is a doula truly necessary? « Back to Group Discussions

[waywornwanderer]

Hey ladies, I've posted a bit on this topic before. My lifelong dream has always been to birth my babies in the peace of my own home, but I settled on perhaps giving birth to this first baby of mine at a local birthing center (attended by a CNM). My husband, who is a student physician, was initially on board with the birth center but after a visit or two felt truly uncomfortable with the idea of me not birthing in a hospital staffed by physicians.

After much discussion, prayer, and meditation, we agreed that I would continue care with my assigned OB-GYN and birth at the hospital affiliated with that medical practice- the stipulation being that my husband would do all in his power to be my advocate and support me in a natural birth. Another stipulation was perhaps hiring a doula. My husband truly isn't against natural childbirth, but is experiencing the natural nervousness of preparing to see his wife give birth for the first time. He intimately knows how much can go wrong in a childbirth, and would like sincerely for me and his baby to be as safe as possible. I, in turn, would like my partner to be comfortable and at peace so that the birth experience not just for me but for our new family will be peaceful. I know my partner will best support me if he isn't actively feeling afraid or uncomfortable around midwives. 

I know many women view this as the woman's choice, and I do agree. But in any given marriage there are particular gives and takes, as well as moments we must take into account specific needs and personalities. In my particular case, I do not believe that overriding my husband's wishes would do either of us much good, nor provide the best start for our family. (He, by the way, would obviously stand by me no matter my choice. He is a very mild and mellow kind of guy. I think seeing a healthy, natural birth in action will prove INVALUABLE to his personal and professional development, and am praying double time for a situation that will allow me to birth with as little interference as possible, given the scenario.)

Anyway, at this point in my pregnancy (33 weeks) I have just now started interviewing doulas. My husband being in medical school, we simply cannot afford a full doula fee so we've opted to look into hiring student doulas who would be able to charge a reduced rate in exchange for the experience of attending a birth. I had no idea what to expect, really, going in, but had several lovely conversations with each of the doulas I spoke with and have narrowed it down to two candidates. One of them, D, has three children of her own and just recently delivered naturally at the hospital I'm registered to deliver at, but she has never attended a birth. The second one, K, has two children of her own and has attended four births so far, all hospital births. Each doula is quite reasonable, charging less than $400 for a full range of care, but it will still stretch our tight budget. The truth is that right now I'm having to decide between a prenatal yoga workshop I wanted to take ($150) and hiring a doula ($200-350); I've already payed out $185 for a Birthing With Confidence course, of which I'll receive $50 back from my insurance company.

I am used to distance running, am immensely stubborn, and have read quite a bit about natural childbirth; I don't feel nervous at all about the birth, but excited about it and truly ready for the experience despite the fact that I know it will be a challenge; my husband, too, is excited about me giving birth naturally, and is ready to support me- he will continue taking a few Bradley style classes to equip him as best as he can to support me in labor.

I want to hear from mamas who have had a *positive* hospital experience and I want to know: what made your birth/experience positive? Did you have a doula? Would you consider that indispensable, or would having a stable husband & mother be adequate? Did you do prenatal yoga, take birthing classes? Which ones? Would you consider those more or less valuable than hiring a doula alone? Did you read any specific bit of literature or use a particular mantra/affirmation that was helpful? Were you especially active during the pregnancy, or before it?

Please, I need advice and encouragement!

xo

[lovebeingamomma]

Saying your ready for the experience is like saying you're ready for a marathon because you've trained for it.  Then you hit that "wall" (in both scenerio's), and go oh crap, maybe this isn't as fun as I thought it would be!  No, doulas are not "necessary".  I had two natural births without one, and one with one (and will have a homebirth with one this time).  BUT, they DO make birth better.  They make it more comfortable, physically, mentally, and emotionally, often in ways that your husband cannot.  In the case of a hospital birth, they sometimes, truly do, change your birth experience entirely, if an OB is giving you crap about something and they advocate for you.  The most important thing I tell my clients (I am a doula), is that if you're unsure about something, you tell the OB, or nurse, "can we please a few min's to discuss this", and then they leave the room and we discuss (and this happens more than you might think).  So I absolutely would hire a doula, that's just my opinion of course.  My birth was so much better when I had one, even though it was my third time having an uncomplicated natural birth.  I would not be nervous about hiring one who has never attended a birth, as long as she has given birth naturally herself.  The biggest advantage I have as a doula is having given birth myself.  I use A LOT of what I experienced myself to help other women.  Some women will tell you that their doula didn't help them.  Believe me, they are in the 1%.  Some truly just don't want to be talked to or touched during labor.  The other 99% find them immensely helpful.  I would bet on the 99%, personally. 

[waywornwanderer]

Originally Posted by lovebeingamomma 

Saying your ready for the experience is like saying you're ready for a marathon because you've trained for it.  Then you hit that "wall" (in both scenerio's), and go oh crap, maybe this isn't as fun as I thought it would be!  No, doulas are not "necessary".  I had two natural births without one, and one with one (and will have a homebirth with one this time).  BUT, they DO make birth better.  They make it more comfortable, physically, mentally, and emotionally, often in ways that your husband cannot.  In the case of a hospital birth, they sometimes, truly do, change your birth experience entirely, if an OB is giving you crap about something and they advocate for you.  The most important thing I tell my clients (I am a doula), is that if you're unsure about something, you tell the OB, or nurse, "can we please a few min's to discuss this", and then they leave the room and we discuss (and this happens more than you might think).  So I absolutely would hire a doula, that's just my opinion of course.  My birth was so much better when I had one, even though it was my third time having an uncomplicated natural birth.  I would not be nervous about hiring one who has never attended a birth, as long as she has given birth naturally herself.  The biggest advantage I have as a doula is having given birth myself.  I use A LOT of what I experienced myself to help other women.  Some women will tell you that their doula didn't help them.  Believe me, they are in the 1%.  Some truly just don't want to be talked to or touched during labor.  The other 99% find them immensely helpful.  I would bet on the 99%, personally. 

lovebeingamomma, thank you so much for your input. :)

I say that I feel excited and ready, but I really mean that I'm as "ready" as I can be at this point in time. I don't feel that I know everything or can even begin to conjecture about what birth will be like for me! like, at all. I guess what I'm trying to say is that I'm not afraid, come what may. it means a lot to hear you speak as both a mother and a doula. I like what you said about doulas making birth better- that's how I tried to describe it to my husband. that I don't view having a doula as some sort of magical fairy dust that will guarantee me a smooth, healthy natural birth, but rather I view having one as having an additional layer of support in having a positive birth experience. that, and the statistics showing that doulas reduce the likelihood of a c-section, epidural, & pit, increase self confidence and ability to nurse, decrease incidence of postpartum anxiety, etc etc.

see? I KNOW that having a doula will be nothing but positive, it's just that 1. I'm having a hard time justifying the expense and 2. I've encountered so much negativity from my mom (a women's health nurse) and others, and will be the first person I know to hire a doula. people are making it out to seem "weird" or "excessive". My mom actually said "you already have the knowledge you need, and you're strong and smart. you have me and Brendan- why do you need this other woman in the room with you? how much is THAT going to cost you?" between the classes I'm taking, the yoga, and the doula, I feel like I'm doing what I need to to go into labor as strong as I can... but I also feel like I'm spending money out the wazoo on things that others have gone without.

sorry, I'm a mess of thought right now. haha. 

[lovebeingamomma]

Originally Posted by waywornwanderer 

lovebeingamomma, thank you so much for your input. :)

I say that I feel excited and ready, but I really mean that I'm as "ready" as I can be at this point in time. I don't feel that I know everything or can even begin to conjecture about what birth will be like for me! like, at all. I guess what I'm trying to say is that I'm not afraid, come what may. it means a lot to hear you speak as both a mother and a doula. I like what you said about doulas making birth better- that's how I tried to describe it to my husband. that I don't view having a doula as some sort of magical fairy dust that will guarantee me a smooth, healthy natural birth, but rather I view having one as having an additional layer of support in having a positive birth experience. that, and the statistics showing that doulas reduce the likelihood of a c-section, epidural, & pit, increase self confidence and ability to nurse, decrease incidence of postpartum anxiety, etc etc.

see? I KNOW that having a doula will be nothing but positive, it's just that 1. I'm having a hard time justifying the expense and 2. I've encountered so much negativity from my mom (a women's health nurse) and others, and will be the first person I know to hire a doula. people are making it out to seem "weird" or "excessive". My mom actually said "you already have the knowledge you need, and you're strong and smart. you have me and Brendan- why do you need this other woman in the room with you? how much is THAT going to cost you?" between the classes I'm taking, the yoga, and the doula, I feel like I'm doing what I need to to go into labor as strong as I can... but I also feel like I'm spending money out the wazoo on things that others have gone without.

sorry, I'm a mess of thought right now. haha. 

I didn't mean to minimize your preperation at all, it's GREAT to be prepared, as much as you can be, as you said.  I would look at it this way, can you afford NOT to have a doula?  And on the note of mothers, they can sometimes be, absolutely, the worst possible person to have in the room during labor.  All mom's are not nurturing and understanding of what you need.  A mom has to have that doula quality to be truly helpful to you.  It's because of how MUCH they love you that it can sometimes cloud their judgment with how to support you.  Now I'm not saying don't have her there, but honestly, it almost sounds like your mom needs a doula too, lol.  Doulas help everyone, mom, dad, grandmothers, everyone in the room, who may need some guidance with how to help you.  Good luck with your birth, I think you'll be just fine!! 

Edited by lovebeingamomma - 12/29/12 at 2:44pm

[buko]

So, I am also a FTM and planning a homebirth (actually without a doula), so take this with a big grain of salt!    (I have also spent literally years researching birth, especially NCB, partly out of sheer fascination.)
 

In your case, I would absolutely, 100% get a doula.  Both of your possible choices sound good.  It's really, really not "over the top" and I think considering your husband's misgivings... even slight (but enough to have you switching to a hospital)... I think a doula may be essential.  Not only can she remind you of your goals, etc. (i.e., advocate for you but THROUGH you), but she can help keep the atmosphere calm and "normal." "Normal" as in "birth is usually safe, reasonably predictable, not inherently an emergency, etc., and what you are experiencing is (probably/almost definitely) normal."  Does that make sense?

I have taken a couples prenatal yoga workshop, and it was totally a nice thing, but if I were birthing in a hospital and choosing between that and a doula, I'd choose the doula, hands-down.  Even if it's not as good as attending a workshop, you can at least watch some videos on yoga for birth for free/cheap.  Nothing compares to having a doula with you for birth-- there's no substitute for that extra person supporting you in that specific way, at such a critical time. 

And, BTW-- this is me, too:

I am used to distance running, am immensely stubborn, and have read quite a bit about natural childbirth; I don't feel nervous at all about the birth, but excited about it and truly ready for the experience despite the fact that I know it will be a challenge

I am not by "nature" a distance runner, but I have completed 3 marathons, and the first 2 were out of sheer stubbornness, because I was really underprepared.  Not to mention that my mom (actually an MD herself, and luckily super-supportive of my HB) had two NCBs in hospital and is my stubbornness role model (and knowing about her NCBs helped normalize the idea in my mind).  At the same time, I have chosen an environment and providers for myself that will facilitate my desired outcome, because my preparedness/stubbornness is not enough.  And as happy as I am to buck the norm and whatnot, I know I (and DH) will be extremely vulnerable in labor and I am under no illusions that I couldn't be coerced into a less-than-evidence-based intervention even if not strictly necessary.  It sounds like your choice is also a pretty good one in that respect-- but I'd say the doula brings you even (significantly) closer to that sort of supportive environment. 

Kind of like...  Oh, IDK...  You train really intelligently for a marathon but don't bring along any fuel (PowerGel, dried fruit, etc.), and don't "practice" with the same type of limited fuel they will be providing on the course*.  Bananas and bagels and Gatorade (or whatever they will provide) might be enough for you-- in fact, there's a decent chance they will be.  But it's better if you know how bananas and your GI tract get along beforehand, or, better yet, to try out bananas vs. PowerGel vs. Gu vs. Sport Beans (my favorite) during your training runs and then bring along what you know will work best for you and not be dependent on what the course organizers provide. 

Maybe not the BEST analogy, but my point is that a doula might seem "extra"-- and her support not the "most" important component-- but she can make a big difference in the outcome.  Back to my shaky analogy-- without the right "tested" fuel, (even with all the genuinely more important other prep), there's probably a 60% chance you'll perform close to ideally, maybe a 10% chance of not finishing the marathon at all (specifically because of the fuel issue), and, say, a 30% chance that you will finish, but feel significantly subpar in doing so.  Those are numbers pulled from my behind, of course!  But just saying...  Unless you have a "bad" doula (which is really unlikely), I think it's only logical to assume, based on research, etc., that there's a decent chance that a doula will improve your outcome at least a significant percentage of the time.       

*For example, I knew my last marathon was providing a really hard-to-find sports drink, so I ordered some online to "practice" with on my training runs, because because I usually tolerate liquid calories better than solid, but I had no idea how my stomach would react on race day to a "foreign" drink.

[HouseofPeace]

I did not hire a doula for money reasons and my husband and I were both advocates of natural birth, and with my second we successfully had a natural hospital birth.  But with my first, I can look back and say I needed more support and care from someone who knew what was going on.  My husband was a great advocate the 2nd time, but it was after he was confident that I could give birth and we had fought the battle together before. 

I would err on the side of having someone who's been through birth before on hand to support you, and encourage your husband.  and also to recognize what you're going through.  i could have had my son w/out drugs if he hadn't been posterior and got stuck for hours on my spine.  even then, my husband's support is the only reason i didn't have a section.  but a doula could have recognized that my labor stalled out b/c of the baby's position and addressed it!  No one did.  and delivering your first OP (sunny-side up) is just not good.  and back labor is NOT normal labor and is really hard.  

my homebirth i would not consider having a doula at b/c my midwife IS a doula and we are at peace and agreement and she's supportive as is my husband now.  and she is in agreement that anyone else present at my births is counter productive for me.

if choosing between prenatal yoga workshop and someone present at your birth to walk you through this crazy thing, i'm with the doula.  my husband asked me to get him a shirt printed 'man slave' due to his choice at being my 'doulos' (masculine of doula, which also means slave).  but i'm of the view that your husband is not really going to be able to play that role.  after this birth, yes, but first time, wife in pain, fear, etc., most men are not cut out for the role (there are exceptions) and it would be worth it to both of you to get support.

[Chloe'sMama]

I am with these other ladies.  My first birth (hospital) we were so prepared.  I was fit and emotionally strong and felt so confident about birth.  I took a hypnobirthing class and DH knew exactly what I wanted.  We were READY!  I had no doubt that I would have my ideal birth experience.  

Lets just say that short of a C-section, every medical intervention was used, most of which were not necessary and I wished that I would have hired a doula to help support me.  My DH was really overwhelmed by watching me 'labor' on pitocin and was experiencing the birth in his own way.... I don't think it was fair of me to think that for the birth of his first child that he could be there just for me and not for himself, if that makes sense.  

Really, I think that it can only be beneficial.  If you don't need her, it may be a waste of a bit of money, but if you DO need the support and advocacy, it will be so priceless.

[waywornwanderer]

And as happy as I am to buck the norm and whatnot, I know I (and DH) will be extremely vulnerable in labor and I am under no illusions that I couldn't be coerced into a less-than-evidence-based intervention even if not strictly necessary.  It sounds like your choice is also a pretty good one in that respect-- but I'd say the doula brings you even (significantly) closer to that sort of supportive environment. 

Kind of like...  Oh, IDK...  You train really intelligently for a marathon but don't bring along any fuel (PowerGel, dried fruit, etc.), and don't "practice" with the same type of limited fuel they will be providing on the course*.  

This is a little of what I'm afraid of- that "preparation", stubbornness, and sheer willpower will not be enough if I don't set the right conditions for myself.  I know that being in a hospital setting automatically places a lot of the control in other peoples' hands, and that in a vulnerable moment someone could indeed coerce my husband or me into a not-strictly-necessary intervention. Methinks that in that regard alone, a doula is worth her weight in gold as a filter & shield. As lovebeingamomma said, someone who can call "timeout" and ask for a few moments of thought and refocusing.

btw, your analogies and explanation make a lot of sense to me, so THANK YOU. :)

I'm leaning towards rearranging some of our budget to make room for hiring the doula AND schedule at least a couple of drop in yoga classes (I won't be able to afford the whole sequence, but something will be better than nothing).

[waywornwanderer]

Originally Posted by Chloe'sMama 

My DH was really overwhelmed by watching me 'labor' on pitocin and was experiencing the birth in his own way.... I don't think it was fair of me to think that for the birth of his first child that he could be there just for me and not for himself, if that makes sense.  

This is really powerful! I'd only slightly considered this idea, but not worded in that way. Husbands/partners MUST experience the birth in their own way, as a process that not only makes women mothers but turns men into fathers. And as much faith as I have in my husband as a partner, husband, and friend, *I* am not in control of his experience (and will be in no position to be in control of his experience, in any case!) It's as much his own as it is mine.

You've done it. I'm convinced.

Thank you ladies so much for your advice. I think I just needed that little bit of a push and to sort through my own thoughts before I committed. I'm going with K- a lovely lady whose husband is in law school, who has two babes of her own, who has attended four births already and has a wonderful wealth of peace and knowledge (a degree in Anthropology to boot). $200 is an absolute steal for her and I just don't think it'd be wise to pass her up.

[buko]

Good for you, www! *hugs*

[etsdtm99]

good decision!

I have never had a doula, for various reasons (i would have for my last birth, if it had not been a homebirth) , but if i could go back and change one thing about the preparation for my first birth hiring a doula would be the thing i'd change, and knowing what i know now, i know it would have made all the difference.. 

[Sunshine_Amy]

Originally Posted by waywornwanderer 

I'm leaning towards rearranging some of our budget to make room for hiring the doula AND schedule at least a couple of drop in yoga classes (I won't be able to afford the whole sequence, but something will be better than nothing).

Originally Posted by waywornwanderer 

Thank you ladies so much for your advice. I think I just needed that little bit of a push and to sort through my own thoughts before I committed. I'm going with K- a lovely lady whose husband is in law school, who has two babes of her own, who has attended four births already and has a wonderful wealth of peace and knowledge (a degree in Anthropology to boot). $200 is an absolute steal for her and I just don't think it'd be wise to pass her up.

Hooray!  I was rooting for both. I got a lot out of my prenatal yoga, personally, it helped me to ground and center into my body.

Regarding which classes to take, the yoga is a great piece.  I did it ALL with baby #1. Here are my own experiences, I hope you find the perspective helpful:

• Birthing From Within workshop. My instructor was horrible, but a friend lent me the book, which I loved. I only did a few art exercises from the book, but I felt they really cleared the path for me in terms of being able to visualize the birth experience, and work through any feelings that arose around birth, being a mother, working with others in planning my birth, having a new baby in my life.....  Good stuff to allow one's self to feel and explore feelings about.  Doing a drawing on any of those,  or on anything that occurs to you, is a great tool.
• Prenatal yoga. This was really grounding for me, and helpful in just Being, and experiencing, my pregnant body, and taking time to feel, and move, and trust my body, in an environment designed for it.  I'm glad you're doing some!  
• A two hour workshop that turned out to be one of the very best pieces, on Creative Movement in birth. In addition to talking about how belly dance was developed as the art of moving one's body and hips for labor, which I found just delightful, we just played with movement in the context of labor. We sat on birth balls and rolled back and forth. We swayed, we moved.  They also played a video, which I'm sure you can find, of a woman named Amber who has an orgasmic birth. I saw it in other classes too, but what I saw only in this class, was footage of her talking about it afterwards, which I LOVE. She spoke of her experience as the energy of the whole universe pouring down through her.  She gave me this image that one can just move and sway, to keep the energy moving, and just flowing down through the body.   That image was so powerful to me, and I love to share it.  
• I don't think you can overdo it on preparation, and I have to raise an eyebrow at your mother's comment, questioning the cost of any of your birth preparation, especially something so vital as a doula in a hospital environment. I absolutely agree with everyone about the doula. In addition to advocating and supporting your birth plan, she will be there with you as the doctors and nurses and even nurse midwives, change shifts.  I'm so glad you're going to do it! 

• Hypnobirthing knock off class.   I didn't use any of the breathing techniques, as I found the equal-in-and-out, audible "ujjayi" breathing I do in ashtanga yoga to be far more trance-inducing and calming. But I was really grateful for the guided imagery in labor visualizations in the class. In particular, she offered some great suggestions for the body to respond positively to even bright lights and other stimulus in the hospital environment.  It put my mind at ease about laboring in the hospital if I had to transfer from my home birth.  I've been inspired, and just wrote up a guided imagery for you to follow. I'll put it in a new post for the other mamas to enjoy too.  

Enjoy the rest of this special ripening time. May you do all you would like to do for yourself!  May money flow to you with ease, and may others sense the goodness and rightness in your caring for yourself, and also in and nurturing other people/things you wish to nurture, however much money is required to do so.     

Namaste.  

[typebug]

Wo

Originally Posted by Sunshine_Amy 

Hooray!  I was rooting for both. I got a lot out of my prenatal yoga, personally, it helped me to ground and center into my body.

Regarding which classes to take, the yoga is a great piece.  I did it ALL with baby #1. Here are my own experiences, I hope you find the perspective helpful:

• Birthing From Within workshop. My instructor was horrible, but a friend lent me the book, which I loved. I only did a few art exercises from the book, but I felt they really cleared the path for me in terms of being able to visualize the birth experience, and work through any feelings that arose around birth, being a mother, working with others in planning my birth, having a new baby in my life.....  Good stuff to allow one's self to feel and explore feelings about.  Doing a drawing on any of those,  or on anything that occurs to you, is a great tool.
• Prenatal yoga. This was really grounding for me, and helpful in just Being, and experiencing, my pregnant body, and taking time to feel, and move, and trust my body, in an environment designed for it.  I'm glad you're doing some!  
• A two hour workshop that turned out to be one of the very best pieces, on Creative Movement in birth. In addition to talking about how belly dance was developed as the art of moving one's body and hips for labor, which I found just delightful, we just played with movement in the context of labor. We sat on birth balls and rolled back and forth. We swayed, we moved.  They also played a video, which I'm sure you can find, of a woman named Amber who has an orgasmic birth. I saw it in other classes too, but what I saw only in this class, was footage of her talking about it afterwards, which I LOVE. She spoke of her experience as the energy of the whole universe pouring down through her.  She gave me this image that one can just move and sway, to keep the energy moving, and just flowing down through the body.   That image was so powerful to me, and I love to share it.  
• I don't think you can overdo it on preparation, and I have to raise an eyebrow at your mother's comment, questioning the cost of any of your birth preparation, especially something so vital as a doula in a hospital environment. I absolutely agree with everyone about the doula. In addition to advocating and supporting your birth plan, she will be there with you as the doctors and nurses and even nurse midwives, change shifts.  I'm so glad you're going to do it! 

• Hypnobirthing knock off class.   I didn't use any of the breathing techniques, as I found the equal-in-and-out, audible "ujjayi" breathing I do in ashtanga yoga to be far more trance-inducing and calming. But I was really grateful for the guided imagery in labor visualizations in the class. In particular, she offered some great suggestions for the body to respond positively to even bright lights and other stimulus in the hospital environment.  It put my mind at ease about laboring in the hospital if I had to transfer from my home birth.  I've been inspired, and just wrote up a guided imagery for you to follow. I'll put it in a new post for the other mamas to enjoy too.  

Enjoy the rest of this special ripening time. May you do all you would like to do for yourself!  May money flow to you with ease, and may others sense the goodness and rightness in your caring for yourself, and also in and nurturing other people/things you wish to nurture, however much money is required to do so.     

Namaste.  

Great ideas here! Thank you for sharing all this.