There are common ideas regarding the kind of woman who should hire a doula. Some think doulas are only for hippy, crunchy moms. Some think doulas are only for those without a partner. Perhaps you think doulas are only for those seeking unmedicated birth. So that leaves the question, are you the kind of woman who should hire a doula?
1.) A woman who is planning a medicated OR unmedicated birth should consider a hiring a doula. Doula support is about so much more than pain management. The prenatal support of a doula is invaluable. In addition to that, a doula can help with comfort measures prior to the administration of pain medication (sometimes it can take time for the anesthesiologist to be available, and sometimes the doctor will not allow an epidural until a certain dilation is reached). There are also times when pain medication is ineffective, and times when labor progresses too quickly for an epidural. Doulas can also help with position changes to encourage labor progress in women with and without epidurals. Even if you have an epidural, that does not mean you must labor on your back! Hire a doula with knowledge of comfort measures and different positions for labor and birth regardless of your plans regarding pain management.
2.) A woman who has a partner, family member, or friend present to support her in birth OR a woman who is birthing alone should consider hiring a doula. Studies show that the presence of a doula yields different results than just having friends and/or family present. Your friends and family bring an intimate knowledge of and love for you, and your doula brings knowledge and experience in birth support.
3.) A woman who is birthing with an obstetrician OR a woman who is birthing with a midwife should consider hiring a doula. Obstetricians and midwives oversee the clinical aspects of labor and birth. Their primary responsibility lies in the well being of you and your baby. A doula does not carry this responsibility, which frees her to focus on supporting you physically and emotionally during labor and birth. While your medical care provider might come and go throughout your labor, your doula will remain with you throughout your labor and into the immediate postpartum period.
4.) A woman who is hippy, crunchy, conservative, liberal, traditional, eclectic, OR anywhere in between should consider hiring a doula. All women should be supported in pregnancy and birth. Doulas themselves come from different backgrounds and different personalities and styles. Interview until you find the right fit!
5.) A woman planning a spontaneous labor, induced labor, OR planned cesarean should consider hiring a doula. While the support needs might look different depending on the circumstances of your birth, a doula is able to offer customized support to meet those needs.
6.) A woman having her first child OR her second, third, fourth, etc child should consider hiring a doula. Every birth is different! I have had five children myself, and I can tell you that not one birth was like any other. While consecutive pregnancies and births might not carry the same uncertainty as the first, each and every pregnancy and birth is unique and benefits from the support of a trained professional.
I could keep going but I'll bet you have noticed a pattern here. There is no set type of woman who should hire a doula. The right doula for you is out there, and I would love to chat with you further to share how I can support you in your birth, no matter which of the above categories you might fall into.
A profession of labor support has emerged over the last two decades. This role is called “doula” from the Greek word “doule”, meaning “maidservant”. The majority of labor doulas are women, though there are male labor doulas. Doulas provide non-clinical services. Doulas do not take the place of obstetricians or midwives, but round out the birth team by providing informational, emotional, and physical support to the pregnant woman and her family during pregnancy, birth, and the postpartum period. Doulas support births in homes, birth centers, and hospitals.
Doulas are not licensed or regulated by the state. There are many certifying bodies that train and guide doula practice. By hiring a certified doula, you know that you are hiring a trained professional with scope of practice guidelines and continuing education requirements.
Most labor doulas will meet with you twice prenatally to get to know you and to help you sort through birth options and your preferences. If you have a partner who will be involved with your birth, it is helpful if they are able to attend at least one of these meetings. Your doula does not replace your birth partner if he/she wants to be actively involved. She can guide your partner in ways to support you in labor, and your doula will also be able to support your partner. Prenatal support is not limited to these meetings. Your doula will remain in contact with you via phone, text, or email throughout your pregnancy to provide information, support, and to develop a relationship with you. By the time you give birth, she won’t feel like “another stranger in the room”. Many women say that by the time they gave birth, the presence of their doula is much like that of their best friend, but with the knowledge and skills to improve the birthing experience.
When you think you are in labor, your doula will meet you in your home or at your place of birth, depending on your contract agreement. A doula will not monitor your baby or check your cervix. She is educated in the emotional signposts of labor and is familiar with the sounds of active labor, and is able to provide support until you are ready to travel to your place of birth. During active labor she offers hands on comfort measures. She can suggest position changes to encourage better fetal positioning and descent. She will remind you of your birth preferences and encourage you towards that goal. She is not there to talk to the doctor for you. She is not there as a gatekeeper to fend off medical staff. She is not there as a birth advocate. Only you or your partner can make decisions. She can help you gather information on which to make those decisions. She will be there as a constant support no matter how those decisions might deviate from your original birth plan. She cannot guarantee the outcome of your birth, but studies have shown that the presence of a doula reduces interventions, can shorten labor, and improves satisfaction with the birth experience.
Doula support does not end with birth. She will remain with you until you are comfortable and have fed your baby. This is typically two hours. She will follow up frequently over the next two weeks to make sure you are adjusting well. In the event of concerns regarding you or baby, she will provide appropriate referrals. Between 4-6 weeks postpartum, she will visit you again to assess your current needs. She will help you process your birth experience and encourage you on your journey of parenthood. For more extensive postpartum support, postpartum doulas are available.
There are doulas to fit every personality and budget. Most doulas offer complimentary consultations so that you can interview several doulas before hiring one. Doulas combine their passion for birth and their compassion for women to help you have a satisfying birth experience. Hire a doula – when everyone else is focused on the monitors, she will be focused on you!
The stats are in . . . In 2015 I served 6 families through labor support. 4 of those families gave birth in birth centers, and 2 in hospitals. 100% of those families were satisfied with the service they received. Why don’t I publish stats like medicated vs. unmedicated, or vaginal births vs c-sections? My role as doula is not about the outcome, as far as method of birth is concerned.
My role is to provide information in the prenatal period. I will make sure you have the information needed to allow true informed consent. I will support you in what is important to you. I will help you think through pieces of your birth plan. I will help you and your partner work through fears about the upcoming birth.
My role is to provide support during labor and birth. I will remind you of the reasons why you wrote your birth plan as you did. I will assist with labor comfort measures, even when that means a double hip squeeze through every contraction for three hours. I will suggest position changes that might help with fetal positioning, ease back pain, or encourage baby to descend. I will guide your partner in ways to support you. I will be there when your partner needs to take a break. I will be constant and present throughout your labor. I will be there when plans change out of medical necessity.
I can’t guarantee the outcome of your birth. I can’t promise that your baby won’t experience distress. I can’t promise that you will have an unmedicated birth. I can’t promise that your baby will be born vaginally. I can promise that you had information and support to help you make the best decisions for your birth. I can guarantee that you will have 100% of what I can offer.
Birth plans are pretty common these days. They can be great tools for helping sort through birth options. Don't wait until the third trimester to work on your birth plan. You might realize you feel strongly about a certain option, and might decide to change care providers or place of birth to better align with your desires. Some doctors and hospitals are not open to birth plans, and this might lead you to question whether that doctor will be a good fit for your labor and birth. Labor isn't a time when you want to have to go in with your defenses up and ready to fight. Sometimes this is necessary, but it is certainly not ideal. There are some things you can do to help your birth plan be received in a positive manner.
1. Know what is "normal" for your place of birth.
Realize that if you go to a hospital asking for no fetal monitoring, when the hospital policy mandates continuous fetal monitoring for every laboring woman, your plan isn't likely to be embraced. If you ask for a squat bar in a facility that doesn't even have squat bars, you have wasted space on your paper. Call the labor and delivery unit of the hospital in which you plan to give birth, and ask about policies and equipment availability. Ask detailed questions like "How many women have you seen labor in the tub in the last month?" You might find that while the hospital says they have tubs, the tubs are used as storage areas or even lack hot water!
2. Your birth plan should be a summary of conversations you have already had with your care provider.
This helps you decide if your care provider will facilitate the birth you desire, and gives the L&D nurses confidence to proceed. For example, if delayed (also called optimal) cord clamping is important to you, and if your doctor objects when you discuss it, you might want to find a different care provider. Also, if you are able to start your birth plan with "My doctor and I have agreed to the following ...", this communicates to your nurse that your doctor is already on board with your preferences.
3. Birth plan should be in bullet point, items listed in order of occurrence, and
limited to one page.
In a hospital setting, your nurse likely has several patients to care for at the same time. Make your birth plan concise and easy to read. For an extra touch, use pretty paper, stickers, or a creative theme to help your birth plan stand out. Keep the labor and birth plan on one page and postpartum and baby care information on another page.
For more help in writing a birth plan, contact your local labor doula to learn what services are available. If you are in the greater Houston, TX area, I would love to speak with you regarding a la carte birth planning sessions or a full labor doula package.