To Doula or Not To Doula

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An extra set of caring hands or too many cooks? PSP members share their advice about hiring a doula.

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Summary:

The positives of hiring a doula:

 

The negatives:

  • Your partner/ spouse can be just as good an advocate; similarly your OB if you have a great relationship with them
  • A doula can make your partner feel insufficient
  • A doula can be expensive
  • A doula can be "too many cooks" in the birthing room
  • A doula is not a substitute for medical advice
  • A birth is over quickly and it’s postpartum is when you need more helps.
  • View all the "nay" responses here.

 

 

FULL RESPONSES:

To doula

Doula postpartum 

To not doula

 

TO DOULA:

 

“My husband and I knew we would want a doula.  It was our first birth experience and we didn't want our parents at the birth because we knew their nervousness would not be helpful to us.  We wanted someone who would be ours throughout the whole labor and birth, not just when we were being checked on or during pushing.  We also wanted someone to help us when we were not sure about something or just help each os us out.  Having planned to be at Brooklyn Birthing Center then being transferred to Maimonides was incredibly scary and stressful and our doula was crucial here (she actually admitted me while my husband spent 45 minutes looking for parking because the parking garage at the hospital was closed!!!).  We interviewed 3-4 doulas and went with my feeling.  The doula we chose reminded me very much of my good friend who is a doula but lives far away, so it was really that instant calm feeling I got.  We used Birth Focus to meet the different doulas.  It is an investment, but I'd do it all over again and will use one in the future if we can.”

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“Was it worth it?: YES. This was our first child and birth, so I knew my husband and I would need some guidance. He agreed that we would likely need help but felt odd about having a stranger ( of sorts) there at such an intimate moment, but by the time we were in the hospital, Rebecca (our doula) didn't feel like a stranger and there are plenty of other strangers around anyway (nurses etc). So if you worry you may feel funny or self-conscious, you have to remember the context you will eventually be in!  Rebecca was so caring and reassuring and guided us through numerous pain-management positions ( until I got the epidural!) and also helped hold my legs and encourage me while pushing (for 3 hours!). We also had numerous pre-birth meetings so she knew us and our wishes well (including reiki sessions, which was so relaxing during pregnancy!!)

What I loved about her was that she was totally non-judgmental in every way. I had had a few miscarriages and was therefore VERY anxious during the pregnancy. She was so calming and reassuring without judging my anxiety (which was over- the -top). She also never inserted her own beliefs about things - instead, she supported and guided appropriately. I ended up getting induced on my due date because I was so anxious (I had been pregnant for a year and half at that point pretty much continuously!) and she totally odd not judge that decision at all, though I'm guessing she may not have gone that route herself! She always knew what I needed and responded supportively.

While I was in labor, she was a champ - hung with us in the hospital through the night, don't think she are or slept much, and was so warm and supportive throughout. She was also very available leading up to the birth and came a week after to check on me- and wrote a beautiful and detailed story about the birth for us!”

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“Both my husband I wanted a doula. We both agreed we wanted the support of someone more knowledgeable and experienced in childbirth and I was aiming for a natural birth. Jax, our doula, was invaluable! First, my labor was quite long, so even though I had a c-section after 30+ hours, Jax was with us and supporting us for a good 24 hrs.  She helped us labor at home and in the hospital, made it possible for my husband to get food and rest as needed, and supported all of our decisions as we needed increasing interventions and stayed until I was in recovery with my little man in my arms. She also came for her follow up visit the next week.

I think it depends on your partner and if you have other people who you are comfortable with supporting you through labor, but I would encourage anyone considering a doula to at least talk to a few.

I also had a postpartum doula come for just 1 day (4hrs) and would have had her come more if my mother and mother in law were not around as much in the first few weeks.  She was also fabulous - I was able to nap, she gave me some breastfeeding tips, made me lunch and generally gave me a chance to pull myself together so that I could be a more effective parent once she left. We would likely hire a doula again, just because you never know what is going to happen in childbirth and having the support is amazing! But I would be much more willing to hire a less expensive/less experienced doula the second time around now that I've been through it once.

And the negative experiences do sound like either a. a doula who wasn't fully committed or b. a personality mismatch, which is why an in person interview is so important.”

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“That's hard stuff! Get yourself a doula!”

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“Statistically, doulas drop C section rates dramatically. They can be expensive but so worth it. It just felt important to have an advocate in the room when things went wrong. Someone I could rely on to give advice and have my best interests in mind.”

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“We are using a doula. We interviewed four people based on recommendations from people we trusted. All four of them were lovely, it was just a matter of the best personality fit. The price of the doula will depend on how many births they have attended. I know people who have had good experiences at both ends of the spectrum. Personally, I think this is money very well spent. There is a bunch of research showing that women who are consistently attended by one person during the birth process (as opposed to a series of l&d nurses though shift changes) have lower intervention rates and better outcomes. Doulas do get booked up, though, so I  encourage people to be looking sooner rather than later.”

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“I found my doula to be the most helpful thing since I labored mostly at home. If you are considering one, definitely go for it!”

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“We are having a home birth (as long as no complications arise between now and December!) and our midwife requires first-time moms to have a doula. I was a little skeptical at first (mainly because I was (and to some extent still am) not totally clear on what they "do" in the whole process, although I'm getting a better idea), but the way our doulas explained their role was to act as a sort of "Sherpa" who has traveled this road many times before and can handle all the non-medical questions that will inevitably arise through the process. I don't, however, view them as giving out medical advice, and if I had a doula who was very pushy about telling me how to handle things like when to go to the hospital, I would be gun-shy too! I would expect our doulas to defer to the midwife (or in others' cases, the doctor) about those decisions. All that being said, we are glad that we are going to have the doula, because neither one of us will have a clue what we're doing!”

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"I was nervous with my first birth too. But there was no way I was going to pay that much for a doula so I opted out. After days of labor my midwives kind of assigned me a doula for free because she had never attended a birth in the US before.  She came to my house the morning of, went to the birthing center with us, and stayed with me and my husband all that day. None of us knew what the hell we were doing but we all muddled through it together and it was memorable and wonderful. I gave her a $200 tip. Second time around, I didn't want to pay again. I found another doula who had never been to a birth. This time my husband and I knew more what we were doing. I told her I would instruct her on what I wanted her to do and she was fine with that and it was just what I needed. The labor was much shorter.  The best thing you can do for yourself is increase your own self confidence. I did this by reading the hypnobirthing book and listening to the CDs. And it's true, or at least it was for me- you just need a kind and nurturing and intuitive person there, that is more important than tons of experience. There are many doulas out there who will charge low fees in exchange for the experience."

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"IMO, a doula is not something you want to cheap out on. If you're spending less than $1200 you aren't going to get the level of experience and support you are probably looking for. Perhaps go with an experienced doula instead of a private room or other "extra" (packing less of your own stuff in your hospital bag and using the hospital's toiletries and gowns will probably save $100 alone). Or pay for extra birth coaching classes for your partner/support person to take, because the emotional support component that a good doula provides cannot be replaced by an inexperienced doula, but can be provided by a partner/mother/sibling/good friend/etc.
During both of my children's births, my doula was essential. Without her, my older child's birth would have probably been a very bad memory because my OB ended up being a complete narcissistic a**hole. Her being there and providing emotional support was priceless. It felt like my doula and the nurses worked very well together and luckily my OB wasn't around for two long because the birth was fast.
At my second birth (different OB!) I ended up having to have a c-section and, although I'm not too squeamish around medical environments, knives, blood, etc. I felt overwhelmed once I walked into the OR and had to get on the table. Believe it or not, my doula calming me down was actually more useful than her coaching me through natural birth for the first child. Since she was experienced she also warned me about ways to reduce the chances of vomiting during the c-section, which was so great because I have a phobia with vomiting.
A professional doula will have a contract specifying the time they will spend with you before, during, and after the birth. Get everything in writing. Check three references and then ask those references for who referenced them and talk to those people as well. Also check Yelp and the PSP review page.
Even the "rockstar" ones have sliding payment scales, so it doesn't hurt to call and ask."

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"This is an interesting thread. One factor that you might want to consider is who is delivering your baby. We had a less experienced, but affordable and very nice, doula at the birth of our second child. And both times our midwives stayed with me the whole time and were great coaches and support. I can't imagine them being better. My first labor was about 20 hours so this was no small feat. Honestly I don't know why we got the doula the second time except I think I wanted a bigger team. It didn't add much since the midwives did everything. I get the sense that if you have an OB they are delivery only and you would want a doula who has some good experience for labor."

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"Review your contract carefully as I should have hired a doula who would move more hours to post-partum when we found out we’d have a planned c-section.  This was on me as her contract was very clear."

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I used a doula for my first baby, and it was great. I really appreciated the support she offered-- before, during, and also after birth."

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"I had a very good experience with our doula for #1 and we’ve gone ahead and hired her for #2. She had a ton of experience (which I would also recommend looking for) and provided great support for not only myself but my very panicked husband.  We took multiple birthing classes and it was amazing how during the actual event we managed to forget everything until she joined us (we were trapped in triage without her for 2.5 hours).   She was also super helpful the first few days when we were at home. We had some initial nursing issues and she was able to provide fantastic support."

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"I would say interview a few doulas, birthing is really intimate and you want someone around you are really comfortable with.     
She provided us with a lot of support beforehand and really let us dictate the help we wanted.  She helped us walk through all the steps of getting to the hospital, who we wanted in the room, suggestions for what to bring...etc.     
I would say the moment she really paid for herself was when my parents wouldn’t leave the room. I kept suggesting they get lunch to get them to leave. They left to grab a snack and our doula asked me if I wanted them back in the room, I said no. She scooped up all of their stuff and brought it out to them and very diplomatically told them she would come get them if I needed them. I was so relieved!     
In the end I labored for 30 hours, it was helpful to have someone else on hand so my husband could rest if he needed to. I had an emergency c-section and she explained to me what I could expect and asked me what I wanted from the doctors, continually advocating for me. She stayed with our stuff and helped get us to our room post surgery. She also helped me get our son to latch right away in the recovery room. She also organized my family visiting the recovery room one at a time so neither my husband or I had to be the “bad guy” with them. My family loved her and had no idea they were being handled the entire time.     
We have stayed in contact since our first birth and am so happy to have her back for this next birth! You should do what you think will make you the most comfortable."

 

TO DOULA - BUT DO IT POSTPARTUM

 

“I just wanted to add that doulas are not just for the birth itself. I am a postpartum doula (and lactation counselor) who works with families immediately after the birth to help them transition emotionally, physically and logistically to their new reality. I constantly hear in my work from those new moms who hired labor doulas but not postpartum doulas that they wish they had made the reverse decision, knowing ( in retrospect) how short the labor and delivery is and how long the process of really blossoming into parenthood takes (and how much support it requires).”

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“I think having a postpartum doula is an awesome idea. For so many generations before us (as I'm sure you know) family, neighbors, village, older children, etc. could help with life-soon-after-baby. I think that kind of support makes a huge difference in postpartum recovery. And I think the amount of energy and time required for recovery can really be underestimated by many. (I underestimated it for myself, although  I know everyone is different.)”

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"We had a post partum doula with my first and it was really helpful! We had her come immediately after delivery so she helped with breastfeeding, giving my son his first bath, and gave a lot of advice on soothing him and creating a schedule for myself once my husband returned to work and I was still on leave. Happy to send you her contact info - she was awesome. Very knowledgeable and also non judgmental.
We decided against a baby nurse since with breastfeeding I felt like I still had to be available for that and didn't feel like a baby nurse would be that helpful but some people really like the help and support they provide."

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"We had a Doula and we found her very helpful before, during and after."

 

NOT TO DOULA:

 

“Had my husband there for baby 1 and that is all I needed. Had a natural birth in a hospital and it turns out, he was totally capable of supporting me through immense physical pain (already knew he could support me through emotional pain when my mom died). If your partner feels like he/she can support you then trust him/her on that. I think doulas can make the partner feel insufficient. I needed to look into his eyes when it really hurt and I needed to have him tell me I was doing great. I heard no one else at that time - just him. I labored at home just fine and he was able to advocate for me in the hospital (not rocket science). It was pretty amazing to just go through it together, can't imagine having someone else there. It would have felt strange and not right- he's always been my support and he wanted to be the one for me. We never considered a doula. To each her own!”

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“We are not using a doula as of now. We're going with a midwifery practice and we got the sense that we wouldn't necessarily need one. My husband already has two kids so I'm hoping his experience in this regard will come in handy!”

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“I didn't have a doula with my first. I had a midwife who had the same birth "plan" as me and a very helpful husband who could handle it. I'd think a doula would be helpful if you don't think you can communicate well with your doc and need an advocate, your husband might not be able to suggest poses or help with labor, or you just want another person around to support you. Whatever makes you feel most at ease is the best course of action. The more open and relaxed you are, the better the experience will be.”

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“My husband and I felt that a doula would make for too many cooks in the kitchen.”

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“We're on the fence about a doula as well... On one hand, my neighbor said it was great to have someone there who could explain things while she was laboring and freed up her husband to be more of an emotional support, instead of running interference with the medical staff. On the other, there's the extra cost + introducing another person into the room. In the end I think whatever you decide will be the best for you.”

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“My husband and I have decided to not hire a doula for a few personal reasons. While we both completely respect others' having one present, we feel that this is an experience for us to share between the two of us (and of course the doctors and nurses and whoever else is already needed in the delivery room). Hiring a doula felt like interference to us- just a gut feeling we had. Additionally, while I have been lucky to be having a very routine pregnancy so far, I do have a medical history which may lead to a c-section. I would prefer a vaginal birth, but I am very comfortable letting my OB dictate what is best for me as delivery approaches…”

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"We skipped having a doula because where and when we gave birth (at St. Luke's Roosevelt) I was told that twins will be born in the OR due to high risk of c-section and only 1 person was allowed in there with me...and that was for sure going to be my husband. My husband and I took birthing classes and he did some reading on his own to make sure he could be supportive.  This was over 3 years ago so not sure if things have changed but I didn't have a c-section despite them calling for a c-section kit after I delivered my son vaginally. One of the doctors in the OR with us told me that I had one last chance to push while they prepped the kit and I did NOT want to be one of those 2-for-1 moms so I beared down and gave it all I got...daughter came out!   No NICU for us either and we ended up only about 4 weeks early so overall a really good birth experience. I was glad we invested the money in educating ourselves and getting support in other ways. While my friends with Doulas had amazing experiences, I think we made the right call for our family."

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"

We had our twins born via c-section. I had a fantastic OBGYN associated with Weill Cornell/NY Presbyterian Hospital, and I can honestly say that the whole experience was warm, caring and overall, wonderful. My kids were born a month early but completely healthy. They didn’t spend any time in NICU. When I was discharged, I walked out of the hospital, rather than being wheeled out in a chair. I didn’t feel that I needed a doula at all, but I also have a very supportive husband. If you trust your doctor (who better can advise you on any medical decision besides the person with extensive training and experience?), and your partner is there for you during the delivery (only 1 person is allowed in the OR for a c-section), your money is better spent by hiring a post-partum doula. This is when we really needed help."

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We considered having a birth doula for our twins but decided against it. We knew at 26 weeks that the odds were largely against having a vaginal delivery and my OB, whom I trusted explicitly, rightly suggested I use the money for post Partum doulas. I made it to my scheduled c-section date at 38 weeks and I am thankful that I had the extra care/help when I got home. My OB and my wife were the best support team I could have asked for during the delivery and in the hospital. If I thought I might have a labored delivery or chance if vaginal birth I would have probably considered it more. Good luck."

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"I am going to be an outlier here - but we hired a doula for #1 and it ended up being a huge waste of money. She didnt stay with me all of labor, I ended up getting an epidural and then she missed the birth. In retrospect, I think I'm happy it was just my husband and me for the birth of our daughter, but I'm very private. So, we are not going with a doula again for #2.
However, I know many people that had lovely experiences with their doulas! I'm sure most are great. But after BTDT we could have 100% done it without one."

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"For my first, I used a cheaper doula who didn't have experience and it was a bad idea.  I suggest getting somebody highly recommended with experience who might be expensive, or just not using a doula.  It's a profession that takes time to learn.  So many varied experiences and learning over time how to let the couple lead is important.  Using a doula is my only regret from my first birth."

 

FURTHER RESOURCES ON PARK SLOPE PARENTS:

 

PSP member recommendations for DOULAS

and reviews for DOULAS - VBAC FRIENDLYDOULAS - VBAC FRIENDLY

 

FUTHER RESOURCES FROM AROUND THE WEB:

 

"I've spoken with a number of you about hiring a doula. I found this document very helpful when my husband and I were interviewing candidates, so I thought I'd share."