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Health, Home, and Happiness: Why do I need a doula? An interview with a California Student Doula

Wednesday, August 26, 2009

Why do I need a doula? An interview with a California Student Doula

I wanted to give you all some information on having a doula, especially if you're planning a hospital birth. I think they are really important to have in any birth, but especially if you are going against the grain in a hospital setting (more on that Friday). Kim agreed to an interview for me.

Personally I've never used a doula, but we've only had home births. If we ever have to transport to a hospital, I do have one who has agreed to meet me there. She knows my wishes for labor and my newborn, and knows her way around both of our hospitals.

Have any of you used a doula? Have any of you wished that you had? Kim can answer any questions you might have in the comments section too.

Can you tell me a little bit about your birth experience and how you decided to become a doula?

My journey toward "Douladom" started when I became a massage therapist. My sister had a baby just after I was certified and, although I didn't know what a doula was at the time, I stayed with her through every contraction. I supported her and did whatever she needed me to do; I even fed her Jell-O at one point! Then, once I was ready to have children of my own, I was one of those moms that reads everything she can get her hands on and I kept seeing blurbs about doulas and it sounded interesting - like something I might enjoy. I learned a lot about childbirth and was especially inspired by a book called "The Birth Partner". Once I became pregnant, I focused more on being a mommy, but I had that in the back of my head and once my daughter was old enough, I pursued doula training. I am still a student doula, and I'm currently working on the practical part of my training. What that means is I've finished all the educational requirements and I'm currently offering my services for free until I can complete the certification process.

What's your contact information?
-My phone number is 707 235-2214 and I'm reachable by email at
(she's in the Santa Rosa/Bay Area of California)

What do you do, as a doula, that is different from what is offered in hospital-sponsored childbirth education classes, independent childbirth classes?

-I've heard (an can attest to the fact) that, in the heat of labor, all the classes, all the books, and all the practice can go out out the window. The best preparation in the world is useless if it is forgotten. As a doula, one of my jobs is to remind the parents of what they learned. I might suggest a position change, I can help to interpret what medical staff says, I can help greatly with breathing and comfort measures. And even more importantly, I'm there for emotional support. Childbirth education is very important and I highly recommend it but education won't be there holding your hand and telling you that you will, in fact, live through this.

What are some important parental decisions that childbirth education classes often skim over?

-The one that comes to mind immediately for me is immunizations. There are definitely two schools of thought on this. When I was pregnant with my daughter, we were quite torn between them. We took our childbirth education through our hospital, and although they addressed the issue, it was mainly to reassure us that their immunizations were safe and they did not believe there was a link to autism. Nobody really told us why we should get our children vaccinated and certainly nobody suggested there may be reasons why not to vaccinate. We had to learn that on our own.

Can you tell us a little bit about how hospitals, doctors, and certified-nurse-midwives often have to cater to insurance companies and outdated hospital policies rather than what is in the best interest of the patient?

-Let me start by saying that I truly believe that hospitals, at least in my area do seem to be making strides in that area. There is still a long way to go. The basic problem is that the medical staff at a hospital are responsible to more than just you. They have to answer to the hospital policies, and to the insurance companies. And when it comes right down to it, they will get in a far bigger mess for NOT using interventions when a mother or child is in perceived danger than they would for medical intervention that may or may not be necessary. No matter how disappointed the mother may be she will, eventually, go home. The people that write the paychecks are here to stay.
Not to say that medical staff don't care about you- I truly believe that most of them do and many of them believe in "natural" or non-medicated childbirth but often, their hands are tied. Many would love nothing more than to practically support your wishes for, say, a non-medicated birth but you are one of several laboring mothers to whom they must attend -not to mention the charts and paperwork involved with each- and they simply don't have the time to offer the care and support they'd like. Often, it's that lack of continuous support that makes the mother feel more alone and therefore more fearful and less able to handle the discomfort of contractions. It's a vicious circle.

How do doulas help in a home birth setting?

-Often in a home birth setting, midwives double as doulas. The benefit to having a doula is that her work compliments that of the midwife. This allows the midwife to focus on the birth itself and give the laboring mother her best attention that way. It's truly beneficial for everyone involved because the parents feel very well supported, and the midwife can be even more effective in her role. It's a beautiful synergy- doula helping midwife, midwife helping doula and that all gets transferred to the support of mom and partner.

Anything else you'd like to add?

-When it comes down to it, doulas are all about support. Women often believe that between their partner and, say, their mother they will have all the help they need. And that may be true, but labor can often be much different than you'd pictured. Sometimes when labor is long and drawn out, your support can get pretty exhausted. Part of a doula's job is to relieve them. We make sure they eat, and we can often help to give you the continuous support you need while they get some rest. Also, there are times during labor when your mind may completely change. You may have chosen someone to help because you thought they'd be encouraging but now their presence feels more like a cheerleader at a sporting event than a birth. A doula allows you to focus on the task at hand, rather than family politics.

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Anonymous Anonymous said...

I agree that you need that outside support person there. I had a midwife with my first but in the end my 9 lb breech baby was not going to come out of me the natural way with one or both of us dying. I ended up on an operating table with a husband who was more scared than I was. The hospital "broke" there one support person in the O.R. policy and allowed my mid-wife to come in as well. Even though it was her first c.section she did an awesome job. My husband and I could not thank her enough. When Emma was born blue and they had to push that dreaded button on the wall to call in the emergency pediatric team - our mid wife was right there at my head, holding my husbands hand and rubbing my forehead till we finally heard our baby girls first cry. When my blood pressure started falling and I was blacking out - she was the first to notice and alert the doctors of my need. It sounds like a doula would have done the same thing. I would encourage any one to look into that extra "outside" support person no matter what the cost. Your family can get to emotional some times and unfortunately the doctors have other patients and the nurses shifts usually change in the middle of you labor - a support person it there for you and only you the whole time.

August 26, 2009 at 12:37 PM  
Anonymous Anonymous said...

I could not have made it without my doula. We hired a midwifery student to act as my doula since the birth center I used was 45 minutes away. The plan was for her to come to our home and labor with me, then we would travel to the birth center when it was time. It was January and we had a huge snow storm. My labor went very fast and we had to pull over on the side of the road because the baby was crowning. Our doula kept us both calm and focused and saved the day. Afterwards, she came by to visit and answer questions. She was a lovely resource. I can't encourage using doula services enough.

August 26, 2009 at 3:00 PM  
Blogger Cara said...

'spirals' was she born in the car? Wow!

August 28, 2009 at 11:17 AM  

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