doula or no doula?

[Anonymous]

I've feel like I vaguely knew before getting pregnant that I wanted a doula. Now that I am pregnant (near the end of the first trimester), I'm wondering what they actually provide and what I hope to accomplish by having one. I know people rave about their doulas, but I am still a bit confused about exactly how they are helpful.

Why will you/did you have a doula? If you aren't having one or didn't have one in a previous birth, why not? Did you regret it?

Thanks for any words of wisdom.

[Anonymous]

I'm planning to have one but am still in the process of deciding which. I'd never really thought about it beforehand, but have had several people (my sister included) tell me recently that they'd absolutely have one next time/if they had the money/etc. Things that have convinced me to have one:

--my husband really wants someone who is focused only on me (i.e. not a nurse/doctor) AND who knows what they're doing who can tell him how to help, what to do, and when. He's concerned that no matter how many classes we take or books he reads, he still won't be able to be helpful! A doula will take some of the pressure off of him (in a good way) so I won't be entirely dependent on him, the one with the least experience with childbirth, for support!

--several friends have recently spent 20+ hours in labor and ended up with an unplanned c-section. I do not want that to happen to me and think a doula will help prevent it.

--kind of the same as above: I'm not planning for a natural birth but would like as few interventions as possible. Knowing that my doctor and the nurses focus mainly on the medical aspects of birth, I also wanted someone to help with non-medical ways of pain relief.

[Anonymous]

I think that a doula would be most helpful with a natural birth, but would be helpful with a medicated birth. I did not have one for my first but used one for my second and there was a huge difference.

The nurses that I had were not supportive and seemed a bit annoyed that I wasn't just laying in the bed. My doula had to tell the nurses that that baby was about to crown so they could call the doc.

The most helpful aspect of the doula was the direction she gave to my partner. The other thing was just someone there to remind me not to tense up or hold my breath, which was essential for keeping the pain under control.

[Anonymous]

I started out in early pregnancy not wanting one, then decided I definitely did want one, and then ultimately decided I didn't. It was the right decision for me. I was not planning to have a natural birth, so I felt like a doula's help would have been very limited. Could she have made me more comfortable? Maybe. Could she have helped me be so much more comfortable as to justify the added expense? I don't think so. I ended up with a very long labor, some complications, and still eventually had a successful vaginal delivery. The thought of having an extra person in the room with my husband and me during that long labor makes me want to break out in hives. My instinct would be if you don't plan on a natural birth, save your money. You can advocate for yourself and get relief when you need it without a doula.

[Anonymous]

I think it might depend on your doctor and hospital. I delivered at Virginia Hospital Center, which is a smaller hospital (relative to some of the other DC area hospitals anyway). I had a fabulous L&D nurse who was very attentive and checked on me multiple times each hour. My doctor also checked on me each hour-- so it was not the typical "doctor just shows up for the delivery" experience that some people seem to have on this board. My advice would be to talk to your doctor about, realistically, how much attention and support you can expect from the staff where you deliver-- if you feel like you will need more than that, then maybe hire someone. I was on the fence about hiring a doula-- ultimately I didn't-- but it was a good decision for me because I really had all the support that I needed from my L&D nurse and my OB. On the other hand, I have friends who delivered at some of the busier hospitals and they found a doula to be really helpful.

[Anonymous]

I don't get this. I had a doula, but she wasn't at the hospital with me or anything. She came to my house for the next three weeks and helped me breastfeed and learn how to take care of the baby (I was a single mom and this was especially nice, someone to help me do laundry, etc). Anyway, did I miss the major part of the doula experience?

[Anonymous]

Anonymous wrote:I don't get this. I had a doula, but she wasn't at the hospital with me or anything. She came to my house for the next three weeks and helped me breastfeed and learn how to take care of the baby (I was a single mom and this was especially nice, someone to help me do laundry, etc). Anyway, did I miss the major part of the doula experience?

there are different types of doulas from my understanding.. your experience seems to have been with a postpartum doula.

[Anonymous]

Like OP, I can't decide whether to hire a doula. We can afford it so it's not about the added expense. At the same time, I tend to agree with PP who said another body in the room during delivery might make her break out in hives. I think whether or not you hire a doula might depend on your ability to self-advocate and also your personality. I have heard some people swear up and down that their doula saved them from a c-section, however, and studies show doula assisted labors are shorter and have less interventions. There are others who say doulas can raise contention in the room with doctors and nurses. I think some places have actually banned them because the L&D nurses feel that too many cross the line and interfere with their job. On the other hand, many nurses are ready to give that pitocin drip you didn't want saying it's "routine" or necessary when it's not, really. For the person wanting low interventions but unsure if you'll know to speak up, a doula might help advocate for what you want. I've heard many people say once you have an epidural the doula becomes much less relevant, so that's something to think about if you're pretty sure you'll go that route. Some doulas will also discourage you from using pain medication, but just like the "interference vs. advocacy" issue you just probably need to be sure you have a competent doula who works right with your personality. I'm personally leaning against a doula, because I've never had a problem with self-advocacy and my husband will be there to back me up. He goes to all of my appointments and will go to all of my birthing classes so I think I'll be better off, based on my personality, with fewer people in my face during that time. Ask me again in 4 months and I might have completely changed my mind! Good luck to you.

[Anonymous]

my midwife recommends a doula but told us that what's most important is to have someone else--besides your partner--be there to help you/focus on you. and anyone can do it--just have them watch video about birthing and being a birth partner.

that said, we haven't decided yet. in part, i think it'll be an issue of cost.

[Anonymous]

Here is my two cents, which ain't worth much.

All over the doula, loved it, felt a little nervous, but signed up for her and a natural birth.

Baby grew breech the WHOLE DAMN TIME.

Decided not to turn her manually.

Doula gave me a WORLD of shit for not trying to have the baby breech. Some serious guilt and craziness. VERY upsetting to first time preggers lady. I was already upset about the impending C and she made it FAR worse.

Moral? ASK THE DOULA HOW SHE FEELS ABOUT A LOT OF SCENARIOS. And feel it in your gut. If you think she is BSing you, can her. If she sounds judgemental, can her. You are doing the best you can for you, DH, and baby. Don't let anyone's voice stress you out.

[Anonymous]

OP here--thanks everyone for this wonderful variety of responses and experiences. I think part of the reason why I'm on the fence is that I honestly don't know what I want my birth plan to be, and don't know about the different options, beyond an epidural. A complicating factor is that I had scoliosis surgery as a teenager, and as a result I may not be able to have an epidural (and may have to have a general anesthetic if I need a c-section). I won't know about this, though, until after I meet with an anesthesiologist in a couple months to talk about the options--but regardless of whether I want an epidural (and I truly don't know how I feel about it, partly because I've always known it may not be an option) I do believe that it will be difficult medically to get one set up, if it's even possible.

On the flip side, I am very medically oriented, not all that granola-crunchy, and certainly don't have respect for pushing natural births on women who do not want them. I worry that a doula will think this way, even if she keeps it to herself. I think I would get one as much for supporting my husband and giving him the opportunity to take breaks as for supporting me. But I'm not sure that's worth $800 or so, and the potential stress of having another person with me throughout labor.

This is all great food for thought. If you have other reactions let me know, as well as questions you'd recommend we ask prospective doulas.

[Anonymous]

Anonymous wrote:OP here--thanks everyone for this wonderful variety of responses and experiences.

I am very medically oriented, not all that granola-crunchy, and certainly don't have respect for pushing natural births on women who do not want them. I worry that a doula will think this way, even if she keeps it to herself. I think I would get one as much for supporting my husband and giving him the opportunity to take breaks as for supporting me. But I'm not sure that's worth $800 or so, and the potential stress of having another person with me throughout labor.

I was pretty much in this category, too. Open to a natural birth if that's the way things played out (i.e. quickly) but comfortable going with an epidural if necessary. In the end, I got pretty far on my own, but really felt that I NEEDED an epidural at 8 cm. Anyway, our doula was completely supportive and wonderful -- not judgmental and not anti-doctor or anti-medical establishment. In fact, she got along great with the hospital staff and took care of a bunch of details, which freed up my husband to support me.

In talking with potential doulas, you should be open about the value you're looking to receive -- supporting your husband, helping you navigate ALL of your options as the birth unfolds, and being open to any and all choices, including epidurals and other medical intervention if needed (vacuum, forceps, episiotomy etc.) Saying you're open to it does NOT mean you're absolutely going to get it -- just that you're not ruling it out. Anyway, as you watch the doula's response you'll know whether she's a good fit for you. The ones who are more dogmatic will likely respond accordingly.

BTW, we went with Heather Wilson (www.heatherwilsondoula.com) and she was absolutley wonderful. In addtion to being incredibly knowledgeable and supportive, she's got a fabulous (and calm!) personality -- we were very happy to have her with us during our big day! Totally worth every penny and more. (And as an aside, she was brilliant with a friend of mine who was commmitted to doing it 100% naturally -- helped her every step of the way.) Good luck.

[Anonymous]

Anonymous wrote:OP here--thanks everyone for this wonderful variety of responses and experiences. I think part of the reason why I'm on the fence is that I honestly don't know what I want my birth plan to be, and don't know about the different options, beyond an epidural. A complicating factor is that I had scoliosis surgery as a teenager, and as a result I may not be able to have an epidural (and may have to have a general anesthetic if I need a c-section). I won't know about this, though, until after I meet with an anesthesiologist in a couple months to talk about the options--but regardless of whether I want an epidural (and I truly don't know how I feel about it, partly because I've always known it may not be an option) I do believe that it will be difficult medically to get one set up, if it's even possible.

On the flip side, I am very medically oriented, not all that granola-crunchy, and certainly don't have respect for pushing natural births on women who do not want them. I worry that a doula will think this way, even if she keeps it to herself. I think I would get one as much for supporting my husband and giving him the opportunity to take breaks as for supporting me. But I'm not sure that's worth $800 or so, and the potential stress of having another person with me throughout labor.

This is all great food for thought. If you have other reactions let me know, as well as questions you'd recommend we ask prospective doulas.

I'm a doula who has worked with a client who had scoliosis and as a result was not able to get an epidural during the delivery. If this turns out to be the case with you, then I would think it is essential that you hire a doula to help you navigate what will (mostly) be a natural childbirth. Unmedicated birth can be very difficult to achieve if you have not prepared and if you don't have the right team of people to support you through it. Now.....even if you can't get the epidural, you will still most likely be able to get IV narcotics; however you can only get those at certain times during labor, and they can cause significant problems that you would probably want to be really informed about ahead of time. Of course, a doula is fantastic at helping you figure out the benefits and risks of things before the birth, as well as helping you create an individualized birth plan that works for *you*.

[Anonymous]

Doula pp, thank you so much for sharing this experience. It's interesting and reassuring to hear that you worked with someone in this exact situation. I think if I can't get an epidural, I will almost certainly get a doula. I just need to make sure I can find one whose personality meshes with mine and my husband's, but I'm sure she's out there!