A new study out of the University of Minnesota concluded that using a doula during pregnancy and delivery greatly reduces the risk of having a premature baby, which also follows evidence that this personal support also lessens the likelihood of having an unplanned C-section.
This is fantastic news for anxious moms-to-be of course, but there’s plenty more to consider when deciding if a doula is right for you.
There are basically three schools of thought when it comes to deciding whether or not you should hire a doula to assist you during your pregnancy and labour. The first, “No, I don’t need that.” The second, “What the heck is a doula?” and the third, a resounding “YES, bring it!”
Type One: No, I don’t need that
If you’re in the no camp, you probably don’t like the idea of additional bodies in the room while you’re in the middle of one of the most intimate and challenging moments of your life. We get you. “Does my husband really need to be in there?” is a question we’ve heard from more than a few moms-to-be. And since there’s evidence that shows that having unwanted or untrusted people in the room can actually stall labour, follow that intuition, mama!
Or, maybe you’re indifferent about having someone else there but you’ve looked into the costs and found them steep. And we mean steep; anywhere from $500-$2000, depending on the doula, and type of package you choose. This could be a hard pill to swallow since you’re the one having to push a giant baby through a tiny opening. Although, if cost is your only concern, there are a few ways to avoid emptying your wallet. More about that later.
If you’re like the majority of women (and even more men) you likely fall into category two.
Type Two: What the heck is a doula?
Maybe you have a loose understanding of what a doula does, but still think they are reserved for women that plan to have their baby in a babbling brook behind their house under a full moon. That’s not untrue, but it’s also not the whole story.
To put it simply, a doula is a support person; A woman (usually) educated in the emotional and physical needs of a labouring mother. They understand the lingo, they take the time to get to know you and exactly what your ideal birth looks like, and most importantly, they are your biggest cheerleader and fearless advocate. They intuitively know when your partner is stressing you out and will instruct them to go out for food. They know exactly where to massage to get you through back labour pains, and they recognize when you’re going through transition so that your midwife, or OB can be alerted. They’re also usually the only person other than your partner that will be with you from your early contractions to your baby’s first latch.
Still, it’s hard to get a full picture of the scope of service that a doula provides without experiencing it yourself, so we thought we should go for the next best thing to help the average woman decide if a doula is right for her. We reached out to Toronto-based doula (and midwifery student) Meredith McLean to ask her some of the most common questions people have about doulas, and to clear up the misconceptions.
What should people look for when they are considering hiring a doula?
“I think they should look for someone they connect with, and not worry so much about their experience or whether they have all the credentials. Trust your gut. You may find that you connect better with someone that is newly (or not even) certified, as opposed to someone with 20 years experience.”
Does that mean that all doulas are certified?
“No. Technically anyone can wake up and call themselves a doula, but there are many doulas, myself included, that go through a certification process. This means we were trained through an organization such as DONA International where we attended a set number of lectures, pre-natal classes, breastfeeding classes, read specific books, and most importantly attended a minimum of three births and were then evaluated by the doctors, midwives, nurses, and mothers at these births.”
What can a woman expect from doula care?
“They can expect to meet with their doula at least twice ahead of the birth, and for full care during the birth. From your first contraction, or as soon as you want her there, to once baby has arrived and you both are settled (typically a few hours later) you can expect your doula to be by your side. We offer physical support through hands on comfort measures like massage, and emotional support by telling you how great you’re doing, telling you where you are in your labour, and what to expect as your labour progresses. We also do advocacy so that you know your options and can make the best decision for you. We don’t step on the toes of medical professionals, but for instance, if we can tell that you’re feeling pressured to make a decision we may ask “do you need a little more time to think about this?” and then help you work through the pros and cons of the situation at hand. We always want the mother to feel like she’s in control and making the decisions about her birth, as opposed to someone else making them for her.
We also typically have a follow-up visit within the first two weeks of the baby’s life to reflect on the birth. We can help the mother write down their birth story, or we can simply talk through any lingering feelings she may still be experiencing. During these visits many doulas bring food, and even do some light housework.”
Is there anything doulas don’t do?
“The long and short of it, we don’t do anything medical. We don’t do anything that involves internal exams, or blood pressure checks. A somewhat crude explanation that people use is that doulas work from the waist up, and midwives and doctors work from the waist down.”
What if a doula has two births at the same time?
“It depends how the doula schedules her births, but typically we work with a backup, although we rarely have to use them. I ensure my client’s due dates are all a minimum of two weeks apart to avoid conflict. “
What if a woman is using a midwife? Is there still a need for a doula?
“A doula has a different set of skills from a midwife, or doctor or a labour and delivery nurse. A lot of people don’t realize that just because you have a midwife it doesn’t necessarily mean you’ll have the doula-like physical and emotional support. A midwife or doctor also isn’t available to you during your early labour, while a doula is.”
Isn’t their partner enough support?
“Sometimes partners can become overwhelmed and stressed out by feeling like all of your support falls on their shoulders. Doulas can work in tandem with partners, trading off massaging the labouring mother to give each other a rest, and doulas can also be a form of support and reassurance for your partner. Especially in a stressful situation like an emergency C-section.”
Speaking of C-sections, if a woman is planning to schedule her delivery, or use an intervention like an epidural, would a doula ever be involved?
“Absolutely. Doulas are not reserved for natural births. Our goal is to help each mother achieve her ideal birth, whatever that may look like. I have been to elective C-sections, and offered support to women with epidurals. In these situations, care leans more towards the emotional support to help women stay connected to their labour. It’s very easy to check-out when you have an epidural, or are in a sterile environment like in an operating room. It’s a lot to do with getting baby skin to skin as quickly as we can, and having as much of a family-centred c-section as possible.”
TYPE THREE: YES, BRING IT!
You already knew a lot of the above, and now you’re just considering your options. If you were already planning on having your best friend, or mother, or aunt in the room with you, then technically they could be considered your doula. They may not have the training that a certified doula has, but if you can count on them for support no matter what, and are capable of leaving all judgment and anxious tendencies at the door then that could be just the answer you’re looking for.
If a friend or family member isn’t an option, but cost is obstacle, there are other options. Doulas are unfortunately not covered by provincial medicare (yet!), but they are often covered by private health insurance. Many doulas also accept payment plans, so if you think you can swing the cost if it’s spread out over nine months, then most doulas are willing to accommodate. After all, it’s often the women that are struggling that can benefit most from their care. Additionally, there are many student doulas looking to gain experience and offer their service for free. FREE!
Ultimately, the decision is yours. Just like every labour is different, and every baby is different, every woman is different in her needs during her prenatal care and delivery. If you’re the type of person that knows they don’t want extra people around, a doula may not be right for you. But, if you think you’ll need, or want, all the encouragement you can get, then a doula may be in your best interest. Especially when you’re two weeks post-partum and that same sweet woman shows up at your door with a pot of soup and tackles your mountain of dishes.