Common Questions & Answers About Doulas
Research studies have shown that the type of support provided by a doula can result in many emotional and physical benefits for the laboring mother and new baby, including fewer medical interventions and improved mother-infant bonding.
Having a doula means you’ll benefit from continuous emotional and physical support from someone trained and experienced in assisting birthing women. In today’s busy hospital environment it is unlikely that a nurse will be able to provide this type of continuous support. A doula will get to know you and your wishes before the birth and can help you advocate for your choices during the birth. Every baby’s birth is the birth of a new family as well and a doula can support all members of the family, including fathers, siblings, and grandparents, as they welcome their newest addition. Lastly, every woman deserves a doula – an extra heart and helping hand as she births her baby.
A doula is a non-medical part of the birth support team. She offers informational support, emotional support and physical support to the laboring mom and her partner prenatally and during labor and birth. A doula may do things like massage, hydrotherapy, helping the mother and her partner know what questions to ask when a test or procedure is presented by the care provider, relaxation techniques, breathing exercises and helping to facilitate the partner’s role.
A doula never replaces a woman’s partner if he chooses to be present at the birth.
While a doula can be very helpful for single women or women who must be separated from their partners at the time of birth, doulas are also valuable additions to the birth team even when a birthing woman has a loving and enthusiastic partner. A doula can suggest ways for your partner to offer you comfort and support during labor and offer him/her much-needed breaks for food or rest. With a doula you will never be left alone! Birth partners may find the physically and emotionally intense nature of the birth experience overwhelming and will appreciate the support and experience of a doula as well.
A doula’s job is to support YOUR ideal birth. While most doulas are enthusiastic about natural childbirth, studies show that a woman’s satisfaction with her birth experience has less to do with the circumstances of her labor and delivery (location, interventions, etc.) than with whether or not she felt included in the decisions being made during her birth. A doula helps you advocate for your decisions and goals. Her only goal is to help you have a satisfying birth experience, whatever that means to you.
A doula is trained to offer many non-medical comfort measures. Physical support techniques include hot and cold compresses, changes in position, massage, use of a birth ball, and counter-pressure for back pain as well as others. Doulas provide emotional support through close physical presence, words of encouragement and understanding and an absolute belief that you can do it! For women using childbirth hypnosis for pain elimination, a doula trained in those methods can provide verbal and physical cues that will deepen relaxation and hypnotic anesthesia.
This is a common misconception about doulas. Doulas support women in all kinds of births and are trained in how to support mothers, not just in unmedicated births, but also with epidural and Cesarean births. We are there to support and validate a mother in anything she feels will contribute to her ideal birth — not our own.
A doula can still be very active at a birth that includes a planned epidural or cesarean procedure.
At a cesarean birth a doula can offer a description of the birth as it occurs or record the birth with a video or film camera while the birth partner sits near your head to provide emotional support, or vice versa. After the baby is born either the birth partner or doula can accompany the baby to the nursery while the other person stays with you in the operating room while the surgery is completed. A doula can also write a birth story of the cesarean birth, helping to reinforce your memory of a beautiful birth experience.
Many women intend to receive epidural anesthesia at some point in their labor. Research shows that the chances of having a forceps/vacuum-assisted delivery or cesarean birth decrease if the epidural is not administered until a consistent active labor pattern has been established. Many doctors allow a laboring woman to receive her epidural when she reaches 4-5 cm dilation. It may take hours of labor before a woman reaches this point. During this time a doula can offer the many comfort measures in which she is trained. Once the epidural has been administered a doula can ensure you are in an appropriate position to protect your back and hips and help you feel more connected to your birth experience by talking ith you about your baby’s arrival.
‘Doula’ is a fairly new buzzword so many people are attending their friends’ births and telling the care providers that they are a doula. It’s important to differentiate between a doula and a friend or family member because doulas are much more experienced and are better welcomed into the birth team by the care providers when they know that the doula has had training and experience.
Now that care providers are seeing doulas more and more in the births they attend, they are understanding that doulas are a respectful and necessary part of the birth team. There are very few care providers who are vocal about their dislike of doulas and most are very glad to have the doula as part of the team since it makes their jobs easier — especially the nurses. A doula is trained to work with your medical care providers to give you a safe and satisfying birth experience. Her role is to help you more effectively communicate with your care-givers but she does not make decisions for you or speak on your behalf.
In the prenatal visit, the clients spend time telling the doula how she can best support them. The doula will ask how soon they’d like to go to the hospital once labor has begun, whether or not they want medication and if so, how soon or late would they like it, what their wishes are regarding pain management if the laboring mom doesn’t want medication and whether or not they want to use the labor tub or give birth in the water. She’ll ask them to tell her about their care provider and she’ll want to know how she can best work with him or her. The doula will spend a fair amount of time getting an idea for how involved the partners want to be and how she can help facilitate that. She’ll want to know if the mother is choosing to breastfeed and what wishes the clients have for newborn care in the hospital and much more.
Women are hiring doulas for all kinds of reasons these days, but mostly, women hire doulas because the hospital staff is just too busy to devote all the time to a laboring mother that she really needs. Also, parents appreciate that they have a knowledgeable person who can help them to make choices, know their options, and be there to support them and only them for this life-changing event. A woman who wants an unmedicated birth might hire a doula to help her manage contractions with non-pharmaceutical pain relief, while a mother desiring an epidural may hire a doula to help her get the epidural in a more timely manner and to help her with techniques to make pushing more effective, which reduces her chances for instrumental or Cesarean delivery.
Across the nation, doulas charge anywhere between $300 and $3,000. Locally in Worcester County, the average range is between $650 and $1,250 dependent upon location, experience and expenses. This investment includes one to two prenatal visits, the entire birth and immediate postpartum period. Some insurance companies are beginning to pay for doulas because statistically, doulas save them hundreds of dollars.
The money you pay when you hire a doula guarantees that she is available for you 24 hours day for two to four weeks surrounding your due date.
That means she is available at three a.m., during Christmas dinner, and when she’s only slept five hours out of the last 36. She misses her children’s ballet recitals and football games and sometimes even birthday parties. A doula also gets to know you and your wishes for your birth ahead of time and can therefore more easily facilitate communication during your birth. In addition, your doula will meet with you at least once during the first few weeks following your birth to offer breastfeeding support and to help you adjust during the immediate postpartum period.
The most important thing is finding the doula that is right for you.
Ask for recommendations from friends and family if they’ve had a doula at their birth. Ask your doctor or midwife if they’ve worked with doulas in the past and get recommendations for doulas with whom they’ve had good experiences. There are several ways to find doulas online. You can begin by searching the websites of the associations that certify doulas. There are some clearinghouse-type sites where doulas can post their information and you can search based on where you live. Interview more than one doula to find someone who feels right to you. Remember that as you interview her she will be interviewing you as well to make sure that you will be a good team while preparing for the birth and in the delivery room.
Here are some questions to ask your potential doula during the interview process
- What is your philosophy on supporting birthing women and their partners?
- Have you taken formal training to be a doula? When? By whom?
- How long have you been a doula?
- How many births have you attended?
- How many clients do you take on per month?
- If I am in labor at the same time as another client or f I can’t reach you, will you have back up? Will she be aware they are back up?
- How will the back up be aware of all we may have discussed prenatally?
- What do your services include?
- What services do you provide or not provide?
- What is your fee structure?
- Can you provide references?
- When do you join us in labor?
- Where do you join us in labor?