Why should I hire a doula? We believe every woman benefits from the special attention and continuity of care that a doula can give. Statistics repeatedly show that doulas can make a difference in the outcome of your birth. Here are a few examples taken from the book Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth, by Klaus, Kennell, and Klaus (1993):
- 50% reduction in the cesarean rate
- 25% shorter labor
- 60% reduction in epidural requests
- 40% reduction in oxytocin use
- 30% reduction in analgesia use
- 40% reduction in forceps delivery
What if I have already decided to get an epidural? Many women assume that having an epidural means that you just sit back and enjoy your labor. Eventhough you lose mobility with most epidurals, you still need to change positions frequently to help move the baby down the birth canal. You will also experience the emotional impact of the labor as your body moves through the process. You may get discouraged, fearful, tired or weepy, and sometimes you have to wait to reach the appropriate dilation (usually 4-5cm which can take many hours). Once you request the epidural it may take time for an anesthesiologist to become available. Your doula will be there to give emotional and physical support and to help explain the procedures that go along with an epidural (IV,catheter, monitors, etc.). An epidural may slow your progress, and the doula can stay with you while other family members or support persons take a break or catch a nap. Many of our clients do get epidurals, and we always manage to stay plenty busy!
Is a doula a midwife? While some midwives have become certified doulas, when we are representing ourselves as doulas we do not perform any medical tasks. We don't take blood pressure, monitor the baby's heartbeat, do vaginalexams or administer medication. Most of us are from non-medical backgrounds, but we are highly trained in the mechanics of labor and in comfort techniques. We may use massage, counter pressure, position changes, hot or cold packs, aromatherapy and visualization to help you deal with the pain and discomfort of labor.
Do you come to my home when I'm in labor? Depending on the type of service you request, you may spend early labor at home with your doula or you might meet the doula at the hospital. If your water breaks, your doctor will want you to come into the hospital to be checked. In some cases you might be sent back home to see if contractions will start on their own. If you do plan to stay at home in early labor, your doula can help make you comfortable and be an attentive companion. We can usually tell when you are entering active labor and will assist in the transition from home to hospital.
How much do doulas charge? In this area the price can vary from $250 to $600. Many of us have a list of services that can be priced individually or as a package. These often include prenatal visits, labor and birth, and a postpartum visit. While some people think it's expensive, consider the service: we agree to reserve the weeks around the mother's due date and are on call 24 hours during that time; we often stay up all night with women in labor and leave our families for extended periods - for many doulas this necessitates hiring a babysitter; and we perform physically demanding tasks during labor such as massage and counter pressure and are often onour feet for hours at a time. The average amount of time we spend overall with first-time moms is about 24-36 hours. By the time we pay our expenses which include training, certification, pagers, babysitters, and travel, we might be fortunate to make minimum wage, and volunteers (usually doulas in training) are actually spending their own money to assist you. So why do we do it? We're committed to providing a much-needed service in our community and believe that we are making a difference in the lives of women and their families.
What if my doctor doesn't want a doula at the birth? Unfortunately there are some doctors who have misconceptions about our role. We do not make your choices for you or challenge the doctor when a decision has to be made, but apparently some people who call themselves doulas have done just that and have alienated doctors by their behavior. We are glad to provide information for you to give yourdoctor that outlines our standards of practice and our code of ethics. Often this clears up the misunderstanding, but some doctors will still refuse to work with you if you have a doula. On the other hand, many doctors in our area actually refer their clients to doulas from our group. If you are planning to have a doula at your birth, you might want to shop around for a doula-friendly practice.
Are doulas covered by insurance? Many women have received reimbursement by their insurance companies but it is not a standard covered charge at this time. We can give you a receipt for your payment along with supporting information that you can submit to your insurance company. You are probably more likely to receive reimbursement if you have a non-medicated birth because they see the savings over paying for medication (an epidural alone averages $1700). Doulas of North America is working hard to secure reimbursement for doulas and we hope to see it become commonplace in the future.
My husbandwill be with me - isn't that enough? We can never replace the support and encouragement of your husband or partner, but our experience has been that we help make the experience much more positive for them by offering suggestions as to how they can better assist you during labor. They may not feel the pain that you're feeling, but they often feel anguish and a sense of helplessness while watching you go through the birth process. Some men deal with this emotional upheaval by "checking out." They may sleep, watch a football game, or just seem to withdraw from you. We try to pull them back into the process by showing them how they can make you more comfortable and be there for you emotionally. There is a great article about this topic on DONA's (Doulas of North America) website. You can access it from the DoulaArticle link on our home page or by clicking here: Dads and Doulas.
What if I end up having a Cesarean? To quote Forrest Gump's momma, "Life is like a box of chocolates...you never know what you're gonna get." Childbirth can and does take some unexpected turns, and a doula will be there to help you navigate through what may be a very stressful time. If you need an emergency Cesarean, we will not be allowed in the operating room. In other situations it will depend on the doctor and the hospital regulations. If we are not allowed to go with you, we can use the time while you're in surgery to move your belongings to the postpartum area or we can stay with friends and family members and give them emotional support while they wait for news. We are often allowed into recovery - that way the father can be with the baby in the nursery and you won't be left alone. Some women hire doulas even when they are having a scheduled Cesarean because they know the value of having the prenatal and postpartum visits as well as someone to answer their questions and give emotional support before and after the birth.
Do you have other questions about birth doulas? Please e-mail us a Pikes Peak Regional Doula Association and we'll do our best to answer them as quickly as possible.
