- Bethany Geisel
9 Reasons to Hire a Doula
Yes, I know, this topic has been done before! However, there's always a new perspective on it. And, it can be super helpful to look at from a more local lens. So, if you live in Westman and are birthing in Brandon, or Dauphin, or Neepawa - here are a few reasons why you might want to consider hiring a doula!
1. Knowledge, of birth, of local policy/procedures, etc
Doulas are birth nerds, birth advocates, and usually just love all things birth and babies! Because we are passionate about the work that we do, we make it our business to stay up to date on not only the best evidence based birth information out there, we also read up on other practices that may be beneficial or provide comfort during labour. We go through a training process that teaches knowledge of birth and of comfort measures, and we also continuously learn about new techniques that can be helpful, so that we can provide you with whatever it is that you might need. We also stay on top of local policies, procedure, and routine practices so that we can help prepare you for what you may expect during your birth. And sometimes, these things change - so even if you’ve had a baby before, some things might be different. Our drive to stay on top of all this local birth knowledge is beneficial to you so that you don’t have to. And if we aren’t sure of something - we have built local connections with medical providers so that we can find out what the changes are so as to be more prepared next time. And even if there is a new policy, we know what questions to help you ask, and can suggest ways for you to take those changes in stride. But if, for example, you’re planning on a VBAC - we have knowledge of what the typical policies are, and can help you to maintain as much comfort as possible when dealing with things like continuous monitoring.
2. Medical/health benefits proved by science
The benefits of a doula have been proved, over and over and over again. Of all things that can be done to improve mother/baby health outcomes, hiring a doula is one that has zero downsides and only provides benefits. This has been shown in studies with thousands of women. It’s been clearly outlined on pages like Evidence Based Birth (on doulas). This updated Cochrane Review outlines it. Here's one from NCBI. Most of the leading childbirth advocacy or educational groups give information on it (such as Lamaze, Childbirth Connection, etc). The major OBGYN societies support it. Here is ACOG's recent committee opinion, which includes a section on continuous labour support. Evidence is overwhelming. Please feel free to review the links to see for yourself!
That all said, a doula is not a magic wand. We can’t make your birth go how you want it. But what we can do is support you in having an empowered birth. And hiring a doula is one way to give yourself the best shot at the birth you want.
3. Because sometimes your spouse/family isn't able to be there (military, farming families, spouses who travel, etc)
We live in an area that encompasses a wide amount of people who live in rural areas, or have jobs that take them far away from home at times. Our proximity to the military base means we have spouses who go on deployments and might be overseas when a new baby arrives. (see the “Due during Deployment" story to read a personal account of this!). Many partners of pregnant persons are farmers, who may need to be out in the fields and not readily able to come home immediately - and in these cases having a doula for extra support can be extremely beneficial! And, there is a lot of oil in the prairies, and some spouses have partners who work on oil rigs, and are away from home for a week or three at a time. Or who work for hydro, up north, and again - are away for weeks at a time. In all of these cases, hiring a doula can be an absolute godsend. The doula knows birth intimately, and can help your pregnant partner feel safe and supported when you are not able to be there to hear about all their pregnancy twinges. Sometimes, it just can’t be helped that you, the partner, has to be away when a baby decides to put in their appearance. Wouldn’t it be wonderful to know that your partner has someone with them who is knowledgeable of what they desire for birth, and who can support their needs at the drop of a hat? We establish a relationship with (preferably both of) you prior to birth, so we are not strangers - we are your birth confidant, and we are able to help and support you with whatever you need, no matter how you want your birth to go, particularly if your person can’t be there for you - even though we know you’d both like nothing more than to be together. And maybe you’re thinking - well, my partner is planning to be here on my due date, even though they work away from home half of the month. You know, that’s awesome - of course you are planning for your partner to be there! But babies don’t come on a schedule - not mine, not yours, and not with predictability. Wouldn’t you rather be prepared to have EXTRA support in case your baby comes on time, with the knowledge that you have the support you need in case that baby comes early or late? Your doula loves to work WITH your partner - we love to support the two of you, and to watch you become a little family together. But we are there for your support if things don’t go according to plan, too!
4. Because even if you feel like you have all the support you need in your partner, sometimes they need someone else to reassure them.
There is a lot of pressure put on partners to be the support person that you need during birth. And yes, some partners absolutely ROCK the role and are amazing supports. But some partners need some extra support themselves. Birth can be unpredictable. It can be extremely long. It can be scary, sometimes. And your partner needs to be able to be there for you, to be your emotional support person, and to help you make your medical decisions. When your partner is scared, or tired (whether from a long labour or from having worked a full day the day before and is going on no sleep), they sometimes need someone who can reassure them, too, or who can be aware of what they need, too.
As doulas, we provide support for the whole birthing team. That means we can tell your partner to go and take a nap if they need one, and your partner can rest assured that you, the birthing person, is well supported. And you can be assured that we will make sure you are well rested and won’t miss the big event! I once had a father who told me that our entire fee was worth the nap he was able to have between 1 and 4 AM. He knew his partner wasn’t alone, and was being supported excellently, so he was able to rest deeply and could come back with energy to support the rest of labour. We also make sure that you are BOTH getting what you need - whether it's something to eat (we don’t need any fathers passing out from low blood sugar!) or a shower (yes, you can run home and let the dog out and have a shower, we will immediately call you if we think you need to come back!). And, we can help to talk through when things aren’t going how you expected - we can help to interpret for you both the medical jargon, we can suggest other ways to think about it, and we can listen if you need to talk about something that happened, or if you don’t understand what is going on or why it is taking so long. The doula is a constant, calming reminder of the normalcy of birth - and we can help facilitate conversations with your care providers when you aren’t sure of what to say or do.
5. Because sometimes your primary care provider can't be with you (busy floor, long labour, not on shift, change of shift, etc)
We often hear that you don’t want a doula because you don’t want some stranger in your birth. That’s totally a valid feeling, and 100% we understand this point of view. You feel a good relationship with your family doctor or your OB, or your midwife, and you want that person to be with you. Hopefully, this is exactly what is going to happen! We would LOVE for the person looking at your vagina and catching your baby is the person you are most comfortable with! But please understand this doesn’t always happen. Lots of babies are born at night, and this means you often get whichever doctor is on call. Or if your family doctor is unable to make it in, again it is the on-call OB. With the midwives in Brandon, you meet them all so you have at least a small knowledge of each of them, which helps, for sure - but there is still no guarantee that you get your primary midwife, or even your preferred midwife. Frequently, there are locum doctors from Winnipeg here to help out, which means you may not have met them at all! And sometimes, babies come faster than expected entirely, which means whoever happens to be on the floor is your baby catcher. So while in a perfect world you would have your primary care provider at your birth, this simply isn’t the case, a lot of the time.
The counter to this argument is that you at least will have the same labour nurse. Again - I certainly hope so! There are excellent labour nurses at our hospitals, truly lovely people who provide wonderful care to labouring persons. But again - you may not even have the same labour nurse. First of all, your labour nurse is likely also a stranger to you, someone who you have just met that day (you meet your doula several times before birth). So your “no strangers” policy is right there kind of out the window. But more than that - you may not even have the same labour nurse on admittance that you have when you give birth! Shift change means a new nurse (and introducing a new person into a labour room is DEFINITELY a disruption, especially if you don’t jive well with them). Lunches, and other breaks mean you don’t have the same nurse. And sometimes, you could go through two or even three nurses, depending on how long labour goes. And then there are also students who may be learning working on the floor, so you might not even have only one nurse - you could have two, or even three coming in and out. Again - in my experience - the labour nurses in Brandon are pretty excellent. They care about their patients. They take classes and courses to help build their skills. But they are also busy. And there are many that have different personalities. As much as they try to respect your birthing wishes, they also don’t know you. They haven’t established a rapport with you, and they don’t always have the time to dedicate 1 to 1 with you to provide comfort, particularly when the floor is busy.
Your doula is someone that you have met prior to birth - at least once, and ideally about three times. We establish a relationship with you - we get to know your thoughts, ideas, and wishes for birth. We learn what you are hoping and dreaming for this birth, this baby, and we are 100% available to you from the time you sign the contract with us. We stay for your ENTIRE labour and birth - which could be 6 hours, but it could be 36. Your doula is there for you - we don’t have other clients we need to go to (one reason why we work in teams!). We are able to support what you need and want, because we have had conversations with you about it before labour happens. Your doula works for you - which means we can do what you need us to do, be what you need us to be.
6. Because historically women have supported each other during birth and its important to reclaim some of that in order to improve maternal satisfaction
Birth has traditionally and typically been in the purview of women. It wasn’t until modern medicine was invented, and maybe the 50s and 60s where birth moved out of the home and into hospitals where it was attended by physicians. The history of birth is pretty amazing, actually, and definitely worth a read if you like that sort of thing (Birth by Tina Cassidy is a good read). In the name of modern medicine, we have done some pretty atrocious things to women in labour, from performing medical experimentation on slave women, to the days of Twilight Sleep, to separating moms and babies in the name of “progress.” Now, things finally seem to be starting to shift back to what is best for moms and babies, although the medical management of birth still has a ways to go to align with evidence based best practices. But prior to modern medicine, birth has historically been women supporting women. You’d give birth with a traditional midwife (way different from a modern midwife, though there is a lot to be said for traditional midwifery knowledge), surrounded by possibly your mother, aunts, sisters, etc - and often even other women in the community who had given birth themselves. Men, and fathers were often not permitted in the room, or culturally speaking did not take part. It was other women who surrounded you, and often, by the time you were ready to have your own babies, you had also seen and been a part of a birth or two yourself, in a support role - whether it was your mother, a sister, or a friend. So women learned how to best support normal physiological birth. They were able to provide support for each other, and took comfort in each others presence. The important aspect of this was that these women were intimately familiar with birth, and it did not surprise or shock them. They did not fear birth, not usually, but understood that it was a rite of passage, a ritual that women must go through in order to bring their babies into the world.
Now, I’m not saying that we need to return to all of this. Obviously, birth has always carried some risks. And so our modern care providers and modern medicine is integral to having a safe and healthy birth. But there is much more that (I believe) we should do to enhance this experience, this transitional time in our lives. And starting with trained birth support people (doulas) is the way to go. As much as it is lovely to have your mother there, often times our parents only experience of birth is there own - and a lot can change in 20 to 30 years. Or perhaps you don’t have a great relationship with your mother - or you know that she will cause you to be more stressed out. You shouldn’t feel as though you have to have your mother in the room if you don’t want her to be. And a doula can fill that space. We are often mothers ourselves (though not always) and can often be quite an empathetic figure. One doula I know likes to describe herself as your favorite aunt. Your doula can be a trusted friend, or feel like a family member. Your doula is familiar with birth, having likely attended more in her career than your own family and friends have. As such, the doula is a support person who can hold your hand, hold your space, and help you to transition through birth as you need to, without putting her own experiences on you. Or perhaps you are lucky enough to have several people with you during your birth - a doula, your partner, your mother, your sister - whatever it is that you need to feel supported is wonderful! And sometimes, as long as everyone there is being supportive of you, the more the merrier!
7. Because birth memory lasts and women deserve to be an informed, empowered part of their own births, no matter what happens.
There have been several studies on birth memory, and how long it lasts. There is something about birth that we internalize, that we cherish, and that sticks with us - be it good or bad. We remember birth - twenty, thirty, sixty years down the road with detail and clarity. No, you may not remember your doctors name, or your nurse. But you do remember how you felt, if you felt supported, and if you felt as though you were in control or a part of the process. Birth matters - you are going to remember it for the rest of your life. Birth stories matter - sharing our experiences can help us to process them, if we have need of processing. Birth is raw, it is visceral, it is powerful and such an experience should be under our own control. Rarely does an emergency happen so quickly that all decision making is taken out of your hands, so at every stage of birth, whether it goes how you wish it to or not - you should ALWAYS ALWAYS be made fully aware of your options, fully aware of your choices, and fully aware of what is going on and why. You may not be able to do anything about it, but you should still be made to feel as though you are an informed part of the process, because it is being made informed of your birth experience that makes you an empowered part of your birth.
8. Because doulas are worth the price you pay
Value for money. Let's talk about this.
We absolutely wish we could be a doula for every single person who wants one. 100%. And in a lot of cases, doulas do provide pro bono work (we are hoping to set up a program ourselves!). But here’s the thing.
This is work.
It is passion, yes, absolutely, omg is it ever a passion.
But don’t kid yourselves.
This is also work.
We dedicate ourselves to our clients. We answer emails, phone calls, text messages at all hours of the day or night (believe me, babies like coming at night so the old 3AM phone call happens a lot!). I get text messages at hours that most other people would be going to bed. And we respond. We answer, every single time. It is hard to keep yourself dedicated to someone for that kind of time. So that is one part of it. Dedication, and being available for you and your needs, concerns, no matter what time of day or night. Next is our one on one time. We offer between one and three prenatal visits with you to establish a relationship, to go through paperwork and to find out what you know/want to know/where you stand on labour and birth comfort and pain management. This is where we get to know each other, where we can answer some of your questions, and where we really build trust with each other. These meetings range from 1 hour to about 2 hours (sometimes longer if we really get off topic!). And it’s fully catered to what you think you need. It’s not canned information spit out to you - you can take a class if you just need information - but it is resources and evidence based information, as well as using our empathy to find out what your feelings are on birth, and exploring those with you, if need be. So figure on at least 5 hours of in person time one on one. And leading up to that - when you have questions, we have answers. But we don’t always have those answers at our fingertips. We have a wide variety of good sources to pull information from, that you may not know to search or may not know how to interpret. So we spend time looking things up for you, sending you relevant and up to date information that isn’t anecdotal or isn’t “well I did this and look how I turned out” experiences that are rampant in Facebook moms groups. We make sure that the information we find for you is evidence-based, up to date, and accurate. And the amount of time we spend looking for this stuff takes time too.
Then there is the actual day you go into labour. Very rarely does someone simply call out of the blue and say “baby’s on the way!” Often, there is hours, if not days/weeks of daily texts or calls where you aren’t sure, or its “Maybe this time!” But when it does finally happen and it is go time - the day you go into labour we spend a lot of time on the phone with you, hearing how you’re doing, provided suggestions for labouring at home, before you truly need us, and helping you feel comfortable about the process when you are just so excited and thrilled that it’s finally time! We help ground you, and sometimes can encourage you to rest if you are able. At some point, you’re going to ask us to come - and we drop everything and go. I don’t know how many of you are able to just drop your whole lives to go to someone else, but we do. We have systems set in place for our own children, backups of backups to make sure our homes run smoothly in our absence, other jobs where we call in others to take shifts for, and so on. We drop what we are doing, and we go to you, and then our in-person job begins. Sometimes, birth goes quickly and we arrive and there is a baby 6 hours later. Sometimes, its two days. Often, it's somewhere in the middle. And while we are with you, you are our top priority. Our other lives, our families are put on hold as we support you.
This is often quite a physical job. We do hip squeezes, trading with your partner, for every contraction for hours and hours. We physically support you in a standing position to have gravity aid the labour process. We go hours and hours without sleep sometimes. We fetch and carry for you whatever it is that you need, often getting you something before you even consider that you might need it. We make sure you and your partner are eating. We try any number of different birthing positions with you, and we hold your hand or massage your back and remind you to breathe. And we help your partner do these things, too. We suggest things for them to do, because after 15 hours, they are tired too. And if all you need from us is someone quietly murmuring, “you got this!” sometimes our voices go dry doing that for you, too. We help encourage you through transition, that scary part where you often lose your shit and feel like you can’t do this anymore. We remind you, realistically, of how far you’ve come and how well you are doing. And we encourage you to do what you need to do for what is best for you, your baby, and your birth - it is, after all, yours. Whether this process takes 6 hours or 26, we stay with you the whole time and ensure that you are supported.
Then the baby arrives, and we don’t leave yet. We spend the first hour or two with you. Waiting for a time when you are ready to be a family unit all of your own. Making sure that you are doing OK. Helping you nurse, if that's what you want. Making sure you get some food. Taking a couple of pictures on your phone for you to cherish, later, of the three of you. And then, when all is calm and you are basking with your new little one, we take our leave, quietly. But still - our job is not over. Postpartum, we visit with you at least twice within the first couple of weeks, again always ready to answer questions via phone or email or text. We help you with breastfeeding. We provide support in the early days and weeks if you need someone there. We are still there for you 100% of the time, as required.
What value can be placed on this, do you think? Is it worth it? Absolutely, it sure is. Our fee may be high, and damn, we wish it didn’t have to be. But truthfully, we still undercharge for what we do.
You can ask our clients.
9. Because doulas are awesome
Clearly, doulas are awesome. We are people who dedicate their lives to you, put ourselves on hold for your birth, and walk beside you through what is a very transformational time. Doulas are usually empathetic beings, who can relate to you and feel for you, and just care deeply about you feeling like you’re having the best experience you possibly can. And so yes, doulas are wonderful, awesome people. And everyone should have one.