I am certified by two different organizations, however, this will include as many optionsavailable to you as I can find to list. If anyone has more numbers available, please feelfree to contact me.
Robin Elise Weiss, ICCE, CD(DONA), NACA, BCCE
The term doula is Greek for slave or servant. Doulas provide emotional and physicalsupport during pregnancy, labor, birth and postpartum. (NOTE: In some areas, the termdoula only refers to postpartum help, in this FAQ I am dealing only with Labor support.). They call themselves many things including: Childbirth Assistant, Labor SupportProfessional, Birth Assistant, Birth Companion, etc.
A doula does not speak for a couple, provide medical or clinical skills (See Question #2on Monitrices.), or act in any unprofessional manner (Most organizations have Policiesthat each doula must follow.).
A doula provides:
- explanations of medical procedures
- emotional support
- advice during pregnancy
- exercise and physical suggestions to make pregnancy morecomfortable
- help with preparation of a birth plan
- massage and other non-pharmacologicalpain relief measures
- positioning suggestions during labor and birth
- helps support thepartner so that they can love and encourage the laboring woman
- avoid unnecessary interventions
- help with breastfeeding preparation and beginnings,
- written record of the birth
- many other possibilities that vary from doula to doula
A monitrice is sometimes a nurse or a midwife, or someone who is professionally trained to provideclinical skills to a couple (fetal heart tones, blood pressure checks, and vaginal exams).
There is some debate over monitrice versus doula. This basically states that thecareprovider (CNM, OB, or DEM) should be providing the clinical skills freeing thedoula or monitrice to provide the emotional support that the client needs.
This also varies from area to area and doula to doula. Some of this is based on theexperience your doula has, some is based on the going rate in your area. the basic rangewould be from $200-$800. However, most doulas will barter, set up a sliding scale, orpayment plans to help those who can't afford a doula. So, do not let this keep you fromhiring a doula.
I am going to give basic suggestions and then list the organizations that I am aware of.
Places you can try to find a doula: organizations dealing with childbirth, your birth place(hospital or birth center), your childbirth educator, your care provider, lactation consultants,La Leche members, anyone who has recently had a baby or works in the field.
Doulas of North America (DONA)
1-206-324-5440 will put you in contact with members in your area.
AskDONA@aol.com is the e-mail address.
snail mail address:
1100-23rd Ave. East
Seattle, WA 98112
ALACEHQ@aol.com for e-mail
snail mail address:
PO Box 382724
Cambridge, MA 02074
National Association of Childbirth Assistants (NACA)
snail mail address:
219 Meridian Ave.
San Jose, CA 95167
The Bradley Method®
According to Mothering the Mother, How a Doula Can Help You Have a Shorter, Easierand 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
- The Birth Partner by Penny Simkin, PT, CD(DONA)
- The Birth Book by Dr. William and Martha Sears, RN IBCLC
- Special Women, Polly Perez
- Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier & Healthier Birth by John H. Kennell , Phyllis H. Klaus , Marshall H. Klaus
- "The Whole Nine Months," Parenting, Gayle Pryor, May 1992, p34.
- Active Birth by Janet Balaskas
- Good Birth, Safe Birth by Diana Korte and Roberta Scaer
- Natural Childbirth the Bradley Way by Susan McCuthcheon
- Silent Knife: Cesarean Prevention & VBAC by Nancy Wainer Cohen & Lois Estner
- Open Season: A Survival Guide for Natural Birth and VBAC in the 90's by Nancy Wainer Cohen
- Obstetric Myths Versus Research Realities by Henci Goer
- Natural Birth After Cesarean: A Practical Guide by Johanne C. Walters , Karis Crawford
- Easing Labor Pain by Adrienne Lieberman
- Rebounding From Childbirth: Towards Emotional Recovery by Lynn Madsen
- Is she certified?
- Does she provide prenatal and/or postpartum visits?
- What can you expect during these visits, if offered?
- How many births has she attended?
- Can she provide references?
- What form of training has she had?
- What types of births has she witnessed (Cesarean, epidural, intervention free, VBAC, teen birth, etc.)?
- Her fee? And does she have a sliding scale or other arrangements available?
- Has she ever worked with your care provider or at your place of birth?
- Does she has back-up arrangements available?
- What will her role be in early labor?
- Will she provide labor support at your home prior to going to the place of birth?
- Is she familiar with many methods of childbirth?
- How does she define her role during labor and birth?
The bottom line is do you and your partner like her.From: CNMPAT@aol.com:
The best way for doulas to work with providers (at least me and the othermidwives I know), is to attend a visit with the client to meet the provider. This provides a way to ask questions of the provider. Granted, physiciansmight not like this, but it is worth a shot, especially if the doula andclient are not confrontational.From: Sheri Payne
My husband was against it at first. My reasoning which finally got him to agree was that I had never been through a birth before ( although I had witnessed my friend's home birth) and he had never been through one even though he's been trained, so let's have someone with experience on our side. April's right, the nurses leave you alone most of the time. It was nice to have someone nearby who was sympathetic and who could tell me if what I was experiencing was normal. Since we were trying to go as natural as possible, I liked having her around to tell me what she thought about the doctor's suggestions. I'm sure the nurses would have rather given me an epidural than sit through the tough contractions, helping me to work through it. My husband was a great help, but when things got very scary near the end and I was in a lot of pain, he fount it very comforting that Paula (doula) was there to help him, too. Even the toughest of men come apart when their wives are in pain. From: Rachel :
I had two doulas during labor (not planned that way, the back-up doula came : first, and then decided not to leave when my primary doula arrived.) It was : wonderful. They waited on me, brought me drinks, massaged my back, gave me encouragement, etc. It was even OK with me that my husband took a half-hour : cat-nap in the middle of it all, so he was more able to assist when it came : time to push. They also helped clean up the mess afterward (this was a home : birth), which was very nice.From: Jiandra@aol.com
Why Use a Doula?
In order to have a positive birth experience,most women need continuous labor support.Although Obstetrical Nurses are experiencedin dealing with a laboring woman's emotionaland physical needs, they can seldomguarantee the support they provide will lastthroughout the labor - especially in hospitalsettings where shift changes, coffee breaks,heavy paperwork and busy nights regularlyoccur. Some OB nurses handle up to sixlaboring couples at a time. Midwives may beable to offer more labor support, but theytoo have clinical duties to which they mustattend.
The father or partner, may be better able toprovide continuous support but has littleactual experience in dealing with the forcesof labor. Even fathers who have hadintensive preparation are often surprised atthe amount of work involved (more thanenough for two people). Even moreimportant, many fathers experience the birthas an emotional journey of their own and findit hard to be objective in such a situation.
Will the Doula replace the father?
Some fathers or partners are concerned theymay be sidelined or replaced by the Douladuring labor. Although individual situationsvary, and one should question a prospectivedoula about her philosophy, generally theanswer to this question is no - she will notreplace him. Studies have shown that fathersusually participate more actively during laborin the presence of a Doula than without one.A responsible Doula supports andencourages the father and enhances hissupport style rather than replaces him.From: Linda
I have been to six births thus far, and I love it as much as I thought I would. It's very hard, emotionally taxing work, but it's so satisfying. I still feel a little unsure because I'm so new, but as my wise boss told me, "When I think about the people who trusted me with their births 20 years ago, I shudder. But the bottom line is, they didn't care about how many "tricks" I knew, all they cared about was that I was there for them and I cared."From: Kate Hallberg
We met our 'doula in training' or childbirth assistant at our childbirtheducation class- a lot like Bradley but not really. The two womenteaching the class also were childbirth assistants. My husband wasinitially more interested in the idea than I was, but I had no objections.Leigh met with us on and off before I went into labor and was on call forwhen I did. She also went to one or two of our obstetrician appointmentsas well as a hospital tour where we were to give birth. Before the birthshe discussed herbal method of inducing labor- See Susan Weed's "Herbalfor the Childbearing Year". She also listened when I needed to complain asthe due date came and went.The morning I went into labor she came over and hung out with me for a longtime. I had been monitoring my blood pressure as I was borderline toxemicand it was Leigh who noticed I was 'pitting' which is a sign of toxemiaafter I had been in labor for 12 hours without a whole lot of progress.She also had a fetoscope and was monitoring my daughter and showed myfriend and husband how to do it. We ended up going to the hospital Mondaynight and discovering that I had low fluid volume and my daughter was having heart rate decelerations with every contraction. That's when thefun began. I took black and blue cohosh tinctures all night- administeredby Leigh to try and get some progress and avoid pitocin. Leigh was helpfulthe next day in providing encouragement and suggesting to my husband and myfriend what I would like in terms of support. (None of us other than Leighhad been to a birth before.)After laboring all day Monday and Tuesday I was finally fully dilatedWednesday morning. In the meantime I had an IV painkiller at 30 hours andtwo walking epidurals following that. Leigh helped the rest of the teamsupport me physically during contractions and finally during pushing. At57 hours of labor we concluded that Ursula wasn't coming out and we decidedto do a c-section. Leigh and my husband were in surgery and then was thereto provide a little breastfeeding support and take pictures after thebirth. For a week or two afterwards she came over and helped a little andchecked on our breastfeeding progress.I've written this with the doula in the starring role- but what was reallymore important was the presence of my husband and friend. The doula helps.From: Sabrina Cuddy
She was wonderful - gave great backrubs in just the right place,helped me get comfortable, made great suggestions, came in when Ineeded a c-section and made sure we got what we needed to bond,went to the nursery with the baby for a short battery of routinestuff...
Q. If you did it, would you do it again?
A. Yes!!!!From: Trish Jalbert
We met with our new doula, and she is fabulous! She's as if we made her to order. From: Anonymous
My doula really helped me through the rough spots. She gave me the encouragement I needed. I have never felt so empowered. My partner was thrilled that she kept explaining everything to him. I liked the way she pulled him into the birth rather than exclude him as he originally thought.
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