I took childbirth classes with a certified doula and knew that moving around was key to a quick labor. She taught me and my husband various positions. In the labor room, my midwife was also extremely helpful — I don’t think I would’ve had such a good birth if she hadn’t been there to move me around. Unfortunately, a doctor wouldn’t know how to help you in this way, or have the time to do so.
“Will my doctor roll his eyes if I bring a doula in the delivery room?”
Maybe. I switched providers at 32 weeks because my practice had a very closed-minded, rude doctor who could potentially deliver my baby. He told me, during our consultation, “you can get a doula, but in my opinion, it’s a waste of money.” He also said that any natural pain relief methods did not work and that he would induce me if things weren’t moving along after four hours. No, I am not joking.
Although your doctor might be like this one (hopefully not, though), most doctors like having doulas in the room. Who doesn’t like the extra help? “Doulas are support people, and everyone can use more support,” says Anthony Chin, M.D., an OB/GYN who practices in Los Angeles (babble.com).
“Where do I Find a Doula?”
The good thing is that you can get recommendations. Most midwives (and some doctors) will have a list of doulas to offer. If you don’t have personal recommendations, check out the listings at DONA International. Interview them over the phone, ask about their experience and certification, how many births they’ve attended, and why they picked the profession. You can meet with them face to face before making a decision — it’s important that the doula you pick “gets” you. Doulas often charge between $1000-$2500 for pre-birth discussions and full-time labor and delivery help, but many of them charge a lot less. Many are willing to attend births for free or for a nominal fee as part of their training. As part of their fee, you can also count on them as a source of information throughout your pregnancy. I know that I personally contacted my childbirth instructor/doula numerous times over the course of my pregnancy. Sometimes, when you’re really concerned about something, the internet just isn’t good enough.
A doula can be there post-partum as well.
While labor doulas attend births, post-partum doulas support new mothers at home in the first few weeks after delivery. If you don’t have family nearby or if you are a single mother, a post-partum doula can be a lifesaver. Knowing how helpful it was to have my mother living us during the first month and a half after I gave birth to Liam, I can guarantee that it will be money well spent (even if it is just 5 or 6 hours per week, simply so that you can shower, do laundry, or cook meals for your family.) Believe me, when you are in pain, tired, overwhelmed, and getting used to caring for a baby all at the same time, there is nothing better than a helping hand.