Updated: May 7, 2020
Pregnant? Thinking about having a child in the future? Maybe you're just interested in options for the soon-to-be parents in your life. Lunita discusses the benefits of having a doula, the differences between a postpartum and a birth doula, and helps you weigh out your options.
Introduction / Preface
If you haven't already checked out the episode, head on over to The Lunita Podcast and give Episode 4: Is a Doula Right For You? a listen. Also, be sure to subscribe to the Podcast, leave us a review if you like the show, and give us a follow on Instagram for updates and conversations with the community.
As we enter a new age of promoting self-care, mindfulness, and healing, more parents are becoming aware of alternative forms of birthing and postpartum support. No matter what type of birth you choose to have, the most important consideration is that you are provided with choices/options and are informed about the benefits and risks associated with them.
What is a Doula?
Once upon a time, the norm for people expecting a child was to have a vast support system of powerful women around them. For the majority of human history, women gave birth surrounded by other women who held great knowledge and experience and offered unlimited support. Giving birth is one of the most transformative, otherworldly, fantastical and painful experiences a human being can go through. The pain transcends time and the physical body and even alters consciousness making it unlike no other experience on this earth. Having others around you who can hold space for you and your baby is life-changing.
Once hospitals began advertising themselves as safer, cleaner alternatives for birth, a large majority of spiritual, intuitive and ancient knowledge associated with birth began to disappear. This is not to say there is anything wrong with giving birth in a hospital; for millions of babies and mothers, they have literally been life-saving. However, it is important to remember that hospitals are in this day and age more recognized as businesses, and with the capitalization of women’s health, it means an undeniable shift in how women are treated during their births. This is something to consider.
According to DONA, a doula is “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible”. This means that while a doula can accompany you anywhere, be it the hospital, a birthing center, or home birth (even to doctors' appointments pre- and post-baby), their actual functions are limited. Doulas are not medical professionals and so they are not responsible for doing any physical examinations on you or your baby, nor are they midwives, OBGYNs or nurses. Even if they have some medical knowledge, their role during birth and/or postpartum is strictly limited to providing support and knowledge for the birthing parent and the family before, during and after labor.
Doulas function in two roles -- birth and postpartum, and while they often provide both services, it is important to try to anticipate (as best as you can) what kind of doula would be best for you.
provide emotional support and knowledge prior to and during labor. Some examples of the services they may provide may include;
helping you make decisions about what type of birth you would like to have,
assisting you with creating a birth plan,
educating you and your partner on how to manage contractions (aka showing you positions that may provide relief during labor and some light educating on what to expect during the labor)
Birth doulas may and can accompany you to wherever you choose to give birth and may often have crucial experience and knowledge about what type of birth experiences certain hospitals offer. Birth doulas may also provide support prior to labor in the form of emotional comfort, some companionship and assisting you with preparation. You will most likely not meet your doula for the first time once in labor. Hiring a birth doula means you begin working with one another way before the baby is born.
provide support after the baby is born, typically between 24-72 hours postpartum
assist with processing the emotional rollercoaster that is birth
assisting you in emotional healing
encapsulating your placenta or offering you suggestions on what to do with it
provide light breastfeeding support
assisting your family smoothly integrate the new baby into your new life
A responsible postpartum doula is also educated and well versed in recognizing complications both physical and emotional that may occur postpartum, such as identifying signs of postpartum depression. While they are not qualified to diagnose any mental disturbances, they should have resources available on hand to guide you towards the support you may need. Hiring a postpartum doula typically means meeting with them prior to giving birth or shortly thereafter.
Is A Doula Right For You?
This is a personal question, and it is between you and your family to make this decision.
**Some studies have shown that when doulas are present during birth, there is a significant reduction in stress, anxiety, chances of a c section, and instrumental vaginal births. The studies also show having a doula present can shorten the length of labor, and children born with doula assisted births were less likely to have a low 5 min APGAR score. In addition, a doula can prepare you for what to expect during birth and help you make informed decisions during birth.
Ultimately, a doula's main responsibility is to respect the wishes of the birthing parent. A doula's obligation is to provide the birthing parent with agency, support, strength, healing and to operate from a place of nonjudgmental and unconditional love. No matter what type of birth you choose to have, your doula should respect your decisions and honor your voice, advocating for you only if/when you are unable to do so for yourself.
Things to Consider
We at Lunita do not believe that doulas are something that should be considered a high-end luxury. No matter your race, socioeconomic status, gender or age, if you want a doula, you deserve to have one. The end.
The prices of doulas range considerably, and while there are some organizations working hard to provide doulas to people of all economic backgrounds (Ancient Song Doula Services), a doula can cost you anywhere from a few hundred to a few thousand dollars.
2. Choosing a Doula
While there are wonderful organizations that train and certify doulas such as DONA, Ancient Song Doula Services, BirthdayPresence, and Carriage House Birth, it should be understood that not all doulas are certified. Not all people advertising themselves as doulas will have all the credentials that you are looking for, and that is ok! Choosing a doula is a deeply spiritual, personal and profound decision. So it is advised that you do your research, interview more than one doula and be very clear about your expectations. Focus on how you want to feel, during this transformative time. Is it Peaceful? Confident? Held? Loved? All of the above?
These are important questions that only you have the answers to. So start by being honest with yourself.
"The reasons for the black-white divide in both infant and maternal mortality have been debated by researchers and doctors for more than two decades. But recently there has been growing acceptance of what has largely been, for the medical establishment, a shocking idea: For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions — including hypertension and pre-eclampsia — that lead directly to higher rates of infant and maternal death. And that societal racism is further expressed in a pervasive, longstanding racial bias in health care — including the dismissal of legitimate concerns and symptoms — that can help explain poor birth outcomes even in the case of black women with the most advantages." Full article available here.
Please understand that we believe everyone should have access to the birth they want and deserve. We believe health care and reproductive justice are basic human rights. Unfortunately, there are those in the birthing world who are not as educated on race as they should be. It is important when choosing a health care provider and doula to have open conversations about their experiences working with people from different populations. If your doula or healthcare provider does not recognize that racism and sexism are pervasive in all walks of life, including the medical field. FIND A NEW HEALTHCARE PROVIDER!
The Wrap Up
Ultimately, as long as you feel supported, educated and respected there is no wrong way to give birth. Listening to your gut and your body is a crucial part of having a positive pregnancy and birth experience. There will be parts of labor and pregnancy that you simply can not prepare for and making an agreement with yourself prior to labor that you will roll with whatever the universe gives you is important. I for one was dead set on having a water birth. I did not make it to our birthing center in time for that to happen. While I was mildly disappointed I chose not to let it ruin my birth experience. We can only plan so much, but sometimes that's just not the way it works out.
In the words of the great January Harshe always remember:
“Who you choose as a provider will play the biggest role in the options, support, and respect you receive through your pregnancy, labor, birth, and postpartum journey. Choose carefully, be picky as hell, and don’t hesitate changing if needed. Love yourself enough to get the care you deserve. As much as you would for someone else you love. Yes, love yourself that much, darling, because you’re worth it.”
DONA INTERNATIONAL - an international organization that certifies and trains postpartum and birth doulas
We also highly recommend the book, Ina Mays Guide to Childbirth what you need to know, to have the best birth experience for you.
Ancient Song Doula Services - Brooklyn based doula services, with a focus on providing adequate birthing support and reproductive knowledge to communities of color
Scientific Trial - on the presence of a doula