Saturday, October 1, 2011

Why I Do a Doula - Support in the Delivery Room

For those of you as yet unaware from my numerous hints, blatant comments and gestation counter [up top in right column of blog,] I are pregnant. At this point, I am 26 weeks along. I was super excited to get the same doula that I had last time, and when gloating celebrating about it in a status update on my personal Facebook page, I got some questions as to what exactly a "doula" is.

A Tale of Three Sisters
Sister Three (S3) is having her first child. Sister One (S1) is super excited to get to be there, and is looking forward to getting to see a birth in action. This is especially poignant for S1, since she was ten-years-old when S3 was born, and was going to be allowed to be in the delivery room for S3's birth, until plans were thwarted due to an emergency C-Section.
Anyway, during S3's delivery, S1 was horrified to watch as S3 was only referred to in the third person (as "Mom," rather than her actual name,) and never spoken to directly by the staff or other family members present. "Have mom do this." "Watch the monitor, and during a contraction, push Mom's legs up and have her sit up and breathe." etc. When staff was even in the room! There were long stretches with no medical professionals present!
So S1 made it her mission to focus on S3, rather than the baby. S1 made cold compresses out of cold water and paper towels (until finally haranguing a nurse into getting an actual washcloth. Which was apparently a huge imposition.) S1 kept S3's neck and forehead cool, kept pillows fluffy (S1 had an epidural, so wasn't mobile,) and murmured words of encouragement. S1 didn't get to see baby come out (even though it's totally sci-fi-freaky-looking, one hears,) but stayed at S3's head, being emotionally supportive. When "Mom" asked questions, staff ignored her. S1 told her everything was great, even though S1 really had no friggin' clue.
S1 was totally peeved about the whole experience, how impersonal it was, even though S3 had her actual OB present, rather than a random on-call doc from the office.
S3's second and third babies were delivered via planned C-sections.

Sister 2 (S2) was having her first baby just a few months after S3 had her second. S3 had had several false alarms and fruitless trips to the hospital. So when S2 went into labor, Dad thought it was just false labor like her sister and made her wait a few hours before finally going the 30-minute trip to the birthing center and midwives S2 had chosen. Had S2 called S1, S1 would have taken her earlier. S1 went to all of S3's false alarms with her own overnight bag, snacks and extra pillow packed and ready each time! S1 even went and TOOK S3 to the last 2 false alarms, so dad could stay home with the older one. So S1 would have gone to as many false alarms as needed for S2.
S2's labor was fairly quick, so by the time they got to the birthing center, there wasn't time for the aromatherapy candles, setting up the music, and all the other soothing things S2 had planned for her birthing experience. S2 is still a little bitter, over 4 years later.

Sister 1 (S1) wanted a hospital birth, but not an epidural. S1 was not aware that there were midwives that could practice in the hospital, so went with an OB. S1 had just read in a pregnancy magazine about something called a "doula." S1 liked the thought of having someone there for her, rather than everyone focused on baby. S1 also liked the thought of having someone there she knew, rather than whoever was on-call at the time. And after watching many episodes of A Baby Story on TLC, S1 liked the idea of having someone there who knew what she was doing, who could help Dad not be the incompetent boob all new dads apparently are in the delivery room.
S1's OB/Gyn quit 1 month before her due date, to become just a Gyn, since she was tired of being on-call. S1 was pleased to discover that their office also had midwives (ARNP/CNMs) who were able to squeeze her in only because all the practitioners were trying to squeeze in the quitting OB's patients. Hooray!
S1 had her doula, midwife-in-training (there was another birth at the same time, so the actual midwife was going back and forth,) her mother, mother-in-law, stepmother-in-law, father-in-law, sister (S2,) sister-in-law, brother, and friend all at the birth (although the guys tended to wander into the lobby a lot during the labor part.) Plus the L&D nurse.
While S1 labored in the tub, the doula organized the sisters and whoever else wanted to help into a relay line moving cans of soda from ice box to rub against S1's back during contractions (back labor. Yikes!) and the old ones back into the ice box. Someone else was pouring warm water over the belly. (Ahhhh.) There were many wardrobe changes as S1 was forced to get out periodically to get monitored on the bed, then back in the tub, etc. Someone made sure S1 kept hydrated with water and ginger ale. Someone to hold the kidney-shaped "vomit bowl." Etcetera.
During delivery, the doula helped chose a birthing position, and organized family to help. One person on cold compress duty, someone else rubbing the back, Dad in front helping support S1's squatting position (and getting his arm squeezed too hard, apparently.) Then the doula was free to take photos (nothing X-rated, per S1 and Dad's request.)
And in the end, instead of being peeved that Dad couldn't read her mind, or preferred to hang out in the lobby with his dad, or the classic "I hate you! You did this to me!" as seen in movies and on TV, S1 had channeled all that irrational labor-anger at the doula! S1 had had an advocate in the delivery room to ensure that her wishes and needs were met, or at least taken into account, since they had talked about them prior to delivery (while in a calm, non-labor state!) S1 had someone giving suggestions, reminders of all the stuff promptly forgotten the second birthing classes were over. S1 had someone focused on making her birth experience everything she wanted it to be. And, in the event of a crisis with the baby or mom, S1 had someone to stay with her so Dad could stay with baby. And best of all? Years later, instead of feeling resentment or a sense of detachment or disappointment in the birth experience, S1 walked out of there feeling like her partner had been her partner during the birthing process... even though he really spent most of the time in the lobby with his dad!
Worth. Every. Penny.

Advice for choosing a doula:

1. Do your homework.
Having a doula present can be beneficial for both the mother and baby. Read up on it, to see if this is a right fit for you. I personally cannot recommend it enough. Even facing a potential planned C-section with this one, if they'll let me, I'd have my husband AND my doula in there. There are things he never ever needs to see, and my innards are right up there. But I also need someone who knows what to expect, someone I can trust, keeping an eye on things; telling me what's happening, making sure they do stitches rather than staples, making sure that everything looks right, etc. Then hubby can just be in there to hold my hand and follow the baby.

2.. Talk to your doctor or midwife.
Some won't work with doulas, in which case I'd chose a different practitioner, since I prefer someone who views this as a team effort, rather than views themselves as "The King." The ones who welcome doulas into their delivery rooms might even have some references for you! (My OB had a sheet of Xeroxed business cards, and we picked the one with the most certifications listed on it!) If not, you can look online for a DONA Certified birth or post-partum doula or go to

3. Interview prospective doulas in person before hiring.
I knew right away that the one we randomly chose was right for me. We're even friends on Facebook now! But you can discuss what you want out of your birthing experience, and see if their values and priorities jive with yours. You can see if this is someone whose face you're willing to stare at for any length of time. If this person's voice is soothing, or just grates on you. All kinds of subtle little things that go beyond "Are you available around my due date and how much do you charge?"

4. Call references.
Although I figured it was a waste of time, since I loved the doula at the interview meeting, and figured she wouldn't give us references from people who had bad things to say. My husband ended up calling, since the doula was insistent that we should check her references. He came away feeling better about my our choice not only in this particular doula, but in hiring a doula in general.

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