Pros and cons of hiring a doula
January 17, 2018 1:44 PM   Subscribe

Mr. Circle and I are thinking of hiring a doula for our baby's birth in June, but we are on the fence. Please share your experience, either as parents who hired one, professionals who've worked with one, or if you ARE one... we'd love some perspectives.

I've read that the C-section rates for families who use doulas are lower, that coaching through birth is one of the most effective ways give birth without any pain medication, and finding a doula with a PT, yoga, or childbirth background can be really helpful. My reason for wanting a doula is that birth is exhausting for both parents, not just the mother. I think it would be wonderful to have the moral and physical support throughout the entire time if Mr. Circle needs to get fresh air, food, or a nap while I'm laboring. I want someone who is well-trained and understands the birth process from experience, both personal and professional. I'm also concerned that I'll be focused on his needs versus my own after 20-some odd hours of labor.... and that in of itself will be exhausting. I want our family to be fully supported through this process, and I'm not comfortable with friends or relatives in such an intimate setting. I think hiring a doula would make me feel free to labor without worrying about anything else. I'm currently using a hypnobirthing app to get into relaxation mode and I'm looking into different books that are available, but I feel like that's not enough.

Some of his concerns are that a doula may be taken as a sign by the medical staff that we don't trust them, that we'd be paying $1000 for someone to simply provide moral support, and that it may be redundant (i.e. "Aren't the nurses there to take care of things? What can a doula do that a nurse can't?").

I think the nurses are too busy to tend to a mother's every need, and are really there for the baby first and foremost. They see births each and every day - they're not there to coach the mother. They're there to ensure a safe delivery. My OB/GYN has mentioned doulas before, and I got the impression that they are welcomed by our health care team.

TL;DR: I've heard doulas mentioned here a number of times, and I'd like personal experiences, both positive and negative.
posted by onecircleaday to Health & Fitness (39 answers total) 11 users marked this as a favorite
No personal experience with giving birth myself, but: in a long labor (assuming no crises/complications), nurses will definitely not be at your beck and call every moment of the experience. If you want to make sure there's someone to bring you ice chips or adjust your pillows or whatever whenever you want, a good doula will fulfill that function.
posted by praemunire at 1:51 PM on January 17, 2018 [3 favorites]

(In case it wasn't clear, that wasn't meant to be a derogatory list of potential requests! I get that labor is very uncomfortable!)
posted by praemunire at 1:52 PM on January 17, 2018

You want a doula, if nothing else than to provide you peace of mind. And if peace of mind allows you a less-stressful labor, then get a doula. And yes, they also do much more than provide peace-of-mind. Sounds like your husband is being a stick in the mud about allowing you to make choices about your labor. It's YOUR labor. Do what makes you feel best. If $1000 is going to break the bank, then a doula isn't necessary. But if it isn't going to break the bank and you think you'd find a doula to be helpful, then I think your husband is being kind of a dick about something he knows nothing about. Why don't you and your husband interview a few together and they can tell you what they can provide that a nurse won't necessarily be able to?
posted by greta simone at 1:58 PM on January 17, 2018 [5 favorites]

It’s only one woman’s experience, but I gave birth twice in two different hospitals in the Boston area and the nurses were absolutely at my beck and call, incredibly supportive, and great labor coaches. My husband was useless, and I knew that going in, and having a doula would have made me feel responsible for TWO people’s feelings. That’s just me, though.

If you want a doula get a doula, it’s clearly an important aspect of birthing for you, but do know that you can find wonderful support with the nurses at the hospital too, in all likelihood.
posted by lydhre at 2:02 PM on January 17, 2018 [3 favorites]

Not to threadsit, but.... just to clarify, I'm looking for personal or professional experiences with doulas. Please, no name-calling or judgement about me or my family. Thank you.
posted by onecircleaday at 2:03 PM on January 17, 2018 [10 favorites]

And to clarify, I mean beck and call for medical things, including refilling my water and adjusting my position in bed, advice about pain medication levels, where I was in labor, emotional support, at al. not in the ‘get me a sandwich’ sense. I sent my husband to get me a sandwich.
posted by lydhre at 2:09 PM on January 17, 2018

Our doctors were FULLY on board (and even recommended) with our getting a doula. She knew our OB practice well. Her presence was not considered "simply moral support" which is kind of a weird way to diminish how overwhelming the whole process is. Birth is medical but it is also just enormously *physical*, as well as psychologically / emotionally maybe one of the hardest and intense moments you will go through. My husband and I are very hands on Do It Yourself people. We hired a doula for first birth and we are both so glad to have had here there. She was important

For me:
- She observed me very closely / knew where I was in the labor process before I did and could anticipate when I might need something (dimmer lighting, a bowl to throw up in, wrapped my lower half in a towel on the cab ride to hospital - together she and my husband could tag team getting our belongings and our paperwork and my giant exploding writhing mooing body from room to room)
- She basically kneed me in the back repeatedly for five hours, an insanely deep and helpful and nearly continuous massage that my husband would not have known to do / have been scared to do on me, let alone have the energy to keep doing for most of the whole labor

For my husband:
- He is the sort who would run himself to the GROUND in total exhaustion being helpful to me, and especially in an emergency. Thing is, running on empty isn't truly helpful to anyone. She directed him through many hours - when to rest, when to eat, when to sleep, when to be on high alert, when to hold my hand, when to get out the camera. He was extremely involved but did not know what he did not know - especially how to pace himself.

To tell you the truth - I feel like having her there was MOST valuable TO ME for how SHE GUIDED MY HUSBAND, if that makes sense. She was not a substitute for him or for a nurse. She filled in the many gaps around us. The second time around we did not need the doula; I taught him to do the knee-in-the-back thing and he knew much more about the whole process. I recommend.
posted by sestaaak at 2:12 PM on January 17, 2018 [23 favorites]

We have hired a doula for my upcoming birth (any day now!) and so far it's been great. I would recommend interviewing a few to see who you have a good fit with and what they offer (my impression is that there is not a standard package every doula would offer). Ours, for example, has done two pre-natal visits in our home, which has made me feel WAY more comfortable with the whole birth experience. She's also basically on call over text, so if I've got some weird question I don't want to bug my doctor about, I can text her about it. These visits have also been great for me to really think through and talk through what I want out of birth, etc. -- the doctor obviously does not have time to go through every single detail with me (and I might not even get my specific OB for the birth depending on timing). I feel a lot more confident now about knowing what I want and how to advocate for it, as well as which things I can push back on versus needing to go with a doctor's best medical judgement.

Definitely make sure your philosophy matches up with the person you hire -- it was really important to me to find someone who is evidence based (i.e. isn't going to be weird about vaccines), would support me in trying for a medication-free birth but not guilt me about it if that ends up not being what happens (we have had really specific discussions about when I would want to ask for medication and what that would look like, and different types of support she can offer regardless of whether I get an epidural or not), etc. Not to say those should be your priorities! Just that I think it's important to really interview people to make sure you're getting someone who will match up with whatever your priorities are.

The level of care nurses provide may vary by your hospital. When we took our hospital tour, they were pretty clear that nurses would NOT be in the room with you the whole time, and would more be checking up on you periodically through labor. My doctor specifically recommended for us to hire a doula if we could afford it and wanted to try for an unmedicated birth. Obviously these factors could vary at different hospitals/birthing centers.

Now, maternity/birth/babies are expensive, and if $1000 is not in your budget, obviously plenty of people give birth without doulas! But to me, even just the peace of mind it's given me during pregnancy has been worth the cost, and knowing that I'll have someone there who actually knows what they're doing is a great feeling. (My husband is wonderful, but -- like me! -- has never been at a birth before.)
posted by rainbowbrite at 2:16 PM on January 17, 2018 [2 favorites]

I did not find my doula particularly helpful, even though I had a high-risk, medically-required induction, with no pain meds allowed to boot. I got a doula because I was concerned about not having access to pain meds, that I'd have a long labor due to the induction, and that my nurse would be more focused on managing my medical care than on helping me mentally/emotionally through labor (which is the right set of priorities, to be clear!). While I would most certainly say that my doula was a kind, empathetic person, I ended up getting much better coaching from my labor nurse, and my husband was comfortable supporting me (mostly just letting me dig my nails into his hand during contractions). My doula just didn't add much to the equation. Maybe she would have been more helpful if my labor had gone on longer, or if my husband was not comfortable with supporting me while I was in incredible amounts of pain.
posted by Jaclyn at 2:16 PM on January 17, 2018 [1 favorite]

I wanted a doula, interviewed a bunch of them and found one I really loved, and a bunch I really didn't feel any rapport with. We hired the one I wanted, and a couple of months before my due date she called saying she was pregnant and her supervisor told her that she couldn't work for us because if she had any complications related to her own pregnancy, she wouldn't be able to be there for us, so we needed to find someone else.

After all the hassle we went through just finding her, we just decided to go without. It was one of my biggest regrets. I didn't get shunted to a C-section, but I know for a fact that most of the things that did go wrong during my labor and delivery would not have happened if I had had an advocate there who was able to help coordinate with the hospital and intercede for me in ways I couldn't and my husband didn't know how to. It's 9 + years later and I still regret it.
posted by Mchelly at 2:17 PM on January 17, 2018 [2 favorites]

I had a doula for both my first and second births (the same one, in fact) and the price was around what you're looking at. I don't regret having hired her at all, despite the fact that my second labor went very very fast (like, 2 hours between showing up at the hospital and giving birth) and having her there likely didn't change anything. I did see having her for my second birth as a type of insurance--basically, not knowing whether I'd have an easy second birth or a long, protracted one, I'd rather be in the position of setting myself up for the best outcome possible and not regretting not having her there down the road. The fact that it was "wasted" money doesn't really bother me (this is obviously influenced a huge amount by the fact that $1,000 was a decent chunk of change but not a painful amount of money for us).

The doula did a make a big difference in the course of my first labor, and I'm pretty sure that without her I would not have been able to avoid the "cascade of interventions" that often ends in c-section. Instead, I ended up with a non-medicated vaginal delivery (and I was someone who wasn't dead-set on that, just wanted to avoid the epidural and maintain mobility as long as possible, so I'm honestly kind of amazed still that it ended up like that). For my first birth, the doula was definitely money more well-spent than the birthing class we took, which in retrospect we could have skipped.

It sounds like you're kind of in the same place that I was, and the factors that I think you should consider to ensure you feel the money was well-spent are:

1. Make sure you hire a doula who has a lot of experience in the specific hospital/birthing center that you'll be using. Hands down the best thing that my doula brought to the experience was knowledge of what was possible to request at my hospital, and no institutional barriers to letting me know those things. (The nurses knew the range of possibilities but their suggestions tended to be quiet and oblique so as not to piss off the OB.) I'm pretty sure the reason I was able to avoid pitocin after my water broke and contractions didn't start is because my doula was able to talk me through some alternatives that I could ask for before we landed on pitocin--and one of those (nipple stimulation using a hospital-grade breast pump) was successful at starting regular strong contractions. I never would have known I could ask for that if she hadn't been there.

2. Ask a lot of questions about when your doula will show up during your labor (and not just when they say they "tend" to arrive, which is total marketing, but what the contract actually says). If you're trying to use a doula to avoid unnecessary interventions, you want someone who will show up once you've been admitted to the hospital, NOT only when you're in active labor - since it's failure to get into active labor after you've been admitted that is the cause of a lot of interventions. (My SIL had access to a doula that would only arrive after active labor started, and she ended up never calling her because by the time she was on the pitocin drip and got an epidural shortly after, it felt kind of pointless to her to have someone there just for emotional support.)

3. IMO it's definitely worth it to pay for someone who actually makes a living doing doula-ing, and not a dabbler who just loves birthing and babies and does it kind of part-time for fun or personal fulfillment. In my area there are a LOT of relatively inexperienced women who train as doulas because they like the idea of it, but don't pursue it very seriously; they tend to be more affordable but lack a lot of the connections that make very experienced doulas super-useful. I was able to reach out to my doula months after my first birth for advice about who I might see for some pelvic floor issues and she was really helpful in letting me know which PTs she'd heard good things about and which ones to avoid--as well as suggest some other resources that ended up being super-useful.
posted by iminurmefi at 2:44 PM on January 17, 2018 [7 favorites]

Our doula knew the ins and outs of the processes at the hospital. She was able to guide us, make suggestions, and let us know what our options were much more succinctly and tuned to our personalities than the nurses. We had a a 5 week early birth which led to a short NIC U assessment. We'd definitely hire her again if we were having more children. Our nurses were also visiting nurses from other locations and so not intimately familiar with the hospital. Our doula was very much on top of the situation from the get go.

That said I thought it was fairly difficult to find a personality match for us and we took a fair amount of time finding one.

In hindsight I'd clarify the post-birth roll- especially if you have a smaller baby. While our doula visited once briefly following the birth she was not a great help in solving the problems we were facing postpartum. Those problems mainly revolved around getting our little peanut to breast feed and the subsequent hollow feelings of 'omg what the h!@# is going on - she's gotta eat'. Those were scary times for us. For the record the solution was lots of pumping and me finger feeding kiddo for a couple of weeks via syringe and tubing - she was just too small to generate proper suction for actual breast feeding.
posted by mrzz at 2:45 PM on January 17, 2018 [1 favorite]

I hired a doula for my first birth & was very happy with the decision. She was a friend, so I had the added comfort of being supported by someone I knew and trusted. My labor was extremely long & difficult; she was able to stay with me even when it got to be too much for my husband to handle and he needed to step out of the room for a bit. The doctors & nurses seemed happy to have her there.

My doula was not involved in any post-partum care. I turned to lactation consultants & a visiting nurse for help with breastfeeding & other newborn issues.
posted by belladonna at 2:52 PM on January 17, 2018

I originally hired a doula because one of the midwives in my practice rubbed me the wrong way, and I wanted a buffer in case that midwife was in charge on delivery day (she wasn't). What my doula ended up doing was some massage during unmedicated labor, staying with me while my husband went to get a snack, and taking notes on the whole day that she later typed up and shared with me. I ended up with a C-section and she wasn't allowed in the OR, so she waited and then stayed with me in recovery while my husband went with the baby. When the baby joined us, she got me started on breastfeeding positions. It did feel a bit indulgent because we didn't ask very much of her, but I'm so glad I didn't have to be alone in that recovery room for an hour waiting for the feeling to come back into my legs... while waiting to hold my baby for the first time.
posted by xo at 3:01 PM on January 17, 2018 [2 favorites]

I was going to hire a doula, my main reason being that if something went south in the hospital I wanted someone with us who could understand what was happening and, God forbid, if I were unable to contribute to making medical decisions for myself or the baby, who could help my husband weigh our options. My husband is an emotional mess during a crisis and especially if the life of his wife or child were in jeopardy he would have needed that support.

The only reason that we didn't hire someone is because a retired family member who I trust a lot volunteered to be on notice and scheduled a vacation nearby close to my due date, and otherwise volunteered to fly in on a moment's notice. If you don't have a friend or family member close by who you trust to make decisions on your behalf dispassionately, it would probably be a tremendous relief to you and your husband to have a doula. A lot of our friends have used one, and I've never heard anyone say that they wished they'd saved the money.

If you're not sure, take some interviews, ask a lot of questions, and then decide.

You didn't ask but I highly recommend prenatal yoga classes, I used a lot of the tools I learned in class during labor to stay calm and stay focused. During my second labor I basically heard my teacher's voice in my head guiding my breathing the whole time.
posted by vignettist at 3:04 PM on January 17, 2018

I think it depends a lot on the ethos of your maternity unit - in the UK, uncomplicated vaginal deliveries are midwife led (it’s perfectly possible to never meet an obstetrician at all during the whole pregnancy if you are low-risk). So the stories I hear from Mum friends who interviewed doulas are very similar to iminurmefi’s - dabblers who just like watching the wonder of birth, rather than anything practical. I can see the point in the US though.

I would absolutely pay for one-to-one postnatal care though! Again a doula wouldn’t have cut it because we needed trained input (DS was premature and needed monitoring). But if you have the option of paying extra for one-to-one registered midwifery care, bite their hands off!
posted by tinkletown at 3:10 PM on January 17, 2018

We hired a doula for our first kid. She attended the delivery, such as it was, because I ended up with an emergency c-section due to placental abruption. And then when my surgery was done it was past visiting hours and couldn't come in. (Which, come to think of it, is weird. She's a paid assistant, why wouldn't she be able to come in?) The main benefit was her notes and advocating for me during the whirlwind that was "get the baby out" o'clock. I do remember her doing some counter pressure with my back labor, which was helpful.

Unfortunately she retired from the doula business. I have been put off by the other doulas I've found because they all offer placental encapsulation, which ew and seems to me to be a signal about the level of woo.
posted by emkelley at 3:35 PM on January 17, 2018

Absolutely do it. We did not, and it's one of our greatest regrets. My wife had a traumatic labor process, and we were both dissatisfied (scarred, both figuratively and literally, in my wife's case) with our medical team's care. We ended up hiring a doula to help with post-natal stuff, feeding and the like, and what a great decision. There's something helpful about someone who is telling you that you're not doing "it" wrong. It's a stressful time, and at some point you'll need the comfort. Even if your labor is uncomplicated and your nurses are attentative, it's still useful to have a doula around.
posted by kevinbelt at 4:20 PM on January 17, 2018 [1 favorite]

We had a doula for all the same reasons you describe, along with that it was our first and she'd seen it before - this was handy during the first 36 hrs of early labour when the hospital had no interest in us! Although I was signed up to the hospital's midwife centre (as tickletown describes) I ended up being moved to the labour ward to be induced - the doula provided a nice continuity of care, by someone who knew me, wasn't freaked out by what was going on, etc.

I found her by contacting the local doula training centre and making it clear I was a scientist/athiest type - they sent us a doula who worked full time as an environmental scientist and was moonlighting as a doula since she was just *that fascinated* by childbirth! She was awesome. Kiddo is three and we are still good friends.
posted by jrobin276 at 4:26 PM on January 17, 2018

A good friend was doula for me for my second birth. (She has lots of doula experience.) It was wonderful having someone to help interpret the nurses' instructions (husband was too busy worrying, and also, had not done this before), and helping me figure out ways to be comfortable (erm, well, less uncomfortable) that were based on me and not "some women like this."

We established that I am not less stubborn in the middle of labor, and gentle nudges of "perhaps you might shift your weight this way" were background noise; "move like THIS" got through to me. A nurse wouldn't have been able to manage the line between "be polite" and "catch the attention of the person trying to squeeze a watermelon through an opening normally the size of a hair tie."

I can't overstate how helpful it was to have someone there to tell me, this is okay, you're doing fine, yep that part hurts - who was neither my husband, who both wouldn't know and was too panicked himself to be convincing, nor the hospital staff, who are invested in an outcome in which my peace of mind is basically irrelevant.
posted by ErisLordFreedom at 5:19 PM on January 17, 2018 [2 favorites]

My partner and I agree that hiring a doula was one of the best things we did during my pregnancy and post partum. Your reasons for wanting a doula with you are great! If your husband is not sure, a) he is not the person who will be laboring and b) see a).

My doula group held classes, talked to us about birth plans, (and were realistic about how things would be in a hospital setting,) and were available for questions through the last trimester. The doula on call when I had my kid was the one who was most simpatico to me (did I wait to go into labor until she was on call?). I still text her pictures of my kid 2 years later. She was the one to tell me I needed a lactation consult when the baby was 7 weeks old, which turned out to be super urgent. If I still lived in the same town I would go for coffee with her every few months.

There was a doula in the group who did placenta encapsulation, there was plenty of woo, but there was also a lot of solid practical knowledge and experience with the many ways people labor and birth. Since neither my partner nor I had ever seen a baby born, it was super helpful for us to have someone in the room who was primarily accountable to us who had seen it happen many times. The nurses were great, the docs were fine, but Anne treated me like a person the whole way through, and made the whole thing more intelligible to me and my partner.

She also got along with all the nurses and knew the delivery nurse from previous births. Everyone was comfortable with her presence and respected her skills.
posted by Lawn Beaver at 5:26 PM on January 17, 2018 [2 favorites]

I know a family where the mother is a doula and the daughter is a wedding coordinator. They've remarked that their jobs have certain things in common. They worry about all the details so you can concentrate on what you need to, and they can act as go-betweens to vendors or care providers, as the case may be.
posted by The Underpants Monster at 5:26 PM on January 17, 2018 [1 favorite]

I'm a husband of a doula who's been a doula for about 25 years. She's made a big difference in a lot of lives. Having someone be an uncompromising and fearless advocate & support for you - your partner is great I'm sure - but a good doula will see you through whatever storm you go through. A good doula is a rock and worth their weight in gold.

My wife doesn't do a lot of births anymore but one thing she tells people when choosing a doula is to make sure you interview your doula well (get references from new moms and from hospital staff!) and go with your gut when picking one. Doulas can be awesome but they are also people and sometimes people don't get along. Child birth is a roller coaster - you're at your best and worst from moment to moment. The last thing you need is someone you barely know second guessing your judgments or coercing you to make choices you don't feel comfortable with.

Good luck! (for what its worth we had a doula and it was totally worth it!)
posted by Ashwagandha at 5:27 PM on January 17, 2018 [3 favorites]

I didn’t have a doula when I had my baby, but would consider it if I ever had another child based on my experiences.

My husband was a good support during labor (hours and hours of back counterpressure), but I felt a big difference in how well I could cope during contractions when my midwife was coaching me. During contractions when she was charting or taking care of something else, I struggled much more. Having someone professional to coach continuously would have made a difference, I think. Before having the baby, I didn’t like the idea of another person in the room, but the mind-melting agony of actually giving birth took away any discomfort I had about things like that and I barely even noticed the million people in and out of my room when the baby showed signs of distress.

I think finding a good fit is important though. We interviewed a woman as a potential postpartum doula and I found her personality so grating that I was turned off the idea of doulas entirely. That also contributed to my decision to not use a labor doula. Finding the right person isn’t easy.

If you do use someone, I guess I’d warn to just be careful about finding someone who doesn’t have too firm an idea of what a “good birth” is. I ended up having a csection for what I felt were really good reasons, well explained by the doctors at the hospital. I recovered fine, my son was fine, and I was ecstatically happy. It made me feel like crap when members of the midwife team apologized instead of congratulating me, and treated what was the happiest moment of my life like a disappointment for not being the perfect natural childbirth. Similar to midwives, some doulas are very very invested in “natural” birth. It’s kind of a balance, since you want someone who will help support your hopes going in without making you feel bad when things don’t go according to plan, and will advocate for you without turning flexibility into “failure.”
posted by sometamegazelle at 5:48 PM on January 17, 2018 [4 favorites]

My mother-in-law is an experienced doula, so we had her come to my wife's labor. There have been times in my life when I have found my mother-in-law annoying, and this was not one of them. It was the opposite of that. I don't know what we'd have done without her.

It turned out that my wife needed to have somebody's hand to grip, on both sides, for basically the entire labor, which ended up being ~10 hours. I was there and my wife's other partner was there, but without our doula neither one of us would have been able to take a break to go pee, get water, wring some life back into our fingers... as it was, we rotated, and all three of us helping were at the absolute end of our strength when the baby came. Because gripping somebody/being held onto that hard for that many hours is taxing, draining work, though it was nothing compared to what my wife went through laboring.

My MIL brought snacks, updated the outside world, made sure we took breaks, helped negotiate the shift change at hour 9.5 when suddenly every single medical person in the room was legally obliged to switch just as the baby's head became visible. We absolutely plan to have her again.

The important thing is for it to be somebody you trust, and for you to be clear about your expectations and for her to be clear about what she can/cannot will/will not do. This was easier for us because our doula was family, but we did have to sit down with her ahead of time and say 'the following are things you habitually do that in this instance will really piss us off so please don't xy and z', and we knew it was a fit when she listened and promised to follow us on that. If you don't get the sense that you are communicating clearly and easily, find a different doula.

I do recommend finding one.
posted by Rush-That-Speaks at 5:57 PM on January 17, 2018 [2 favorites]

One caution: check your contract carefully before you sign it to make sure you don't have to pay the full price if the doula can't attend the birth.

My friends doula was not able to attend the birth at all because the doula was ill. It was the doula's decision to stay home, not my friends decision. However, the doula insisted on still being paid in full, which was $$$$.
posted by Murderbot at 6:39 PM on January 17, 2018

Without reading everyone else:

We hired a doula and then had a surprise emergency c-section. (It happens.) I was still very very glad that she was there even though the c/s happened like 30 minutes after she arrived. It was a scary situation and she was there to help my husband who was terrified and confused (the father is not a big priority for the medical staff in these cases). As soon as she landed in the LDR room, she immediately got to work helping with the preparations for imminent surgery--helping me sign the consent forms in between contractions, getting my jewelry off and stored safely, trying to get me in a more comfortable position. Then she accompanied us to the OR. She was able to take the first pictures of our baby by thinking quick and handing her phone to a nurse as he was over on the other side of the room (beyond the Forbidden Zone of the drape) being weighed and measured and pinked up. I was way out of it, so she coached my husband through his first moments of being a dad, and they sent baby back to the LDR with them while I was being stitched up. Once I got back into the room I was still shaking like crazy from the meds, so she helped establish breastfeeding even though I couldn't actually hold my baby yet.

It was probably one of the shortest work nights of her life as a doula, but for me and my husband it was an incredibly valuable service she rendered. Yeah, the nurses are there, but their concern is A#1 the baby's health and the mother's health. The night I gave birth, the maternity ward was absolutely slammed (it was a major women's hospital, a huge maternity ward, and there was absolutely no room left at that inn) and the nurses were doing all they could just to keep up with checking vitals. The nurses are usually going back and forth between several rooms. A doula is there just for you.
posted by soren_lorensen at 7:05 PM on January 17, 2018 [3 favorites]

I had a doula and am happy I did! It was nice having my own personal advocate who knew more about the process than my husband and I.

I think we lucked out because the nurse on duty during most of my labor was cool with a non-medicates birth as well.
posted by vespabelle at 8:04 PM on January 17, 2018

We had a doula and it was the best money I’ve ever spent.

I’m sure all doulas are different, but you get to interview them before committing so find one you connect with.

We did a completely natural childbirth with no drugs, and I’m pretty sure that was possible because we had the doula there. The nurses were great. They were absolutely responsive to requests, but they were very passive participants. Our doula always had another idea for helping my wife along. Different positions, breathing techniques, ways to keep her calm and focused.

We took classes. We went together. I read books. I was fucking diligent, and yet it was my first birth and I was pretty useless. When I did suggest things they didn’t go over well. The doula’s experience of 500 births made her very confident and that helped both of us immensely.

I can not recommend a doula enough. Absolutely do it. It’s a fixed cost and you’ll look back on this experience your entire life.
posted by jeffamaphone at 8:25 PM on January 17, 2018 [2 favorites]

I had a doula. I didn’t really benefit. I was induced for medical reasons and then sent for c-section for failure to descend. The doula wasn’t really helpful in the decision making process. I did feel better having someone there, but I don’t think it was worth the price of admission.
posted by crazycanuck at 8:48 PM on January 17, 2018

Our doula was the teacher of our childbirth classes, and we hired her in part b/c my partner was afraid he would just freeze in the moment and not be able to support me. Even though my child's delivery did not go as I had hoped it would (stalled labor + emergency c sec 40 hrs later), we were glad she was around. Our small town hospital was busy, we only saw our midwife every few hours and our dr. wasn't on call that day so the c-sect was by someone we'd never met. Even our doula had 2 clients at 2 different hospitals that day,so we didn't see her as much as we might have, but we knew that was a possibility going in and even then her presence was a helpful constant. She was well known and respected at the hospital, i'm sure there was some note on my chart that said we were one of hers. One benefit we didn't really anticipate that helped us was that she was able to guide my partner to be an informed advocate. As an example, when the nurse told us it woudn't be possible to have him and our son in the recovery room, our doula told him that was the nurse's decision and not hospital policy, and he was able to successfully change her decision. (20 months later when we had our 2nd it was standard procedure as much as possible). She couldn't advocate for me, but she could give him the right words. Of all the parenting decisions I have replayed in my mind, hiring her has never been one of them.
posted by littlerockgetaway at 9:33 PM on January 17, 2018 [1 favorite]

My ex and I were assigned a doula as part of a study at Kaiser, for free. It was great. Difficult labor (25 hours), so one huge thing was that she clued in each of the 3 shift changes as to what was up, knew all the lingo, etc. Explained everything that was going on, invaluable for a first-timer.

It was great to have someone who was there purely to support the birthing mother, in whatever way possible. Similar to littleocgetaway's experience, our doula was the advocate for the mom, arguing for what she wanted when everyone else had their own agenda, and more often then not getting her way. She knew about the pain management value of everything from caresses to a short of shower to the hard drugs, etc.
posted by msalt at 12:00 AM on January 18, 2018 [2 favorites]

I think a lot may depend on where you plan to deliver.

My first kid was born at a good but busy, no-frills public hospital (we lived in Australia). The ward was packed full that particular night and once I was admitted it took me another 20 hours to deliver, and with the shift changes and inability of the nursing staff to give anyone their full attention due to how busy it was, my husband and I were pretty much on our own til the end. I wish I’d had a doula then, because I was on pitocin and my daughter was posterior (which no one realized until about an hour before she was finally born), and I feel like having someone able to spend more time with us and provide consistency across shift changes would have identified that earlier and even if we couldn’t turn her, would have helped me cope with the pain (the pain!) and have made it less exciting during pushing when she ended up in some distress because of how long it was taking.

I thought seriously about a doula for my second pregnancy. A woman I worked with had done it full time before her current career and still did it for friends occasionally and she and I talked a fair bit about it. When I got pregnant I was a Kaiser patient in California, which is a hella efficient system but not very personal, and I was starting to lean toward hiring my friend because I expected a similar experience to the one I had with my daughter - busy nurses, etc. We ended up moving cross country to the Boston Area when I was 7 months pregnant and moving far out into the burbs and I delivered at a smallish hospital with a fairly new birthing center and on-call midwives from my OB practice, and the night I delivered I was one of maybe three patients in the whole ward so I had very attentive nurses and a lot of visits from the on call midwife - so even though I spent about 15 hours in the delivery ward and saw a few shift changes, I felt like I had all the support I needed around pain management, positioning, walking, progress, etc. I think a doula would have been a waste. But that was just because of a lucky combination of the type of hospital and staff (both of which I’d researched carefully) and the fact that it was nearly empty the day my son was born. But if I were to have another kid at this hospital (which I am not, I am so done) I wouldn’t bother with a doula. If I were back at Kaiser though? I would for sure.

So tl;dr: think carefully about the kind of staff and resources your delivery hospital can provide, and ask around for others’ experiences delivering there, to gauge how much support you’re likely to have by default and how much you’d need to source yourself.

Also, a random tidbit: there are post-partum doulas too. I wish I’d had one with my first when my husband had to go to sea three days after I got home from the hospital (though the hospital midwife home visits were a lifesaver). A friend who didn’t have a lot of family or friends able to support them with their kid also had a postpartum doula and they found it really valuable to have help around the house, get sanity checks on things, provide first-pass lactation support, and so on. So it may not only be the birth you should consider.
posted by olinerd at 2:10 AM on January 18, 2018 [2 favorites]

I hired a doula when the plan was a hospital birth, because I did not trust the doctor or hospital to respect my wishes. The doula, who was very experienced, ended up giving me the courage to make the switch from hospital/doctor to birth center/midwife which was ABSOLUTELY THE BEST DECISION EVER for me, for a lot of reasons. (I hired her late in my pregnancy, and when she came on board and I was expressing my concerns to her, including the fact that I was too far along to switch courses, she told me about women who had switched providers WHILE IN LABOR -- it's never too late to change your mind!)

Ironically, I found I needed the doula much less at the birth center than I would have in the hospital but just her giving me the courage to make that decision was worth its weight in gold PLUS she took amazing pics of the birth, which my husband and I were too preoccupied to think of doing so that alone was also worth her fee.
posted by rabbitrabbit at 8:02 AM on January 18, 2018 [2 favorites]

I asked my doctor which doulas he liked working with, to try and get around the "might take this as adversarial". I also interviewed some he didn't mention, to make sure I was making a good choice.

The doula I did hire was just the most amazing. My husband had shingles throughout my final week of pregnancy including the 60 hours of labor, so if I hadn't had the doula, I would have been essentially alone with nurses that I didn't know.

Oh, and she did take really incredible pictures during the eventual c-section while also being supportive of me and my needs throughout.

So, A++++++ would hire again.

I would have hired a doula for my second baby but we ended up with a scheduled c-section and my dr told me that hospital rules would require me to choose between doula and my husband in the OR. We had moved, it was a new hospital.

p.s. if you happen to be in Boulder, I can give you the name of the doula.
posted by freezer cake at 10:28 AM on January 18, 2018

Another thumbs up for doulas... we had an awesome medical crew for our son's birth 1.5 years ago, but the doula really brought the whole thing together. If you're in PHX, get with Kelly Sunshine. She was incredible.
posted by ph00dz at 10:50 AM on January 18, 2018

I had a doula for my first labor, and I have no regrets about it. Labor is long and hard, and the nurses I happened to have did not do much in the way of coaching for me. I knew my husband was likely going to be anxious and maybe not thinking straight depending on what happened, and I was terrified of giving birth. The doula was my insurance policy to try to help myself get the best out of the experience that I could.

I had an induction and was in labor for about 24 hours, kind of a typical first time labor, so I definitely got my money's worth out of her. I was at 8cm and further for about the last 12 hours of it. I got an epidural but I still continued to have the worst pain of my life, so didn't find that very helpful. I feel like I would have paid $1000 just to have the doula there for that hour I was going through transition and she did sacral counter pressure for me. It was the single best thing for my comfort during the whole labor experience.

I did end up feeling that my doula wasn't the greatest personality fit for me. I am very comfortable with medical settings and medications, whereas she was more comfortable with home birth and avoiding medications. She said it was fine that I chose to have a hospital birth and an epidural but I ended up feeling judged. I chose her in part because she taught the hospital prenatal breastfeeding course and was a great teacher, but after I gave birth and struggled seriously with breastfeeding, she seemed even more judgy and told me that "breastfeeding should never be painful." That was not helpful at a time when I was going through pain I deemed worse than most of my labor during breastfeeding.

So I would agree with interviewing a bunch of people and feeling them out to make sure your attitudes match up and that they can roll with the decisions you want and not try to impose their own philosophy or paradigm on your situation. As for the cost, consider getting a doula student who would charge you less (although they may be less experienced, they could still certainly fill the functions of support person etc). Final note: like many other people here, I taught my sister in law what the doula did for me during labor and used her as my labor coach the second time around, so I felt like there were lasting benefits to having used her.
posted by treehorn+bunny at 8:39 PM on January 18, 2018

Just for a counter perspective, I gave birth last week with no doula and I don't feel like I would have benefited from one.

I may have just lucked out hospital-wise but I was able to summon nurses whenever I needed to get me water/ice, information, meds, help going to the bathroom (while I was hooked up to stuff), advice on pain control, breastfeeding/pumping assistance... (And my husband to get me juice, hold my hand, charge my phone, call our parents, coordinate errands with our friends...)

I had originally hoped for a natural birth but had to be induced/monitored/IV'd after my water broke at 36wks. A nurse then advised an epidural which I did get and think ended up being a good choice, and I didn't feel pressured. My ob/gyn told me when/how to push during that phase and it went well (and despite spending 24+ hours on pitocin without starting active labor I was able to avoid a c-section).

YMMV - I'd suggest going on your hospital's maternity tour to get a sense of what they will provide and if it seems like they'll be flexible with your wishes or like you'll want an extra advocate with you.
posted by anotherthink at 11:26 AM on January 19, 2018

Couple of comments upthread about asking the hospital staff or your doctor for recommendations. This is excellent advice, for more reasons than you would think.

I asked my doctor for recommendations, and he couldn't give me any. I called several of the doulas in my area and without outright saying so, they basically all refused to work with him. A few weeks later he revealed his true nature to me by screaming at me in his office (the story isn't relevant but I definitely did not want to be in L&D with that guy). I ended up changing doctors in my 3rd trimester. If I'd been able to read between the lines a little more I would have realized that the doulas I'd spoken to were trying to tell me to find a different doctor.

So if your doctor can't give you a name or two of someone they like working with, dig a little deeper.
posted by vignettist at 2:14 PM on January 24, 2018

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