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Tuesday
Nov062012

Gettin' our doula on

Let's talk about doulas. We've hired one, for starters. And both Mike and I feel really good about the decision. I know a doula is not for everyone - everyone approaches childbirth differently. One of my sisters gave hardly a thought to her own experience, and even though she described her 19 hour labor as the worst thing ever, she had a beautiful baby boy with no complications. But as much as I love and admire her, she and I approach this whole baby-having thing very differently! She didn't read any books or information; I'm reading everything I can get my hands on. She barely thought about what to expect or what might happen; I can't stop thinking about it.

I've educated myself, and Mike is educating himself, on what happens physically during chlid birth. I know there is very little we can do to control those things, and that's fine. As long as I'm armed with knowledge, I can deal with that. But what had me so anxious was the environment, the atmosphere. I was scared to be so out of control of those things. I read and heard a lot of stories of women who were caught up in situations they didn't understand and later regretted. My stepmom is in nursing school and currently learning about labor and delivery, and with all this new information, she just keeps saying, "I wish I could go back and do my births over again." Interventions were used that were probably unnecessary, but she was not really involved in the decision making. Someone said, You need this, and so she got it. 

I'm worried about my ability to deal with the pain, but I KNOW I would not deal well with that type of environment. I know myself well enough to understand that if there are decisions being made and I'm not involved, or I'm confused or unsure, it will only make things much worse. And that kind of stress is not good for a healthy, progressive labor, from what I understand.

Here's the thing. Despite all my reading, I still know nothing about what is going to happen in real life. I've never been there, done that. All you mothers who have done this before are probably laughing at my preparations, thinking nice try, it'll all mean nothing when you're in the moment. Which is EXACTLY why we hired a doula!

If you're not sure, a doula is basically a birth coach, companion and advocate. They are not medically trained like a midwife, but a "real" doula is certified and educated. When we first shared that we were considering the idea, several people said to me, "You're paying someone for that? Hell, I'll do it!" But those people clearly do not get it. If I just wanted someone to hang out with me, I'm covered. My mom and my husband will be with me. What I need is someone who knows what's up, who understands my thoughts and preferences, who understands what is happening physically, who can navigate the hospital system. 

What I picture is this: It's been hours, and I'm getting weak and start to think I can't do this anymore. The nurses pick up on this and try to talk to me into some kind of medical relief. Without the doula, I'd almost definitely say yes because I don't know what else to do. And Mike and Mom wouldn't dare argue because they love me and see I'm in pain. But with the doula, other options might be offered. She would explain that when you start to feel helpless and hopeless, it's usually a sign that you're nearing the end. She would remember our previous conversations and know that I'd like to try alternative coping methods first. She's know what to suggest and be able to walk me (and Mike and Mom) through things. When I tell her to screw herself, give me the drugs, she can ascertain whether I really mean it or if I'm just panicking. Ultimately all decisions are up to me and the doula is there to support whatever I choose and whatever happens, but she is an educated third party who is focused 100% on my situation (unlike overworked nurses who are attending to many patients!), and who is not emotionally invested in the same way my family is.

To elaborate, the doula we hired is not trying to shove an unmedicated birth down our throats. She has attended home births and hospital births. She has been with women who went in knowing they'd get an epidural, women who didn't want one and changed their minds, women who thought they wanted one and found they didn't need it, etc. She has stressed that she does not have her own agenda - her job is to learn about us and support us any way she can. 

As for me, I'm not bull-headed about having an unmedicated birth. I'm a damn sucker for pain relief! But my approach is that I have no idea what to expect, I can't possibly know. So I want to find out, see what happens, see what I'm dealing with and how I react. Then make informed decisions when they need to be made.

We're working through lots of possible scenarios with the doula so she can understand what we're thinking and get us more information when needed. She also helps us think through pre-and post-birth/labor things too. A lot of women don't know what happens or what is supposed to happen after the baby is born, for instance. So she'll walk us through things like what is the goop they put in their eyes and why. Are we ok with that? When and why do they typically take the baby out of the room, and is that ok with us?

Yes, I know, we're overthinking, we're overpreparing. I get that. I'm ok with that. It's who I am and how I operate. I was anxious before, really anxious. I feel so much better and more calm already, and we've only met with the doula once. That alone, to us, is worth what we're paying her.

Common questions:

1. How much does it cost?
We are paying our doula $625. We are able to use our HSA (by invoicing it as birth education or assistance or something), and we are making payments.

2. What does that cost include?
Two prenatal visits where we go over everything I mentioned above. 24/7 phone and email support throughout the pregnancy. Attendance at the birth - she comes as soon as we call her and stays through the entire thing, even if it takes so much longer than I even want to think about! She helps us get settled after the birth, and leaves when we are comfortable, breastfeeding and ready to be alone. She usually returns the next day to check in. And we get at least one post-partum visit to process everything. She also has a lending library and has already given us several books to pour over. And she has access to lots of information and resources we probably wouldn't otherwise know about.

3. How did you select this doula?
We started by googling doulas in our area and found a local doula co-op. I contacted about 7-8 of them and heard back from three. Of those three, we chose two to interview. (If anyone ever reads this and wants to know what we asked at the interview, I'm happy to share!) We liked them both as they had similar philosophies and approaches. But we had more flexibility in payment with Jen, so we hired her.

4. What if your doula can't be at the birth?
This is highly unlikely, but certainly possible. She knows our due date and will make sure she is available (eg: no out of town trips, etc) before and after that date. However, she may have her own medical emergency or other circumstances that keeps her away. In that case, one of the other doulas in her co-op becomes available. We have the opportunity to meet the other doulas if we want to, but we'll most likely just put faith in that Jen will be there.

5. Does Mike even need to be there if you have a doula?
YES! I've read that some fathers feel threatened by the idea of a doula, but Mike has been on board since the beginning. In fact, he loves the idea because it takes some pressure off him. He was thinking he'd have to be everything to me -- a medical expert, a coach, a comfort. But with Jen in the picture, he can simply focus on taking care of me. In fact, Jen explained that she is really there to support all of us. I think of it like this: Mike is my comfort, my mom is my strength, and Jen is my coach and advocate. We're quite the team! 

I know most people have stopped reading by now, but if you're interested in knowing more, I'm happy to answer any questions. Also check out doula.com as a place to start.

Reader Comments (4)

I think you are wise to do what will make you the most comfortable. Who cares what anyone else thinks/feels, this is your birth! Good for you Shannon. I am so happy that you are at this place where you can make this decision. I, unfortunately, had to have a planned cesarean, but if I did not have to be in that situation, I know I would have had a doula also. I don't think I'd be able to understand anything but PAIN, and I'd want an advocate there for me other than my husband and mommy.

Anyway, I'm so excited and happy for you, Mike and the baby! Your little one will be here soon...eeeekk!

November 6, 2012 | Unregistered Commenteralibaba41

If I could go back, and if money wasn't a huge issue (well, I guess it wasn't that first time), I would absolutely consider a doula.

I had an epidural after well over a day of laboring, and when it was time to push I couldn't tell push from pull. I had no idea how or where or when. And on top of that, I had to do everything on my left side because when I moved to my back or towards the right the baby's heart rate dropped to dangerous levels. So there I was, on my left side, with that cross bar that looks like it's for doing gymnastics, and a bedsheet wrapped around it, with me pulling on that and trying to push a baby out. The nurse said "if you're pushing in the right place, you'll feel like you're pooping, and you might a little bit, and that's ok." I was SO DESPERATE to FEEL something and know I was doing it right and making progress, that I just prayed I would poop, so I'd know. But nothing. And then baby apparently would come down a bit. And they'd say "breathe" and she'd go right back up. And repeat. Yadda yadda. Anyway, all this to say that maybe if I'd a doula in there with me, someone would've better articulated the how, where, and when and I'd have had a vaginal birth.

One other suggestion? Have Mike and your mom PRACTICE their counting. Sounds silly, I know, but I was SO IRRITATED with my mom and husband, who counted in hushed, nap-time voices. Nice and slow and soothing and quiet. OMG. *I* wanted the counting you see on Baby Story or like, Biggest Loser. I wanted get-er-done, hardcore COACHES yelling at me to keep me IN THE GAME. I wish we'd discussed that beforehand. LOL.

November 6, 2012 | Unregistered CommenterLindsay A

We considered a doula with our first pregnancy but ultimately decided not to because I was pretty sure I'd opt for an epidural. I always viewed doulas as assisting with pain management but I 've heard otherwise. Katie (From Magerks to I Dos) had a doula and had a really good experience. I know others that had doulas with great experiences. And another way to look at the situation, the doula is acting as an advocate for you AND Mike. Oftentimes, especially when in the midst of labor, people will just concede to whatever the hospital staff tells them to because they don't want to make waves. The doula will make sure your wishes are heard. She'll also provide support for Mike (and this is perspective I got from dads who've used doulas).

Good luck! I'm excited to read your experience.

November 7, 2012 | Unregistered CommenterCharm City Kim

So excited to be able to share the miracle of the birth of your baby with you and Mike. Thank you for including me in this special day. Love you so much.

November 7, 2012 | Unregistered Commenterjill

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