What is a doula? A doula is not, as my brother thought, a part of the female anatomy. She is a birth companion, someone who has a deep understanding of the birth process. She knows the stages of labor, what helps to keep things moving and when is a good time for the mother to take a break and conserve her energy. A doula is there to make sure the partner feels needed and useful, to remind the couple to eat and drink, and to help couples remember their labor desires in the face of pressure from the medical team. A doula does not have her own agenda; she is there to help the couple have whatever kind of birth they desire and she knows the risks and benefits of various procedures. (Also to note: a doula can be a man, but as they’ve traditionally been women, I will continue to use the feminine pronoun.)
Until somewhat recently, I wasn’t very familiar with the doula concept. I thought she was someone you hired if you were without a partner. But after I had Menininho, I wished I’d had a 2nd person with us, someone to stay with me so Mark could go with our baby to ensure our wishes were carried out.
As I became more active on Twitter, I met several doulas: Kayce, Gina, Cassie, Desiree, and others. They gave me a much more accurate picture of the doula’s role and I realized that if I got pregnant again I would want one. Having another family member or friend to help would be ok, but a doula brings a level of expertise that I knew I’d want to help me be successful with my goal of a VBAC.
There is data to show that doulas are effective:
Women cared for during labor by a birth doula, compared to those receiving usual care were
26% less likely to give birth by cesarean section
41% less likely to give birth with a vacuum extractor or forceps
28% less likely to use any analgesia or anesthesia
33% less likely to be dissatisfied or negatively rate their birth experience
(Hodnett E, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews 2003. Issue 3, via DONA, taken from Birth Faith)
I was lucky that Mark was on board with this desire. After I became pregnant with Smudge, I started my doula research in earnest. I wanted someone who was comfortable with the idea of a high-intervention VBAC, since I knew I’d need an epidural and frequent monitoring, and who would be ok with being a support through a c-section should things end up that. I also wanted someone who had some experience with VBACs and wouldn’t just give up on me as being someone who would end up getting cut again.
The first time I spoke with P., I knew she was the woman I wanted as my doula. I told her a bit about my situation and she immediately had several ideas for keeping labor moving even while being confined to a bed with an epidural. She also counseled me to plan out what an idea c-section might look like for me, because otherwise I might allow the result of c-section equal failure, and that should not be the case. I came home and told Mark that we were set. I did attend a local meet-the-doula night later that week to be sure, liked almost everyone I spoke with (one doula immediately began to question the research about Marfan patients using epidurals and insisted I didn’t need one, so that was the end of that interview), but kept coming back to P., who was also there.
Long story short, she contacted me shortly thereafter about setting up a formal interview with Mark present. That was a great opportunity for him to learn more about how the doula aids the husband during labor. We signed the contract later that evening.
I feel like a huge weight has been lifted from my shoulders! Although I’m very excited to have Smudge, I’ve also been really apprehensive about the labor given my previous experience and knowing at least some of my team would prefer me to have a c-section. (For example, while the anesthesiologist promised I’ll be allowed to go till 5 cm before I get the epidural, I lost track of how many times she talked about “the c-section” and how I am at “high risk” for a c-section and all the different reasons I might need a c-section…not because of having Marfan, but just because I’m doing a VBAC, and research doesn’t support her assertions.) I’m much more at ease now knowing I have someone on our team who is rooting for me to be successful in what I believe is best for me and my baby.
Have you had a doula before? What was the experience like?