I trained as a doula in 2009 and have attended over two hundred births since that time. My last “doula baby” was born yesterday, and I am now shifting my focus to my final year as a student midwife. When I was a doula, I firmly believed every woman needed a doula. My thoughts now might surprise you.
Every single woman giving birth in the hospital needs a doula. Why? A doula is a walking billboard that the woman wants to know her options and wants individualized care. Hospital birth is the least likely place to have a natural birth with 1/3 of births ending in Cesarean sections and most utilizing pain medication. Nurses are not trained in normal birth or comfort measures, though some great rare ones have studied to be able to support natural patients. The bed is the magical place in which nothing can go wrong so women are encouraged to stay put there, but this makes pain worse and labor longer. A doula can help buffer this hostile environment to natural birth.
Outside of the hospital the answer depends. I have noticed something very interesting in the birth center-first time moms cope much better with labor in the birth suites than in the hospital. Ninety five percent of my doula clients were in the hospital, so I’ve seen many women attempt (and conquer!) a natural birth in an environment where it is an uphill battle to do so. At the birth center, women come in with the decision to keep the temptation of drugs far away. They also must trust the process and deal with the “what if” fears well before arriving in labor. They know why they want to birth outside of the hospital, and therefore without medication, and have had to defend their reasoning for nine months. They are sure they can do this.
As women walk into the birth center without fear, their labor progresses nicely and they cope so very well. I see first time moms birthing as swiftly and easily as second time moms. The midwife and birth assistants are always nearby and they stay in the birth suite once the mom needs their support. This is usually near transition or later at the birth center since moms and dads come in so prepared. Some have doulas but many don’t. I am shocked, but truly, it happens that women can cope in the right environment without a doula-especially when the support people take our class and read the books to be able to support mom well.
Some women who plan to birth with us could still benefit from a doula. The first time mom, because her labor is likely to last longer than her subsequent labors, is one of them, especially since she’ll have a lot of time to labor at home. The woman with a traumatic previous birth story could use a doula for herself and probably her partner too. Some woman who are planning a first VBAC can benefit from doula care.
Many people have assumed the birth center provides a doula (me) since I work there. However, that’s not accurate. Two of us are trained as doulas but we are not acting in that role exactly. Of course our doula skills are utilized and we coach, encourage, and strategically help you change positions but we do not breathe with you through every contraction like a doula does.
As I start acting in the primary midwife role, I will be by your side through much of your labor at the birth center. I will be monitoring you and your baby but the doula side of me will never disappear and I’ll coach, hold your hand, rub your back, and encourage you. I found myself jumping in and doing all these things in a birth with a mom who had a doula-team work! But I’m not coming to your home to doula you before you’re admitted to the birth center. 😉
Doulas in Wichita Falls are few these days. We’ve worked with some we gladly refer our clients to often, so please ask us who we recommend. Our favorites are professional, mesh with our philosophy, work as a team with our staff, and encourage open communication between the mother and her midwife.