Doula Etiquette

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Hi all!

I am about to go into labor any day now and wanted to hear your opinions on doulas. I am delivering at the hospital I work at (I'm an RN on a med/surg floor) and have hired a doula to assist me and my husband in labor.

It is VERY uncommon for women to show up with doulas at my hospital. In fact, my doctor said she has never had a patient use one, ever. So I am a little worried about the impression this is going to make on my nurse. I want to make sure we don't step on my nurse's toes and that he/she understands that, if anything, the doula's presence is going to make their job a whole lot easier.

My doula will NOT be speaking to the staff on my behalf. She will simply be there to help me get through the pain of labor, as I'm trying to go unmedicated.

What are your thoughts? How can I set myself up for success right away? My goal is true collaboration among all parties.

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Specializes in Rural Health.

I think they are awesome, wonderful, fabulous people.

I work in a facility right now that doesn't support women's choices very often, including doula support and my moms have told me in confidence that so and so is really doula, but they tell everyone else it's a sister or mom or friend.

Remember this is YOUR birth and not theirs.

Congrats and good luck to you!!!!!

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That is sad that those women feel they have to lie about it to preserve their relationship with their nurse. I have thought about doing the same though, depending on the vibe I get from my nurse.

Thanks for your response! In the end, I'm not too too worried about it. Being a nurse myself though, I just really don't want to come across as a difficult patient.

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Specializes in Community, OB, Nursery.

It is unfortunate that perception is often colored by one or two bad experiences; doulas are no exceptions. The L/D nurses I work with that have issues w/ doulas have them because a couple doulas have come in and run the show. IMO, this gives the 99.5% of wonderful doulas a bad name and that is sad.

The nurses I work with have no issues with doulas, as long as they are there to support and care for the laboring mom and not to dictate to her how to labor. The best one I remember helped a 19yo primip through a long labor and she delivered a 9lb baby naturally on an intact perineum. That is a good doula.

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Specializes in ICU, CVICU.
It is VERY uncommon for women to show up with doulas at my hospital. In fact, my doctor said she has never had a patient use one, ever.

Hey- think of yourself as a pioneer- a trailblazer impacting the way care is delivered in your own facility! Seriously, it is YOUR choice if you want a doula. Best of luck with your delivery :)

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Specializes in perinatal.

I find doulas to be very helpful. As a l&d nurse it is always helpful to have a extra pair of hands, especially when laboring more than one patient. It is nice for the patient to have someone by her side giving her constant support. I consider the doulas part of my team and we get along well. I do know some of the more "conservative "doc's completely ignore them and act sarcastically to them. Even some of the midwifes seem a bit put off by them, guess they think they are moving in on their territory. Anyway, I think doulas are wonderful and they also provided great breastfeeding support once you have gone home.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I find most doulas very helpful. It's helpful for us all to know our roles and keep to them-----doulas who know their role are best. I have had experiences with a few who did not and it was hard to work with them. I also have found nurses' attitudes can bring out the best or worst in anyone, doulas no exception. I prefer to see them as a member of the team; we are all there for the laboring family and am glad they (doulas) are there as sometimes, as I am simply too busy to give a lady one-on-one labor support as much as I would like to. I recommend having a doula, in any situation, especially if you are undertaking natural labor.

Make sure he/she has references and experience!

Good luck and I wish you a safe and joyful birth experience.

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Your nurse shouldn't have a problem with your doula- she is no different than a mom or a sister there for you for support- only that she is much better trained in helping you cope during your labor. You don't have to explain who is with you usually. I had a doula with my first labor, I was 21 years old and my only support was my husband and my doula. I wanted a natural birth- but I didn't achieve it due to not knowing what to expect- what labor would REALLY feel like. My second labor I had my mom and I delivered naturally (on pitocin by the way)- due to the fact I knew that labor was aweful- but it's managable. Just believe that you can do it and you can! The main thing for your doula is make sure you really connect on a personal level- I really didn't feel close to my doula so she wasn't very affective to me- I liked my momma better :)

Please remember, you are not there for the nurse's comfort- the nurse is there for yours. You worrying about "inconveniencing" the nurse is completely turning the her purpose upside down.

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Depends on the Doula and the nurse.

For my first baby.. nurse was horrid.. not sure Doula would have helped situation.

2nd baby... Nurse was great and open to our ideas. As well was OB. (we requested a nurse that was on board with our plan). Nurse and I disagreed for a few moments while in labor but otherwise she was fantastic. Doula was awesome.. because of my experience with baby #1 I didn't like my nurse during labor (altho she was great I just went in not a fan of her). I got a fantastic natural birth no issues...

I would just make sure you have a written plan, your OB is ok with ALL of it. As well as anyone who may be covering for them. I would request a nurse who is OK with your plan as well. And be prepared to if need be have and let your doula back you up, and speak for you when necessary.(with basic things, definatly not for major stuff). It will take all your focus to get thru contractions you won't be able to. I will start some doula training in the next year... but for births that I have attended as an unofficial doula I have had to advocate for issues reguarding IV's, constant monitoring etc.

My friend her OB said hep lock OK. Resident said no. One very stern chat in the hallway later... friend was allowed to labor with heplock and drink at her own will. Those little things your doula can do for you and help you IF your questioned at all by anyone.

Good luck! HAppy birthing!

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Just had a very good experience with a new doula. She asked me after the delivery to evaluate her and we had a good discussion about why we worked well together.

I treated her as part of the team from the beginning. I always gave reasons for interventions (pt was on Mag and Pit) and tried to negotiate when possible.

She didn't come prepared for a battle and limited her role to support for mom.

She made the comment that she was so afraid of getting a mean nurse because other doulas had warned her. I gave her the advice to treat the nurse like they are nice and that the hospital staff will honor requests until proven otherwise. Dont go in ready to fight!!

There was also a lay midwife in attendance (the patient had planned a home birth) and she on the other hand undermined the physician's orders and compromises that I had worked out with the patient. She took off the monitors telling the patient that intermittent monitoring was okay, she got the patient up to the bathroom when the MD had wanted her to use a bedside commode. She told the patient I was being over cautious in taking her blood pressure so much. She encouraged the patient not to allow the NICU staff to be in attendance for standby. She frustrated me!!!!!

The doula told me I hid my frustrations well. The important thing was not to stress the patient who managed an unmedicated birth.

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Specializes in L&D telephone triage.

I work in a teaching facility. Therefore, they have treated everyone like they are sick, not just pregnant. However, things are changing. Some nurses don't like the idea of doulas and birth plans. My feeling is, I can work with you if you can work with me. I understanding what your's requesting, but if NEEDS come first, just make sure you and your doula are prepared to compromise and I am prepared to give your every consideration I can. I don't mean for this to sound bad, but if I need you to get out of the way, it's not because you're a doula. It's because you or you child need something different at the time. I will explain what and why I'm doing something as soon as I can. I have had births that have had good doulas and birth plans and births that have had bad or unrealistic plans. We're all here for your comfort and protection. But, most of all, we're here for a healthy baby and Mom.

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I am all for doulas helping our moms....I feel that most of the time, I am not able to be there and support our moms due to patient loads and ridiculous amounts of charting. I do however feel a small twinge when a mom does come in with a doula because I have felt on more than one occasion that I was the enemy in the room...which I AM NOT! I want more than anything for the mom to have a nice lady partsl delivery with as little intervention as possible! Sometimes I have felt like I am interrupting when I am required by policy to monitor and those things.....and it is very difficult when the patient listens to the doula for advice and disregards the nurse's suggestion (I do do this on a regular basis). IE) pt is 2-3 cm, primip, contracting every 5 minutes and wants to get in the birthing tub....I advised against it at that point because contractions were mild to palpation, 5 minutes apart, and she was in her latent phase-the tub would most likely relax those puny contractions away....the doula threw a fit saying that I was barring her progress so she could get an epidural! I am all for the tub, less charting and it usually speeds everything along. so-I am all for labor support, but please don't view the labor nurse as the enemy!

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