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The doula dilemma

When we started this pregnancy I never questioned whether I wanted a doula at my birth, it was just a given. I’ve read the statistics about reduction in c-sections and requests for pain medication etc. Add the fact that Joel was so nervous about my childbirth that he actually asked if I’d be mad if he waited in the waiting room like they did in the 1950’s (Obviously my answer was hell yes I’d be mad!). It just seemed like a no-brainer.

When I realized how expensive they can be I was a little discouraged but I found out the practice we’re going to has doulas on staff at a much lower rate than hiring a private doula. Win!

Except now I’m having second thoughts.

While the practice doula is significantly less than a private one it’s still a good amount of money for us. So, I’m going to try and sum up why I’m having doubts and hopefully you all can tell me if there’s some big thing I’m overlooking that will make it worth the money.

1. We won’t get to have a personal relationship with the doula. There are three that rotate on call so we get who we get. We’ve met one and she was really nice but I’m worried we’ll end up with someone we’ve never met and end up clashing personality wise somehow.

2. A big benefit I keep hearing is that a doula comes to your house and helps gauge when you should actually go into the hospital  so you’re not “on the clock” sooner than you have to be. The doulas from the practice don’t do that. They get called to come in once we’re in the hospital and confirmed in active labor. If I’m not very dilated they won’t come even if the hospital decides to keep me there.

3. No home post partum visits. I’m not too concerned about this but it’s a benefit I keep hearing about so I thought I’d list it.

4. Only halfway through the Bradley Method classes Joel is feeling pretty confident about being my primary coach.

5. My mom will be there as a secondary coach. She is an RN. She also has had 6 natural births, 5 of which were at home. She has been a coach for six of my two sisters’ kids. I have watched her interact with the nurses at some of those births and she is very good at understanding exactly what is being recommended and explaining to my sisters why it is necessary or not.

6. I trust the doctor and midwives of the practice. They have an extremely low c-section rate and are huge advocates of natural childbirth. I trust that they will not recommend anything out of convenience or because they “want to get to their golf game.” If they feel I need an intervention I trust they will explain the reasons and that it will be in the best interest of me and the baby. I don’t foresee us needing a doula to advocate for us.

Given all those reasons I’m not sure what purpose a doula would serve that isn’t being served by Joel and my mom as coaches. Wouldn’t a doula just be redundant? Or am I missing something big here? I will spend the money if I can find a really good reason because I want my birth to go as smoothly as possible. At this point though I’m feeling like the support network I have set up is sufficient and adding a doula would be doing nothing more than adding an additional expense.

Am I wrong?

 

14 Responses to “The doula dilemma”

  1. Jade says:

    Hi Abigail,
    Thanks for posting this – I am having a similar dilema!

    Before we even started trying I had presumed I would get a doula, even though it’s not very common in Scotland, like you, I read about the statistics etc and thought, well of course I need a doula!

    Currently we have decided on a birthing centre which is all natural and stangely for the first 3 months I seem to have forgotten that I was going to get a doula. If all goes well and I end up going to the place I’m booked in I don’t think I’ll need one. I am confident that they have the same ideals as me.

    However, my nagging concern is what if something changes and I become high-risk and cannot go to the centre I want but end up in the hospital, then I know I will want to have a doula because the norm there is not for natural birth. But by the time that happens it may be too late to get a doula that is available, I think there are about 3 in the city we live.

    Thankfully cost is not too much of a concern, we’re not paying for delivery, I don’t think it’s even possible to do it privately in Scotland and the doula fees whilst still a consideration are not particularly high.

    Good luck with your decision,
    Jade

    • abigail says:

      Honestly if cost wasn’t a concern I would have a doula without question. Almost everyone I talked to said that if my mom didn’t have so much coaching experience they would highly recommend one. I don’t know what your support team would be like without a doula but I know they can be an amazing help, especially if you’re planning on avoiding any unnecessary interventions. It’s not an easy decision either way, trust me, I know.

  2. Mariah says:

    I haven’t actually *had* a baby yet (soon please!) but from what you described, it seems like your mom would be perfectly suited to the supportive-and-knowledgeable role that I picture the Doula to be in. Especially since (I’m assuming) she can also be there before & after for the home visits and things that you said the practice doula wouldn’t be doing anyhow. Perhaps I’m being naive, but I *think* you’ll only get pushed into things as much as you let yourself (for example, if you end up at the hospital). If you can be a strong advocate for yourself (and again, I have no experience and no idea how hard/easy this will be), I think you’d be okay even without the doula. I’d go without. But you’ve gotta make it up in your own mind. Good luck!

    • abigail says:

      I’m thinking you’re right. I’m hoping that being pushed into anything won’t even be an issue but I know I’ll have Joel and my mom there to advocate for me, if necessary and it helps that I’ll have the back up of knowing my doctor/midwife is also on my side. The only slight concern would be the nurses but based on everything I’ve heard about the hospital they really shouldn’t be an issue.

  3. Zahara S. says:

    If my mom was as experienced as your mom, I think i would be more comfortable just having her there than a “trained” doula. I might change my mind if I ever have babies but I think that there will never be a better advocate than your own mom. Plus you already know her so there is no personality clash, and I bet she’ll make as many home visits as you need without a fee : )

  4. Melisa Wells says:

    I don’t know, call me old school (because I am) but having Joel there and your mom too, who is an R.N. AND obviously knows you very well 🙂 seems to be enough to me. When it comes down to it, all you need is a team that will get you safely through the birth. You’ve already got a built-in cheering section.

    • abigail says:

      Definitely. I know having a private doula would be a nice luxury and would even qualify as a necessity if I couldn’t have my mom there for some reason. But I think my support team will be great as is.

  5. Beth says:

    I would have loved the opportunity to have a midwife/birth center for my birth. The husband and I even did some reserach about it, but we live in a rural area where it isn’t common there aren’t really any options for us. I think it’s awesome that you have these opportunities! A.K.A. I have no opinion for you since I never was able to consider the options!

    But for the record, we LOVED the hospital we delivered at! My prenatal care clinic I was less happy with, but the hospital and delivery were amazing.

    • abigail says:

      We actually are birthing in a hospital. It’s a really great hospital and their policies are very supportive of natural birth. Plus they have a below national average c-section rate. And the practice we’re going to has both OBs and midwives. So, I think we’re getting the best of both worlds.

  6. Tricia says:

    Hi there! I’m a new reader, but I’m pregnant with #3 due this summer and I thought I’d chime in.

    1. Your husband might feel like he’s going to be the best labor coach on planet earth, but because he’s never coached you through labor before, he has no idea what’s going to happen. Plus, it’s your first! Labor and birth RARELY go how we expect, not that that’s a bad thing, just that feeling confident beforehand isn’t the best indicator of how you’ll “perform” if you get what I mean.

    2. Your mom sounds like she is truly in a very good place to be an excellent labor coach. But I know for me? My mom annoyed me. And my mom and I are best friends, thick as thieves. Like I said, in labor, you have NO IDEA what’s going to help you or annoy the crap out of you. A doula is an outsider that is trained in ONLY HELPING LABORING WOMEN, not in being your mom and worrying about you 😉 The “mom as doula” model is a risky one!

    3. When you’re at a 6 and not progressing, but your water isn’t broken yet and the doctors want to break it to move things along, will you be able to deny that or think clearly? That’s an intervention that can lead into the “cascade of intervention”. When you’re in so much pain you can’t open your eyes, and they’re suggesting an intervention, and your hubby is just worried because he’s never seen you in this much pain, and all the things he was taught to do in the Bradley class are making you want to punch him, who will be your advocate? That situation I described above isn’t atypical: it’s normal. A doula KNOWS what you want, even when you and your birth partner are too discombobulated to remember what the hell you decided.

    I’m giving birth this time at a birth center after two hospital births. I’ll have a doula, whom I’ve already met with and love. My husband has been there through the births of our two sons, and while he was so sweet, he just wasn’t a doula! We took Bradley for our second birth and I chose to do hypnobirthing this time around. Bradley didn’t work for us, but it’s an awesome program for lots of women! You’ll love it, I’m just a weirdo. I say try and find a NEW doula that’s trying to build a portfolio, one that is volunteering to be a doula so she can get her name out into the birthing community. They usually do it for free or for VERY reduced prices.

    Doulas are worth their weight in gold, and you need one that can come to your home. One of the main reasons that women end up on the cascade of interventions ride is because they went to the hospital TOO EARLY. Even the most birth-friendly of hospitals have protocols in place to prevent litigation. You can’t be in labor for more than 24 hours without significant progression or they start interventions. You need a doula that can advocate FOR YOUR WISHES, not that of the hospital from which they’re contracted.

    GOOD LUCK! I’m sorry if I seemed rude or snippy, but I’ve had two vaginal deliveries at a hospital and I know what happens. For our second birth, I was so ready to deny ALL unnecessary interventions. I’d been through it before, I was NOT going to have a replay of my first birth. My OB was a huge natural birth advocate and I was ready.

    I ended up with all the same awful interventions, and a husband that was just as confused as I was. That’s why we’re at the birth center this time. I’m NOT SAYING your experience will be mine, no two are ever the same. But I’ve been through it twice, and I know what can happen in the heat of labor!

    • Abigail says:

      You definitely didn’t seem rude or snippy at all! I very much appreciate you taking all the time to write out your thoughts and experiences on the matter.

      I’ve been really lucky to watch my mom act as a birth coach to my sisters. I’ve watched the hospital try to push different interventions and she was always great about explaining them to my sister, knowing what my sister wanted and advocating for her to the staff.

      I know that’s no guarantee that she, Joel and I will be the perfect birthing team but I really believe it is my best option. You definitely brought up a lot of great points and like I said before I really appreciate you taking the time to come by and share your thoughts with me.

      I’ll be following your birthing journey this time around on your blog. I hope you get exactly the birth you’re hoping for!

  7. Tricia says:

    Hi there! I’m a new reader, but I’m pregnant with #3 due this summer and I thought I’d chime in.

    1. Your husband might feel like he’s going to be the best labor coach on planet earth, but because he’s never coached you through labor before, he has no idea what’s going to happen. Plus, it’s your first! Labor and birth RARELY go how we expect, not that that’s a bad thing, just that feeling confident beforehand isn’t the best indicator of how you’ll “perform” if you get what I mean.

    2. Your mom sounds like she is truly in a very good place to be an excellent labor coach. But I know for me? My mom annoyed me. And my mom and I are best friends, thick as thieves. Like I said, in labor, you have NO IDEA what’s going to help you or annoy the crap out of you. A doula is an outsider that is trained in ONLY HELPING LABORING WOMEN, not in being your mom and worrying about you 😉 The “mom as doula” model is a risky one!

    3. When you’re at a 6 and not progressing, but your water isn’t broken yet and the doctors want to break it to move things along, will you be able to deny that or think clearly? That’s an intervention that can lead into the “cascade of intervention”. When you’re in so much pain you can’t open your eyes, and they’re suggesting an intervention, and your hubby is just worried because he’s never seen you in this much pain, and all the things he was taught to do in the Bradley class are making you want to punch him, who will be your advocate? That situation I described above isn’t atypical: it’s normal. A doula KNOWS what you want, even when you and your birth partner are too discombobulated to remember what the hell you decided.

    I’m giving birth this time at a birth center after two hospital births. I’ll have a doula, whom I’ve already met with and love. My husband has been there through the births of our two sons, and while he was so sweet, he just wasn’t a doula! We took Bradley for our second birth and I chose to do hypnobirthing this time around. Bradley didn’t work for us, but it’s an awesome program for lots of women! You’ll love it, I’m just a weirdo. I say try and find a NEW doula that’s trying to build a portfolio, one that is volunteering to be a doula so she can get her name out into the birthing community. They usually do it for free or for VERY reduced prices.

    Doulas are worth their weight in gold, and you need one that can come to your home. One of the main reasons that women end up on the cascade of interventions ride is because they went to the hospital TOO EARLY. Even the most birth-friendly of hospitals have protocols in place to prevent litigation. You can’t be in labor for more than 24 hours without significant progression or they start interventions. You need a doula that can advocate FOR YOUR WISHES, not that of the hospital from which they’re contracted.

    GOOD LUCK! I’m sorry if I seemed rude or snippy, but I’ve had two vaginal deliveries at a hospital and I know what happens. For our second birth, I was so ready to deny ALL unnecessary interventions. I’d been through it before, I was NOT going to have a replay of my first birth. My OB was a huge natural birth advocate and I was ready.

    I ended up with all the same awful interventions, and a husband that was just as confused as I was. That’s why we’re at the birth center this time. I’m NOT SAYING your experience will be mine, no two are ever the same. But I’ve been through it twice, and I know what can happen in the heat of labor!

    • Abigail says:

      You definitely didn’t seem rude or snippy at all! I very much appreciate you taking all the time to write out your thoughts and experiences on the matter.

      I’ve been really lucky to watch my mom act as a birth coach to my sisters. I’ve watched the hospital try to push different interventions and she was always great about explaining them to my sister, knowing what my sister wanted and advocating for her to the staff.

      I know that’s no guarantee that she, Joel and I will be the perfect birthing team but I really believe it is my best option. You definitely brought up a lot of great points and like I said before I really appreciate you taking the time to come by and share your thoughts with me.

      I’ll be following your birthing journey this time around on your blog. I hope you get exactly the birth you’re hoping for!

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