What is a birth doula and why should I have one?

As doulas we accompany you during labor, taking care of your emotional needs throughout birth. We also provide support and suggestions for your partner that can enhance their experience of birth. How this applies to each woman can vary widely: some women want a gentle, reassuring presence at their birth to help them with breathing and comfort measures... others want a full-blown labor coach to enforce their birth plan... still others just want an extra person on hand to take pictures, coordinate relatives, watch kids and run errands. We don't go to births with any personal preconceived ideas of how it should play out; your birth plan is our birth plan. We are there to discover what your wants and needs are, then exceed them in every way possible.

If you like statistics, this might impress you. In research studies doulas have been proven to...
Decrease medical intervention in labor:

• Reduce the need for cesarean by 50%
• Reduce the length of labor by 25%
• Reduce the use of oxytocin by 40%
• Reduce pain medication use by 30%
• Reduce the need for forceps by 40%
• Reduce epidural requests by 60%

6 weeks after birth, mothers who had doulas were:

• Less anxious and depressed
• More confident with their baby
• More satisfied with their partner (71% vs 30%)
• More likely to be breastfeeding (52% vs. 29%)

*These statistics appear in 'A Doula Makes the Difference' by Nugent in Mothering Magazine, March-April 1998. **Study cited in "The Doula" by Klaus in Childbirth Instructor Magazine, Spring 1995.

What about the dad, will he feel replaced?

Many people are confused as to how doulas interact with the laboring woman's partner. Rest assured that our job is to bring the soon-to-be mom and dad closer together during labor. We do not replace the partner or usurp his role. Having a doula present enables the father to relax because there is someone there to guide both of them through the process. Most partners have had very little exposure to birth and laboring women. We am there to reassure the dad and show him labor support skills so that he can be involved in the birth right from the start. We take the burden off his shoulders and allow him to participate at whatever level is most comfortable for him. Even though seeing his laboring partner in pain can be scary, we work hard to encourage him that what he is seeing is normal and there are ways that he can soothe her discomfort. Many glowing testimonials come from fathers who are just amazed at how helpful and supportive the presence of a doula was for him.

Why would I want a stranger at my birth?

Trust us, by the time you give birth, we will not be a stranger! From the time you first contact us, we will begin to build a relationship with both you and your partner. As a matter of fact, for most typical hospital births, it is likely we will be the only person you know caring for you. Most OBGYN's and nurse midwives work in a group and whoever happens to be on call during your birth is who you get. You will also be randomly assigned a nurse you have never met and will likely go through one or more nurse shift changes. As your doula, we will be a constant reassuring presence for you and your partner, regardless of who the other support staff may be.

How is a doula different from a midwife or nurse?

We provide only non-medical support for the laboring woman. Doulas do not perform any medical procedures such as: checking baby's heart rate, vaginal exams, blood pressure checks or catching the baby. Because we am not responsible for your medical care, we are free to devote our entire attention to helping you through each contraction.

What if I want pain medication?

We are trained to support women in ALL birth scenarios. Even if you are planning to use pain medication or are just "open" to using it, we will be an invaluable part of your birth team. Doulas can help you gather all the information you need to make an informed choice about pain medication and give you a realistic picture of how you can expect your labor to change. Just because a woman has pain relief, it does not mean she has stopped laboring or needs less support. Many times the emotional needs of the laboring women are even greater when she has medication. We can also help with positioning and other comfort measures to reduce the negative effects of the medication and will be a key support during pushing which can require more coaching with an epidural. For the 5 to 15 percent of women who do not receive complete pain relief from an epidural, our role becomes even more important in helping the woman to cope with her contractions.

What do Doulas cost?
Most doulas are willing to work with you to help afford the service, so always ask about payment options, and whether or not they offer a sliding scale fee.

If a new doula feels like a good fit for your personality, then they might be the best doula for you. Or perhaps you prefer to pay a little more for a more experienced doula. Either way, it's horrible to see couples who want a doula go without because finances are tight. When it comes down to it, though, don't let money stand in the way of hiring the doula that fits you and your family best. Childbirth is a special time in your life, and a once in a lifetime experience for you and this newborn. Your baby, your health, and your memories and experience of the birth are worth the price.

Ask yourself, "how much did we spend on our wedding, or our vacation last year?" The birth of your child shouldn't be the time to get frugal and cut corners. When comparing rates, don't forget to consider the extras that many doulas offer with their doula services. Make sure you find out the details of the payment. Any fees for the extras should be clearly explained in their contract.

Some women have been able to get insurance to help pay for their doula. This is something that varies from insurance provider to insurance provider. You can always ask your insurance company. Most of the time, you'll need to hire and pay for the doula yourself, and then later approach your insurance company for reimbursement.

If your insurance company turns down your claim, appeal it. This may or may not get your doula covered, but you'll make clear to the company your interest in having doula services part of the benefit's package. They may include the benefit in the future.

Another option is to use your flexible spending account, if you have one.