Doula recommendations for a Sunnybrook delivery in Toronto?
February 14, 2012 1:57 PM   Subscribe

I'm currently pregnant with my first child (whee!) and as a single-mom-to-be am kind of freaking out. It's been recommended to me that I investigate hiring a doula to help with labour and delivery as well as post-partum. I need recommendations if you have them on the who as well as what to look for in a good doula.

I'll be delivering at Sunnybrook in Toronto sometime in late April if everything stays on schedule.

Was having a doula worth it? What do I need to ask to figure out whether a doula is right for me? Any specific doulas in TO you can recommend?

posted by machine to Health & Fitness (13 answers total) 7 users marked this as a favorite
A doula was the single best decision I made while pregnant. Just having someone in the room who knew the process ("and now the nurse has to take your blood pressure" or "you can't eat now but that doesn't include Popsicles, should I get one for you?") was invaluable. This was even more true when things were not going as planned, not only as she was a voice of calm reason but she provided alternatives that my doctor (who we nicknamed dr. Knives thanks to the number of problems to which his one and only solution was caesarean now). I can't suggest specific doula in TO, but in general I'd say find someone you are comfortable with, and someone whose philosophies and goals about the process match yours. Also, make sure you know what her back up plan is in case you go into labor while she is with another client...I got an alternate, as I went 3 weeks early, and I was glad I had met the backup doula before I had to spend 2 days pantsless with her!
posted by girl scientist at 2:24 PM on February 14, 2012 [1 favorite]

Not in Toronto so I can't give specific recs, but I can tell you what my experience with a doula was.

We hired our doula to help us have a natural birth in a hospital. So we asked whether the doula had attended births in that hospital before, since that was really relevant. We also asked some hypotheticals, and the "what's the worst/hardest experience you had" and generally looked for someone who clicked with us.

At 35 weeks pregnant, at one of our meetings with our doula, we voiced our increasing concerns with having a hospital birth, but that we figured it was too late to change course.

Our doula told us that it was never too late, and shared stories of clients that had changed care providers while in labor.

So we switched: fired our OBGYN, found a midwife and a freestanding waterbirth center. And it turned out to be such a great decision, since I had a 74-hour labor, with a lot of stalling (failure to progress beyond 4-5 cm for over 24 hours) and 11 hours of pushing. There is no way I would have managed to have my natural birth at the hospital but, thanks to our doula's encouragement, my son's birth was 100% natural with no interventions at all.

So. That right there was MORE than worth the cost of the doula.

As far as the actual birth itself, since we were at a birth center where all the things we wanted to the doula to help us avoid were off the table anyway, she wasn't really necessary most of the time... maybe a bit helpful with support for my husband, or to make sure I wasn't alone if he needed a break or whatever, but as far as the labor went, I didn't feel like she really made a huge difference.

BUT, at delivery, she took the pictures that would not have been taken otherwise, which is completely invaluable to us now. As soon as our son was born, my husband and I were OMG BABY and taking pictures was the last thing on our minds. But we now have absolutely gorgeous photos taken in the minutes after the birth and I am forever grateful to her for that.

SO. Totally worth it for me. I have heard other stories, from friends of mine who delivered in hospitals, that having the doula there during labor and birth and shortly after was really important, both to act as an intermediary/advocate with nurses and as someone to be with mama if baby gets taken off somewhere (NICU etc.) and dad goes with baby.

Also, I think there are stats that women with doulas are less likely to be c-sectioned, which if true, would be another argument in favor.

TL;DR get a doula. (If you can't afford one, I think there are a lot of doulas-in-training that will work pro bono for the experience. Which means they may or may not be as useful in certain situations.)
posted by rabbitrabbit at 2:30 PM on February 14, 2012 [1 favorite]

Definitely worth it. I had an unmedicated birth and labored at home with doula and husband for a good while (was at 5cm when we got to the hospital, I think). Without her we would have gone to the hospital much sooner, which is usually bad for birthing progress, and we would have been much more scared. If you're on your own, I'd definitely try to get someone to support you when laboring at home, ideally, someone who has been present at other births!
If you want to go for an unmedicated birth, the doula can also help you to keep the hospital people from being too interventionist and mediate between you and nurses/doctors. It was very helpful to have someone with us who knew how the hospital system works, even though she's no medical professional.
What to look for: we basically ended up with the first one we spoke to, an acquaintance/colleague of my husband who wasn't even a "proper" doula or anything (no certificates). I just felt good in her presence which was the most important thing to me. She just had a very calm, relaxed attitude. And of course she should be on one page with you re: birthing philosophies. That, I think, is easier if you're leaning towards going unmedicated; but of course there are also doulas out there who support more mainstream approaches.
posted by The Toad at 2:33 PM on February 14, 2012 [1 favorite]

OH, I somehow missed that you're single! In that case, though I recommend a doula highly already, I really think that a doula would be a must-have for you. I couldn't even fathom having a baby while only surrounded by hospital employees, with no one there only for you (birth team).
posted by rabbitrabbit at 2:44 PM on February 14, 2012 [1 favorite]

OH, I somehow missed that you're single!

BTW, being "single" doesn't mean you can't have a friend or relative with you as a birthing partner/coach. Just sayin', nothing against hiring a doula, too/instead.
posted by tristeza at 3:36 PM on February 14, 2012 [2 favorites]

Here is a Toronto-based doula (who is studying to be a midwife, but also still doula-ing).

I know her via facebook, through a number of friends, and she seems super-dedicated and enthusiastic about what she does.
posted by Badmichelle at 6:08 PM on February 14, 2012

My doula experience: instead of going with the slightly more expensive doula I really clicked with, I went with a cheaper one who was nice, but who was really not very experienced. Bad idea. I had a traumatic birth (not her fault) which she was just not able to deal with much (maybe her fault, though hopefully she learned something that helped future clients).

Get recommendations from other women (you can ask for those from the doula you interview) and go with your gut. In the stress of birth, you need someone you trust, respect and can rely on.

Make sure she's on board with your plan and that she understands what you want, as much as possible.
posted by emjaybee at 6:22 PM on February 14, 2012

I used to work for an organization that trained doulas all over North America, including Canada. Alas, the organization is no more, but I learned lots and lots about doula-ing and choosing a doula. As emjaybee, above, stressed, you must really like your doula, on a personal level. You will be spending some very difficult, stressful time with this person and if there's anything about her that bugs you, no matter how trivial, you will be super-bugged right when you most need her.

Also, choose a doula whose own birth philosophies match your own, especially if you plan to give birth in a hospital. If you feel strongly about any aspect of your labor and birth, you need her to support you, both in your own resolve, but also in helping communicate your needs and desires to the other providers (nurses, ob/gyn, etc.).

Some (definitely not most) doulas specialize in or prefer to work with clients giving birth in a hospital, or specialize in home births. They can also help you make that decision yourself if that's something you are questioning. Doulas can provide you with lots of knowledge, and also should support you in the way YOU want to labor and give birth. If you sense a doula has a strong agenda that does not match yours, she may not be the best match for you.

I don't know what your thoughts and goals are about how you plan to give birth, but if you have planned to have a "natural" labor and birth, a doula can be invaluable in coping with pain. She will use different methods to help you cope and avoid medication or other medical interventions--IF THAT'S WHAT YOU WANT. For example, movement, including walking, rocking, etc. can be very effective to reduce pain. Also things like different kinds of touch (firm or gently massage, effleurage, etc.), aromatherapy, and other sensual methods. Positioning can be very effective; for example, sitting on the toilet (though many people are turned off by this, thinking it's dirty or the baby might fall in!) is a great method to open up the pelvis: most people instinctively and by mindless habit, allow their muscles to open up as soon as they sit on a toilet. Or squatting. Or many other things. But a good doula will be aware of all these things.

A great book to read is "The Birth Partner," to help you learn about what kinds of help a partner, friend, relative, or doula can offer.

I recommend the organization, DONA(Doulas of North America) to find a doula. It is a large organization with many, many member doulas. You should be able to easily find a good match in the Toronto area. Congratulations, and good luck to you!
posted by primate moon at 8:22 PM on February 14, 2012 [1 favorite]

I am not using a doula, but looked into it and have friends who did - several of those had great experiences and a few had doula horror stories, so choose carefully.

Make sure that the doula is actually there to help you do what you want at the time, and not coming in with an ideology. In particular, make sure that the doula will not see herself as an 'enforcer' of a predetermined birth plan (i.e., won't intervene to keep you from getting pain relief you ask for, even if you originally didn't plan on using it) or will not simply abandon you if something she sees as undesirable or contrary to her ideology (such as induction or a c-section) becomes necessary.

If you are giving birth outside a hospital (in any setting, including a birth center), make sure that you know the doula's policy on transfers: will she continue to help you if you need to transfer from your planned setting to a hospital in an emergency? Will she show up at the hospital at all if a problem late in pregnancy means you end up giving birth there, contrary to the original plan?

These posts on choosing a midwife may be helpful in going over some of the issues, though obviously they are not all relevant to doulas.
posted by Wylla at 4:29 AM on February 15, 2012

Absolutely, get a doula, if you are a single parent, I cannot recommend this enough.

I had a midwife rather than a doula, but there are, as Wylla notes, some strong similarities. I had a hospital birth, and things were absolutely awful until the midwife got there, and then things were fantastic and amazing.

I would also add that the doulas need to be aware of the rules and procedures in your particular area, so that they can tell you when something /is/ necessary, and when it's just doctors trying to make more time for themselves at the expense of your comfort. (for example, having you in the bed when you're not actually needing to give birth.)

I'd second that you need to actually like them. You will be spending a /lot/ of time with them.
posted by corb at 7:09 AM on February 15, 2012

My doula was indispensable. I wanted a Bradley Method-style birth with as few interventions as possible and no pain meds, and when I ended up getting induced unexpectedly for PE, with the prospect of ensuant anti-seizure meds, a lot of my emotional preparation went straight out the window. My husband was there and was as helpful as he could be, but having the support of someone who'd seen many many births, knew my goals, and was there just for me was critical. She guided me to some mental and physical coping strategies ("move your hips"... "do you want to try the tub?"... "focus on a single point on the ceiling, blow your energy up there" [it made sense at the time]... etc) that I wouldn't have found otherwise. At one point, things were really getting going and I was starting to panic and despair about dealing with pain and not knowing if my contractions were effective, her support got me through that wall to a point where I had something positive to focus on again. I did get through it without pain meds, as I had wanted (in hindsight, unmedicated birth was totally doable and actually a very positive exhilarating experience, but at the time it was harrowing and I totally support any woman who opts for pain relief btw), and I really attribute it to my doula knowing my goals and helping me with them.

We have a local doula group who host speed dating-style events where parents can briefly interview a number of them, and that's where we found the doula that seemed best for us. We liked that she seemed smart and had evidence-based technical answers for our questions, and that her personal style (clothes/makeup) made sense to us, and that she was supportive of crunchy birth things like homebirth and unmedicated birth but she wasn't strident about it and she emphasized that she supports women through all kinds of births and what's important is that (after healthy mom/baby of course) the mom feels okay with what happened at the birth. Also she was very familiar with staff and procedures at the hospital where I delivered, which made her a more effective advocate for me. ALSO we had two meetings and a lot of email correspondence before the birth, discussing things happening in my pregnancy and various aspects of my thoughts about birth, which was helpful at the time and no doubt strengthened our working relationship for the big day.

Thirding that it's super important to be comfortable with your doula on a personal level. When the day comes and you have emergent PE (*circumstances may vary*) and are in a hospital bed with meds up your hoohah and you realize your nurse is snippy and your doctor only stops in once every four hours and it's the start of a long long night, you don't want to have any tension in your relationship with the doula.
posted by thirteenkiller at 7:49 AM on February 15, 2012

Agreed that a doula you click with is vital, and that experience can be very important. We interviewed a few doulas, and most of them had attended only 2-5 births. The doula we chose had attended over 400, and that experience definitely helped her help us. She was more expensive (twice the rate of the inexperienced doulas!) but it was welllll worth it.
posted by rabbitrabbit at 8:25 AM on February 15, 2012

Definitely check a lot of references... A good friend hired a DONA-certified doula who decided to leave without telling anyone while my friend was in the middle of labor. I'm sure it's a rare occurrence, but definitely not something you want to deal with during or after birth. Best of luck!
posted by mingshan at 10:28 AM on February 15, 2012

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