Doulas - what are the pros and cons?

Anonymous
I am far from being "hippy" and found a doula to be very useful. Its important to interview and find one that fits your needs. I agree that some doula's out there may be too granola, which is fine for clients that want that type of support. My ob/gyn actually recommended ours to us. I was looking for someone knowledge about positioning and coaching as well as how to manage nurse/hospital protocal issues. When you interview your doula ask how often she attends birth at your hospital of choice and whether she knows the staff.

What was most useful is helping with the what to expect while it is occurring. The books, classes, other women, nurses, and ob/gyn don't really prepare you for the birth and when you are in the middle of it its hard to get a sense of where you are at. The doula can help fend off non-necessary interventions. A good example is that even if your doctor is fully supporaive of your birth plan, you will run back into nurses who go in the other direction.

Good examples...gee, we have to keep re-positioning the monitor if we do it every 20 minutes, how about we just slip in an internal monitor (which would keep in bed on your back). This has nothing to do with with medical need just a nurse who would prefer to monitor form the station.

The positioning and moving around is really critical to managing the pain. DH would not have known what to do and the nurses weren't offering any suggestions. It also gave DH a break. Labor can be long and it was nice to let him go grab something to eat without worry that he would miss the baby. Sounds silly but made a difference.

Its much easier to avoid unecessary interventions if you labor at home longer. I felt more secure with a doula with us rather than just trying to figure out just from a voice on the telephone when to come in. If go to hospital at say only 2 cm, they will feel pressure to spped things along for you.

I have heard that Sibley either doesn't allow or is hostile to doulas.
Anonymous
Doulas are fully allowed and often welcomed at Sibley. Sometimes it is just the personality of the nurse or doctor that might give you a negative vibe, but they are definitely allowed. Most nurses at Sibley are very kind to doulas.
Anonymous
Anonymous wrote:I am considering using my best friend as our "doula". She has four kids of her own (youngest is 6 mo.) so I consider her "experienced" in the L&D department as well as being very familiar with the PP period afterwards.

Plus, since she is such a close friend she knows us very well and "gets it" (our personalities, our ideal birth plan, our sensitivities, our personal space, etc.) so we don't have to explain or justify anything to a stranger (ie a doula).

We certainly would get her nice gift (or maybe just give her cash - haven't decided yet) as a token of appreciation, but since she is willing (in fact, she was very honored) we feel comfortable knowing we'll have someone trusty helping us.

Don't know if that is an option for you OP, but just something to think about if you have any really good friends that are moms and wouldn't mind standing by your side and assisting you.


This is a great idea but I would think of this person as another birth partner, not a doula position. My doula had no experience in giving birth (yet) but she had a lot of experience in how to make a laboring woman more comfortable, with back rubs, etc. A good friend with four children wouldn't necessarily know how to do that but she would still be an asset.
Anonymous
Anonymous wrote:
Anonymous wrote:I am considering using my best friend as our "doula". She has four kids of her own (youngest is 6 mo.) so I consider her "experienced" in the L&D department as well as being very familiar with the PP period afterwards.

Plus, since she is such a close friend she knows us very well and "gets it" (our personalities, our ideal birth plan, our sensitivities, our personal space, etc.) so we don't have to explain or justify anything to a stranger (ie a doula).

We certainly would get her nice gift (or maybe just give her cash - haven't decided yet) as a token of appreciation, but since she is willing (in fact, she was very honored) we feel comfortable knowing we'll have someone trusty helping us.

Don't know if that is an option for you OP, but just something to think about if you have any really good friends that are moms and wouldn't mind standing by your side and assisting you.


This is a great idea but I would think of this person as another birth partner, not a doula position. My doula had no experience in giving birth (yet) but she had a lot of experience in how to make a laboring woman more comfortable, with back rubs, etc. A good friend with four children wouldn't necessarily know how to do that but she would still be an asset.


In the original posting (about the best friend) I don't see much of a difference in compared with a doula - in fact it seems that the best friend actually has real-life experience especially with 4 children (plus I'm sure post partem experience) so I can definitely see why this particular friend would be chosen over a doula.
If it comes down to doulas know how to comfort a laboring women because she can give back rubs...well, I'm pretty sure the best friend can improvise.
Anonymous
All of the things that my doula did, and knew how to do to alleviate my laboring pain and to help me get through labor, including helping my husband, came from years of experience assisting laboring women. Assisting someone in labor 100 times and going through labor yourself four times are just different kinds of training.

A friend would be a great laboring partner but would be a different type of support from an experienced, trained doula. No question.
Anonymous
We didn't totally love our doula, but I will say she was a huge help in alleviating pain. Also, we were at Sibley and had no issues with having a doula.
Anonymous
I birthed at a birth center, so our "birth assistant" served as our doula. She was awesome, did a great job of supporting my husband, so that he could support me. It made me feel comforted that if the need arose to be transferred to a hospital, she could advocate for my birth plan with the hospital staff. If you would like a natural/unmedicated childbirth, I would strongly recommend a childbirth preparation class that is more intensive than the ones offered at the hospital. Bradley method, hypnobirthing, etc. There are lots of options out there. For my long labor, I know I used every ounce of info I gathered in those classes.
Good luck!
Anonymous
My doula was with me for 20 hours (long labor) - I think I got more than my money's worth! And there is no way my DH could have provided the kind of labor support and help with pain management that she did.
Anonymous
Pros:
A doula is a resource in the weeks leading up to your birth. Among other things, you can talk through prelabor signs with her and have her help you determine if you’re in labor (and avoid a trip into the hospital for false labor). She’s an excellent sounding board for questions/concerns.

A doula can come to your home to help you labor there as long as you’re comfortable. It’s very reassuring and calming to have a professional with you who can tell when it’s a smart time to head in (especially when you’re trying to stay home as long as possible). It also can help you avoid heading into your birthplace too soon.

A doula is with you continuously throughout your labor (not breathing down your neck, but a supportive presence and ready to help whenever you need her). Nurses are in and out of your room periodically. It’s really not their job to offer non-pharmacological pain relief support. Your OB might come in to check on your progress occasionally (and will definitely be available if there are problems), but is otherwise AWOL until you’re pushing. I felt like, without my doula’s guidance, I’d be staring at my husband wondering what the heck to do and what the heck was going on.

Doulas are experts in natural (unmedicated) childbirth. They can help you with coping mechanisms and offer suggestions to ease/speed your labor.

Most doulas are knowledgeable about breastfeeding as well and can assist with your first nursing session.

Cons:
Every doula approaches birth differently – it’s so important to find the right doula for you. That takes some research and time talking to a variety of women. If you don’t end up with a good match, that can color your birth experience.

While cost might be a barrier to some, I think my doula was worth every cent.
Anonymous
Has anyone worked with the organization "Momease." They have many services, including duolas. I took their breast feeding class at GW which was quite good.
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