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Baby On Board
The Doula Thread (karma: 14)
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Thu Mar 22, 2007 12:30 PM
Made sticky by hylndlas (107168) on 2007-03-23 07:14:10 This is just too good a thread to lose! Thanks so much for taking the time to post this Nadine....I think this will help a lot of mothers!

As most of you know, I'm completing my birth doula certification with DONA - Doulas of North America. I often read posts where members say things like "I don't think I'll be able to handle the pain" or "People tell me just to get the epidural because it's too painful"...

You CAN handle it. Unfortunately, common medical practices and the media have separated us from the concept of natural normal birth as a situation that every woman can remain in control of and endure with grace and wonderment.

There are ways that you can minimize pain during childbirth, paving the way for less intervention and less potential complications. Basically, by entering a hospital, you are approaching a staff with views birth as pathology - as a disease with myriad complications, and more often than not, you will be pressured to have an epidural, pitocin induction, episiotomy, etc. If you want a normal, natural birth, you'll want to have someone by your side who believes in birth as a natural body function, and understands the psychological and physiological details of childbirth and how they work together.

So what exactly is a doula? The word doula is a greek term essentially meaning "woman caregiver". A doula meets with the pregnant woman or couple about three or four times before labor begins to establish a relationship and get familiar with the couple's hopes and desires for birth. When the woman goes into labor, the doula either meets the couple at home, or at the hospital. Sometimes the couple will have the doula wait out early labor with them at home, and then transport to the hospital together, because the longer you stay at home, the better your chances are of avoiding intervention.

The doula is familiar with breathing, visualization techniques, massage, and other de-stressing techniques to help the mother stay in a positive space during labor. Some people assume that having a 'stranger' there will interfere with the intimacy of the birth. On the contrary. The doula often reassures and allows the woman's partner to feel more comfortable with what is going on and focus on the woman with more confidence. Additionally, the hospital staff will be in and out of the room at random - changing shifts, etc. An unfamiliar face can stall labor. Having the comforting presence of the doula can allow the couple to focus on each other rather than adapting to new faces, and the constant presence of someone familiar with birth is almost always welcome, especially since nurses are so 'in-and-out'.

A doula is also trained to assist you in getting started with breastfeeding. This can be extremely helpful to the mother who wants to breastfeed, but lacks the support or confidence to proceed on her own.

The support of a doula results in shorter labor, healthier mothers and babies, more positive feelings about birth, less C-sections, less forceps and vaccum extraction deliveries, and studies prove and support these findings. A brief Example

For more detailed information and a GREAT book, check out [www.amazon.com . . .]The Doula Book by Klaus, Kendall, and Klaus.[/url]

A doula is not a medical practicioner and does not interfere with the hospital staff. The doula's job is to back YOU up, and support what you want. Having a supportive presence can help you assert yourself to ask the hospital staff what you need, and to object to any practices that you feel may not be appropriate, but the doula does not object FOR you. The doula does not advocate for you, but her presence empowers you to advocate for yourself!

How do you find a douls? How expensive is this going to be? Well, there is a great site called bellywomen.net which acts as an advertising service for doulas who will provide free or reduced-rate services, and for women who are seeking a doula in their area.

You can also check out the websites of these doula organizations:

DONA (Doulas of North America) - www.dona.org

ALACE (Association of Labor Assistants & Childbirth Educators) - www.alace.org

Birth Arts International - www.birtharts.com

You can always contact the doula trainer from a particular organization and ask if they have any doulas-in-training who will attend births for free to fulfill their certification requirements. Otherwise, doulas charge anywhere between $300 - $800 per birth, but most will work on a sliding scale if financial need is dire.

There are many many more details about doulas that I have not really included, but I'm sort of waiting for a phone call, and decided to post this, very off-the-cuff. If any questions arise as you read this, post away! I love talking about birth!

48 Replies to The Doula Thread

re: The Doula Thread
By Louisemember has saluted, click to view salute photosPremium member Comments: 17315, member since Thu Jun 06, 2002
On Thu Mar 22, 2007 12:53 PM
I've always wondered what, exactly, a doula was - ever since I first came across Venicia.

I was just wondering if there'd be any instance in which a doula would side with a doctor and advise painkillers or a Caesarian? Would it only be in life-threatening situations, or not at all?
re: The Doula Thread (karma: 1)
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Thu Mar 22, 2007 01:09 PM
The doula will side with the mother, always. If the mother happens to request an epidural, then it becomes the doula's duty to ease the mother through the insertion of the epidural. If a cesearean becomes imminent, then it's the doula's job to comfort the mother through whatever conflicted feelings she may have about having a cesearean (failure, guilt, fear, etc)and to encourage her before, during, and after the surgery.

We don't advise the mother to do anything medically. We make sure she knows all of her options prior to birth, and then stand behind her so that she may implement those decisions during birth. The whole philosophy behind woman-centered birth is that the woman is in charge and knows what she needs, even if that conflicts with the doula's personal beliefs or preferences.

The hope would be that the doula would provide enough comfort to allow birth to proceed with as little pain as possible, so that the pain-killers or C-section are not an issue. Of course, it doesn't always happen that way, but that's the aim! :)
re: The Doula Thread
By Queen_Jojo Comments: 4947, member since Sat Aug 27, 2005
On Thu Mar 22, 2007 04:03 PM
I think what you're doing is fantastic! Most women when they go into hospital are already in labour and get to meet the person who will deliver their baby for the first time then. When a midwife's shift finishes most hand over to another midwife so the poor mum to be doesn't know if she is coming or going. I know midwives are paid to work set hours but shift changes in the middle of giving birth can be distressing for the mum as she gets used to one person then she goes and along comes another!
With a doula you have a familiar face who can help and support both the mum and dad to be.
When I had my last 2 babies I brought my own midwife to the hospital with me and it was so nice knowing she was going to be with me for the duration of my labour and birth.
One question I do have is, are you allowed into a c section?

Queen_Jojo
re: The Doula Thread
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Thu Mar 22, 2007 05:09 PM
Yes, the doula is usually permitted to accompany the woman in the event of a C-section, just like any other member of the family would be allowed to accompany her.

Excuse all the typos in that first post! I just re-read it, and gosh am I embarassed.
re: The Doula Thread
By oz_helenmember has saluted, click to view salute photosPremium member Comments: 11196, member since Sat Aug 10, 2002
On Thu Mar 22, 2007 05:59 PM
Edited by oz_helen (35388) on 2007-03-22 18:03:40 edit
Edited by oz_helen (35388) on 2007-03-22 18:05:19 found *one*!
Thanks for all this information, Nadia.

I've been thinking a lot about "next time". And lately I've been thinking that having a doula as well as a midwife would be beneficial to me, so that I can avoid the cascade of interventions I faced last time. Even though my husband was very well informed, he got to the point where he was overwhelmed and mentally and physically exhausted so that he felt he was no longer able to have control of the situation (with regard to keeping to the plan), especially when the pressure was on. I think it would be good to have a doula if only for there to be another person to restate and confirm the mother's decisions; someone who has no direct emotional response to "seeing a woman in pain". (That was Shane's reason for agreeing to the interventions: he didn't think I could take the pain anymore and he couldn't bear to see me struggle any more.)

My main problem is that I've started looking for doulas and have discovered that there appears to be only one registered in my state!

Nadia, would you come to Australia to be my doula? ;)

Helen
re: The Doula Thread
By glitterfairyPremium member Comments: 12135, member since Tue Oct 01, 2002
On Thu Mar 22, 2007 06:39 PM
I've already decided that if/when I ever have kids, I'm having a doula. There's no ifs or buts about it...it seems like a very commonsensical thing to do (ie have someone experienced supporting you for the time that's needed, rather than just till the end of their shift).

Venicia's already offered to be my doula :D Yay!

It's a pity that there's only one registered doula in ACT, Helen. Perhaps there are more in NSW or VIC willing to travel a little bit? (especially if they're near ACT anyway...) good luck!
re: The Doula Thread
By oz_helenmember has saluted, click to view salute photosPremium member Comments: 11196, member since Sat Aug 10, 2002
On Thu Mar 22, 2007 06:54 PM
Oooh! I've found another one - it took a bit of digging. I had to search under a few different terms. The latest one actually lives 5 minutes away from me! So maybe I don't need Nadia to travel all that way for me after all.

(You can still come if you want, though, Nadia!)

Helen
re: The Doula Thread
By crunchyPremium member Comments: 4810, member since Wed Nov 05, 2003
On Thu Mar 22, 2007 06:55 PM
I just wanted to say that thanks to your link, I've found myself a free doula!!!

*muah*muah*muah* :D :D :D

Thank you so much!

Now that that is underway, I wanted to ask a question or two. She is going to be working for free, so would it be customary for us to pay for gas and maybe a meal or two here or there? I feel that we need to do this, as she lives more than an hour away from us, and is still offering this service, which I just find amazing.

Well, that's the only question I can think of off the top of my head, but I'm sure I'll have more later. It's supper time!

Again, thank you so much for your information. You're wonderful!
re: The Doula Thread
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Thu Mar 22, 2007 07:23 PM
Hehe, if y'all are paying for airfare, I'll travel anywhere, and doula for free :D .

Aly, I am so glad you found a doula! Yay! I think that buying your doula lunch, or offering gas $ is a lovely gesture. She may or may not accept, but it is nice to offer if you can, considering the distance. At the end of services, a small token gift is always a nice gesture. Certainly not expected, but it's certainly appropriate.
re: The Doula Thread
By KimmieVmember has saluted, click to view salute photos Comments: 436, member since Wed Sep 22, 2004
On Thu Mar 22, 2007 08:14 PM
I think that is a great thing you are doing Nadia. You will really be helping mothers who want to have a birth with less interference, but might not be ready, or able (for whatever reason) to have a home birth. All of your posts have really helped me to form better ideas about childbirth, and childrearing in general. I'm definitely not planning on having kids for quite a few more years, but I've already decided I want a home birth. Ever since I got the "baby rabies" a while ago, I've been looking up all kinds of info online. I spend most of my "I have nothing better to do than be lazy online" time reading the forums over at mothering.com learning about all of the AP/natural methods of childcare. I still think some things are a little "out there" but overall it's been so informative, and to think if someone would have asked me a year ago about having kids I would have said "no, never" followed by "If I do have one I want an elective c-section so i won't have to go through all the pain". Needless to say, my views on the whole matter have definitely made a 180. I think you will make a great doula. Best of luck!
re: The Doula Thread
By SaraTheGrouchmember has saluted, click to view salute photosPremium member Comments: 8600, member since Thu Apr 17, 2003
On Thu Mar 22, 2007 08:35 PM
What's the difference between a midwife and a doula?
re: The Doula Thread
By Celebrianmember has saluted, click to view salute photosPremium member Comments: 7921, member since Thu Mar 31, 2005
On Thu Mar 22, 2007 08:51 PM
Well I want one! I sound like a kid demanding a new toy, right?

The next child, though, I don't want just any doula...I want NADIA! It would be so awesome to meet you while in labor. Reading your posts on DDN is like reading your mind in some ways and I'd know your insides, so to speak, before I met your outsides. :D

So, uh, do you do Florida?
re: The Doula Thread
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Thu Mar 22, 2007 09:02 PM
Edited by NadiaLadida (116697) on 2007-03-22 21:03:28
Edited by NadiaLadida (116697) on 2007-03-22 21:05:23
Thanks guys, I hope I can be a good doula. Florida? Sheesh, I wish! My sister is having a homebirth in Florida soon, and I'd love to be there. Virginia is just a wee bit far away...

Want to move to Va? :D

Sarah, I'll try to provide a better definition of doula vs. midwife tomorrow - I am on my way to bed. Essentially, a midwife is medically trained to facillitate normal birth, and handle complications if they come up. The midwife also handles prenatal and postpartum care. Basically, the midwife can do what a doctor can do (and more, in some instances), except perform a C-section. A doula, however, has no medical training and provides emotional support to the birthing woman and her family. A doula does not make medical decisions or offer medical advice. However, she has a thorough knowledge of normal childbirth, interventions, complications, breastfeeding, etc. I'm not very medically-minded which is why becoming a midwife doesn't appeal that much to me.

My next step after becoming certified as a doula, will be to attend a midwife's assistant training workshop at 'The Farm' to get a better grasp on the medical aspect and get certified in neonatal resuscitation and other useful skills and just basically add to my knowledge, resume, and skill-set. Then I'll fall somewhere in-between, I guess.
re: The Doula Thread
By d4jmember has saluted, click to view salute photosPremium member Comments: 12490, member since Fri Aug 27, 2004
On Thu Mar 22, 2007 09:26 PM
Cool - I know about the Farm - I have one of their cookbooks. Didn't know it was still in existence!

What I'm gathering from this thread is that a doula is a volunteer position?
re: The Doula Thread
By SaraTheGrouchmember has saluted, click to view salute photosPremium member Comments: 8600, member since Thu Apr 17, 2003
On Thu Mar 22, 2007 11:38 PM
So basically, if a woman chooses not to have an OB deliver the baby, she'd need at least a midwife present? Or can the doulas actually perform the delivery too in addition the emotional support?

PS - My name doesn't have an H in it.
re: The Doula Thread
By oz_helenmember has saluted, click to view salute photosPremium member Comments: 11196, member since Sat Aug 10, 2002
On Fri Mar 23, 2007 02:54 AM
Yes, Sara, a doula doesn't replace a midwife, so if you didn't have an OB, then you need a midwife present. I don't think that a doula would be trained in dislodging a cord from around the baby's neck, for example.

But anyone can "catch" the baby. You don't need to be a medical professional to do that. I was looking at a website today and there were pictures of a birthing mother's father (the baby's grandfather) catching the baby as it came out. I thought that was pretty cool - they'll always have that bond.

Helen
re: The Doula Thread (karma: 2)
By panicmember has saluted, click to view salute photosPremium member Comments: 11592, member since Thu Dec 16, 2004
On Fri Mar 23, 2007 05:05 AM
Nadia, I could have used your doula experience the other day. I had a big Mexican dinner, and I really needed some breathing exercises to push that baby out the next morning (if you know what I mean). But enough about that. I don't know why women are so whiny about childbirth. I mean, women used to just squat down behind a tree and *plop* out shoots the baby and then back to work. No epidural. No doula. No three months of vacation. I think women are getting too lazy in this day and age. Doulas represent everything that's wrong with this country. Pandering to pregnant women. Come on, ladies! It's natural!! Squat, push, and back to work.
re: The Doula Thread
By oz_helenmember has saluted, click to view salute photosPremium member Comments: 11196, member since Sat Aug 10, 2002
On Fri Mar 23, 2007 05:24 AM
^*SLAP*

:P

Helen
re: The Doula Thread (karma: 1)
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Fri Mar 23, 2007 06:33 AM
Panic, actually there are techniques that you can use to assist in releasing your grande chimichanga. Interestingly enough, many of the loosening up and relaxation techniques for birth are also effective in dealing with constipation. However, my experience with spicy mexicam meals is that they usually don't need much help coming out the next day. :O

So basically, if a woman chooses not to have an OB deliver the baby, she'd need at least a midwife present?


Most women who choose to birth at home choose to have a midwife, but some actually prefer to have a UC - which stands for Unassisted Childbirth, and the woman and her partner birth without assistance. I presonally, would not be comfortable having a UC, but some women feel strongly that UC is the option for them.

Some women who birth at home have a midwife and a doula. A one-on-one relationship with the midwife can result in the midwife performing as midwife and doula. Midwives often bring an assistant or apprentice to the birth, as mine did, and the apprentice sort of acts as a doula. Of course, this saves the parent/s some $$, but still, some women will choose to hire both a midwife and doula.

Or can the doulas actually perform the delivery too in addition the emotional support?


No, the doula is hands-off as far as the birth goes. And in women-centered childbirth, the language of empowerment is important, so we don't say that anyone 'delivers' or 'performs the delivery'. The woman births the baby. She's in control and in charge.

I'm going to be trained as a midwives assistant eventually(more about that training HERE), but when I am acting as an assistant, I will be playing a different role than when acting as doula. For instance, when I am assisting a birth as a midwife's assistant, my doula services will benefit the situation. However, when doula-ing, the midwife's assistant hat will come off completely, offering no medical assistance, advice, or input during the birth.

Most doulas are going to be working in a hospital. The doula interfering with hospital staff will do nothing but create tension in the birthing room, and create hostility between doulas and staff. This produces bad outcomes for the mother, and bad outcomes for doula's reputations working in hospitals.

Sara, sorry about mis-spelling your name. I know alot of Sarahs and Saras, and sometimes the H slips in when it's not necessary.

What I'm gathering from this thread is that a doula is a volunteer position?


d4j, Doulas charge anywhere from $300 - $800 per birth. Doulas-in-training often offer their services for free in order to get the required amount of attended births for their certification. After I get my certification, I still plan to offer volunteer services to clients in domestic violence shelters because of my experience working with victims of abuse.
re: The Doula Thread
By pelerrojamember has saluted, click to view salute photos Comments: 1125, member since Fri Mar 18, 2005
On Fri Mar 23, 2007 06:46 AM
Thanks for the info! Interesting as always!

I have a brief question: I'm not pregnant yet and wont be for a couple of years but something has been nagging at me - I'm probably 99% sure going to end up having a c-section because I have diabetes and us diabetics tend to have big babies. Would it still be reasonable to hire a doula?

I'd still like to have some control over everything (ie. NOT have the doctors wisk Jr. away for 30 minutes before I even get to see them etc). I also imagine I'll be completely freaked out by both surgery and the fact that motherhood was iminent. And as for my hubby...well, let's just say he *really* hates the idea of someone cutting into me and is likely to freak out.
re: The Doula Thread
By Queen_Jojo Comments: 4947, member since Sat Aug 27, 2005
On Fri Mar 23, 2007 06:52 AM
^^Panic, not all women are lazy, and not all women want epidurals!
My daughter, who didn't have an epidural, was up and about 1/2 an hour after delivering her son and did her first dance comp when he was 3 weeks old!

Queen_Jojo
re: The Doula Thread
By Birk Comments: 278, member since Mon Nov 14, 2005
On Fri Mar 23, 2007 07:20 AM
Pelleroja wrote:
I'm probably 99% sure going to end up having a c-section because I have diabetes and us diabetics tend to have big babies. Would it still be reasonable to hire a doula?


I don't think you should make up your mind on that yet. There are options and you should decide at the time. I am speaking from experience here. I had two midwife assisted natural births. One baby was 10:10, one was a diminutive 10:1. No pain meds, no episiotomy, not forceps. There as a little bit of tearing with each since both decided to stick a hand out and wave, but no problems healing either.
Also, IMO, a doula benefits anyone. You might need your hand held and some information. Hubby cannot always provide that. A doula is informed and can help you get the birth you need, Caesarean or not.
re: The Doula Thread
By NadiaLadidamember has saluted, click to view salute photosPremium member Comments: 4229, member since Sun Dec 19, 2004
On Fri Mar 23, 2007 07:33 AM
pelerroja, while diabetes raises your risk factors, there are measures you can take to prevent pregnancy/birth complications which could potentially result from diabetes. You should contact a specialist before you try to get pregnant to intensively micomanage your diabetes before and during pregnancy. This can greatly reduce risks such as big baby, hypoglycemia, and other complications. These measures may result in a healthier baby, and at the same time, reduces the chances of 'having' to have a C-section.

And yes, doulas will attend a C-section, and it's reasonable if that's what makes you comfortable. If the situation was borderline, and you knew that C-section was a possibility, but wanted to shoot for a vaginal delivery, then a doula would be HIGHLY recommended.

Jojo, don't listen to panic. He's notoriously full of crap.
re: The Doula Thread
By pelerrojamember has saluted, click to view salute photos Comments: 1125, member since Fri Mar 18, 2005
On Fri Mar 23, 2007 04:06 PM
Thanks for the great advice guys :)

Hoping I wont 'have to' have a c-section and shall be looking for a good team of specialists in NJ once I relocate...or at least a team who wont automatically intervene with every diabetic. But I'll also be looking up a doula for some extra support, regardless.

Just out of curiousity, what does one to to qualify as a Doula?
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