How did you choose a doula?

April 22, 2010 7:01 PM

What's most important in choosing a doula - experience, warmth, or views on birth?

I haven't found a doula I feel sure about yet, and time is running out.

What we want: 'continuity of care' and to have an experienced support person around. It will just be me and my partner in a big and extremely busy labour ward; and we won't have met any of the hospital midwives beforehand.

We don't want someone who is anti-pain-relief, because I want to keep that option open. I have found a couple of prospective doulas and one midwife who insist that they will support me whatever my choice. But I am having a really hard time choosing between them.

One doula is much younger than me and fairly inexperienced, but has a comfortable and unthreatening presence.

Another is older, very experienced (including in the hospital I am booked at) and has a stronger personality. I suspect she is pretty pro-natural birth, but she also seems very professional about not letting her own views get in the way. Her personality could be good - in that I would feel comfortable telling her if I wanted to be left alone. I think she would also communicate assertively - but appropriately - with medical staff.

Another option, much more expensive, is a private midwife acting as doula. I think she is pretty 'crunchy' and mostly does homebirths, but obviously she has actual medical knowledge and a lot of experience working in hospitals (although not my hospital). I assume she would also be professional enough to not let her views get in the way, and would know how to communicate appropriately with medical staff. If money was no issue I'd probably pick her, but it's a lot to pay when all I might need is someone to get me ice chips and tell me to breathe!

So, how did you choose your doula, and how did that decision work out?

posted by 8k to health & fitness (8 answers total)

I had a midwife at the hospital for my second delivery (an OBGYN for my first) and loved it. The continuity of care aspect was exactly what I was looking for. She was more on the forceful side of the personality spectrum which was good. During a delivery I wanted some one who could be assertive to the hospital staff as well as to me. I would much rather someone with a lot of experience (especially at the hospital where you will deliver) and a strong but calm personality. I, personally, would not like someone too "unthreatening" - I would feel that they might be "wishy washy" when the time came to help make suggestions or decisions. Also I am in Canada so the cost thing doesn't apply. Remember, though, no matter what any one says the most important thing is to feel comfortable with the situation and people you are surrounded by. Good Luck!
posted by heybearica at 7:48 PM on April 22, 2010

References are good way to gauge the situation. Ask for references from your options, call, and see what the references say. Ask the references all your questions above.

Honestly, selecting the right doula for yourself has as much to do with personality as experience. All the experience in the world isn't going to help if the person makes you uncomfortable, and all the right personality traits isn't going to do you any good if the doula doesn't step up to the plate and support you the way you want to be supported.

So ask yourself, what it is you want support with? Do you want support in navigating the labor process in this large labor ward? Then you may want to select someone who has experience specifically with that hospital. Do you want support in your labor decision making? In this case, you want someone who has some knowledge of various labor support methods, include since you don't necessarily have the goal of natural birth (nothing wrong with that, either!). Do you want someone who supports your labor partner as much as she does you? Then you want to ask your labor partner who he/she thinks is a good fit and work that into your consideration.

You sound like you have some good options, and it sounds like you need to figure out what it is you want from your doula and how much of that you want and how much your options you think will provide of all of those things. I think speaking to past clients can help clarify that as well as which option might be best for you.
posted by zizzle at 7:54 PM on April 22, 2010

*including pain medication options since you don't necessarily
posted by zizzle at 7:56 PM on April 22, 2010

We chose an older, experienced Doula, and were disappointed. We simply were not a priority for her. She skipped my early labor to demonstrate at the capital about pre-natal care, and arrived at the hospital about 15 minutes before my son was born. She never had time to go over our birth plan, but bugged us afterwards to fill out petitions to state officials about her pet political issues. For my first pregnancy, we had a midwife delivery at the hospital, and it was very nurturing and professional. Unfortunately, when my son was born, the hospital we chose decided to bar midwives because of what they called "insurance risks." I wish we had chosen the younger Doula who seemed eager to help us, instead of what we then thought of as firm and motherly, but later thought of as pushy and self-involved.
posted by Malla at 8:00 PM on April 22, 2010

Having someone with a strong personality can be a real life saver at a busy hospital. Without someone being assertive on your behalf, plenty of things can go very very wrong. Also, if she's experience at that hospital - is she well liked? Will she be able to call in a favor if you need attention immediately and no one is around? Or, is she disliked and people will go out of their way to avoid her? Get recommendations. If a doula won't provide recommendations, run away.
posted by stoneweaver at 9:01 PM on April 22, 2010

I chose my doula based on her personality -- I wanted someone who seemed to be on the same page as me as far as what I wanted & who wouldn't be afraid to help me maintain focus. That being said, I work in the medical field & have a pretty strong personality so I wasn't so concerned about my ability to be assertive but more about my ability to focus. I wanted someone who could make useful suggestions ("how about turning on your side, how about standing in the shower, etc") rather than someone focused on my oneness with all other birthing mothers or some other hippie-dippy stuff like that. So I think it at least partially depends on what you hope to get out of it. My feeling was that I'd be less apt to take advantage of the experience a doula could provide if I didn't jell with her, personality-wise.
posted by oh really at 11:11 PM on April 22, 2010

What's most important? Trust.

I chose my doula purely on instinct. My criterion was that whoever we picked should not be too crunchy-granola, and Summer wasn't; but I liked her the second I laid eyes on her, because she reminded me of my sister.

She turned out to be a godsend. I had my kid in a super-medication-happy upper-middle-class hospital. When I told the anesthesiologist I was going to try to get through labour without an epidural, he said "I'll see you soon!" Summer ran interference with the hospital staff, advocating for me and defending my choice; and then when I said I wanted to try fentanyl, she was all support and no judgment. Between the opiate and her guiding me to move and tone and get in and out of the tub, we had a fast, safe birth with minimal intervention. 29 women gave birth in CPMC that night and I was the only one who didn't have an epidural.

I would strongly consider not getting a doula at all. If you just want somebody to be around and be supportive, that's your partner's job.

It was our first birth, and Summer supported my partner too. Second time around, we were confident enough to fly solo. But that was largely thanks to her.
posted by rdc at 11:13 PM on April 22, 2010 [1 favorite]

I think the most important thing is that the doula either shares your views on birth or is willing to put her own aside and stand up for what you want. I spent a lot of time in a group of doulas, planning to become one, and some of them have vehemently strong views. For example, they were all appalled that I would choose to trust my GYN with a hospital birth if I should ever become pregnant. To them the only sane choice was a midwife in a birthing center or a home birth. I stress that this was the one particular group of doulas I hung around with... not all feel this way. So just make sure she's really willing to support YOU and what YOU want your birth experience to be.

The doula also needs to know she is not a doctor and when to step aside. When I told my aforementioned GYN that I wanted to be a doula, she told me a "horror story" about a patient who had been pushing for 3 hours, was exhausted, the baby was starting to struggle, and the doula wanted the mother to try pushing in a different position when it was becoming apparent the mother would need an emergency C-section. The doctor had to ask her to leave.
posted by IndigoRain at 4:40 PM on April 23, 2010