What's your experience with doulas?

Specialties Ob/Gyn

Published

  1. Do you think having a doula improves delivery outcomes?

    • 36
      Yes, it's a great idea for all involved.
    • 1
      Only if staffing is lousy, and that's not predictable.
    • 8
      Can't say, because I know nothing about doulas.
    • 11
      No, what a waste of money.

56 members have participated

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?

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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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.

I think that's pretty clear. Most doulas always work this way and many encourage families to interview other doulas and not just hire her because they called her first. Using a doula is far more effective when there's a previous relationship, even if that's just one or two meetings. Generally the only doulas who work with families they haven't met are hospital-based (whether paid or volunteer) or volunteers with another organization, such as social services or a maternity home. (Even most volunteers, such as those for military moms with Operation Special Delivery, are able to meet with families before the birth.)

But I don't agree with "going through the DONA site". DONA is simply the most well-known doula training organization, not the best by any means, and their certification means that a doula has taken a 16-hour minimum training course, read several books on childbirth, attended 3 births and got evaluations from those involved, attended a childbirth education class, and written an essay about the value of labor support. Is any of that a reason why a family should choose a DONA doula over an experienced but uncertified doula?

I'm not running down DONA, but their certification isn't the be-all and end-all.

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They have tips on how to hire a doula and questions to ask on the DONA website. Maybe that's what SBE was referring to.

Another consideration is that few people even bother to interview the person they hire to provide their maternity care. Most just pick whoever is nearby and covered by their insurance. I think that's sad.

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Specializes in 66H.

i had a doula with my last child (#4). i had already had 3 natural births but we had moved to hawaii, i did not really know anyone and we thought that my husband would not be able to be there. she was also a nurse, and she was wonderful. my husband could not be there, so i was so glad that i had her. i delivered by midwife at a military hospital, and she was very ok with me having a doula. i only wished that i had had one for the first 3. worth every penny! i did worry that the hospital would not work with her or have a problem with her being there. from my perspective, the midwife thought it was great, the nursing staff, not so much. but then they did not really work very well with the midwife either. the only reason things went smoothly was because they basically just left us alone until the baby was born. from my doula's perspective or at least what she said to me was that she had worked with many of the nurses prior to retiring and becoming a doula. They liked her and probably treated her better than other doula's.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I think that's pretty clear. Most doulas always work this way and many encourage families to interview other doulas and not just hire her because they called her first. Using a doula is far more effective when there's a previous relationship, even if that's just one or two meetings. Generally the only doulas who work with families they haven't met are hospital-based (whether paid or volunteer) or volunteers with another organization, such as social services or a maternity home. (Even most volunteers, such as those for military moms with Operation Special Delivery, are able to meet with families before the birth.)

But I don't agree with "going through the DONA site". DONA is simply the most well-known doula training organization, not the best by any means, and their certification means that a doula has taken a 16-hour minimum training course, read several books on childbirth, attended 3 births and got evaluations from those involved, attended a childbirth education class, and written an essay about the value of labor support. Is any of that a reason why a family should choose a DONA doula over an experienced but uncertified doula?

I'm not running down DONA, but their certification isn't the be-all and end-all.

Ok Let me please be clear here: I am not promoting any one organization over another in my statement about checking out the DONA site. My point was, as said before me, there are tips on the DONA site as to what doulas do and what to look for when hiring one. No where did I say it was a "be all, end all" to the subject of doulas and their role in health care or what it's worth to their clients and the health care team.

What IS clear to me, is many people out there have no idea WHAT a doula is or what their role is in childbirth care/support, including many health care professionals. This thread really proves that point, from what I see, and in my experience, I know this is true, as well.

Thank you for the opportunity to clarify my point of view on the subject, Wendy. I can see where I may have misrepresented myself before.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
They have tips on how to hire a doula and questions to ask on the DONA website. Maybe that's what SBE was referring to.

Another consideration is that few people even bother to interview the person they hire to provide their maternity care. Most just pick whoever is nearby and covered by their insurance. I think that's sad.

Well said. I am glad you clarified this. I am sorry I did not make myself clear before. I am really sad at how few people take the time to shop around when it comes to health care attendants. I realize insurance has a lot of control over what doctor/midwife one may choose, but doulas are hired strictly by choice. And if I had to pay out of pocket to avoid poor care in a hospital I did not want to give birth in, or at the hands of people who disrespected me, I definately would considering paying myself, if at all possible. Childbirth is HUGE and one of the defining moments/times in a family's life.

Honestly, I have seen people hire doulas I would not allow in the room with me, let alone care for me in what may be the most vulnerable and special time of my life. In our society, we are so careful about what car we drive, or appliances we put in our homes, and we will spend big bucks for "the best". But the same folks will hire a professional like a doula without checking him/her out or having an interview, first. Seems mighty risky and foolish to me.

Ok enough from me.

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Thanks for clarifying, SBE--I've heard people advised "only to hire DONA doulas" and thought that's what you meant when you said "go through the DONA site". Some hospitals have even gone so far as to say only DONA doulas can join their volunteer programs, and EVEN to say that only DONA doulas are welcome in the delivery room, hired privately by the family! These hospitals are trying to keep some control over doulas, I guess, and I can understand why they wouldn't want "bad" or poorly performing doulas, but picking up on the most-marketed organization as the standard doesn't make sense.

Here's a direct link to the "how to hire a doula" guidelines from DONA that SBE suggests: http://www.dona.org/mothers/how_to_hire_a_doula.php

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Specializes in Ante-Intra-Postpartum, Post Gyne.

I think it depends who you ask. For me, I think Doula's are great. I want to even become one on my way to becoming a midwife. I however am not sure I would ever get one, only because I have enough people in my family and connections that I would not need to hire one. However, only being a student nurse and having not ever dealt with one in a working relationship I can not say. When I was doing my pre- requs I talked to a friend of a friend who was going to nursing school on the east coast. She said that although Doulas were a big help, some of them (not all of them) would tend to get in the way and act like they knew more than every one in the room, including the nurses and doctors. I believe in being a client advocate, and would want some one to be pushy for me when need be (I do not want an episiotomy and unless I am delivering a baby extremely early keep your scalpel away or I will kick you in the face) but I can see how one could be annoying.

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Specializes in L&D.
I've never had a doula at a delivery.

steph

Me neither, but I'm new to OB

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Specializes in L&D.
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.

I beg to differ. I personally had an epidural with both of by births and I don't believe I'd want to do it any other way. I had no pain, no nausea, could move my legs (not able to get out of bed of course). I was able to rest comfortably and sleep through my labor. Most of my patients are the same way.

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

Anecdotally, I am totally for epidural in some cases. I am also pro-natural for those who really desire it.

But for my case, I feel an epidural kept me out the OR to have a c/section with my son. After about 16 hours of labor, 12 on pitocin, finally, I broke down and got an epidural at 8cm w/my son.I felt the OVERWHELMING urge, no FORCE---- take over me to push and they told me "sorry you can't." Well this went on for an hour, the force to push and being told "don't push yet"----- and finally I said "enough, already EPIDURAL PLEASE". I am so glad I did this. Turned out, son was persistently OP and had no fontanels (sagittal systosis) so they had to use forceps and episiotomy which extended to 3rd degree tear---to get him out. I can' t imagine enduring 3 hours' pushing and forceps w/o the epi. It (the epidural) bought me 2 hours' sleep from 8-10 cm, and great relief for what would have been an unbearable pushing phase.

The joy I felt seeing my son emerge into the world, I can't even describe. I am so glad he came lady partslly, but it was a tough go. I feel the epidural enabled this experience to be so pleasant for me in what could have been an unbearably painful birth. Nope, no regrets here.

I find most my patients are satisfied, too. It's become a really fine science, with patients able to push and participate yet not feel too much pain or discomfort. I think it's definately appropriate for SOME patients. I see few regrets in my experience, either.

But that is not to say epi's are not without risk or side effects. But most of my moms consider these worth it as trade-offs.

To each her own.

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I didn't mean to imply ALL women are dissatisfied with epidurals or that there is no good situation to have one. Just that I regularly see women who are dismayed to dicsover that the epidural isn't the perfect solution that they had been told. Not enough that they would decide not to get it in most cases, just enough to be somewhat taken aback. I just think many women giving birth feel that is the only option.

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