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Doula FAQs ~ answers from two Doulas

Posted on October 10th, 2013 by | 20 views

We as doulas are often asked many of the same initial questions. So, I thought we could answer some of those questions up front for you. But I wanted to give everyone a better understanding. Just as each mother is similar but unique, so is a doula. These answers are from two separate doulas (not me) that did not collaborate on their answers. I hope it gives you a bit of a broader perspective. – Doula Laura

FAQ and Answers:

What do you feel is one of the most important things a doula can bring to a birth?

Doula one: Her education and experience. The doula is the clear head in the room that can help guide a mother and her partner to the birth they have been looking for. With the doulas help they can be sure that all their question will be answered and they can leave their birth experience well informed and confident.

Doula two: One of the most important things a doula can bring to a birth is her heart. Anyone with the compassion to care for women and a growing family can be a “doula” during childbirth. A doula’s heart knows how to be present, how to sit quietly, how to send love, acceptance and trust. The heart knows how to send the signals to the rest of the body to encourage just the right words to come out, just the right touch, just the right solution to unfold. Sometimes being a doula is about doing less and just being; Being open and connected and willing.

Does/would a doula have a personal opinion about a client’s pregnancy and birth journey?

Doula one: No. A doula is an informational platform and should only be there to insure the clients have the tools they need to make an educated choice. She does not come with a personal agenda.

Doula two: Of course a doula has a personal opinion about a client’s pregnancy and birth. We are human beings, and women at that- we have opinions about everything! Does it need to be spoken? Usually never. Should it affect the way that doula treats her client or the outcome of the birth? Definitely not. Will it challenge the doula to provide the very best care for each individual based on what their needs and desires are and set aside her own ideas? Yes, all the time. We don’t form these ideas out of nowhere- we see lots of things unfold in all sorts of ways. We have identified a lot of almost-truths about the birthing process, but the sign of a great doula is one that lets the parents discover their own truths about their process.

What can a doula do to help a husband or partner? 

Doula one: A doula is a wallflower when she needs to be and completely hands on when she needs to be. She should be able to read the signs of her clients and know when to do what. She can tell a partner what a good place is on the back that she might want touch or when to offer her water. When the partner needs a brake the doula can step in and be the second hand for the partner.

Doula two: Oftentimes fear prevents the partner from participating in the birth at the fullness of their capabilities. The doula is a reassuring compass in the labor process. She acknowledges the normalcy of labor and birth, and encourages the partner with helpful ideas and factual information. The doula is there to bring the couple closer together, take good care of both of their needs and allow the partner to participate in a capacity that is most helpful to mom and most comfortable for the partner. If all else fails, the doula also knows how to kick Dad off Angry Birds and send him on a coffee run.

What if  a client is planning a natural birth and decides for medication during labor? 

Doula one: The doula will always try to advocate for the mother’s wishes according to their prenatal talks before she was in labor. If a client changes her mind it is important that the doula makes sure she understands her choice and is making an educated decision.

Doula two: This can feel like a discouraging moment for Mom and it is okay to acknowledge all the emotions that go along with that turn of events. However, this mama is prepared for the unexpected. Her doula has talked through all the possibilities of what can occur in the unknown of each birth and each scenario has an acceptable solution. This mama intuitively knows what her body and baby need and the doula honors that call above it all.

What if a client knows that they want an epidural for their labor?

Doula one: A doula should talk with her during her prenatal on what the pros and cons are of having an epidural. If the client is open to getting one, the doula should explain to her how important it can be to set a goal; such as not getting the epidural before 7cm to ensure that the chance of having a c-section based on getting the epidural too soon can be ruled out. That way if the birth does ends in c-section, the mother can feel confident that it wasn’t because she got the epidural; but for obvious medical reasons.

Doula two: Then Client gets an epidural! Not everyone should have a natural birth. Only the mothers who want a natural birth should plan and prepare for one. But all mothers should receive all the appropriate education about epidurals. They should know all the risks and benefits of the medication how it works and what to expect. They should also still have a planned method for coping with the intensity of labor. There will be some period of time that they will experience discomfort- What if active labor is fast and furious before the arrival at the hospital? What if the anesthesiologist is in surgery? What if the epidural only works on one side of the body or not at all? Preparation and education is key while making any plans for labor.

How does your role change if a cesarean section is needed?

Doula one: The doula’s role doesn’t change. She is still there to provide emotional and informational support, to insure the client still feels heard and that all her needs are being met.

Doula two: If a cesarean is needed the doula still has a very important role. She now needs to make sure the parents understand what all of their surgery options are and help them advocate for themselves to get what they want. The doula can sometimes go into the surgery with the partner or tag the partner out if he needs to leave with the baby. There is usually much more recovery involved with a cesarean and the doula can help with keeping the mom comfortable afterwards and making sure breastfeeding has a successful start. The doula can also help prepare the parents for the changes that will need to be made once they arrive home to facilitate healing.

Why do women need a doula if they have nurses?

Doula one: Nurses are great, but they also can have a very full day and it’s hard to say for sure if they can give the client the time and support she needs. Also labor can be a long process and nurses change shift. Throughout labor a client could go through two to three shift changes and have many different nurses, making it hard for the client to stay calm and consistent throughout the journey.

Doula two: Doulas do not perform any of the clinical tasks that nurses do. Nurses are directly responsible for the care the mother receives at the bedside, such as; temperature and blood pressure taking, reading the monitors, administering medications and doing vaginal exams. A doula does not perform any of these tasks. Nurses are not able to spend continuous time with each patient to meet the emotional and physical needs of a laboring mother- they have other duties and patients to monitor. The doula stays with the laboring woman all throughout the labor and birth to make sure she feels well supported emotionally and physically.

What does a doula’s role look like if a homebirth is planned?

Doula one: A doula’s role is very much the same. Although, it can feel a lot easier for the doula because birth at home is a lot less complicated then at a hospital. There is a low amount of intervention and the client is in her own space so she’s very familiar with her surroundings.

Doula two: The doula usually arrives before and stays after the midwife and at a homebirth. The midwife is responsible for the health and well-being of both mother and baby and is not always able to give the laboring mom 100% of her attention to her emotional state. The doula is able to continuously focus on just Mom’s comfort and head-space while the midwife sometimes must make some important medical decisions.

What is different between a doula and a midwife?

Doula one: A doula mothers the mother during labor and delivery. A midwife cares for the mother and baby throughout pregnancy and is responsible for the health and safety of the both of them.

Doula two: The midwife is a primary care provider. She is educated, trained and qualified to care for all of the low-risk pregnant woman’s medical needs throughout pregnancy and the postpartum period including the delivery of the baby. The doula does not complete any medical or clinical tasks and is not responsible for the health and safety of the mother and baby. The doula is a labor companion, accompanying the parents on this journey and making sure they feel educated, comfortable and supported throughout the process.

Why does having a doula seem so expensive?

Doula one: The statement, “you get what you pay for”, comes to mind with this question. A doula doesn’t have to be expensive, but typically her price is set at how much experience she has. There are doulas available that service low income families or military families at a low cost, but being a doula is a job. We ensure that the quality of care is such that we earn what we make.

Doula two: The average rate for a doula in San Diego is $500-800 per birth. This does seem like quite a hefty chunk of change when you first see it but I personally have never come across anyone who regretted hiring a doula when reflecting on their birth. The doula not only spends the entire labor with each couple- which is usually 12-24 hours- but the doula spends many, many hours helping the couple prepare for birth before labor and even visits with the new family in the postpartum period. We are on-call for 4-5 weeks when waiting for the birthing day to happen and are unlimitedly available to our clients by text, email and phone from the moment we are hired.

* * Embracing Labor is a team of San Diego labor support offering Birth & Postpartum Doulas, Childbirth Education, Lactation Counceling, Placenta Incapsulation and Prenatal Massage. Visit embracinglabor.com to learn more, receive free education and a complimentary consultation.

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