Labor Support with a Doula

I’ll admit it.  The first time I’d even heard the word doula was during our Bradley Method classes before the birth of our first baby.  At the time, my husband and I were rather certain we wanted to handle natural labor and delivery on our own.  We make a great team, and thankfully everything went beautifully in our first, second, and third births. 

If only we’d have known what we were in for with number four.  Oy!  I say that in jest, of course, and honestly I’m not sure how the process would have been different with the support of a doula.  Curiosity gets the best of me, though, and I’d certainly be open to the possibilities if the opportunity ever presented itself again!

The following guest post, answering common questions asked about doulas, is by certified doula, Martha Artyomenko (CD) DONA

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What is a doula?

A doula is a labor support professional who is trained to offer information and comfort measures to women during pregnancy, labor and sometimes even postpartum. She does not offer medical care, but plays a support role for your husband and you, during pregnancy and childbirth.

Won’t the nurses be there for me?

Most nurses are fairly busy with their duties with several patients, and sometimes labors run longer than your favorite nurse’s shift. They will say goodbye, quite cheerily, while studies have shown that a continuous support has reduced labor lengths as well as other many benefits.  A doula will be there from the very itty bitty hours of your beginning labor, until the end. She will check in on you afterwards, and be there to phone for weeks on end later after the birth. She is not only there to support you, coach you on how to get through the discomforts of pregnancy, but also for your husband and family.

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Will my husband feel replaced by a doula? Won’t he be enough support for me?

Many husbands are wonderful support for their wives in labor, but often some women do not realize the emotional strain it can put on a husband who is watching the woman he loves the most go through the experience of childbirth. A doula is not just there for the laboring mother, but also the father to be. Often coaching a father on how to support his wife ends up bringing the two of them closer together.  Also, if a husband struggles with labor, but wants to support his wife, a doula will step in and let him be the husband and not have the pressure of coaching her through every step of labor.

I want to have pain medication, so why would I want a doula?

There are many things about pain medication in labor that have pros and cons, but a labor support person has a role to play in a medicated labor as much as an unmedicated labor.  A labor can progress in a smoother way with different positions, encouragement and other support during the labor, even while the mother is feeling no pain, thus reducing the risk of c-section and other interventions.

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I don’t have a lot of money, and paying a doula is really out of our budget. Can’t my friend or relative do the same thing for me?

There are some friends and relatives that can do a great job as a labor support person, and this is better than nothing, but there is something to be said for training! A doula undergoes training as well as a lot of constant study on the topic of childbirth, postpartum women, and different stages of pregnancy.  Cost can be an issue for many people, but one thing many people do not know is that many doulas have a sliding scale or offer other forms of payment such as trade.

A doula can be a friend, a confidant. She will set her life aside to be there to answer your questions. She will work very hard to help you to get the birth experience that you desire. Birth has many unexpected twists and turns, some of them beyond your control. A doula can help you to have a more positive experience, no matter what happens.

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Martha Artyomenko is a homeschooling mother of four sons and is a certified doula through DONA.  Martha enjoys reading and writing book reviews on her blog in her “free” time.

Have you had the assistance of a doula during pregnancy and labor?  Please share your experience! 

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Comments

  1. I think having a support person/group aside from your husband is so important! Especially with your first. My mom {who had six kids herself} worked in labor and delivery for years and served as my doula with my two girls and will do it again with my boy arrives this fall. She was an amazing support, because she could talk me through my contractions, letting me know what was coming next, while my husband was emotional support. And they worked great as a team, when I started to freak out over something, and helped calm me back down.

    • I wonder if the way you do it with your first (provided the experience was positive) “sells” you on the method? I think so… I feel that way about the Bradley Method. Would NOT want to do labor without that knowledge. :)

  2. For my third delivery my husband and I enlisted the help of a Doula and I am so thankful.
    We did it a bit differently, though.
    Instead of having her there for the birth, she worked with my husband and me in the weeks before the delivery so that he could be a much better support. She gave us a reading list and also walked us through several exercises so we would both be ready.
    The time and money were definitely well spent and we had an amazing birth experience.
    My doctor also applauded our decision and I have no doubt our training made a HUGE difference.
    I wish I had known about doulas for my first two deliveries. Both went well, but would have been much better.

  3. A doula is a WONDERFUL thing to have if you find one you trust and have similar philosophies. With our first birth we wanted to have one after we got to know our Bradley teacher and trusted her so much. However, she was on her once a year vacation while we labored. Believe it or not, she still helped us (twice) via phone while on her vacation! And it made some of the decisions we had to face a bit easier as we knew she understood us and was on our side for our desires….and knew enough medically to know if we were making smart decisions too! And when you are in labor for 46 hours with broken water and strep B you want anyone who isn’t just focused on the ‘this is protocal’ way of dealing with things.

    And she was there with us for our second (very fast) delivery. And will be with us for baby 3 as well! Everyone I know that used a doula says they wouldn’t change it and that includes families with great birth education and those without. It is great to have someone focused on you and your husband while in labor who is just there to help you and guide you and walk through it with you. The best OB or midwife or delivery nurse is going to do what they can, but they may not be there the whole time (shift change or other patients) and they are focused on the medical side of things with you and the baby. The doula is such a wonderful emotional support, as well helper!

    For instance in our last birth my husband was leaning over the birth tub rubbing hard on my lower back. This position was very hard on his back and she was able to get him the birthing stool to sit on to make the angle better. He didn’t ask her to, but she saw a need and filled it right away to help our birth proceed. I never knew this happened until after the birth, but it made things easier on him and never interrupted me or his ability to help me. She was also able to have cold wash clothes ready to lay on me immediately after giving birth (when I realized how hot I was) and did things to just anticipate what I ( or my husband) needed at any given moment. She also was able to talk me through things in the middle of contractions while the midwife was focused on the baby and my husband was working on my back. Her voice literally cut through everything else and helped me focus on what I needed to at that specific moment. I hope I never birth without her! Or my midwife or husband, of course :)

    Heather

  4. I cannot recommend having a doula highly enough! My husband and I took a childbirth class with a doula, and we thought the class was sufficient to get us through labor. However, my baby was posterior, and I had the longest, most horrid back labor the entire labor. I had to transfer from the birth center to a hospital because of the incredible pain and my lack of progress and length of labor (40 hours total). After the first 12 hours of laboring at home, my husband and I felt like we were completely in over our heads, so he called our birth instructor who dropped everything and came to be our doula. What a GOD SEND! She was with us from that point through the birth and was absolutely invaluable in her support to me physically and in helping me make decisions–and in avoiding the c-section that the doctor was talking about at one point. Even though I didn’t get the labor and birth I wanted (all natural at a birth center) because my body had other plans, I feel like I had a very rewarding birth experience in the issues I had a choice in. I could NOT have done it without my doula. I am sure everything would have ended differently and I would have a more negative view of my whole experience if it weren’t for my amazing doula. Next time we get pregnant, she’s the first person we’re going to hire for our birth team!

  5. Oh–and I wanted to mention that my doula is the one who suggested I get an epidural, which helped me realize it was okay and practically necessary at that point. I had labored for 24 hours without drugs by that time (and been without sleep for the most part for over 36 hours), and she had tried all her techniques for helping make my pain manageable, but she saw–with her experience–that I was beyond any comfort measures she or anyone could offer and I was past the point of complete exhaustion. When we discussed my pain level and how much longer I thought I could go, she said that what was experiencing was not pain–it was suffering–and labor should not be suffering. Even though I was SO determined to have a natural birth, she really helped me realize that it was okay to go to the hospital to seek pain relief. I wasn’t a failure for doing so. That was a HUGE weight off my mind; I wanted what was best for me and the baby, and I realized getting pain relief was the best. I have to say that getting that epidural was one of the best feelings in my entire life! Especially know I had first done EVERYTHING I could with excellent labor support.

    All that is to say, next time I hope for a properly positioned baby with no back labor so I can give birth naturally…with my doula’s support! :-)

  6. I’ve had four babies, and used a doula with my first only. My doula was, uh, how to put this nicely? Worthless.

    We did Bradley method classes, wanted to go natural, and that’s why I enlisted a doula. I met with her several times before the birth and liked her just fine, but I didn’t check her references! Big mistake.

    She didn’t do any harm, certainly, but she was just an extra person in the delivery room. And after the birth, I never heard from her again, even though there was supposed to be a significant amount of follow through after delivery–services that I’d already paid for!

    I had a good delivery, but it was because of my husband and an unbelievably-amazing midwife, not because of the doula.

    It’s extra trouble to check references when hiring a doula–but do it!

    • That is too bad your doula experience was worthless! One thing to consider is that you have a positive memory of your birth and delivery and studies have shown that is one thing that doulas do, even if they never speak and are only in the room!!! Just something to consider so you might not have realized what it can do!

    • So glad you and your husband were prepared for the birth you desired with Bradley classes. That was money well spent for us!

  7. Johns Hopkins University has a program through their nursing department where their (trained) student nurses volunteer as doulas as part of their schooling. It’s completely free! Other universities may have similar programs.

  8. I’m not sure if our area has doulas but honestly – I liked having that special moment with only my hubby.

    • That worked for us, too, especially with our first 3 births. I can’t help but wonder if a doula may have changed the outcome of our fourth delivery, though. (I know, I know… I’ve gotta let the imperfection GO!)

  9. For my third labor, I was going for a VBAC. I had had a C-section withmy second, due to a partial abruption of the placenta. By this time, i knew I needed extra support, so we decided to have a doula. I think I found a service through the yellow pages, or possibly from the hospital.

    A nice woman came to my house, met with me for about 15 minutes, took my check, and told me to call them when I went into labor. This left a sour taste in my mouth, but I shook it off. I do remember that I explained to her that I felt I responded better to someone telling me what to do rather than suggesting.

    Once I was in labor, a called the service. A different lady showed up than the one whom I had met. She seemed nice but very shy. By the time I got to transition, she was scared of me. I ended up with pain medication that sent me to sleep. I would wake up in the middle of a contraction in extreme pain. I ended up with lots of tearing. I was not a happy camper!

    My next labor, I asked a friend to be my labor coach. She was wonderful! She was firm when she needed to be, gentle at the right times, and an encourager throughout.

    When asked by first time mothers if i recommend a doula, I always respond that having a good friend there can be just as good, if not better, based on my experiences.

    • This is a good reminder to make sure you ask them what they provide, let them know what you expect and how you labor. Don’t just interview one doula. Ask around and find doulas in training, but know that sometimes some of them, depending on their experience, may not be what you want.

      I have seen both sides of it, where the good friend freaks out when you panic as they were not prepared, where as someone with some experience and training can prepare for that.

      For me, the first meet, we talk. Then if you decide to engage me, we sign papers and do a deposit check. Then I attend at least one prenatal appt. with you, I meet with you a couple other times if you would like, talk on the phone as much as you want, email, I am always available for you. Then there is the labor/birth, I stay afterwards for awhile and visit at least once postpartum as well as being available again for as long as you want by phone and email for any questions/issues you may have. If you need resources in the area that will help you, just ask….

      This is more the norm for doulas that I have met, but I have not met many outside my own area.

    • How wonderful to have a competent, understanding friend to support you in labor! (Bummer that the paid for service wasn’t all it was advertised to be, though.)

  10. I knew from the beginning of my pregnancy that I wanted a drug-free birth, but I had a STRONG leading from God to seek extra help. So I talked to my OB about doulas, and she recommended one she’d worked with before. Fast-forward to week 38 of my pregnancy, and I’d developed life-threatening complications. Because we had a good doula, my OB was willing to let us try for a natural birth when normal protocol would have been to do a C-section. And thanks to our doula’s support, I delivered vaginally with no pain meds and got breastfeeding off to a solid start.

    DH and I agreed later: we would have done fine without the doula if it had been a normal birth–but, with the situation we had, there is no way we’d have stayed out of the OR on our own. All the pain-management tricks we’d learned were out the window because of the restrictions put on me by the complications, and the nurses were freaking out and just wanted to hook me up with every intervention they could think of. Our doula was the only one who knew how to keep things on the natural track.

  11. I had no less than seven nurses during my (fairly short!) natural birth with David. It was just a busy birthing night at the hospital. The nurse that was there during the actual birth was amazing – her telling me to breathe made SUCH a difference. Even with my mom and husband there, I would have paid to have her there through the whole birth. Maybe I will next time!

    • I had the opposite with our third. It was such a busy birthing day that they pretty much left me alone until I said “Uh oh, baby’s here!” and started pushing. LOL (How awesome to have THE perfect nurse at the perfect time!)

  12. I only have one child but I wish I could have afforded a doula. I was really shocked at how little the nurses or Doctor were around. They hooked me up to the pitocin and came to check on me every now and then but offered very little, next to none, labor coaching. I want to save up so I can have a doula with my next child. The statistic behind having the extra support and help are amazing to having a better birthing process.

    • In my experience, the doctors and nurses are as involved as *I* want them to be, but I know that differs greatly at each hospital. I still wonder if my fourth birth would have been different had we chosen to drive back to our original birth care center (1 1/2 hours away).

      • One thing to remember if you look at the part above about affording it, many doulas have a sliding scale, some will trade, some of the ones in training are much cheaper as well. Call DONA and get a list of ones that in the training program in your area!

  13. I didn’t have a doula with my first baby because my husband and I thought it would be redundant – he is my biggest support in everything in my life, so why wouldn’t he be during my labour? Well, let’s just say he didn’t know all the right places to “Press HARDER!!” during my lovely experience with back labour and to be honest, it was tiring for him to be at my beck and call physically and emotionally for the 30 hours! It got to a point where I was more worried for him than the fact that I was a bewildered first time mom who had to push out a baby! Needless to say, as soon as we got pregnant with our second we hired a doula! LOVED the experience! My husband still provided tonnes of support – this time with his own support system in place with the doula. I highly recommend hiring a doula no matter what type of birth you are planning on having.

  14. Thank you for the post! I am expecting baby number 2 and this helped me to reflect on baby #1. Though unplanned, my sister ended up coming to the hospital with us. It was such a blessing to have someone else to help when there was something my husband had to do, paperwork, phone calls, and to help me when he needed a break (or to eat!)He didn’t feel that he was leaving me alone. It was also perfect when he really just wanted to be with the baby but I still had to deliver the placenta and be stitched, so my sis supported me through that. I will be looking into a doula to have extra support this time around!

  15. I did not have a doula, but my husband was the best coach I could ever have. We used the Bradley Method with #2, #3, and #4. We also had our fourth baby at home. Check out our blog to read about our experience.
    http://sistersplayinghouse.blogspot.com/p/homebirth-story.html

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