What is a Doula, and do I need one?

Miscellaneous and Personal Stuff I Must Share
21

As far as I can tell, most do not, though some might.

The price range is pretty wide, the ones I’ve looked at are around $500, and for that they consult with you before birth, keep in contact with you through phone & email whenever you have questions, attend the birth (most will come to your house before you go to the hospital), and will also come on a visit after you give birth. The one I’m looking at in particular also will let you use her pregnancy/baby bookshelf as a lending library, which is nice.

22

I encourage you to rent the film The Business of Being Born. The Business of Being Born (2008) - IMDb

It is a documentary about several women who had home births with a doula. Ricki Lake had a hand in producing the movie and also had 2 home births. I came away from this film quite impressed and rooting for more home births when possible.

One good thing is mother is able to bond with baby right away. A lot of doulas use the “water birth” method, fill the tub or inflatable pool with water , mom gets in and baby pops out swimming. It really all seems very calming. Oh, and it’s much cheaper than hospital births.

I’m certainly no expert on birthing babies, since I never had any, but I really enjoyed the movie and came away endorsing the home birth method. Of course, it’s not for high risk pregs but for healthy moms I think it’s a groovy way to be born.

23

Many doulas have a philosophy that anyone who wants a doula should have one, regardless of ability to pay. They may work out a system of barter, where you offer something for them in exchange for their services–anything from doing handywork around their house to designing a website for them.

24

Pregnant In America is a good one too. The Business of Being Born is available to watch instantly on Netflix.

Home Birth was awesome, and for people like me and my wife, the only way to go. We were at home and comfortable (mostly, we had to transfer to the hospital, but that’s a whole long story that I am not going to get into). I can totally understand why it would not be a good thing for some people though. Some people feel safe and comfy in a hospital, and if that’s who you are, that’s great.

25

Thanks for the input and congratulations everyone! :slight_smile:

Eh - I’m in Canada. Even if I have every medical intervention possible, a full drug cocktail, 12 doctors, 14 surgeons, 17 residents and 37 nurses in attendance, my bill at the end of it all will be $0. (FWIW, this scenario is perfectly fine with me. I’d prefer to have lots of experts on hand in case anything goes wrong).

If we choose to have a doula it will be at our expense, although I can claim it back from my extended health benefits.

My birth team has already indicated that they will work with a doula, and they’re also quite clear that they don’t do home births - they do hospital births, so I guess the two aren’t totally mutually exclusive. FWIW, most of my friends have had their babies at the hospital that I’m going to be delivering at and they were all very pleased with the care, atmosphere, etc. It features many services to make the delivery as comfortable for mom and baby as possible - birthing pools, showers for mom and dad to share (so he can massage her back - not for sexy time you perverts), etc. If I choose to add a midwife to my team, I can (I will not be doing this).

My birth team is made up of a group of female family physicians that deliver as a side thing. They switch off with another all female team of family physicians for the deliveries. A OBGYN will be on call in case there is anything wackado. Additionally, I can expect 2 or 3 residents to be participating in the process. If all goes well, baby will be delivered by a woman - something that is important to me. If all does not go well, then men are welcome to come on in and do whatever needs to be done.

As far as people giving me a hard time about having medical interventions. Well, to be honest - I don’t give a shit what other people think. It’s my body that’s going to be dealing with this stuff - if I want drugs, I’m having drugs, thankyouverymuch. Ditto for a C section, forceps, etc.

I’m not crazy about the idea of being induced and I’ve discussed this with my birth team - they’re happy to work with me on this. ( I would rather have a c-section than be induced).

26

Good. More than anything its induction of labor that causes birth complications. Honestly, I don’t see anything wrong with doing a scheduled C section if you feel like you are going to want the interventions anyway. It’s a major surgery and it’s not easy on your body, but it’s easier on your body than going through labor and then having to have a c section anyway.

27

We didn’t have a birth doula, but we did have one for the first week or so after we came home. Well worth the money, I thought.

28

Oh, I meant to add that my birth plan means that as soon as Jr. appears, s/he is placed on my chest to canoodle while dad cuts the cord. A lactation consultant will come by shortly to assist with breast feeding right off the bat which is fairly bond-y. Jr. will receive a bath about 4 hours after birth from a nurse as well as me if I’m up for it.

Obviously, if everything goes to shit then the above goes right out the window. ;):smiley:

29

I don’t have a problem with women giving informed consent for drugs and other procedures. What I have a problem with is that the medical establishment (in America at least) tends not to give women enough information to give informed consent. They seem to believe that interventions are good, and I can understand that, since even the illusion of control can feel much better than watching and waiting for an unpredictable natural process. However, there is a lot of research showing that interventions cause more harm than good. So I would encourage you to do some independent research about the evidence for and against such things as continuous EFM, NPO during labor, routine IVs, and so forth, before making your final decision. I found Henci Goer’sThinking Woman’s Guide to a Better Birthincredibly enlightening and empowering.

One thing I haven’t seen mentioned in this thread is a postpartum doula. This is an entirely different job - a woman experienced in baby care and (usually) breastfeeding who comes to your house after you have the baby. She will help cook and clean, teach you how to care for your newborn, answer questions about nursing, etc. I think every woman, whether she births alone in the woods or gets knocked out cold at 38 weeks for a c-section, can use someone like this!

Congratulations on your pregnancy!

30

One of my good friends is a doula. I’d at least look into it. Warning, some doulas are as much about “their” idea of your birth plan as making sure you get the birth you want. Some can be very judgmental about interventions or medication. So find one that understands its about what you want (and a healthy baby) and not about her. (To me its like finding a yoga coach, I enjoy yoga. I enjoy being taught yoga…but prattle about my chakras is NOT what I’m looking for).

If you don’t choose to have a doula, I’d really recommend a “secondary labor coach.” Husbands can become the most useless creatures in the world (mine was and several girlfriends confirm my case was not unique) watching their child be born while their wife is in pain. A good friend, preferably one who has given birth, one who will be in town (mine was in Montana because I gave birth three weeks early) and who shares your birth philosophy, and whose presence you find to be relaxing and comforting (maybe not your mother in law?).

31

I don’t want to give you grief over this, as it’s up to each person how they choose to labour (and while I did mine natural, I did leave the door open to an epi if I really needed it).

However you might want to look into the effects of drugs on the baby, since they will get into the baby’s system as well, and they can take longer to get over them than you can e.g. the elimination half-life of pethidine in a newborn is about 22 hours, compared with three hours in a mother. For this reason I decided I wouldn’t want pethidine (side effects for the baby can be drowsiness, trouble breathing and delayed breastfeeding). Research on epis seems more ambiguous.

32

Thanks!

I will be getting regular visits from a public health nurse after the birth to assist with stuff at home including lactation and whatnot. If necessary I can have additional sessions with a lactation consultant. Also, my mother and mother in law will both be available to assist with cooking cleaning, caring, etc.

I’m afraid a post natal doula would get bustled right out of the place, given the circumstances. :slight_smile:

Unauthorized Cinnamon - thank you for the reading suggestion. I can say that none of the items you mentioned (Continuous EFM, NPO, IVs) are part of the plan with my birth team unless things go horribly wrong. I believe (and will confirm) that at point zero I go in, perhaps get some morphine if I’m about to rip someone’s head off, an epidural at an appropriate time, much wailing and gnashing of teeth and then BLAMMO Jr. arrives. There’s no shaving, enema, IV, inducement, c-section, etc, unless absolutely necessary. I was told that if a c-section becomes necessary, I will need to remove my belly button ring.

Suffice it to say, I’m not worried particularly about my birth team or my birth plan. I guess I’m wondering if there’s a role for a doula for me or if I’d be better off saving the $$ and getting a mani/pedi after the fact. :stuck_out_tongue:

33

Protocol in most hospitals I’m aware of call for continuous EFM for anyone with an epidural.

34

Dunno - my info says that fetal monitoring will be done periodically except in cases of pre eclampsia, or whatever. No mention of epidurals. I’m in Canada if that makes any difference.

35

It probably does. As best I can tell, Canada has a different attitude to birth than America does, and that’s probably to your benefit. If you don’t have the fetal monitor on or an IV you are free to walk around and do your own thing and stay comfortable. Just be sure to stay hydrated if you don’t have an IV (we were told a sip of water every other contraction), and remember to pee every hour or so even if you don’t think you need to.

And honestly, I recommend taking a Bradly Method class, even if you think you are going to want the interventions. It’s always good to learn more about what your body is going to do when you are pregnant and in labor and ways you can deal with it* both with and without drugs. My wife and I like the Bradley classes because they weren’t only focused on labor, but on the whole pregnancy and doing what you could to be health and happy and *ready *when labor came.

Feel free to tell me to go to hell at this point for offering unsolicited advice. :smiley:
*it meaning the pain as well as all the other stuff.

36

Second the Bradley Method suggestion - I didn’t take the classes but read a book, and it was fab to get a good understanding of not only the physical but the emotional stages you go through in labour. Knowing these gave me a good cue as to where I was in labour, despite the medical advice to the contrary. Given that you’re facing the unknown, that knowledge does really empower you and you can feel less nervous - and it can compliment the medical intervention you are planning, as you get a good feel for where you are (e.g. can’t have epis etc too close to the 2nd stage etc).