is a doula worth it? — The Bump
Natural Birth

is a doula worth it?

I'm 31 weeks with my second baby and I'm considering a natural hospital birth.  I had planned one with DS but was induced at 40 weeks and ended up with an IV and epi. 

I don't like the idea of a home birth and the nearest birth center is maybe 45 minutes away and has a very high transfer rate to their partner hospital.  So I had planned to deliver at our local hospital (10 min away) but at the tour this week I got the impression that the nurses there were unprepared to help/deal with a natural delivery.  For example, I asked whether women could choose to deliver in a position other than reclining and the nurse gave me a blank stare then said, "I think we have a squatting bar around here somewhere.  I'm not sure where it is.  We haven't used it in so long." 

My ideal would be to labor at home for as long as possible and arrive at the hospital when I'm already 6 or 7 cm (is that realistic?).  I'm wondering if it would be worth it to hire a doula.  I'm a reserved person by nature and don't love the idea of someone watching me be that vulnerable, but I also really really want to avoid a c-section and will do almost anything to avoid one.  The doula I'm considering is also a midwife and could do internal exams, which might help me avoid leaving for the hospital too early.

But I'm wondering if it's worth the expense.  Around here, most of the experienced doulas charge around $1000 to attend a birth, unless they're students.  I know using a doula can shorten labor a bit and help avoid interventions, but is it worth that much?  Did you use a doula and are they necessary?   

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Re: is a doula worth it?

  • It's a really personal decision.

    My doula is $550, not $1000. I got her to change some of her prenatal visits this time to post-partum support visits, as that's what I need more. DH really wanted a doula again because she made him feel so much more confident and useful last time. I needed her for physical support (hip squeezes and back counterpressure), knowledge (she was great at knowing when to go to the hospital, no fingers in my vagina requires), and a calming presence.

    Whether it's worth "that much" depends on how much money that is in your life and how much you want what you want. "Necessary"? Of course not. Women have babies without a doula every day. Whether they have the experience they wanted or the one they could have had is somewhat less clear cut. 

  • I used a doula and she was worth every penny we paid her.  I am a reserved, quiet person.  I am usually uncomfortable around strangers especially when I am in pain and have my lady parts exposed.  However, I wanted a natural birth more than anything.  I knew that having a doula has many many benefits and as a FTM I had no idea what to expect in L&D.  My H and i interviewed a few doulas and went with the one that we felt most comfortable with.  Our doula was amazing in L&D.  She reminded my H were to apply counter pressure,  she made sure I drank water, she helped me try a couple of positions to ensure LO was not sunny side up.  Those were all a huge help.  She knew several natural birth friendly nurses at the hospital and had us request them when we arrived.  We ended up with an amazing nurse who supported the birth plan we wanted and never questioned us on pain medication, positions, refusing continuous monitoring, and refusing a Heplock.   We truly believe that our doula made our birth a positive experience.  I highly recommend a doula to any mom.  They are worth their weight in gold!

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  • We ended up getting our doula for free!  She's my old boss from waaay back in the day and we were catching up last week and she mentioned she's a trained doula.  So I'd check around and see if you know anyone already, it may surprise you who's a doula!  Alternately, you could check to see if there are any free/reduced cost doula programs in your area.  In my small-ish city there is a volunteer group of doulas that donate their time to help women out.  They aren't all DONA certified or even trained, but they receive a bit of training through the program, enough to help a laboring mom.

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  • Yes, it is realistic to labor at home and arrive at the hospital 6 or 7cm dialated. I labored at home with my Doula (who could not do internal checks) for as long as I could and arrived at the Hosptal at 7-7.5 CM. 

    As far as hiring a Doula, thats a really personal decision.  I hired one for the birth of my son and it was the best money I spent.  She will be with me for this birth as well.  I am usually a reserved person but I never felt like she was intruding or awkward that she was there.  I would say they are totally worth it

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    BabyFruit Ticker 9/19/12: Miscarriage at 12wks due to Triploidy, D&C 9/24/12 - I will forever miss you my little angel
  • Lol, I just posted about this, too and I didn't see yours. I am right along with you. I am a private person and it is definitely a vulnerable state you are in. Thanks to the PP's for their advice. Part of me is leaning towards hiring the Bradley instructor we just spent 10 weeks with.
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  • I wish every time I think about it I had hired a doula for the birth of my daughter. I went in planning a natural birth, and thought my doctor would back me up. But my hospital had NO idea how to handle a woman wanting a natural birth. The only thing the nurses knew was constant monitoring and women laying in bed the entire time, they freaked out every time I took off the monitors to walk around. It was a nightmare for dh and I to explain my birth plan and wishes while trying to deal with the physical and emotional aspects of giving birth. Long story short, I ended up on a pitocin drip, hooked up to monitors, and delivering with my legs in stirrups because I was just too tired to fight anymore after 22 hours of constant back and forth with the staff and dealing with a difficult labor. I managed without pain meds, but it was by far not the experience I should have had (none of the interventions I accepted were necessary). Poor dh still has issues with it, because he feels like he failed me, when in reality he was just ill-equipped to deal with the constant nagging and medical terminology thrown over our heads to threaten us. This time I'm planning a home birth, and since I know my midwife is 150% respectful of my wishes I won't have a doula, but if I were having to go back to the hospital for whatever reason, I would DEFINITELY hire one.
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  • The other thing to consider is where and with who you're planning to give birth. 

    If you're in a highly supportive environment (like a birth center) with a highly supportive team (like a pro-natural birth midwife), then you'll likely be fine without a doula.

    If you're at a hospital with a conventionally-minded OB, then I'd highly recommend the doula.

    There are plenty of women on the board that had great births without a doula... but very few of those women had "the usual" hospital births with an OB group. 

  • shiwayshiway member
    I think if you are even considering getting a doula you should for sure I that route. I have recently become a doula and out of my 6 births I've attended, all went in wanting a natural birth all for different reasons and 5 out of 6, 5 avoided epidural a 1 had it because it was that or csection. I don't think it was because I'm SUV an awesome doula I'm brand new and so much I encountered was new to me but it was because they someone there with a little training and knowledge and had the support when things got hard and didn't have to follow hospital procedures and could help make informed thought out decisions. Even with super supportive prepared partners, having someone there with a levelhead at all times and can say "this is normal" lets keep going! I'm so pro doula not because I am one but because I also do natural Birth
  • I agree with all the PPs - and while I usually don't reply if there have been a string of answers that reflect my opinion, since the point has been made - I'm replying because I feel so strongly that a doula or very good knowledgeable support person IS SO important.  Especially in a hospital setting - and in the one you describe, even more so. I'll go out on a bold limb and say that you won't get the birth you want by yourselves at that hospital - docs and nurses can be so intimidating and you and your husband WILL feel vulnerable to THEM. And you'll feel empowered with a doula at your side, not vulnerable. She'll be good at keeping you relaxed, making small suggestions and staying out of your and your husband's way.  I've NEVER heard of anyone feeling their doula made them uncomfortable, ever.

    I went into my first labor super relaxed and naive that it would all just happen just right - and ended in C/S for reasons I know a doula could have helped us avoid.  Positioning of baby and how to respond to the docs when they said it was time to intervene, with questions like 'Is this medically necessary?" and " Can we have several minutes of privacy to discuss this among ourselves?" to "what are our options other than this intervention?" etc.  

    So for #2, I did get a doula and it made ALL THE DIFFERENCE!  Not only in the birth itself (successful hospital unmedicated VBAC) but in how I processed it all, and postpartum nursing, care, etc.  It was worth all the money.  After the birth of our #1, we easily spent the money of what a doula would have cost on breastfeeding help, pumping supplies, formula, etc over the first 6m  or year. (She was deep-suctioned at birth and never figured out nursing, had formula before my milk came in and then I exclusively pumped for months and she has some severe life-long food allergies), none of which happened from my #2 - (it's almost impossible for me to separate the experiences and outcomes, and research supports the connections)

    And any splurges you've considered for baby gear, IMO, should go instead to doula services.

     Just look at the VBAC board, as one example of how many women want different experiences than the ones they got the first time around - I'd also say if more women had doulas, there'd be a lot more satisfied moms in regards to their births, even if they still end up medicated or in c-sections.  

     OK, off my soap box.  I'm done :)  Shouldn't have had that 2nd ice tea at lunch. 

    Good luck!  

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