Doula?

[Anonymous]

Hi, I'm due with my first baby in a few months and I am wondering if I should hire a doula. Does anyone have any advice on doulas and any recommendations for a good one in NoVa? I'm really not sure exactly what they do and I don't know if it matters but I plan to have an epidural - since it's my first I'll probably need all the pain management I can get. I'm delivering at Northern VA Hospital Center and hopefully with Dr Elliott. thanks!

[Anonymous]

A doula can always be helpful. But frankly, unless you're loaded, if you're set on the epi and laboring in the hospital, I wouldn't bother. I can search online for the kinds of services doulas offer, by starting at dona.

[Anonymous]

I was reasoning along PP's line of thinking - why should i get a doula if I'm getting an epidural, it'd be waste of money. Didn't hire one and now I regret it. Of course hindsight is 20/20, but I ended up with a c-section that I am not convinced should have been needed, and it's possible that having a doula there would've changed the outcome. For example - I ended up pushing for 2 hours, the baby was malpositioned and not coming down, and no one - not the OB nor the nurses - even made a suggestion to change positions. A few people told me that the nurses would be like having a doula anyway, well maybe it was my bad luck but I did not find that to be the case.

I do agree with PP though that since you are getting an epidural, only hire a doula if you can afford it.

Good luck.

[Anonymous]

You might want to have a doula because:

1) By getting the epidural, you've already started down the "cascade of interventions" that might lead to a c-section, like that which might have happened to PP. (Epidural already comes with artificial breaking of the bag of waters, automatic blood pressure cuff, an IV line, internal fetal monitoring, and sometimes a urinary cath.) So, if you're set on an epidural, you might want to have a doula there to help prevent that cascade from turning into a c-sec; and

2) She can also help move/hold/support you in different positions that you probably won't be able to get into yourself. (And I guarantee the nurses won't have time to do this.)

[Anonymous]

Anonymous wrote:You might want to have a doula because:

1) By getting the epidural, you've already started down the "cascade of interventions" that might lead to a c-section, like that which might have happened to PP. (Epidural already comes with artificial breaking of the bag of waters, automatic blood pressure cuff, an IV line, internal fetal monitoring, and sometimes a urinary cath.) So, if you're set on an epidural, you might want to have a doula there to help prevent that cascade from turning into a c-sec; and

2) She can also help move/hold/support you in different positions that you probably won't be able to get into yourself. (And I guarantee the nurses won't have time to do this.)

I agree with this poster. And you don't have to pay an arm-and-a-leg for a doula - you can always look for a doula who is looking to get certified. She may not have as much experience, but she'll be much cheaper in cost.

I don't think there's anything wrong with wanting an epidural, but please take some time to read about all the "interventions" that can cascade from choices we make in childbirth. The movie, The Business of Being Born had someone make a comment - "people spend more time researching a new TV set then they do about birth".

I ended up with an epidural with my birth, then made it to pushing and the baby wouldn't descend...thus off to the OR for a c-section. The nurse never suggested alternate ways to push. I hired a doula for #2 and she's already told me that even if I end up with another epidural, there are things I can do differently when pushing. I really think had I hired a doula with #1 that I would not have had the c-section.

[Anonymous]

Anonymous wrote:A doula can always be helpful. But frankly, unless you're loaded, if you're set on the epi and laboring in the hospital, I wouldn't bother. I can search online for the kinds of services doulas offer, by starting at dona.

Depending what your philosophy is with child birth, they're many school of thoughts out there. Although DONA happens to be one of the two oldest organizations out there , you have several organizations out there to choose from and they all have listings: ALACE ( Association of Labor Assistants and Childbirth Educators), CAPPA, (Childbirth and Postpartum Prfessional Association) ICTC (International Center for Traditional Childbearing), CBI (Childbirth International), BirthWorks, and Birthing From Within

[Anonymous]

Hi there, I saw your posting regarding a doula and wanted to respond. I am a doula in the process of becoming certified and am happy to help you out at a VERY reasonable fee. I was impressed with all of the responses you received about the value of having a doula. If you would like to speak further, please contact me at [e-mail]. Hope to hear from you, Shereen

[Anonymous]

Thanks for asking this question. You're not the only one with it. Was wondering also if a doula is needed for someone who has no problem with getting an epidural. I come from a medical family so I'm not suspicious of doctors and nurses. However, I would like to prevent having any unnecessary surgeries or procedures. Any advice/ pros & cons /recommendations on doulas? Live in Alexandria, VA, but doctors are Reiter, Hill, Johnson & Nevin which means I'll most likely be in Georgetown or Sibley hospital.

[Anonymous]

During my delivery at Sibley, I had two nurses, one was in training but had previously been a doula. She was amazing. The other nurse was mostly busy with the business of checking my iv, etc. but this nurse in training focused her attention mostly on me. I had an epidural, but also had horrible back labor that the epi did nothing for. The nurse massaged and helped me through that labor and was in general a very positive force during delivery. I am pregnant now with my second child and am strongly considering hiring a doula b/c of this experience. I think the extra attention is so welcome at a time of stress!

[Anonymous]

I had in the deliver room:
OB and delivery nurse
husband
mom
doula

Next time, I will only have the husband and the hospital staff. I really just wanted to be left alone. The delivery nurse was fabulous (bring a box of chocolate for your delivery nurse).
Consider the possibility of a birth without the epidural. Yes, there is some pain but its only for one day and your baby may be better off for it.

[Anonymous]

Consider the possibility of a birth without the epidural. Yes, there is some pain but its only for one day and your baby may be better off for it.

PP - Why do you presume the OP hasn't considered her options and decided on an epidural as an educated choice? This kind of sanctimony and (false) scare-mongering is inappropriate, condescending and ridiculous. Medicated birth does not present a risk to the baby or the mother, and the many, many of us who chose to have an epidural are a bit of weary of the judgmental attitudes of the natural birth crowd.

OP - the doula thing is a total personal preference. There's a financial dimension to the decision, but beyond that it's a question of what suits your preferences best - factor in feelings on privacy, desire for extra support and assistance, your level of confidence in the medical profession, and probably more intangibles as well. For me that calculus weighed strongly against having a doula for #1, and nothing about my 'birth experience' has caused me to rethink that decision for #2 (or the epidural decision for that matter.) My reasoning was that the money would be better spent on my kid's college fund; that I didn't want the drama of a third-party (particularly one who is not an MD or registered nurse); and that I trusted my doctor fully to intervene only if and as necessary.

Obviously, your calculus may well be different, and if you opt for a doula there are lots of DCUMs who can give recommendations.

[Anonymous]

I can't tell you whether to get a doula or not, that seems like a decision you'll need to weigh on your own. But I don't think you should listen to this "cascade of intervetions" crap. I think like the same 2 people write the same "cascade of intervention" crap every time someone posts a question about epidurals. It's ridiculous. Yes, your labor could slow down with an epidural, but it could also slow down without own. My partner is an anesthesiologist and has given hundreds of epidurals to without them leading to a "cascade of interventions." Talk to your doctor, do some research, and decide based on that whether to have an epidural, hire a doula, etc. Good luck.