I know as a doula and birth professional who works with hundreds of families a year, there will always be families who want a doula who has the most experience at a higher price tag, and there will always be families who are happy to work with a less-experienced doula at a lower price tag. There is no right or wrong, there is just what is right for you.
Doulas aren’t like other professions we may sometimes link them to – take nurses, for example. You understand when you have need of a nurse that they all met a standard competency, and they all work to keep that license up. Even if your nurse went to school in Washington, or Florida, or the Netherlands, there are core competencies all nurses are expected to learn. There can be some slight variations, but for the most part, the educational requirements are similar.
In contrast, according to DoulaMatch.net there are over 120 doula training organizations. This means there are over 120 different ways to become a doula! The hard part is figuring out just what the training, certification, and experience means. When we look at websites or Facebook pages, doulas can pretty much appear the same. Each organization has different requirements for doulas to carry their names. Here are just a few of these:
I certified as a doula with DONA International in 2004. At that time, there were very few organizations to choose from. Now the amount is staggering! I think I would have still chosen DONA today as my values and what I wanted from a certifying organization hava not changed.
Many people don’t want the pressure of a governing organization hanging overhead. I have met so many people as a birth professional, and one thing that always amazes me is the wide variety of jobs out there! In learning about families’ occupations, I have found it is not unusual to have a professional agency, governing board, or larger organization that steers how people do their jobs. Architects, Realtors, Doctors, Cal Trans Workers, College Professors, Sandwich Makers, Day Care Workers, Teachers, Linemen, Physical Therapists, Lawyers, Dairymen, Nurses, Pharmacists, Landscapers, and even Doulas (I have a lot of clients who are doulas!), have organizations above them that offer scaffolding and organization.
I am a lone doula, and this I what DONA offers me – DONA gives me information, education, and support to aid me in doing my job. DONA sets expectations, they disseminate new evidence and educational opportunities, they create routes to streamline my work. DONA looks out for me, so I can look out for my clients, and that is why I stick with them.
After writing this, I realized Kim James offers much of this paralleled information on DoulaMatch.net. She has laid it our more succinctly and without bias; refer to her page to see more ideas about what information you’d like to know about your doula candidates.
For you doulas out there, who did you certify through, and what led you to that decision? Share what you love!
I once wrote how teaching about birth is like selling a house. I was happy to see Joyce's comparison here, and even happier how her points lined up with reality. We hear many analogies for the roles doulas hold. I think this one stacks up well -- what do you think?
Although doulas are increasingly popular additions to the birth team, not everyone is clear on what they do for a birthing family. There are several useful analogies out there, but the comparison of a doula to a real estate agent is less discussed. So here is my attempt, 10 ways a doula is like a real estate agent!
1. The doula's goal is the client's goal.
Just like your real estate agent is not searching for his/her perfect home, your doula is not pushing her perfect birth onto you. Your doula will get to know you before your birth as much as possible, so s/he knows what you want in your birth.
2. Your doula can help you navigate your options.
Your real estate agent knows her/his local real estate market, just as your doula knows his/her local birth market. Your doula can help you find the best birthplace to fit your desires, just as your real estate agent can help you identify your ideal neighborhood.
3. Your doula is up-to-date on the current market.
Your real estate agent will know how properties are selling currently. Your doula will be familiar with local maternity care.
4. Your doula knows what to look out for to help you have a positive birth experience.
Just as your real estate agent knows what items to ask for on your offer (the appliances!), and whether or not the cracks in the plaster walls are something to fret about, your doula will know what questions you need to ask in order to make informed decisions.
5. Your doula is trained and experienced in the field.
Even a brand new doula without children of his/her own has received extensive training in both normal childbirth and its variations and complications, and in caring for childbearing women. Just like a real estate agent has been trained in navigating the real estate market.
6. Your doula will support you if you change your mind about what you want.
Just as your real estate agent will continue to help you if you change your property search criteria, no matter your reasoning, your doula will support you if you change your mind about choosing that hospital, or planning an epidural, or having a waterbirth.
7. Your doula will offer his/her advice, but you are the decision-maker.
A real estate agent will offer her/his advice when pricing a property, or writing an offer, but you are still the one making the sale or the purchase. Your doula will remind you when you stray from your birth plan, but this is your birth, and your baby.
8. Your doula knows where to go for complementary pregnancy and birth services.
Your real estate agent knows the title companies in your area, the lenders, the exterminators, the inspectors, and has worked with them before. S/he can help you find a reputable professional in your property-selling/purchasing process. Your doula knows the chiropractors, the accupuncturists, the prenatal yoga instructors, the lactation consultants, the babywearing groups, the back-to-work support groups, in your area, and can help you find perinatal professionals in your area to help you.
9. Your doula will walk you through the entire birth process.
Just as a real estate agent will assist you through the entire purchase or sale, your doula will help you from the earliest inklings of Birth Day through the first couple of hours postpartum. Whether her support is over the phone, email, text, or in person, your doula is supporting you the entire time.
10. Your doula follows up with you after your birth and helps you adjust to your new family.
Your real estate agent will follow up with you after your sale or purchase to make sure everything continues to go well, and answer any last-minute questions. In the years after your property purchase, you can even contact your realtor for referrals on remodeling projects! Your doula is the same way. Just because your contract period has ended with your birth doula does not mean you cannot contact him/her again! For example, the definition of postpartum depression is any depressive symptoms in the year following the birth. Your doula wants you to be well, go ahead and reach out to her if you need anything.
Joyce Dykema, MSc, CD(DONA), HCHD, became a certified birth doula in May 2012. She is also a trained Hypnobabies® Hypno-Doula, volunteers as leadership for ICAN of Lincoln, and is an Evidence Based Birth Instructor. Joyce is a woman-focused doula. While passionate about natural birth and what research shows is the best for moms and for babies, the goal she strives for with every client is for women to have empowering and positive births, as the woman defines it. In addition to her doula credentials, she holds a BA in psychology and an MS in biological sciences. She breastfeeds, uses cloth diapers, uses baby sign language, babywears, and homeschools because these choices made sense for her family; she encourages others to explore and find what makes sense for their families. Joyce and her husband have three children, and live in the Lincoln, Nebraska area.
Do you remember what it was like for those first couple years or those first few births, when being a doula was new and invigorating? Monalisa is a newer doula on fire for this work! I love hearing about her feelings, experiences, and excitement -- it stirs those feelings up within me and reminds me why I continue to love being a doula. Monalisa and I had the same doula trainer, and I am confident she learned the skills (to add to her already huge heart) which will help her on her doula journey.
I am a doula working in the Porterville and Tulare County area of California. I have worked as an in-home care provider for 15 years. In 2015, I attended a DONA-approved birth workshop. I quickly realized that I had not only found my passion, but I also found a tribe of strong, like-minded, loving and selfless women. I had never met these women, yet they accepted me and supported me -- they believed in me! These women instilled confidence in me and what I held within. My two-day workshop quickly came to an end, but these friends have remained close to my heart.
February of 2016 was my first experience as a birth doula, and it was EXTRAORDINARY! I knew without a single doubt this was my calling, this is what I was meant to do.
The remainder of 2016 was spent focusing on my family. Before I knew it, 2016 had come to an end. I had been feeling disappointed and very unsatisfied. I reflected back to remember the last time I had felt genuinely happy, fulfilled, and ALIVE: February of 2016, almost a year before, when I had helped welcome little Miss Katalina into this world. It was crystal clear: I needed to get back into my doula journey -- I need these mommies and they need me!
February 2017, I was on Facebook and came across a friend who had just announced her pregnancy. I quickly private messaged her to say congratulations, and in the course of our chatting I mentioned I was a doula, and I shared what doulas do. Then I offered my support if she wanted it, to which she quickly replied, “OMG, that sounds good. Yes!!”
I was shocked! What just happened ! Did I just get a client!?!?!?! YES!!!!
Our journey as mommy-to-be and doula had begun. She didn't seem to have a lot of support for pregnancy-related things, so I called around to get information about services in our area. Classes were being offered at our local hospital. I asked if she was interested in going, and she said yes. Every Monday evening, we got together for a quick snack, a review of her week, and we went over ideas for her labor and birth. Afterwards we attended the birth class together. Mondays, for the first time EVER, were now my favorite day of the week!
At home I read my doula books, strategically put together my doula bag, and went over our family plan on what to do when I got called to a birth. I was very thorough and clear to my family that I could be gone for 24 hours or more, and they needed to take care of each other.
April went on so slowly, it seemed like the days dragged! What does one do when their client’s due date is April 20 and it’s barely April 10? Role play! My family helped me out. We acted out different scenarios as laboring mother and doula. I have the best family! I must give credit to my daughters and my wife, they are always so willing to play along with my crazy ideas!
Every night I checked my phone, synced my Fitbit notifications so that my watch would alert me when my client called, and made sure my doula bag was all set and ready. I woke up numerous times a night to check things, and then I’d go back to sleep (but not a deep sleep because I was so worried I’d miss the call!).
Finally, April 20 had come -- this was the day we had all prepared for, this was the day we had reenacted over and over and over. But no baby came. My client felt great! She had no signs or symptoms of prelabor or labor. Every morning and every evening we’d chat: “How are u feeling? Do u feel any changes?” And she’d reply with a smiley face: “I feel good!”
The week went on like this, until one morning, I got the call! My client had been up all night with small inconsistent “cramping.” She was at the hospital. She assured me she was okay and she’d get back to me after getting checked out.
I went about my normal day. I took the kids to school, went to work, and gave my boss and coworkers a heads-up that I’d probably be clocking out early. Everyone was super supportive; we had all been waiting on this very special day. By noon my boss said, “get out of here, I can see how anxious you are, we will be fine.” So by 1pm I was clocking out and on my way to Sierra View hospital in Porterville.
Aril 26, 2017, I walked through the hospital doors and was asked where I was going? I proudly said, “I’m going to labor and delivery, I’m a doula.” Along the way I was asked again, where I was going? And again, so proud and full of glee I said, “I AM A DOULA here to see my client” I got buzzed in and at this point I think I was floating through the halls -- not even walking!
I opened the door to see my client in bed with the biggest smile I have ever seen. I calmly said “Hello, Honey, this is the day you have been waiting for!” She replied back with, “Yes, I can’t wait to meet my son!” I then introduced myself to the father of the baby and his mother. They looked confused, nervous, and unsure. We had never met, and it was now becoming apparent they had no idea who I was or what on earth I was doing there.
I gave them a brief description of myself and what it was I had to offer as a doula. Still confused-looking, they said, “ohhh, okay.” I then excused myself to get things ready. Again, they looked at me like I was crazy, and I know they wondered what the heck I had in this bag that I held onto so closely. Little did they know that my doula bag was my MAGIC BAG, my bag of TRICKS, my Other Half.
I went behind the curtain and begin using my electric pump to air up my peanut ball. My pump was not working! I felt my face turning RED, how could this be? My peanut ball was my main tool! Then I remembered I had also packed a hand pump just in case something like this happened. After airing up my peanut ball I set up a diffuser, battery-operated candles, a portable speaker, and massaging lotion just like my client and I had discussed.
Next I asked my client if she’d like to get up and “walk the baby out?” She smiled and got out of bed. We walked around and around and around -- I was definitely putting in my Fitbit steps! Every time the nurses came into the room they oohed and awed over how relaxing the room felt and how it had smelled so good!
Contractions got slightly stronger but still were not consistent. It was now 6 pm and my client's progress was slow. The doctor recommended Pitocin. My client declined -- she knew the pros and cons and opted not to take it at this point. Her doctor supported her decision and said she’d check back in at 9pm. 9pm came and still not much change had happened. Father and grandmother were sitting in the corner of the room and were now starting to look a bit more concerned. They were unsure how to help the laboring woman.
I knew I could role-model for them if they didn’t want to jump right in. I proceeded to sway, dance, and hum through contractions with my client. I continued to give her words of encouragement; I continued to remind her of how strong and capable she was. I reminded her to trust in her body and to “let it go.”
Let It Go was a song my client loved and was very passionate about, so I was sure to have it ready on my phone along with earbuds and a few play lists for her labor journey. With every passing hour, my client held on strong. She trusted me, but more importantly she trusted herself. We got through every wave together. At midnight, she decided to try the Pitocin in hopes that it would help her dilate and make more progress. My client went on for the next three hours with back-to-back contractions, stronger and fiercer than before.
I looked at her partner and gently said, “She needs you, your son needs you.” I coached him through the double-hip squeeze and applying pressure to her back. After just a few minutes he was saying “let it go,” and humming through the waves. They found their rhythm and they were riding the waves together! While he worked her back, I worked her feet and legs. And his mother encouraged him and she supported him, and she supported the laboring woman. We all worked together as a team to give this woman and her baby a better, healthier, birth experience.
It was now 3 in the morning and my client fought with everything she had and then some, but she needed rest -- she opted for an epidural hoping it would take the edge off so she could get some sleep and finishing dilating.
The epidural did not take, and she was still in agonizing pain around 5. The staff decided to turn off the Pitocin hoping we’d see some change. The nurse came in and checked but my client was still at 7 centimeters, 90% effaced.
9am came and the doctor checked -- she was now at 7-8, but the doctor was concerned she had already endured so much and was not dilating accordingly. A cesarean birth was suggested. For the first time in almost 24 hours, my client cried. Her mother was holding her and saying, “Baby, I know this isn’t what you wanted, but you have to do what’s best for your baby.” My client signed the consent form and the doctor went to make the arrangements.
Meanwhile the nurse and I are still rotating my client from side to side with the peanut ball, hoping it would expand her pelvis and allow for baby to come down.
It’s now around 9:50am and the laboring woman says she has to push! She’s told not to push, to breathe through it, that they are almost ready to take her. She says it again, and this time she adds, “ I KNOW MY BODY!!!”
Wow! She had remained so soft spoken her entire labor, but when she said “I know my body!” I knew that momma lioness was roaring, and by golly, we had better listen!
The doctor checked and said, “We are having this baby!” By now the room was filled with at least half a dozen staff. Everyone was spread out in their strategic little stations, waiting for their role in the birth, but right now it was all about the woman!
The doctor was in position, the nurse was on the right side and the mother of my client was holding her baby tight, encouraging her, cheering her on, coaching her through. Father was a wreck! It was all becoming reality. I stood back next to him, rested my hand on his back, and said, “It’s all going to be okay. Your son is coming, and you did amazingly good job, Dad.” This is what being a doula is. We are not there to take away from the family, we are there to guide, to help, to support.
On April 26, 2017 at 10:41, I witnessed three miracles: One was watching a beautiful baby boy enter this world. The second was seeing a family evolve and come together to work as one unit. And the third was understanding a boy became a father and a girl became a mother.
April 26 was nothing less than magical, REVOLUTIONARY! Why wouldn’t I want to live my life being a doula? Birth is the closest thing to magic out there.
Monalisa Orduno serves families in California's Central Valley. Other than working as a doula, she lives a pretty typical mom-life, caring for, shuttling, and cheering on her children and her wife. When she isn't enlisting her family to doula role-play with her, she spends her time devoted to her kids' various activities -- football, horses, ghost-hunting, or shopping for make-up. Monalisa takes time to continually educate herself with personal study and trainings. She loves being a doula and is excited to dig into this calling. "My kids are my BIGGEST accomplishment, and being a doula is my second." Visit her on her Facebook page or her website.
Amber is no stranger to the 31 Days of Doulas project. She wrote about the advantages of a doula who hasn't had children yet, how doulas help in all kinds of births, and her "labor" as she started nursing school. This year's addition gives us a peek inside Amber's life. Nursing school is not easy! And Amber's confidence was shaky -- until she realized the true value those doula skills held.
Doula training has a way of bringing out the best in people. Sure, before I was a doula, I was caring and compassionate, but I was also a wild 20-year-old who wasn’t always focused on others. When I completed doula training at 22 years old, my eyes were opened to the injustices that many women and families face as they meet their baby for the first time. I was made more aware of how much what we say matters, and how important it is to simply listen and respect people. During my training, I also learned physical skills to provide comfort. I didn’t know it at the time, but the knowledge I gained over my two-day doula training would stay with me, even when I wasn’t supporting women and families during the childbearing year. Most notably, my doula skills have all proved extremely useful as I’ve journeyed (yes, sometimes trudged) through my last 2.5 years as a student nurse.
Prior to starting nursing school, I absolutely loved being a doula. Being present for one of the most intimate moments in a family’s life was an immense privilege. The qualities that I already had were allowed to shine when I was a doula for a family. Once I started nursing school, I was immensely saddened that the magical relationships that I built with my doula clients would be a thing of the past. It was time to become a nurse, and my touchy-feely relationships would only be distant fond memories.
At the end of my first semester in nursing school, I was talking to one of my professors about how much harder nursing school was turning out to be, in relation to my expectation of what it would be like. Her response was one I vividly remember. She told me that you can be a nurse forever, and learn all these fancy technical skills, but that it is extremely hard to learn how to be truly empathetic, be good at listening, and have emotional intelligence towards your patient. She told me that it seemed I already had these skills. It wasn’t until she pointed this out to me that I had really stopped and realized just how much I had translated my doula training into my practice as a student nurse.
I hadn’t realized it, but I had been all of my patients’ doulas. The older folks who had dementia who just needed someone to talk to, the veteran who was depressed, the widow who was confused and scared because she didn’t know where she was -- these were now my doula ‘clients’. Except, they were my patients.
There was something that I brought to my practice that was slightly different than some of my classmates. Now, the other students in my cohort are amazing. We are all very different, and have very different skills. Some of them are fearless, they always jump at the opportunity to insert an IV or catheter. I, on the other hand, was sometimes almost petrified with anxiety just thinking about doing something I didn’t feel confident in. Some of my other classmates were really book-smart, they had memorized complex physiological processes and medications. I sometimes compared myself to these other students, and felt inadequate, that I would never be as good as them. But, once I realized that emotional support was my strong suit, I stopped beating myself up.
When it came to talking to patients who were depressed, needed someone to talk to, had just received bad news, had dementia and missed their loved ones, or were in pain, I felt very comfortable. It seemed that knowing appropriate yet comforting things to say came easily for me, and I didn’t shy away from using physical touch on my patients. With this knowledge in hand, the rest of nursing school has been different for me. Yes, I’ve had some tough days (and nights!) but I know that every single one of my patients felt emotionally supported, respected, and truly cared for. I know that if I were in the hospital, this is how I would want my nurse to be, too.
Now that I’m at the end of my nursing school journey, I feel confident that I’ve left a trail of cared-for patients in my wake. The unique set of skills that I will always carry with me as a doula can be translated into any area of life, and I am so happy that I don’t ever have to stop being a doula. I am especially grateful that I also had the opportunity to share some of my doula-ness with my classmates. I think some of the knowledge about providing comfort will stay with my classmates. Some of the doula wisdom I’ve shared with my class, which can be translated to almost any patient are:
I’m planning to start working as a labor and delivery nurse this summer, so I will truly get to put my doula skills to use on my patients. But, I also know that wherever nursing may take me, no matter a patient's sex, age, or whatever brought them into contact with our medical system, I will always be their doula.
Amber is a special soul to me. Years ago when I was bringing the first of many DONA-birth doula trainings that my former trainer, Connie Sultana, would offer in Chico, CA, I got a phone call. It was Amber's mom. She asked me questions about doulas, the training, what it would mean for someone like her daughter who had a fascination with helping people and a passion for birth. She passed along that information to Amber, and the rest is history! Amber and I became fast friends although we weren't exactly peers -- me with three kids, and she, college-aged and free! But we had a connection, and we built on that. Slowly we started finding more doulas, bringing Connie back for more trainings, serving families, and creating plans for better ways to serve families. Eventually we helped form Chico Doula Circle. All this time, Amber was set on getting into a nursing program. I moved away, and she got into a program -- and here she is, at the end of that schooling-journey, ready to jump into the world as a nurse! Amber will be an amazing nurse, in any field, although her heart is set on birth. I am so excited for what her future holds!
I'm sure we have all heard different myths about doulas -- whether it's thinking doulas catch babies like midwives, or they come together to dance beneath the full moon -- there are a lot of misconceptions out there. Becky amazes me -- not only is she a comic genius when it comes to doula humor, her graphic art choice is the perfect medium to convey her message. She addresses common myths about doulas, and leaves us full of happy feelings for the work we do.
There is often confusion over what a doula is. Many times I have talked with couples nervous about a doula possibly taking over their birth. They are afraid that a doula may guilt them into a certain type of birthing. To add a little silliness I have illustrated examples below with my subpar Window’s Paint skills. These show the differences between someone that will fight against your birth, a duel-a you could call her, and a doula, or birth support for your choices.
This may be new to you, but doulas are not just for natural birth. They are for anyone wanting more support for their birth. Doulas are helpful in cesarean births, medicated births, natural births, hospital births, home births, single parent moms, and so much more. Whether you have a plan or not, we are here for you, no light sabers involved. Note: In the odd case that you want light sabers at your birth, we can help you with that. We do not discriminate against nerds; we just won’t use them to stop your choices.
The next concern often had regarding doulas: "But I want my husband involved. I want him to intuitively know what I need.” If he helped start this baby business, then it totally makes sense to want him right there involved in the birth.
Can I tell you my secret? We LOVE it when dads are hands-on and involved. It is our biggest goal to facilitate the best connection between you and your partner. We know that dad helps get the oxytocin and birthing hormones going. Some men need a little direction along the way. They are new to this. Our job isn’t to replace dad, it’s to help him help you best. If dad isn’t there this works the same for grandmas and friends. We will not erupt in flames if someone else gives you counter-pressure.
I met with a doctor today. He was a little on-guard, and he felt the need to explain how he goes out of the way to help his patients. Sadly, too many providers have met some kind of duel-a, or have heard stories of them. All he knew was that I was a doula and he assumed that I had a negative view of him as a doctor. In reality, I have yet to meet a provider that did not want the best for mom and baby. Sometimes they have differing opinions on care, and different points of view, but they all care. Doulas are not out to defy anything medically related. We need the medical team so that we can focus on emotional support and comfort for mom and the family.
Doulas work with mom’s birth team to help her best reach her desires. Doulas will encourage you to choose a provider that you feel you can trust that you can work with together. They encourage mom to ask questions, find evidence-based information, think over benefits and risks, and if needed, help mom stand up for herself. Our job is not to have a show down with the medical staff. Our job is not to speak for you. Our job is to help you get the information you need to make choices, and to support you as you speak for yourself.
I am not a duel-a. I am not out to fight or prove anything. I am a doula -- a supporter of women, babies and families.
Becky Hartman serves as a birth, postpartum, and bereavement doula, birth and pregnancy photographer, Benkung belly binder, and energy worker. She has been shaped by her own births, and the realization that education factors into creating an empowering experience. Becky strongly believes women can follow their hearts and they will know the decisions that are right for their situations. She encourages families to learn, explore, develop ideas, and then go with the flow of their birth experience. Becky lives with her family in Clearfield, Utah.
When it comes to doulas and the support they offer, I'm a sucker for a good, old fashioned, positive birth story! Today's feature is just that. I also appreciate how Dorothy shares she did all she could to prepare herself for birth, yet she still credits luck and genetics for her experience, because when it comes to birth experiences, we don't always get to pick how things will go.
“Why are you still working?! Your due date is next week, what if your water breaks while you’re at work?”
“Oh that’s not going to happen to me, they do that in movies for dramatic effect. In real life, the water breaking in a gush only happens to about 8% of women, that won’t happen to me, I will be fine”
This was a conversation between myself and my good friend Jammie one week before my October 13th due date with my first child. I had an easy pregnancy, no morning sickness or vomiting, and I had not taken a single day of work off the entire nine months. I manage an office, it’s not physical work and since I had felt fine, I felt no reason to stop working even with my due date right around the corner. I wanted to maximize my time off after the baby arrived. Little did I know, I was about to be one of those 8%...
On the morning of October 14th, one day overdue, I awoke to my dog barking. She doesn’t usually bark at night unless she needs to be let out to answer the call of nature. I groaned internally. “Ugh, it’s 2:30 a.m., I don’t want to get up and let her out,” I complained internally. Then I thought, well I probably have to pee anyway, it’s only been an hour since last time I peed and everyone knows how often pregnant ladies need to pee. I heaved my big, pregnant belly up and began walking to the bathroom. "Oh, I guess I really had to go," I thought, as I felt fluid trickle. By the time I got to the bathroom, there was a gush and a lot of fluid. Apparently my water had broken, signaling that the arrival of my baby was imminent. I called to my husband and told him to get up and let the dogs out while I cleaned up.
The first call I made was to our doula. I had made the decision to hire a doula fairly early in my pregnancy, and she came highly recommended from a mother of 6 that I have known my whole life. I hired a doula because I was afraid of having a hospital birth, I was afraid of being forced into taking unnecessary medical interventions during labor, and afraid of being bowled over by a medical team that had never met me, knew nothing about me or my baby, and didn’t know what I wanted from my birthing experience. I envisioned an intervention-free birth, preferably at home, with a midwife. My husband, rightly concerned with my health and that of our unborn baby, objected to my home birth plan and preferred a hospital setting. The compromise came in the form of our doula, who I wanted to help me through an intervention-free hospital birth.
“My water just broke, should I go to the hospital?”
“How do you feel? Have your contractions started yet?”
“I feel fine, I am not in pain and having no contractions yet.”
“It’s up to you whether or not you’re ready to go to the hospital. However, it can take some time for the contractions to catch up once the water breaks. Since your water is broken, if you do go to the hospital, it's likely they won’t allow you to leave once you’re there.”
“Ok, well I don’t want to go too early, I think I will wait a while and go later. I should not go to work though, right?”
“NO!!! Do not go to work, and keep me updated.”
After getting off of the phone, I called my mother and told her the news. I told her I wasn’t going to the hospital yet and I didn’t expect the baby to arrive for several hours, probably not until late evening. I expected a long labor, everything I had heard and read said that most first time mommies have a long labor so I was prepared for a marathon. With this in mind, I decided to go to work. This decision was made because I knew I couldn’t get someone to cover me, I work at 4:30 am, and I just planned to go briefly to give a quick morning meeting and inform my staff that I would be out until the end of my maternity leave. My husband got dressed and drove me to work, and I was there for half an hour before we left and drove through McDonald’s for breakfast to be fueled up for all the work ahead of me!
At home around 6:30 am we both laid down, I wanted us both to try to get some rest for the long day ahead. I was having minor contractions at this point, 15-30 seconds long and 5 or so minutes apart. At about 9 am I sent my husband to drop our dogs off at a friend’s house. My contractions had increased in frequency and length but I was still not ready to go to the hospital. I was texting our doula and asked how long I could safely wait to go to the hospital? She said it was up to me how long I felt safe staying home, and she advised me to contact my doctor for an appointment to check my progress. If I had progressed enough, I could go directly to the hospital, but if I wanted to go back home, I could do that too. That sounded ideal to me, my doctor’s office was located in the parking lot of the hospital I would deliver at.
This is why I wanted a doula and why I decided to go with our doula specifically; she listened to me, asked me how I felt, and asked what decision I thought was best for me. Essentially, she helped me to decide for myself instead of just telling me what to do or what she thought was best. From our prenatal courses, she knew my concerns about having a hospital birth and advised me with that in mind. Our doula knew that I was concerned about going to the hospital too early in labor, and that I was concerned about having my movement in labor restricted by monitors and hospital rules.
The most important thing that I learned from our doula was that I had choices for this process. I could be in charge. There were productive ways to communicate with hospital staff to facilitate the birth that I wanted, and decisions that I could make to affect my birth, like the decision to stay home and labor for a while instead of going straight to the hospital when my water broke. I didn’t have to be merely a participant in my labor, I had choices and a voice. In our prenatal courses, we had talked extensively about my birth plan, making 2 or 3 drafts before we were satisfied with it. I also made a gift basket for the nurses and doctors in the hospital, to thank them for their hard work, and partly to schmooze just a little bit! The birth plan would help to communicate what I wanted in the heat of labor, and the gift basket would help them to remember me in a positive light.
I called my doctor’s office. When I told them my water was broken, they told me to go straight to the hospital. I explained that I wasn’t ready yet and that I wanted my doctor to check me first. Fortunately my doctor was working and agreed to see me at 11:15 am. I took a shower, which was the best shower I have ever taken in my life, so relaxing! And my husband and I departed for the doctor. We pulled into the parking lot shortly after 11 am and I knew in my heart that we weren’t going home. My pain level had increased significantly since 9 am, but I was still unsure whether or not to go straight to the hospital. In my mind, I was clinging to the 4-1-1 rule (contractions every 4 minutes, 1 minute in length, happening for at least 1 hour) and I wasn’t there yet! My contractions were only about 30-45 seconds long, and I didn’t think they were long enough for me to go to the hospital.
Once in the doctor’s office, I had trouble disrobing from the waist down and getting up onto the exam table. When my doctor arrived and checked me, we were both surprised to find that I had already dilated to 5! It was time! I was going to the hospital! I was put in a wheelchair to go across the parking lot. I texted our doula: “I am at 0 station and 5 centimeters dilated, I need you here ASAP!” “I’ll be there as soon as I can!” My husband accompanied me to the room and I sent him back out to the car for the hospital bag. The desk nurse gave me a hospital gown and asked for a urine sample. I got into the gown but the urine sample wasn’t going to happen. I was in too much pain, and I curled up on the hospital bed in the fetal position instead.
When my husband got back from the car, I was crying. “I need an epidural, I can’t do this, I’m going to die!” Cue the theatrics! He went for help. The nurse checked me and immediately ordered a birth kit; baby was coming faster than any of us anticipated. I asked for an epidural. My husband asked if I was sure, and in that moment, I certainly was! The nurses told me it would be at least an hour before I could get one; in retrospect I am sure they knew there simply wasn’t going to be time. The baby was going to be there before the anesthesiologist anyway! Our doula arrived around noon I believe, and everything became a blur. I was very lucky that my doctor was on duty and was there for the birth. Between her, our doula, my husband, and the nurses, everything seemed to happen at lightning pace. Almost immediately, they had me pushing, I had plenty of help and support. My dear husband, who had pledged to stay by my head during labor to avoid the potentially traumatizing show, found himself holding one of my legs up while I pushed, after a nurse said “here, help her." Before I knew it, baby was crowning. My doctor asked if I wanted to touch the head? “No! What are you talking about?! We are wasting time, let’s get her out of there!”
At 1:13 pm, Tegan Janine arrived. 7 pounds, 3 ounces and 18.5 inches of pure, healthy perfection. I remember seeing her for the first time, her arms outstretched. As they laid her on my chest, I was overwhelmed with emotion and disbelief. She had arrived so quickly, I was caught off guard and burst into tears, “I’m just so happy." Delivering the placenta was slightly problematic, it didn’t want to dislodge itself. The doctor massaged away at my abdomen for 20-30 minutes, and I cursed loudly…but it was eventually delivered. I was given a shot of Pitocin in my thigh because I was bleeding a little more than they would have liked, but otherwise everything was fine.
All of the preparation and planning were worth it. The decision to hire a doula and educate myself on my choices and decisions was crucial. I am extremely fortunate that I had an easy pregnancy and a fast labor, many mothers aren’t as lucky as I was. I recognize that genetics and pure good luck played a huge part in me having a positive labor experience. I hope that by sharing a positive story of birth, other mothers can feel more confident. There are so many terrifying stories of labors gone wrong, I feel that women need to hear that labor can be a positive experience.
Dorothy and her husband reside in Bakersfield, CA. Along with Tegan, they share their days with two adorable Daschunds. Dorothy is currently pregnant and getting her out-of-the-hospital birth wish: her baby will be born at a local birth center.
I am a lover of doulas and what they do for families. We need to hear how we are doing, how we are being perceived, if we ever want to improve! When we get those bits of negative feedback, it is an opportunity for us to change and be better, not shrink and get resentful. We are all just people, trying to do the best we can. Communication is an important piece of the doula-client relationship -- the more we can communicate, before and during a birth, the better satisfied we can all be.
I hate to be Debbie Downer, that is not in my heart at all. I hired a doula for what I thought were realistic reasons. Like so many others, I read the statistics: shorter labors, lower uses of epidurals, happier feelings after the birth; those were the ones that stuck in my mind. I just didn't expect things to go the way they did, and when they went, they went fast. I felt like my doula went along with that, while I was left behind feeling alone.
I know one admirable quality of any doula worth her salt is good working relationships with the nurses and doctors at the place of birth. I was impressed by the stories I heard from my doula, the goings out to lunch with nurses, the sittings next to doctors at conferences. I will admit, it made me feel like she integrated well into the hospital process. What I didn't expect was that she might need to maintain that balance. When push came to shove in my situation, I did not feel she was with me, on my side. I felt like she was on their side, and it was her job to get me to feel good about coming to their decisions and preferences.
In a way, this was the beginning of the isolation. I had heard hospital doulas who are provided by the hospital or volunteer/work for the hospital sometimes have a hard time being neutral. I did not worry about this, because my doula was independent and nonaffiliated with the hospital. She did have a family member who was high ranking on the infrastructure of the hospital board, but again I saw this as a bonus, not a deficit. In reality, I think it aligned her with the hospital's way of doing things. It made it seem like her job was to help me buckle to that agenda in a less threatening way than if it came from a staff member.
I had a complication when it came time to push. Suddenly I was being rolled over, yelled at urgently, and told to push, even without a contraction. Extra people came rushing into the room. I was hearing all kinds of instructions at once. I closed my eyes and tried to do what they told me. My husband was no where to be seen or felt. My doula was also lost in the haze. I had no clue what was happening. I needed the tiniest bit of an explanation. The one person I would have expected this from was not there. My doula.
After the baby came out there was an audible sigh of relief. She was taken to a flat table to be given air and make sure she was breathing like she should. I felt the smallest touch from my husband's hand, and I wanted to gobble it up and have it take me away. He was scared too. We watched as our baby was being poked and prodded, mask on her face, lights flashing and alarms beeping. I looked for my doula and she was talking to the nurse about how frightening that was, and how she was sorry the nurse had to get up on the stool to help move me because the nurse was pregnant.
I could have used the emotional support my doula was giving my nurse.
It took a while before anyone explained what happened. It took even longer before our baby was brought to us. I felt pretty insignificant. I felt alone and afraid. Soon after the bustle in my room went down and I was considered recovered, my doula announced she needed to go move her car before her meter ran out. She said she would be right back.
"That's ok. I think we are ok now." She looked at me with a puzzled expression. "But the baby isn't back from the nursery. Do you want me to wait and see if we can get you nursing?" I let her know I was really tired, and I would ask for help from the staff if we needed it. She came over, gave me a hug, and said, "Thanks for having me as your doula."
Really I just felt sad. I felt let down. I wanted more mothering, and I got what seemed like a bubble gum teenager who was only with me until the cooler kids came (her friends at the hospital). I am not writing off doulas forever. I still can't deny those statistics. But next time, I am going to ask different questions, and remember to be impressed by different answers.
Lindsey is a high school math teacher and new resident to Harrisburg, Pennsylvania. Her husband, daughter, and Shar-Pei, Bluto, are expecting the arrival of a new baby around Thanksgiving. She is just starting to reach out to potential doulas.
Did you know, those fabulous statistics we read about regarding "continuous one-to-one emotional support provided by...a doula," don't diminish if the person in labor also happens to be a doula? That's right! Even doulas hire other doulas, because we know EVERYONE deserves a doula -- even a doula. Are you tired of the word doula yet? Because it happens to be World Doula Week, and I am pretty positive the "d" word will be prolifically used herein -- fair warning! Now, settle back and read why doulas choose to have that unique support and help only doulas bring to birth.
Other reasons are longer, and they still make a lot of sense:
"Preparing for my fifth baby I considered a doula. However, my husband has been such a great support and I found myself using all the common reasons not to have a doula. I worried it may interfere with the dynamic between me and my awesome, supportive husband. I worried about expense. I also have precipitous labors and didn't know if I'd be able to make it to the hospital, much less if my doula would make it. I spent much of my pregnancy helping my own doula clients plan their births. Yet I struggled to focus on my own. Finally I realized that I needed some help to focus and plan on my birth. Talking with my doula was invaluable. She helped calm my fears and work through trauma from a previous birth. I still didn't know if she would be able to make it in time but having her help me prepare and knowing she would be there to help me process afterwards was a big comfort. I also knew that I could use all the hands I could get for counter pressure. When my birth came, it was longer than expected. It was wonderful to have someone that knew what I meant when I asked for different counter pressures or rebozo techniques. She read my mind so I didn't have to verbalize each step. I was able to hold onto my husband while she gave counter pressure -- to hug him while still having the comfort measures. In transition I was grateful for multiple hands providing relief. I have birthed four times without a doula. I have supported countless families as a doula myself. However, having a doula for my fifth baby, I will never personally go back to not having one again. There is always a use for one. You never know what may happen or how useful a doula may be."
-Becky Hartman is a doula, photographer, and energy worker in Davis County, Utah. She just birthed her 5th baby this past week, so this is all fresh in her mind! To learn more, visit her website and go "like" her Facebook page.
Sometimes the decision seems made for you:
"I didn't actively choose to have a doula for my births -- it just happened that the universe provided them. They were just the right amount of hands-off until absolutely necessary, and then hands-off again -- which is exactly how I work. I felt so relieved I could let myself fall into the network provided for me by my community. I'm eternally grateful to these women who gifted me their work, both emotional and physical! My midwives through the years have been amazing support, as well. There's nothing I would change about my births, thanks to their skilled care."
Bryna Sampey is the creator behind the Portland-based Doula My Soul. Always about community, she and the others at Doula My Soul offer birth and postpartum doula support, breastfeeding help, classes, and more.
Seeing mom working so hard to bring their baby out? Making noises that seem more appropriate coming from a howling monkey instead of a human? Watching things that maybe one has only seen on Discovery Health Channel through half-closed eyes? The blood, sweat, and tears of it all? Does that answer your question?
Birth is an amazingly transformative event in the life of the family. As a doula and an educator, of course I relish in the whole thing and view baby's emergence as a spiritual experience unlike any other. I am comfortable with the noises of labor and the sound of hard work -- the music which accompanies this great act. Not everyone is, though, and not everyone feels sure about the birth process and the safety of their partner, the laboring person.
My husband and I have been married 21 years. On our 11th wedding anniversary we found ourselves seated across the table from each other at a Chinese food restaurant. At this point we had three of our four boys, the youngest just a year old. I decided to start the conversation.
"I want us to think about our time together, and take inventory of our relationship, our family, and our lives." My husband suddenly looked like a he walked into a pop quiz. He didn't look eager to answer my probing questions. I was joking, but this did lead to one question that had been on my mind lately: "Well, answer this for me -- did you enjoy being at our babies' births, or would you have rather waited outside until it was over?" Being a birth-lover, I knew what answer I wanted to hear -- did I have it within me to hear the other answer, too?
"Honestly, I would have liked to come in when it was all over." I did kind of know this, I don't know why I was expecting to hear that other answer. I love my husband, and to his credit, he never left me needing or wanting more during labor; coupled with my doula's support, he was my main pillar of strength. I know he appreciated my doula's way of caring for me, of anticipating my next whim, of comforting not only me, but also him.
The realization set in that labor and birth is not everyone's cup of tea.
I have seen partners, unsure in the beginning, actually put a glove on and check Mom's cervix (with the help of a wonderfully encouraging midwife). I have seen a dad be the first to touch his baby's little head as it peaked ever-so-slightly out. I have even seen a baby tumble out into a dad's strong hands. But a partner does not have to do any of that to be involved and to show his or her love for the laboring person. Hands are important, but the location of hands is not. Hands on hair, hands on forehead, hands on back -- hands on hands -- can be accomplished by a birth partner at any comfort level. Touch is the goal -- touch and loving words.
In my husband's case, he held my hands during the most intense parts of labor, and he encouraged me with his voice; sterile gloves were not needed for either.
When I was in college, I worked at a gift and candy shop. It was an easy gig, I got to eat all the homemade chocolates I wanted, and I worked mostly unsupervised and alone. I remember distinctly, an interaction with a customer where I just wasn’t feeling it. I decided I didn’t have any energy to add anything extra to my exchange with her. She brought me her merchandise and attempted to make conversation, and I sat with a sour look on my face, going through the motions of ringing her up. (This is all horrifyingly embarrassing to me now, by the way, but as a teen, I didn’t give it a second thought.) Suddenly the woman said, “It seems like you aren’t in a good mood today.” She said it kindly, without expectation, and it hit me: She noticed I wasn’t being nice!
Wherever doulas gather, there is a question often asked: “Can I thank a nurse?” Not meaning, can I say thank you when she brings us a chair or a drink, but, when I notice a nurse going above and beyond for my client, can I send her a thank you note later? Is this appropriate?
I have heard doulas answer, absolutely not! She is just doing her job. If she hadn’t been your client’s nurse, she would have been someone else’s. She did it yesterday, she did it today, and she’ll do it tomorrow. She is being paid to work as a nurse. She is just doing her job.
As a doula and a childbirth educator, I take clients in the Bakersfield, Visalia, Hanford, and Tulare areas of Central California. I recently attended a birth where I witnessed a nurse just doing her job. It wasn’t that the nursing care she gave was poor – it was just her flat affect showed she simply had nothing else to give. Just like the teenaged-Stacie in the opening story, this nurse was going through the motions with no smiles, no casual conversation, no empathy for the pain my client was dealing with. She was on autopilot, she could have been a robot, and we all noticed it seemed like she was in a bad mood. In that moment, it felt like she hated her job and resented the fact that someone dare be having a baby on her shift in L&D.
As people, don’t we like to hear when someone notices and appreciates the job we are doing? I know I do! Why not, then, send a note to a nurse you felt went above and beyond versus just doing her job? In fact, send it to her boss, and her boss’s boss! Send that praise onward and upward! Let the world know you appreciated this nurse’s attitudes and efforts, her care and concern.
Fortunately, I can say this is a rarity. Most of the nurses I encounter are helpful and kind to the families they serve. We all have bad days, and I bet that lady I served so long ago doesn’t even remember me and my attitude way back when. But the day your baby is born – every person who walks in or out of that room can become a permanent fixture in the recollection of that memory. I still have deep, personal feelings for the nurses who cared for me through all my births, and how grateful I am that they are filled with positivity!
♥ four young boys and a boy dog (offspring)