Should You Hire A Birth Doula?
Posted By Beth Shea On January 22, 2013 @ 3:00 pm In education,green maternity,green pregnancy,health & body,prenatal | 10 Comments
At 31 weeks pregnant, I can no longer be in denial over the fact that I’m going to need to go through labor to give birth to my precious baby. After a traumatic first birth experience (although the end result was a blessing = healthy mom and baby), I am carrying a lot of baggage, fear and uncertainty with regard to my son’s upcoming birthday. I recently watched The Business of Being Born , and it dawned on me that hiring a birth doula to be my advocate and labor coach might be a good idea to help ease my mind, and hopefully my experience. I have been actively researching doulas and the role they play in assisting birthing mamas, but the question still looms for me, “Should I hire a birth doula?” Here’s a look into the decision-making journey.
The word “doula ” is derived from ancient Greek and means “a woman who serves.” The modern-day definition of a doula is a “trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth.”
A doula’s role is to “mother the mother” during her labor and delivery. She is a trained advocate who is present to help carry out a mother’s birth plan  and it is her job to help communicate the mother’s desires to care providers, ensuring that the mother’s needs are met and her wishes respected. Doulas often employ massage, aromatherapy, hypnobirthing, and other relaxation techniques to help mothers cope with labor pain. A doula’s goal is for a mother to achieve the best birth experience possible, and to create a happy memory of the day.
A doula does not replace a doctor, midwife or nurse. Doulas are not medically trained and they do not perform the following or any other medical interventions: vaginal examinations, blood drawing or temperature taking, monitoring fetal heart rate.
DONA International  cites that numerous clinical studies have proven when a doula is present to support and assist the mother at her baby’s birth, the following positive findings are a result:
And according to the American Pregnancy Association :
“Other studies have shown that having a doula as part of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and the request for an epidural by 60%.”
*Babies also benefit when their mother is supported by a birth doula. DONA International adds that “babies born with doulas present tend to have shorter hospital stays with fewer admissions to special care nurseries, breastfeed more easily and have more affectionate mothers in the postpartum period.”
I think every woman would opt to hire a doula if money was no object. But the expense of hiring a doula makes it an unaffordable option for many. Certified birth doulas typically charge between $700-$1100 for their services, and in big cities like Los Angeles and Manhattan, their rate is around $1500-$2000. That’s a big chunk of change; and insurance companies typically do not include doula coverage/reimbursement in their policies. But people spend thousands of dollars on their wedding day, so why not spend a fraction of that amount on the momentous occasion of giving birth to your child?
NOTE: All of the doula services I have contacted request that their fee be broken up into several payments. Some money is due at the signing of the contract, some is due at 36-38 weeks and the remainder is due at birth. This left me with the question, “What happens in the event of an unplanned C-section?” One service said if the doula did not provide labor support due to the mother having a C-section, that the money could be put toward postpartum doula care at a $25/hour rate. Another service said the money was non-refundable in this event, and that the doula would be present to provide support during or after the C-section, in the hospital. However, most hospitals only allow one other person to be present at the C-section, and typically a mother wants her partner with her. So even though the birth doula’s role may become obsolete in the event you have an unplanned C-section, you’ll still owe her money.
1. Don’t let a doula usurp dad’s role. Instead hire a doula to enhance dad’s ability to provide support and security during labor, with the comforting knowledge that you and baby are being cared for every step of the way.
2. Hiring a doula will give you the peace of mind that you’ll surely see a familiar face when you go into labor. Take it from me, I had about 6 different nurses due to shift changes during my first labor, and my doctor thankfully stayed after her shift to “catch” my baby, but had she not, a doctor I had never met would have delivered my daughter. So many OBGYNs work in groups nowadays, and if your doctor doesn’t happen to be “on call,” or if she is on vacation, you’ll likely be seeing a doctor you’ve never met at one of the most important moments of your life. A doula however, can be a constant source of comfort.
3. Make sure you’re on the same page with your doula — ie: if you are aiming for a natural birth but then decide you would like an epidural, make sure your doula will be supportive no matter what route you choose. Don’t hire a doula who imposes her beliefs on you, hire a doula who helps you uphold your beliefs by giving you all of the information you need about the decisions you need to make, and by respecting and providing emotional support for you at all times.
Well-rounded decision making must always include looking at the pros and the cons of any situation. It is worth noting that it has been reported that some labor and delivery nurses feel threatened by and at odds with birth doulas — claiming that doulas try to question their authority and get in the way of decisions that should be made by medically trained staff. It’s the “too many cooks in the kitchen” syndrome.
This sign, posted at a hospital in Provo, Utah  says it all when it comes to the threat some hospitals perceive doulas to be:
“Because the Physicians at Aspen Women’s Center care about the quality of their patient’s deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in a “Birth Contract”, a Doulah (misspelled) Assisted, or a Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.”
*Since some hospitals are clearly defunct, it may be beneficial to ask your doctor if he has any doula or doula service referrals, so he is aware of your desire to have a doula present during labor and delivery and may be able to recommend one who works well with his team.