Do I really Need a Doula?

When it comes to bringing a baby into the world, there are so many things you could throw your money at, it's hard to know what you really need, and what you could do with out. The evidence is pretty clear that hiring a doula can bring so many benefits to a laboring family. Some of which are very long-lasting. Many people ask me what a doula offers that a midwife, sister, or friend can't. It turns out, there's a lot a doula can do for you that your bestie just can't (but there is room for her on your birth team, too!).

• A doula is the trained professional in the room whose only job is taking care of the birthing mother and her partner. This is particularly true in hospitals where nurses, midwives and doctors are not only focused on mom and baby, but fetal heart monitors, blood pressure readings, IV drips, and charting. They are also tending to multiple patients at the same time, which means they may not be available to answer your questions, help you find a better position, or get you a popsicle. This doesn't mean they are doing a bad job, their job just requires a lot more than making sure mom is laboring as comfortably and efficiently as possible.
• If you are in a hospital setting, your doula is the only person in the room not bound by hospital policy. Of course, a great doula will always form positive and respectful relationships with hospital staff, and work to form a cohesive team, deferring to their expertise at times. But--we are not staff of the hospital and therefore can bend the rules a little more if necessary. My doula brought me some food after I had been in labor over 24 hours with nothing to eat. That was much needed, and allowed me to keep up my strength (for another 48 hours, if you can believe it!).
• Continuity of care can be very critical to having a birth experience you feel happy about. Again, this is most relevant in a hospital setting, but the people who are with you the most during labor--the nurses--you most likely have never met before. Hopefully, they have read your birth plan, but they have not had the time to talk with you extensively about your hopes and fears related to this birth. They haven't spent time learning what makes you relax, and what causes you to tense up. They haven't been texting with you for months getting to know you on a personal level. In the best of circumstances your preferred midwife or OBGYN will be on call during your labor. Hopefully you have met and feel comfortable with all of the practitioners in your practice, but they still won't know you as personally as your doula will. This really matters when you are in the thick of it. Sometimes it's hard to express your needs in the moment. Your partner can advocate for you and your doula can be there to support both of you as you do so.
• In an article written and posted on the website Evidence Based Birth, the results of a Cochrane review from a randomized 2012 study by Hodnett et. al of woman who received continuous support during labor was thoroughly explained. It was clear that having continuous support had tremendously positive effects on the outcomes of deliveries. Even more interesting, when that continuous support came from doulas, the results were even better than when it came from midwives, nurses, childbirth educators or a friend or relative of the laboring woman. Women who received continuous support from a doula experienced:
  • 31% decrease in the use of Pitocin
  • 28% decrease in the risk of C-section
  • 12% increase in the likelihood of a spontaneous vaginal birth
  • 9% decrease in the use of any medications for pain relief
  • 14% decrease in the risk of newborns being admitted to a special care unit
  • 34% decrease in the risk of being dissatisfied with the birth experience

So it's clear that hiring a doula can REALLY help to ensure that you have a birth experience you feel happy about, which can have a major impact on your breastfeeding experience and the postpartum experience in general. But how do you make room in the budget? For many of us, the doula fee can be a significant amount. Tune in to the next blog for some great practical tips on how you can fit hiring a doula into your budget.