When you’re pregnant, birth stories start seeping out of the woodwork. And as I await the birth of my second child, all the tales being told by the parents in my playgroup have one thing in common: a doula. “Thanks to my doula, my birth was so comfortable!” “I don’t know what I would have done without my doula!” “My doula made my child’s birth such a beautiful experience!” Doula, doula, doula.
My husband may have been too stunned to respond to my request that he drag the anesthesiologist into my room by the hair, but he didn’t do so badly as a birthing advocate. He held my hand, kept me in ice chips, and supplied enough pithy commentary to keep my head from spinning off my body. Luckily, my first child came into the world after only six hours of active labor, and we both thrived in the aftermath.
Yet, upon hearing my friends’ birth stories, I felt like my first experience lacked a magical, mystical birthing fairy that would have ushered my child into the world with the joy and merriment of a Broadway musical.
The DONA (Doulas of North America) International website cites numerous studies that claim doula support is instrumental in decreasing Cesarean rates, dystocia (non-progressive labor) and the need for pain medication.
Brooklyn mother Marisa Schwartz claims that her doula made all the difference in how both her children’s births turned out. Having experienced a serious allergic reaction to an epidural during her first birth, she credits her doula for keeping her out of harm’s way the second time around. “She went to the mat to figure out an alternate pain-relief cocktail,” Schwartz says. “To this day, I’m thankful for her big mouth. My husband would’ve been way too intimidated to say something like that!”
Doulas’ blend of medical knowledge and advocacy can be indispensable to moms who are afraid their attending medical personnel will dismiss their carefully laid birth plans in the melee of the big day.
“I wanted a natural birth, but couldn’t help but squirm during contractions, so the fetal monitor kept falling off,” mother of two Erin Patterson recalls. “The nurses kept scolding me to lay still! My doula found my OB and suggested an internal monitor. After that, there was no scolding, and I could move around and labor comfortably. My doula made her $1,400 right there.”
But hospital staffers aren’t quite as sold on doulas’ value, and nurses often see them as an intrusion. A study published in The Journal of Perinatal Education says that a whopping 44% percent of responding mothers described the relationship between their doulas and their labor and delivery nurses as hostile, resentful and confrontational, which impacted their birth experiences negatively.
It happened to Shannon Rivero. “I made it clear I didn’t want a catheter, but the nurse put it in when my doula left to get me a bedpan,” she says. “I only wanted good vibes in the room, but the nurse I had was aggressive, angry and abrupt.”
Tara Brooke, owner of Power of Birth, a doula service and childbirth education center in Manhattan, has had Doulas are a great safety net – if you can afford it.mixed dealings with labor and delivery nurses, but sees things improving. “It can get territorial like any job, but our roles are completely different. These days, nurses are just happy to see an extra set of hands,” Brooke says.
For one, Dodi Gauthier, a thirty-year labor and delivery nurse from Santa Barbara, CA, agrees. “I personally love working with doulas, but ten years ago, I think more labor and delivery nurses were feeling their jobs were being usurped because doulas had more time to do the comforting we enjoy,” she says. “But with more doulas on the scene, nurses are realizing that the more support you can put around a family having a baby, the better.”
That’s particularly true when it comes to getting the breastfeeding support that many hospitals don’t provide.
“The first time around, I was on so many drugs, I could barely hold my son, let alone figure out how to feed him,” says Schwartz. “It was the day after Christmas and the hospital was shorthanded, so the nurses didn’t show me how to hold or feed my son, they just threw him at me and left. Fortunately, my doula came to the rescue.”
Doulas are a lot like a supplemental IRA – a great safety net – if you can afford it. The DONA website says the average birth doula costs between $300-$800, but I’ve heard quotes up to $1,500, especially around New York City.
The DONA website claims that more than twenty-five insurance companies have provided some third-party reimbursement for doula labor support, but none of the mothers interviewed for this story saw a cent.
Patterson lobbied to get her insurance company to kick back for the doula used in both of her births, but her efforts fell flat. “I appealed twice, but my insurance company refused to reimburse me stating lack of medical necessity. I found it ironic. I avoided medication with my doula’s help. She saved them a lot of money.”
When it’s time to go home, postpartum doulas can lend a hand for an hourly fee that averages $15-$60 an hour.
“Mothers are often neglected postpartum,” says Gauthier. “She still needs help with pain and breastfeeding. If the father doesn’t get much of a paternity leave and her family is miles away, she’s left at home to fend for herself. A postpartum doula can really help out.”
Robin Muskin was grateful for hers after the birth of her first child a few years ago. “I was stuck alone in the ‘burbs, and didn’t have a clue what I was doing,” says Muskin. “The doula was a big help with breastfeeding and the everyday things you don’t think about, like holding my son so I could make dinner or take a shower.”
In other words, a doula is a mighty shield-for-hire against the hazards of insufficient birthing support. They take the heat off of partners unequipped to act as knowledgeable birthing advocates and compensate for overworked and inattentive labor and delivery nurses (the women on my neighborhood parenting message board have plenty of horror stories about feeling “punished by the hospital staff”). They also provide postpartum support in a day and age when the proverbial village it takes to raise a child has all but dissolved.
The terror and elation of childbirth forged a new degree of intimacy between my husband and me, and I’m counting on his strong grip and snappy repartee to again be what grounds me come take two. But rather than take my chances, I’m going to join the ranks of the doula’ed. I just wish I could get the care I deserve without having to dip into my unborn’s college tuition.