What's your experience with doulas?

  1. I'm an RN who has had plenty of experience in post-partum, L&D recovery, nursery, and in the wellness area in general, (plus other nursing experience.) I am curious to see a surge (can I use that word?) in the use of doulas in our area. Women want to choose a wise support person, my words, who will be certain to attend their birth. The numbers say that there's a huge cost savings when a doula is used. Of course there may be self selection, in that women who want a doula aren't looking for a scheduled C-section, for example. What is your experience with doulas? Are they generally very competent and helpful to both staff and their patient? Do you think it's a good idea, overall, for women to have a doula?
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  2. Poll: Do you think having a doula improves delivery outcomes?

    • Yes, it's a great idea for all involved.

      64.29% 36
    • Only if staffing is lousy, and that's not predictable.

      1.79% 1
    • Can't say, because I know nothing about doulas.

      14.29% 8
    • No, what a waste of money.

      19.64% 11
    56 Votes
  3. 42 Comments

  4. by   adrienurse
    Better yet, are they given respect and taken seriously by more medical oriented staff?
  5. by   nurturing_angel
    In all my years of working OB, I've only seen one doula who thought she should be making all the decisions for the patient involved. In fact when mom starting talking about maybe asking for pain medication, this doula threatened to leave and not return if any meds were used. So mom "toughed" it out and had a med free delivery. The only one happy about that was the doula. But in the wide scope of things I love doulas and in fact am planning to take some doula certification classes to improve my support skills for my patients who do not have a doula for whatever reason. Doula's are not plentiful around here. So importing them in from "the big city" is the only way for most families to get them.
  6. by   SmilingBluEyes
    Most doulas are WONDERFUL. They know their roles and I am pleased to work with them in any way I can. Like anything else, you have your good and not-so-good.

    If the family wants them present, I think that is great. I will do all I can to include them in my plan of care and work with them for the good of my patient. That is simple enough for me.
  7. by   ElvishDNP
    I am all for them, during labor, PP, home, whatever. Like Deb said, there are good & bad just like in anything else. Most recently we had a 20yo having her first baby (a very young 20 at that) who had a doula with her. Some of the other nurses made fun of them because as they were walking the halls the doula would do a hip squeeze (poor girl, she must've had back labor) c each contraction. But you know what? That girl had her baby med free, in about 9 hours (1st baby!) and didn't tear. I think that speaks for itself. I plan on having one c my next baby. I didn't know any better the first time.
  8. by   BonnieSc
    I'm most interested in hearing from the people in the "waste of money" camp... not for a debate, but I'd like to hear where you're coming from.

    I'm a senior nursing student and a doula. A good doula will definitely be beneficial to a mother/family, and I think the best way to make sure you have a "good" doula is to form a good relationship when they all arrive at the hospital. The doula will work with you and be supportive of you if she feels like you are respecting the mother. When a doula and a nurse work together, it's a very happy situation--the mother feels supported on all sides--no matter WHAT interventions take place. A doula can help a mother understand why internal monitoring, for instance, has become a necessary intervention (if something about the labor leads the MD/CNM to order it). The mother who's after the perfect non-interventive labor might not want to listen to the nurse, but if her doula can encourage her to listen to the nurse, that means a lot. A mother might perceive childbirth as "me-and-the-doula vs. the hospital staff"; the good doula will bridge that divide and help her perceive the experience as "everyone here for me and my baby".
  9. by   Spidey's mom
    I've never had a doula at a delivery.



    steph
  10. by   bagladyrn
    I couldn't participate in the poll as there wasn't a response for "I love working with a good doula, but have run into some of the other extreme". A good doula can really help the laboring mom, do all the things to help her have the kind of delivery she wants, encourage her when things get tough. A bad doula intimidates her client - yes I DID have one walk out on a patient in mid-labor when she opted for pain medication, and fosters distrust and an adversarial climate with the nursing staff.
    I think a great move for doulas would be to contact the head nurse on the OB units where you will be attending clients and set up a meeting as an inservice/introduction with the staff so that you all know each other and understand each other's roles before you come in with a laboring woman.
  11. by   tinyscrafts
    If a doula walks out on a woman that chooses pain meds that doula should be strung up by her heels!!!!!!!! (i've only heard rumors of this, I know lots of doulas and not one does this) This infuriates me (a doula) REPORT HER TO HER CERTIFYING ORGANIZATION!
    I often wonder if it is sisters or friends calling themselves doulas with some of the nutty things I've heard.
    I will admit that on a few occasions i got the stink eye from a nurse because i was carrying out moms very clear instructions to me to suggest/encourage other comfort techniques when she started to ask for pain meds. These moms often put great time and effort and research into their choices and they are very direct about what they want and at what point they want to throw in the towel. Some develop code words etc...

    I did hear once, from a client, that her doctor called doulas "con artists" He just can't imagine what it is that we provide that he doesn't.... LOL he should really come hang out with me at a labor sometime. cracks me up.
  12. by   tinyscrafts
    Quote from bagladyrn
    I think a great move for doulas would be to contact the head nurse on the OB units where you will be attending clients and set up a meeting as an inservice/introduction with the staff so that you all know each other and understand each other's roles before you come in with a laboring woman.

    Does anyone really have time for that??
    I'd be willing.
  13. by   BonnieSc
    Quote from tinyscrafts
    If a doula walks out on a woman that chooses pain meds that doula should be strung up by her heels!!!!!!!! (i've only heard rumors of this, I know lots of doulas and not one does this) This infuriates me (a doula) REPORT HER TO HER CERTIFYING ORGANIZATION!
    I often wonder if it is sisters or friends calling themselves doulas with some of the nutty things I've heard.
    To be fair, anyone can "call" herself a doula. There are many, many wonderful doulas out there who have no formal training, and many more who have training but haven't chosen to get a certification.

    I think leaving after a woman gets an epidural is pretty dumb, but I have heard of several doulas who practice that way. I hope they make it clear to their clients when they're hired. I know I'm preaching to the choir, but there are a LOT of things a doula can do for a woman who has an epidural.

    I've heard of other doulas who have their clients sign a contract saying they won't smoke, drink, or use drugs during their pregnancies. That's also not my style, but every doula is different.
  14. by   SmilingBluEyes
    A birthing family wanting to hire a doula would do well to go through the DONA site and interview the doula BEFORE hiring her. We are so careful about buying cars, furniture and appliances, for instance. We should be just as picky when choosing birth attendants. At least that is my opinion.

    www.dona.org
  15. by   CEG
    Well, I am a doula so I didn't vote I can say that I have never had a client with an epidural but I have had a couple opt for stadol which I encouraged them to do based on our pre-birth discussions.

    I think more women than we realize are unsatisfied with their epidurals. They complain of itching, breakthrough pain, nausea, not liking the sensation of not being able to move their legs. But then like everyone does- after the baby is born they focus on the baby and forget those negatives. They are unaware that laboring med free is a fairly achievable goal because of the horror stories they hear.

    With both of my births I opted to have spinals. I went in each time hoping to go natural and gave in to wanting pain meds. I really regret it becuase it made me nauseated, loopy enough that I can't remember much, sleepy, itchy, etc. I would have been much happier without the meds even though no one pressured me to get them. I take that with me to births and try to be true to the woman's desires within the situation.

    By the way, DONA's motto is "a doula for every women who wants one." A DONA doula is supposed to support a woman's desires whether it is an epidural at 30 weeks or to give birth hanging from a tree in the rain forest.

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