Birth Doulas

tntrn, ASN, RN · Aug 26, 2009

Where I work, about 85-90% percent of the patients elect to have an epidural, so honestly, there's not much need for a doula, IMHO. I've had a doula present for a couple of my patients and there was just nothing for them to do, after the epidural went in and the pt. was comfy. If more gals would elect to go natural, I think it would be very helpful if the nurse/pt ratio is not 1:1. Where I work, our labors are 1:1 and the RN is in the room 95% of the time. If that is not possible where you are planning to volunteer, then I think having your assistance would be welcomed. Good luck.

beachmom · Aug 26, 2009

We like them except if they try to prevent us doing our thing.

We have one in our town, and she is great helping laboring women. I haven't worked with her, but the other nurses like her because she makes their job easier.

We have a lay midwife here who has been barred from the hospital because she would do things we consider unsafe, like unhook moms from monitors even though baby was clearly in distress. She also encourages moms not to have their babies get eye meds or vit K shots. (Not doing hep B, I understand and can support, but the others are important.)

I am a baby nurse planning on learning labor soon. I was thinking of taking a doula class, just so I can be better supporting the natural labor moms.

CEG · Aug 27, 2009

I think I might have a different perspective as someone who is a former doula. I think doulas are wonderful. In my experience most nurses do not have time to provide true labor support, very few know how to do it, and very few even want to try.

As for "talking patients into things" a doula is not acting ethically if she talks someone into doing something. She should only discuss risk vs benefits and let the patient make the decision. For instance eyes/thighs mentioned earlier- if mom/dad are STD free and baby has had a nontraumatic delivery it really isn't a risky decision to skip them. A doula who pushes her clients one way or another is not a good doula. .

miss81, BSN, RN · Aug 27, 2009

I think I might have a different perspective as someone who is a former doula. I think doulas are wonderful. In my experience most nurses do not have time to provide true labor support, very few know how to do it, and very few even want to try.
As for "talking patients into things" a doula is not acting ethically if she talks someone into doing something. She should only discuss risk vs benefits and let the patient make the decision. For instance eyes/thighs mentioned earlier- if mom/dad are STD free and baby has had a nontraumatic delivery it really isn't a risky decision to skip them. A doula who pushes her clients one way or another is not a good doula. .

I've never had experience with Doulas, but I didn't think that they have the education or authority to be teaching people about medical treatment. Therefore, I wouldn't think that they would influence parents on what is best for their child. They are not midwives, NP's, or nurses... AND I am a L&D RN. We are 1:1 and I do provide 100% of the labour support. I certainly do know how to do this, it IS my job to do this and I think that myself and most of my colleagues do a great job!

hallcrest · Aug 27, 2009

My wife had our daughter nearly two years ago. She had a natural birth in the hospital and we had outstanding nursing care as well as an outstanding doula who happened to be a L&D nurse. I should note that the doctors and nurses are relatively accustomed to having doulas at the hospital we delivered at - so that probably helped in terms of the 'too many hens in the henhouse' situation. A fantastic experience and great teamwork by all. Thanks nurses and thanks doulas!

nurturing_angel · Aug 27, 2009

We don't often get doulas where I work but I have to say I do love to work with them when they are here. I also encourage moms to consider using a doula when I teach my childbirth classes.

:typing

HeartsOpenWide, RN · Aug 27, 2009

I've never had experience with Doulas, but I didn't think that they have the education or authority to be teaching people about medical treatment. Therefore, I wouldn't think that they would influence parents on what is best for their child. They are not midwives, NP's, or nurses... AND I am a L&D RN. We are 1:1 and I do provide 100% of the labour support. I certainly do know how to do this, it IS my job to do this and I think that myself and most of my colleagues do a great job!

I am a doula and also a L&D nurse with a 1:1 ratio in a small rural hospital and I do not see how any nurse can be 100% of the labor support. A great deal of time is spent charting, calling the anesthesiologist, calling the OB/Midwife, adjust I.V. pumps, ect ect. 100% labor support in my opinion can only be given by a doula who only leaves to pee. A nurse simply can not give the labor support that a doula can, no matter how awesome the nurse is...maybe your hospital is very unique, but I have never seen a nurse get in bed with a client, rub her feet for an hour straight, use massage oils, brush her hair, ect. I think that nurses can come in at a close second, but doulas still give the most labor support.

okchug · Aug 27, 2009

I trained with DONA in 2006 and have loved being a doula. Although, I haven't taken a birth client since starting RN school last year & I miss it. I have always had great experiences with L/D nurses, BUT there has NEVER been 1:1 staffing. So, I was a nice pair of helping hands both with mom and the families. If there was 1:1 I might have been in the way....

It all depends on your approach, attitude, and respect of the nurse's role. A doula is there to support mom..not to interfere or influence. You've got to know when to step back and allow the nurse to do her/his job.

Honestly, some places around here have nearly banned doulas because some of them have caused so much trouble and interference- they go in with an "us versus them" attitude. So you end up with a mom/dad/family immediately on the defensive and potential conflicts.....gives the rest of us a bad name.

The bottom line on labor positions, delivery options, eyes&thighs, etc. is that the couple should know about those specific facility policies BEFORE checking in. & it is not a doula's place to sway them either way.

It's a really great thing that you are giving your time to moms in need of support- bless you. Good Luck.

runmommy1 · Aug 27, 2009

A doula is the "mothers helper" she is an advocate for her clients. It is not her job to sway the decisions of the laboring couple, but to help them remember what their birth plan is. The doula is not to give medical advise, nor interpret medical information for the couple. A professionally trained doula knows her role and lets others do theirs.

I have never had a complaint from a nurse, but rather compliments about how I made their job easier.

DoulaJane · Aug 27, 2009

As a hospital based doula, I am very careful to avoid stepping on toes. Although I don't meet my couples until they are admitted, I trust our childbirth educator to ensure that couples are informed so that they can make a decision about their care based on benefits/risks. It's not my place to speak for the patient. My role is to protect their birth experience by providing a calm and relaxed environment and empowering the woman to trust her body. I love this job!

Elvish, BSN, DNP, RN, NP · Aug 27, 2009

Personally? If they are good at what they do, then they are priceless -- just like any other member of the chain.

Most of our labors are 1:1, but even so, a doula is invaluable. Not concerned with charting or anything like that, just supporting her laboring mom. My favorite doula, the first one I ever saw at my current job, was one that helped an 18yo primigravida go natural and deliver her 9lb 5oz baby on an intact perineum after a 24hr labor. (Not to say she or the mother would have failed had she gotten meds or torn or whatever, just that it's a nice thing to watch when it works.)