To hire a doula or not?

[belltree]

Hello,

I have heard great things about doulas in general, and most books I read suggest hiring a doula. This is my first baby, we plan a hospital birth and have a very natural birth friendly midwife.

Neither my husband or I have family around. And I feel a doula could help me finding my way through birth, maybe instead of an experienced mother? I have also read the positive birthing statistics associated with using a doula.

The negative side for us is: Doula fees run in this area between 600-700$. We are both in grad school and can easily find other (better?) uses for this kind of money, for us this is a lot. Would it still be worth it? We feel our midwife is awesome, would we still need a doula in addition?

What would you do? What have you done? How did you find your doula?

[JLKMneely]

This is my second child and although I have a Bradley trained husband and CNM, I decided to hire a Doula. We do not have family around and that is really what prompted me too hire one. She is great! If my husband can not come to appointment she is there, I call her for everything. Doulas reduce the c-section rate by almost 50% they also reduce any chances for interventions that you do not want. It may be possible to work out a payment plan with the Doula. It never hurts to ask

To find one in your area check http://www.dona.org/

Good Luck

[rimom]

Another idea is to find a doula-in-training. In order to become doula certified you need to work with a few families (who will evaluate you) and experience is key to being able to charge $600-700. Maybe see if someone would work with you for half that...if you are open to someone with less birthing experiences.

[Mama Rana]

Unless you MW takes on a limited # of clients, chances are she's not going to be able to sit with you as you labor. My first labor was in a birth center, with my Bradley-"trained" [he attended classes, but didn't get much out of the experience] husband, my parents, a MW and a MW-in-training, and I STILL wish I had hired a doula.

Good luck!

[BethSLP]

Our doula was $800. Worth EVERY PENNY. seriously.

my doula was very hands on. Applied counter pressure to my back and was there for EVERY contraction. I don't know what I would have done without her. She literally had everyone working as a team. She had the nurse and my DH working on me as well. I had 3 sets of hands on me for just about every contraction.

Ive heard some doulas are not this hands on, but a good interview/references would make this clear to you.

My doula literally saved me mentally through the birth. Her words were so helpful. Also just telling me what to expect like "you just changed position, so this contraction will be worse but after that it will be like the rest. the first contraction in a new position is always worse." That kind of stuff really kept me anchored and kept me from freaking out.

More than the support aspect, a doula is there to make sure you are informed about any possible interventions. Before they try and do something, she'll make sure there's a pause in there to consider options. Otherwise you could find your bag broken without your consent, or any number of things.

It sounds like you've got a great care provider, but hospitals are hospitals and sh*t happens there. A doula is a great protection, guide, and support. Your CNM will likely not be there throughout the whole labor.

Also, any chance insurance will cover some of the fee? I haven't submitted mine yet, but a billing agent at a birth center in town will bill my insurance for the doula fee. The billing agent charges $25 to do this, and supposedly most clients are getting about half of the fee back. It depends on your insurance, but its worth a $25 gamble.

XOXO
B

[kcparker]

I am a doula, and I had a support person at my birth, so I am biased. But I'd say DO it. It allows your husband to be more fully present for you on an emotional level as it frees him up from trying to remember all the details from the childbirth ed. class, allows him to step out to grab a cup of coffee for 15 minutes without abandoning you, gives him support in that the doula can show him how to do counter-pressure or reassure him that mooing like a cow is a totally normal, good thing for you to be doing. If you are in a hospital, likely the midwife will come check on you periodically and will be there for pushing, but she might have two or three other laboring women there at the same time. The nurse might or might not be of help, but she's also going to have other patients and charting duties. Plus, a doula can help you decide when to go to the hospital and can help navigate any possible interventions that are suggested.

About the money, I would say - you get to have this baby ONE TIME ONLY. No do-overs. I bet you've spent that much money on similarly important events like your wedding, so why aren't you and the baby worth it? What's more important than your family? A few student loan payments, 20 meals out on the town, a brake job? (well, that one is important too) Having a doula ups the odds that you will have a satisfying and maybe even amazing, life-and-consciousness-altering birth. Most doulas will barter, take payment plans, and if you live in a college town, might offer student discounts. Ask about options. I give a discount to grad students (having been one myself).

As for finding one, you can search through the doula organization websites: DONA, CAPPA, Childbirth International, ALACE, ask around at prenatal yoga classes, the midwife's office (she may know some), LLL meetings, the local food coop, mothers groups, etc., or just google "doulas, my city". A doula will meet with you free of charge for an initial interview, and you and your husband can interview a couple to find one whose energy and attitude you like.

PS - if you or your DH has a job with a flex spending account, it will pay full reimbursement for doula services.

[HappyHappyMommy]

Many of the people I know had doulas and were very happy they did and I support anyone who wants to have a doula to do so. One of my closest family member is due this spring and has a doula and I'm very happy for her.

However, I thought you might find it helpful to hear from someone who did not have a doula. I considered having a doula and interviewed some. I thought the ones I interviewed were fine, but none were fantastic. Cost wasn't a factor at first, but as we interviewed doulas, we did say a few times "Would you pay to have this person with us? I don't think so." We had several complications in the pregnancy and we'd been through those together and as the our baby's birth got closer, my partner and I talked and we decided to proceed without a doula.

In the end, I'm really glad we did not have a doula for this birth. I'm a private person and, during labor, I was really happy that it was just my partner and I most of the time. We saw our OB, who we adored, occasionally and hardly ever saw a nurse. (I was in a hospital.) I had a fantastic birth!

In reading this board, I've seen lots of women who have had doulas at their births and been happy, some who have had doulas at their births and been unhappy, some who have not had doulas at their births and been happy, and some who have not had doulas at their births and wished they had. I don't think there's one right answer for everything and I think it depends a lot on the birthing woman, her family and friends (if any), her mw or ob (if she chooses to have one), and the doula.

I hope you have a wonderful birth whatever you decide!

[BethSLP]

I also should add that I feel a doula is almost imperative (IMO) for a first time mom. Birth generally takes much longer the first time around, thus a lot more interventions have the potential to be offered/take place. With the C-section rate in this country, I would definetly consider it money well spent to have a doula. Their outcomes speak for themselves.

Its great you have a natural birth supportive provider, but like everyone else has said, she won't be there during most of the labor. The pushing part is not the part where you need support, guidance, etc. the most.

I guess I might sound extreme, but I find the thought of stepping into the hospital without a doula to be a huge gamble. Not trying to be alarmist, but its honestly how I feel.

XOXO
B

[Talula Fairie]

Especially for a first time hospital birth, YES get a doula!

[beebalmmama]

I did not have a doula. But I did have my best friend there along with my dh. I really feel that I could not have had the natural hospital birth I did without BOTH of them. My dh was my emotional support and my friend was great in applying pressure, getting me water, cool rags and relieving dh. My CNM was there almost the whole time as well, but from what I hear from other people that is rare. I birthed in a very small hospital and was the only woman in the labor and labor recovery ward.

[mags]

If your DH is going to be there with you, it depends on how he will do as your support. My DH is a great support, so I never felt the need for a doula. However, I know some husbands are practically useless, so in that case I would definitely recommend a doula. Also, I do agree that if you are not the type of person willing to be very blunt about what you do or don't want for a hospital birth a doula would be helpful. I was VERY direct with letting the staff know what was or wasn't ok, I didn't care if they thought I was being bitchy or bossy (btw, I'm an RN, although not a maternity nurse, but know my patient rights), but I feel that I can advocate for myself pretty well. My DH was the support I needed. I am kind of weird about strangers touching or being in my business, so maybe I am one of those ppl that is not well suited for a doula, b/c I would not be able to relax with her there unless the doula was a close friend of mine that I already know. I want to be in control of the situation instead of handing it off to someone else to be my advocate. However, if you do not know how to advocate for yourself, esp for a hospital birth, I would say a doula would suit your needs perfectly.

[marge234]

We're having our first in a hospital, with a MW, are doing the Bradley training and decided to hire a doula. My DH is a doll, he's reading all the books and isn't afraid to be an advocate. Still, we thought things would go better for both of us with someone who's very familiar with all the processes. Also, I want to labor at home for as long as possible and I'll think feel more comfortable doing that if with someone validating that everything's OK. Good luck with your decision and birth!

[grethel]

Thanks for this post! I've been considering the same thing -- should we or shouldn't we use a doula?
It's my 2nd kid but dh's 1st (and my 1st was 12 years ago). I had a decent experience the first time around, but I'd like to be more confident and empowered this time. Due to being high-risk, hospital birth is our option and we can only go to an urban hospital where the l&d dept. is very clinical, which is bothering me. I feel with a doula, I'd have a better chance at a lower-intervention birth in that setting.
Dh is very helpful, lovely and supportive, but he sometimes finds it upsetting when I'm in pain, and I have the feeling that he will be more an emotional support than hands-on. I've discussed the idea of a doula with him, but he thinks it would be weird having a "stranger" share our whole birth experience (I'm not sure how I feel about that part either). Also, doula fees in our area, from what I've researched, are shockingly high. We would only go with someone with a lot of experience -- just a personal choice -- and the fees we're seeing are around $1500 - $2000. At that price point, I'm not sure the extra support is worth it.
We've still got time to think about it, but I'm grateful for the thoughtful posts here that are helping me learn more about my options.

[mamatolevi]

YES YES YES YES YES!!!!!!

worth every penny. some ins companies will cover it, but don't ask first. it gives them a chance to say no and have a record of the refusal. just file the claim. if not covered you should be able to get reimbursed as a medical expense through your FSA if you have one. That's what we did.

[musemor]

If I was planning a first birth in a hospital and wanted to do it without pain medication, I would absolutely get a doula, or have a close friend/relative there in a doula role. My (homebirth) labor was 24 hours and it was great to have someone to spell my husband when he got tired, hold my hand while he refilled my water bottle, empty the birth tub while we took a nap after the birth, etc.

[Lovin' It]

My very experienced, highly recommended doula charged $400.

I cannot put into words how much hiring her changed our lives.
I recommend it highly.

[belltree]

Wow, what a wealth of comments!

I read all of them to my husband and he is getting more positive about hiring a doula as well. I have a midwife appointment tomorrow and will talk with her about this topic as well. She has a Cesarean rate of 9.8%, which I think is great for the US. The hospital itself is small, and there is usually just one birth at a time. If she can't come, she has a backup midwife with similar attitudes and CSection rates.

But I really want to ask specifically now, if she has worked with doula before, if she has recommendations, her thoughts on it, how much time she usually spends with a woman once she is in the hospital, etc.

For me the doula would really be for the labor at home and also to have a stronger advocate in the hospital and someone, that can tell me what certain doctor questions translate to. My husband is great and very supportive, he reads tons of books, comes to apointments, will come to the childbirth classes etc, but he comes from a culture, that is not very blunt and outspoken; so usually I do this part in our marriage if necessary, but I am not sure, how much I will be able to speak for myself during a long labor.

I am someone who thrives on being amongst people, so I hope this will be similar during labor as well. I am getting more and more positve about this topic and think I will at least start calling some doulas in the area and ask for interviews and see if there is one, that feels great.

[BethSLP]

Originally Posted by grethel

I've discussed the idea of a doula with him, but he thinks it would be weird having a "stranger" share our whole birth experience (I'm not sure how I feel about that part either).

I know this is on a lot of people's minds, but I don't think of a doula as a stranger. By the time you get to the birth, you'll have had many conversations with the doula. They are as familiar as the OB (usually much more so).

Also, there are lots and lots of strangers at a hospital birth In fact, the doula can help minimize the "traffic" by protecting your space there.

You have to interview them and see how the vibe is. Most likely you'll feel a sisterhood with them as they guide you through something that is the most intense thing you'll ever do.

I have a wonderfully supportive DH too. However, DH doesn't know how to help manage birth the same way a doula does. He isn't going to have a position change suggestion that he would feel comfortable suggesting to his wife who is in pain, because he doesn't have the experience to know what works, what doesn't, etc. He doesn't have a ton of "tricks." And my DH went through all the birth classes with me, read, etc. In the end, its all speculation to them. They haven't done it before.

Also, DHs get extremely emotional in that situation too. I think its a lot to put on a husband to expect them to be able to advocate/protect/support all at once when its a stressful event for them too. I have read a number of stories on here where a doctor goes for the scissors to cut an episiotomies and the DH just freezes and watches it happen. They live with so much guilt because they didn't speak up or protect their wife, but it is impossible to know how you will react under those circumstances. I feel so badly for those DHs....

XOXO
B

[belltree]

Originally Posted by BethSLP

I have read a number of stories on here where a doctor goes for the scissors to cut an episiotomies and the DH just freezes and watches it happen. They live with so much guilt because they didn't speak up or protect their wife, but it is impossible to know how you will react under those circumstances.

This is very true. Thanks for pointing this out - my husband is fascinated by anatomy and how things work, but seeing someone being cut or even imaging having to cut the umbilical cord is just so not his thing.

[penstamon]

DH and I struggled with this question early in pg and the first doulas we interviewed were not to our liking. The one we hired is training to be a midwife and although I was still hesitant at first, I knew she would be there for us. The $ we are spending is already bringing returns- our doula has been very hands on and almost like our midwife (we have an OB), she even loaned us every natural childbirth book I could want. She is quick with remedies for my problems and is genuinely concerned with our pg and experience. She sends me articles and will answer questions faster and with a more "natural" option than my OB office. I have come to see how lucky we are to have her even if we haven't birthed yet! She has been wonderful.

DH is a strong man who would not back down in the hospital too quickly (I presume) and is VERY wary of the medical establishment. BUT- the last thing I want is DH to be fighting and stressed out in protection mode instead of calmly by my side. Hence, doula will be able to play whatever role we need.

FWIW- I am also a grad student and strapped for cash. Look around your area- look for training midwives/doulas, look in your tribal area, google searches, etc. I never would have found our doula without a persistent search. I also found a doula who would work for free (no experience) but she was not the right fit. We live in a rural area and I was shocked by the # of doulas I dug up!