Still not sure about this Doula thing? Read on to find out more about what doulas do, and what we don't do!
Dads and Doulas
A concern of many families as they look at the possibility of hiring a doula is that the doula will take the dad's place. Here are some thoughts from dads that PPRDA members have worked with:
"Having a birth doula was one of the best elements on the day of our daughter’s birth. Having the extra person in the room who knew how to handle the situation allowed me to focus on my wife at all times without worrying about other factors. Rachel was instrumental in helping us communicate with the nurses and the doctor, and getting my wife anything she needed while I remained at her side. For an easier birth experience, Rachel is wonderful to have around." - Will, father of Charlee Elizabeth
"I've run a number of marathons. I've done a lot of hiking with a heavy backpack and I've worked forty hours straight on call; but going through labor with my wife was more strenuous and exhausting than any of these experiences. We could never have done it without the doula. She was crucial for us." - A Father (Taken from "The Doula Book.")
Almost immediately upon finding out that they were pregnant for a second time, dad asks the mom: "Did you call the doula yet?" (Has happened with several members and repeat clients.)
It wasn't long ago that dads were not allowed to take part in the births of their children. The waited nervously, pacing the hallways in anticipation of the moment that they could look at their babies from behind the nursery glass. Today it's fortunately much different. Not only are dads expected to be in the delivery room, they are also expected to be an expert in birth. This is where the pendulum has swung too far the other way.
Today, after taking a childbirth class that is only once a week for anywhere between 4 weeks and 8 weeks, dads are expected to be experts in the following (among other things): routine hospital protocols and procedures, experts in the physiology of normal birth, the risks, benefits and alternatives to all hospital procedures, the emotional signs of labor, advocating mom's wishes to the staff, positioning techniques for a variety of labor situations and all manner of emotional support.
That is a lot to ask of a dad. Especially when he wants to simply enjoy the birth of his baby. This is why having a doula can fill in some of those roles that the dad may not be comfortable filling. No doula wants to replace dad. That is not her job. The doula supports the entire family. For the dad that wants to be very involved at a birth, the doula can increase his efficiency by giving him pointers, encouraging him in his work and reassuring him that the birth is going very normally. She can also give him much needed breaks when they are needed. For the dad that is understandably a little more timid, the doula can take a primary support role and involve the dad as much as he is comfortable. While dad is the emotional support for mom, a doula can be the physical support role in doing acupressure, counterpressure and massage. Or the roles can be reversed. Labor support goes far beyond just an occasional massage, hand holding, and "you're doing a good job." It is a many faceted role and often times takes more than one person.
Doula by Definition
The term "Doula" is Greek in origin and it is translated "A Woman who Serves." It has been adopted by the birth community to mean professional labor assistant or companion.
There are three types of doulas: Antepartum, Birth/Labor and Postpartum.
An Antepartum Doula is defined as a person who has achieved specific training that relates to assisting pregnant women who are classified as high risk, pregnant women who may or may not be on bedrest, or pregnant women with medical conditions necessitating the need for help. This assistance includes education and physical support such as bed rest assistance, sibling care, errands, meal preparation, home care, and emotional support. The antepartum doula does not perform any clinical care. This role is strictly non-medical. The antepartum doula has extensive knowledge and training in the area of high risk pregnancy support. (CAPPA)
A Birth/Labor Doula is defined as a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth. The certified doula is trained to deliver emotional support from home to hospital, ease the transition into the hospital environment, and be there through changing hospital shifts and alternating provider schedules. The doula serves as an advocate, labor coach, and information source to give the mother and her partner the added comfort of additional support throughout the entire labor. There are a variety of titles used by women offering these kinds of services such as "birth assistant," "labor support specialist" and "doula". (DONA & CAPPA)
A Postpartum Doula is defined as a woman who assists the new mother, baby, and the rest of her family after the birth of the baby. She offers education, companionship and nonjudgmental support during the postpartum fourth trimester . She assists with newborn care, family adjustment, meal preparation and light household tidying. The postpartum doula offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary. (DONA & CAPPA)
Doula Myths
1. A doula will try to replace my husband as my main support person.
A doula enhances the father’s support by helping him relax and have confidence in his role. Doulas can support the dad by meeting his needs, offering him rest when he is tired, and assuring him that things are progressing normally. Having more than one support person ensures that you get the support you need while the team is able to support each other, supporting you. Read more on dads and doulas in the section below.
2. Doulas are only for “crunchy earth mamas” that want natural childbirth and she wouldn’t support me if I choose medication.
Doulas are not the epidural police! Birth is not so straightforward that every birth can be the exact same. Medication is merely a tool available to you in labor - nothing more, nothing less. A doula recognizes that this is YOUR birth. She works for you. Her job is to ensure a satisfying birth experience as YOU define that. She is there to help you achieve the experience you desire, whether that is at home, the hospital, with all the medical technology available or with none of it. What is important to the doula is that if a mother chooses medication for her birth, that decision is fully informed with regards to the risks, benefits and alternatives.
3. I don’t really see the need for a doula, her role is redundant.
The doula’s role in childbirth is not like that of anyone else. A doula is the only member of the support team that is solely there to stay by the mother’s side and provide answers, comfort, encouragement, peace, and confidence as needed throughout the entire process. A doula’s role is to make everyone else’s job a little easier.
4. That’s what the nurse is for.
First time moms are usually surprised to find out that when they arrive at the hospital in labor that the nurse leaves the room frequently. Nurses often have several patients at a time and there are frequent shift changes. Even if you are fortunate enough to have a very helpful, attentive nurse that is on her shift throughout your entire labor and delivery, she won’t be able to stay solely by your side. But if you hired a doula you are certain to never be left alone and when she works with that nurse, you have double the wonderful support! Also, nurses do not labor with you at home and tell you when it is a good time to go to the hospital. Your doula will.
5. I have a midwife, I won’t need a doula too.
Midwives do provide wonderful, personalized care, but they sometimes have to be more involved with the clinical aspect of your delivery and may sometimes have to leave your side. Having a doula as well ensures that you will have personalized care on the clinical, physical aspects of delivery, and personalized care from a doula who’s sole focus is on your well being and feelings about what is happening.
6. A doula will intrude on this intimate, private family moment.
Labor and delivery rooms can become very chaotic places with many people you don’t know running in and out. A doula can actually act as a guard on your privacy by running interference on excess staff and facilitating communication between you and your caregivers so there is less need to check in on you unnecessarily. She can help you maintain a private, soothing atmosphere. A doula can also preserve your memories of these intimate moments by documenting them for you by taking photographs and/or notes.
7. We’ve been to a class, we’ve practiced our breathing, I know what to do.
When labor actually gets going it is hard to remember everything you learned in class. Things may happen that you don’t understand, especially when you experience pain during contractions. A doula understands the physiology of childbirth, she knows medical lingo and she knows ways to make labor easier and shorter. Having a doula with you is like taking your childbirth educator to the delivery room!
8. A doula is a stranger, I won’t be able to relax and be myself in front of her.
Doulas take the time to get to know their clients personally before labor ever begins. By meeting you in your home and answering questions, as well as providing loving touches in her prenatal care, a doula ensures that by the time you arrive in the delivery room, she will be the most familiar, comforting face you’ll see there.
9. The medical staff will automatically respect all my wishes.
Unlike a doula, they don’t work solely for you. There are many factors and routines that shape the medical care you receive in a hospital. Many times it is simpler to follow standard procedure than to work with each birthing mom on their preferences regarding her options for childbirth. A doula can help make sure your wishes are respected in birth.
10. I have already had a baby, I know what to expect.
Each pregnancy and childbirth comes with its own set of circumstances and issues. A mom who has already been through the process would especially benefit from the help of a doula because she knows from experience what she wants or doesn’t want this time and a doula can help her accomplish her goals.
11. I can’t afford a doula.
Doulas fees vary from area to area and based on experience, may vary from doula to doula. With a little research and questioning you can find a doula in your price range. If you have asked around and price is still a problem, consider asking your health insurance about covering or sharing the cost of the doula. Doulas services are also frequently covered on a flexible spending account if you have one. With the rising popularity of doula assisted births and the amazing statistics on how doulas can actually lower the cost of your childbirth, many insurance companies are getting on board. If you are still having trouble affording your doula, talk with her. Doulas are caring, flexible people and most will work out a financial plan with you that works best for everyone.
Many will also work out a bartering system of some kind.