Birth is expensive – I get it. I’m facing all of that right now. Scans, blood tests, Dr’s/midwife bills… it goes on and on. On top of that, I’ve just signed up for HypnoBirthing classes, and for first time mom and dads there are prenatal classes, prenatal yoga, lactation consults, buying a ga-zillion (often expensive) things. It’s all just hectic.
And then there is the doula, which doesn’t seem all that important when facing the million bills, unexpected needs, third trimester exhaustion and hubby asking “what on earth is a doula?”
I’ll save you my shpeel on why I think you really, really reaaaaaally should consider hiring a doula (I am a doula, and have had a doula at both previous births – so am a huge advocate) but I’ll just give you some food for thought, inspired by Wellness Mama Blogger, Katie.
As a doula, it is an honour to be invited to participate in anyone’s birth team, and having done it numerous times, I am always inspired and in awe of labouring moms. There really is something so primal and raw about a mother labouring – it is beautiful and astounding to witness. While doula’s are certainly not the be-all-and-end-all of births, there is a lot of evidence that the presence of a doula can shorten labours and (in some cases, drastically) improve birth outcomes.
What is a Doula and What Does She Do?
What Does a Doula Do? The word “Doula” comes from the Greek word doule, meaning “handmaiden” or “woman who serves.” That is precisely the role of a doula for a labouring woman: to serve the labouring mother and help her have her desired birth outcome.
In essence, a doula is a massage therapist, friend, therapist, DJ, court jester or anything else a mother needs her to be in labour. She is a shoulder to cry on or an encouragement when the mother thinks she can’t go on. Most doulas go through a rigorous training program before assisting women in labour.
A doula is trained in labour and childbirth and provides continuous support to a labouring mother. Her focus is tending to and helping the mom and supporting the relationship of the labouring couple. Doulas often support laboring women by:
- Providing continuous emotional and physical support,
- Giving information if asked and helping the mother find resources to research her birth choices (before labour),
- Using comfort measures like massage, suggesting different positions and helping with relaxation breathing,
- Accommodating the mother’s wishes for the birth environment (low light, soft music, etc) to the extent possible in the place of birth,
- Encouraging the mother to communicate with her doctor and to be informed about any procedures and interventions (a doula does NOT give medical advice or interfere with the doctor/mother relationship),
- Supporting the father or birth partner in the best way to support the mother. A doula never replaces the very important role of the birth partner and a good doula will help the birth partner by suggesting ways that he can support the labouring mom and things that can improve their synergy in labour.
But WHY a Doula?
Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualised care based on their circumstances and preferences.
Doulas are educated and experienced in childbirth and the postpartum period. We are prepared to provide physical (non-medical), emotional and informational support to women and their partners during labour and birth, as well as to families in the weeks following childbirth. We offer a loving touch, positioning and comfort measures that make childbearing women and families feel nurtured and cared for.
Doulas are also great at practical help: taking photos at your birth, moving your bags from one room to another, keeping you hydrated, massaging your lower back through a tough contraction, helping you understand ‘medical talk’ going on around you, filling the bath if you desire a water birth, and they’re always on the other side of the phone when your waters break, you lose your mucus plug, or you’re onto your 17th cup of red raspberry leaf tea…
Numerous clinical studies have found that a doula’s presence at birth
- tends to result in shorter labors with fewer complications,
- reduces negative feelings about one’s childbirth experience,
- reduces the need for pitocin/oxytocin (a labour-inducing drug), forceps or vacuum extraction and caesareans,
- reduces the mother’s request for pain medication and/or epidurals.
Research shows parents who receive support can:
- Feel more secure and cared for,
- Are more successful in adapting to new family dynamics,
- Have greater success with breastfeeding,
- Have greater self-confidence,
- Have less postpartum depression.
So, how do you go about Hiring a Doula?
In South Africa, the best thing to do is to check out WOMBS (Facebook and website) as well asMamaBamba and just ask around. Chat to your gynae or midwife. Doulas gain the most business from word-of-mouth, because I think actions really do speak louder that words in this type of ‘industry’.
Interviewing a number of potential doulas is really important – but might feel a bit weird, right? Even if you’re not sold on the idea, I’d recommend just meeting with a couple and chatting stuff through, and soon enough you’ll get a feel for what they can do to support you in your birth and if you want them as part of your birth team.
Here’s a cheat sheet on what to ask (thanks to Wellness Mama)
Important Questions to ask when considering a Doula:
- What is your training? If certified, through what organisation?
- Are you available around my due date?
- How many other clients do you have around this time?
- What is your philosophy about birth and how do you most often support women in labour?
- How many births have you attended?
- Have you attended births at my birth location and what were experiences there?
- Do you have experience with my caregiver?
- Do you have a backup doula and will I meet her?
- At what point in labour do you meet up with us?
- How do we contact you during labour? Are you always on call?
- What coping techniques do you find most helpful?
- What are your fees?
- Why did you become a doula?
- Have you given birth yourself? Did you have a doula? What were your birth experiences?
It is also really important to connect with your doula and feel like you can trust her. She will be with you during one of the most intimate and vulnerable times in your life, so your comfort with her is vital.
Money, money, money…
The cost of a doula varies greatly depending on where you live. Doulas who are working toward certification (student doulas or doulas-in-training) may offer discounted or free rates (WIN!), while some really experienced doulas can cost a pretty penny (but often offer awesome benefits such as a whole toolbox of tricks, use of a TENS machine, prenatal massage, training in HypnoBirthing and so on). In general in South Africa, the rate seems to be around R3000. For the most part, medical aid will not cover this cost, so needs to be calculated into your birth budget.
This might sound like a huge additional (and maybe even seemingly unnecessary) expense, but considering the additional expenses that can occur without the presence of a doula, can be just as much if not more. If for no other reason than protecting the birth experience and the deep (deeeeeep) memories associated with your birth experience, that was enough for me. In my mere 32 years of being alive, one thing I’ll always believe in is community, The Village, and it is in these times of very real vulnerability that continuous loving support can make or break. We were never ever meant to birth alone.
And so, have you ever had or considered using a doula? What was your experience?
Contributor: Debbie Knighton-Fitt, Pure Beginnings pregnancy ambassador & author of the Our Greenish Life Blog.