Do It With a Doula

When it comes to labour every mom-to be is searching for a feeling of control. And the first place they look is to their caregiver options – Midwife? Family Doc or Obstetrician?

Through my three pregnancies I was in the care of: a midwife, high-risk perinatologist, family doctor and an O.B. And they were all great, because I learned that it isn’t the initials after the name that matters; it is the chemistry between you. You need a good working relationship with your caregiver so that you feel safe enough to ask them all the stupid questions that you want.

My first choice was a midwife but my first pregnancy turned high-risk and we leapt up the care ladder from a midwife to a high-risk doctor. I ended up with a cesarean at 37 weeks and a healthy newborn and my husband got to keep his wife and baby.

During my second pregnancy, I was adamant about being a VBAC (vaginal birth after cesarean) and after much thought I decided that a combination of a family doctor and a doula was going to give me the best care and the greatest feeling of being in control.

I figured that my husband would be there for me but since he hadn’t been through a labour before, he might be riddled with anxieties and not know what to do. But a doula would be calm in the face of contractions, vomit and extreme cursing (or in my case contractions, cursing and extreme irritation with the hospital staff).

When it came to a doula we chose carefully, we looked for someone who had a set of skills that would aid us no matter how the pregnancy and delivery went, and we also wanted someone who would be knowledgeable without being judgmental. We found Tanya who is a wonderful combination of skills and empathy. She was also clear about the perimeters of her job as a doula as opposed to a midwife or labour nurse.

Tanya is a massage therapist and I would recommend to anyone looking for a doula that they go that route. She gave me massages throughout my pregnancy which meant she knew how I reacted to pain as well as my weak spots. It also gave us a lot of time to talk about the birth plan, fears and to become closer friends. I was always up front with her that I wanted an epidural, and even though I knew that she would not personally make that choice she was happy to support us. For my reasons of wanting an epidural check out my post Bring On the Drugs.

When I went into labour with Sam, she gave me massages until she let us know that it was a good time to go to the hospital. Once we were at the hospital she set us up, making sure that everyone knew that I was a VBAC but with no risk factors.

As the labour became more intense, I asked (umm…yelled) for the epidural and once it was administered and I was more comfortable, she gave my hubby a back rub and went on the all important coffee run. Once the baby started heading out she became the official photographer, leg holder and breastfeeding advocate.

My third labour came so fast and furious that there wasn’t much to do other than talk me through the car ride and into the elevator. She realized that I was in transition in the car and did her damdest to get me to the delivery floor before the baby made her way into the world. In fact, if we had waited any longer she would have had to cross some professional lines and deliver Jenna. She didn’t do much official doula-work during the labour, she did something more important; when I was feeling shell shocked by the whole experience she let me know that was OK.

Having a good doula is like having a guide on a dark and mysterious hike up a mountain, they have done the trail before and can offer guidance. I have friends who have had some bad experiences with doulas, either because the doulas ended up fighting with the labour nurses or forced them into a delivery scenario that they didn’t want.

The website childbirth.org quotes the book: Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier and Healthier Birth, by Kennell, Klaus, and Kennell (1993), having a doula can give you a:

50% reduction in cesarean rates
25% shorter labor
60% reduction in epidural requests
40% reduction in oxytocin (pitocin) use
30% reduction in analgesia use
40% reduction in forceps delivery

She doesn’t mention the back rubs, coffee and photography but I am telling you those are priceless too! A perfect delivery room accompaniment is a doula who understands your desires but is flexible enough to realize if and when your needs change. And if she is a massage therapist, then all the better.

To find a doula in your area try: (sorry Tanya is busy with her own kids)

Word of Mouth: the best method
Doctors and Nurses: some doctors love having doulas in the delivery room and they will often remember the ones they liked best. Some doctors and hospitals dislike doulas, so you may want to take that into consideration
Ask your childbirth educator for a recommendation
Post a message looking for a doula on a local pregnancy support website
Check out these organizations:
Doula Care
Dona
Be persistent in your search. Interview different doulas to get a feel for who is right for you. Some are incredibly crunchy and some may be too pushy, you will know when you find someone who fits for you and your partner.