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Any woman who has had a baby can tell you, giving birth is one time when extra support can be a life-changer. Thats where doulas come in. Unlike midwives, doulas are not medical professionals and dont physically deliver babies; theyre there solely to provide emotional and physical support to women at the end of their pregnancies and throughout labor.
But clearly their services are in greater and greater demand, as the number of certified birth doulas in the United States has exploded in recent years, with 2,636 practicing today, up from only 31 in 1994 (according to DONA International, a professional doula association).
Here are ten things you should know when deciding whether to get a doula.
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1: Doctor, Doula — Why it's a good idea to have both
Your doctor will be in and out of the room as you labor, but a doula will stay with you from the beginning and wont leave until the baby is born, the placenta is delivered, and, if youre going to be breastfeeding, the first latch is established. (Doulas will also come to your home if you want to labor there for a while before heading to the hospital). To keep you comfortable during labor and delivery, your doula might massage key pressure points, apply warm compresses to your lower back or set you up in a hot shower to ease the pain of contractions. And when you (or your partner) become completely overwhelmed and exhausted, she will be your one-woman pep squad.
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2: Your doctor might be grateful for the help
Talk to your OB/GYN as soon as possible about your plans to hire a doula. Many OB/GYNs see the benefits that doulas provide and encourage their presence in the delivery room. Doulas are support people, and everyone can use more support, says Anthony Chin, M.D., an OB/GYN who practices in Los Angeles.
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3: Your doula won't be a third wheel
Unless your significant other is a midwife or OB/GYN, he or she isnt going to know nearly as much about the birth process as your doula. Even if its your second or third time having a baby, there will likely come a time when your partner will probably feel overwhelmed. Your doula is there to guide both of you through the process. She can suggest specific ways your partner can help you, while respecting the intimacy of your experience together.
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4: You can get recommendations
The best way to find a doula is through word of mouth. Get a list from friends and friends of friends or from your midwife or doctor. Start with phone interviews. Ask potential doulas about their experience and training, how many births theyve attended, and why they decided to be a doula. If you dont have personal recommendations, check out the listings at DONA International.
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5: You can interview them face-to-face before choosing
This might seem obvious, but as you are going to be spending some very intimate time with your doula, its critical that you like her. Will you feel comfortable letting her see you naked, throwing up, crying, yelling, swearing — maybe even defecating? Ask your potential doula about her birth philosophy, her feelings about natural and medical births, and how active or laid-back she tends to be in the birth room. If shes part of a doula practice, do some comparison shopping and ask to meet with one or two of her colleagues. Your partner should come with you to the interview, as he or she will be working closely with the doula, too.
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6: Doulas are more affordable than you think
The going rate for a doula varies widely, depending on location. In New York, Los Angeles, and San Francisco, seasoned certified doulas charge between $1200 and $2700 for pre-birth discussions and full-time labor and delivery help. However, in most other parts of the country the cost is much less. Even on the coasts, though, there are ways to find an affordable doula. All doulas-in-training need birth experience, and many are willing to attend births for free or for a nominal fee. A quick search on NYCs craigslist (search doula under childcare) found several doulas offering reduced, pay-what you-can rates.
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7: You can use your doula as an information source
Expecting moms can lean on their doulas for emotional support and valuable information and advice in the weeks leading up to the birth. This can be particularly helpful for first-time moms, uncertain about how to differentiate between, say, Braxton Hicks contractions and the real thing. When my water broke, I called my doula, Tara, first — and then my doctor. Tara suggested I eat before heading to the hospital — a lifesaving suggestion since I had a 24-hour labor and an unplanned c-section ahead of me.
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8: No matter when you have your baby, your doula will be there
Unlike doctors and some midwives, doulas only schedule a few births a month. That means theyre almost guaranteed to be there for the big event. I had my son, Lucien, on Christmas Eve, and still, Tara met me at the hospital in 15 minutes flat and never once complained about having to eat Christmas dinner out of a hospital vending machine. My midwife, on the other hand, was vacationing in Paris for the holiday and missed my birth. With many doctors and midwives working in group practices, its a relief to know therell be at least one expert at your birth who you have an ongoing relationship with.
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9: You don't have to be shy during labor and delivery
You can ask your doula to do anything you can think of to help you. Whether its a foot rub, grabbing your partner a coffee from the cafeteria, changing the CD, or advocating on your behalf to get the anesthesiologist in the room this minute with your epidural, your doula is there for you.
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10: You can also hire a post-partum doula
While labor doulas attend births, post-partum doulas support new mothers at home in the first few weeks. Since my husband and I didnt have family nearby, we sprung for twenty-five hours of post-partum doula care over a six-week period. It was money well spent. We had no idea what we were doing; my husband, Neil, had never even held a baby before, and I was swollen and sore and struggling to get the hang of nursing. For a few precious hours each week, our post-partum doula carried Lucien in a sling while I napped and showered, taught Neil how to change diapers, did laundry, showed me how to get Lucien to nurse more productively and kept my energy up with a steady supply of veggie-avocado-and-cheese omelets. Now, whenever I'm invited to a baby shower, I skip the onesies and wipe-warmers and give post partum doula hours as a gift.
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