Monday, October 25, 2010

The Doula -- or "Dude-la" -- Post

Some of you might remember reading about one of my couples that accidentally gave birth at home last year.    The plan was to have their doula - who was at the birth - have a doula-in-training shadow her at this upcoming hospital birth.  Frank, the father-to-be, referred to the student doula as "the dude-la" -- she was to be his doula!  His "dude-la" was actually at another birth when Nancy gave birth at home, much to Frank's dismay.  I wish I could take credit for coining this term, but I have to give credit where credit is due.  It makes me laugh every time I think of it.

I always have a couple of doulas that I refer my students to, usually for a bargain price, as my students are usually very prepared for labor and birth.  A bit less work for her -- certainly less educating on her part.  I am very picky about who those doulas are.  Like lactation consultants, doulas are not all created equal.  I knew of a doula in Albuquerque that had a 90% epidural rate! Certainly not the doula I wanted for my students!

The first question I always ask is why she wants to be or why she became a doula.  I am amazed at how many women become doulas because of a personal traumatic birth experience.  They want to help other women not go through what they went through.  That is totally respectable, but not necessarily who I want at my couple's births.  She will often be defensive and looking for things to go wrong.  Her "bad" birth experience led her down this road and she is, in my opinion, trying to right a wrong.

I have been writing about the birth team a lot lately -- doulas, midwives, and OBs.  I've decided that it is 50% of the "requirement" to having a happy birth experience.  Education is great, an absolute must, but if you are surrounded by people who do not believe in your ability to birth your baby without medication or intervention, you likely will not be doing so, no matter how prepared you and your partner are.

If I were looking for a doula, these are things I would want to know:


Has your doula given birth?  (It is hard for someone who has not gone through labor and birth to understand the thoughts that go through a woman's head during labor.)


Where did she give birth and why did she choose that location? (If you are planning a homebirth and you are hiring a doula who has only given birth in a hospital, you might ask her why she chose to not birth at home.  She may, deep down, be fearful of birth.  Or maybe it was an issue with insurance.  Or maybe her husband was too fearful.  Find out why she birthed where she did.)

Did she have medication or intervention?  (When the going got tough, how did she handle contractions?  What seems to be her general attitude about medications and interventions in labor?  Does she really believe that these things are usually not needed?  On the flip side, is she willing to use intervention if required?  Does she recognize that sometimes a woman may need intervention or medication?)


Has she ever been "overdue" and how did she deal with that?  (A woman will naturally doubt her body's ability to start labor on its own towards the end of pregnancy.  Having an encouraging doula by her side, reminding her that her baby and body knows just when the time is right, is crucial.  The "overdue" woman is bombarded with questions of when she is going to finally induce, and her doula will be her rock in refusing induction.)


How long were her labors?  (There is an emotional tug-of-war here.  Most women hope for a short labor, but that is often much harder, physically, than a longer one.  A long labor is not only physically challenging, but very mentally difficult.  It's just interesting to hear her perspective on length of labor.)

What is her c-section rate?  Epidural rate?  (Some things are obviously out of her control, but if her rates are higher than you think they should be, she may not know how to really help a laboring woman - which may be a physical or mental issue.  If she doesn't know her rate, ask her to figure it out.  You'll be doing her a favor, trust me.  She should know this information if she's never figured it out.  If her rates are high, she can evaluate what she can/should do differently, and if they are low, it will help her in talking to potential clients.)


Where is her favorite place to doula?  Hospital, home, or birth center? (Listen to her answer on this one.  This tells you who is the most supportive of doulas at a birth.  It's usually the places where she feels like she has the freedom to work with a couple and her opinions and experience is valued.  These are usually good places to birth.  If a doctor or hospital is not at the top of her list, it's usually because they have policies and procedures in place that make it hard for her to really help you. They are usually resentful of her presence and feel that she is interfering with their work.)


Does she have backup with similar rates and philosophies?  (I don't want certain doulas at my student's births, so I want my doulas-of-choice to have doulas backing them up with similar styles and philosophies.  Things come up in life, and your doula could have the flu the day you start labor.  Ask about her backups.  You will all be more comfortable if you know these things in advance.)
  

Does she have "time limits" of being away from home (nursing baby, child care, husband's job, etc.)?  This is one reason I don't doula.  I have lots of kids, all attending different schools.  I don't let them ride the bus, so I spend half my day in the car.  I don't live near family to depend on either.   Oh yeah, and I have a husband with a demanding job.  Lastly, I don't have the patience necessary to be good doula!  If she does have "time limits" she may be very distracted.  Know what the issues are and how she deals with them.  For example, she may need to pump breastmilk every 4 hours during your labor.  If you are fine with that, great.  If that will drive you crazy, she's not the doula for you.)

Lastly, ask her what she literally brings to a birth? (One of "my" doulas is a massage therapist so she doesn't bring a lot of physical items to a birth.  She brings her hands, ready to work.  She knows acupressure points that stimulate labor and actively uses them throughout labor.  Other doulas have a bag that they bring, full of "birth toys" to help throughout labor.) 

It's nice to know what your doula brings to a birth, both literally and figuratively.

I hope this list helps you in your search for a doula.  They are such an important part of the birth team.  I see more epidurals and c-sections at births without a doula than those than have a doula.  And if your husband is resistant and wants the job all to himself, start calling the doula a "dude-la" and remind him that she is there as much for him as she is for you!

35 comments:

Diana J. said...

That was a great list - thank you! The only comment I would have of dissent would be the fact that I know several birth professionals who were wonderful professionals for years before giving birth themselves. My doula finally had a VBA3C, but not until she'd been a doula for years. Also, neither of my midwives had given birth (one has since had a baby), and they are some of the best in the state. However, I think having a baby enriches a birth professional, undoubtedly, so it goes both ways.

Thank you for your blog - I enjoy it so much whenever you post! :)

Sarah said...

Great list, Donna! I'm curious who the ABQ doula was--don't want to send anyone in the 90% epidural direction!

Interesting you mention traumatic births and not having given birth, because when I took a doula training workshop last year, about a third of the attendees fit into these categories.

I also happened to notice at that workshop that a couple of the women who were drawn to the occupation weren't really into "helping" or "serving," which (for as much as the word "doula" gets a lot of flack) is *vitally important* for the birthing mama to have a helper who puts her own needs and desires aside, in my opinion. I don't know how this would be recognized before birth, but somehow it revealed itself in that workshop. Hmmm.

One more question: did you call and interview doulas (or any provider, for that matter) to take your pick, or did you find them from others' recommendations, or a combination?

Anonymous said...

Donna, this was great!
I especially liked the paragraph on location. I am brand new & have attended only one birth & that was before training- but I have clients due in Dec, Jan & Feb. & already, I am seeing the effects that the location will have on limiting my ability to help.

I do absolutely see your point in the traumatic experiences; and there were several of those at my training also. I too had a what could have been a traumatic experience, but it was the support I received (from my midwife who has never had children of her own) & my nurse (who was a friend), my aunt & sister, who regardless of the situation-kept it from being traumatic & helped it be beautiful, even in the scary situation. I was so wonderfully impacted by the home birth I attended before deciding to become a Doula as a lay-Doula, & the support at my last birth, a c-section for prolapsed cord, that I want other woman to have that support. It makes a world of difference no matter the our come, when you have a good support.
I do see your point, and it's validity. But I would caution then to ask further- What have those birth experiences done to influence your desiscion to be a Doula?

Also, I didn't know I had options till after my fourth hospital induction stuck in a bed. I was stuck in a bed, with pitocin, & wanted natural...but had no idea there were Bradley classes, or other options. And, I wasn't disappointed, I was happy with how far I got & the outcome of a healthy baby... But when I saw my friends beautiful home birth, my eyes were opened! I was in awe! I wanted to have that. I couldn't do home birth because my hubbu was freaked out & had not had the pleasure of seeing what I saw, but I began to read book after book & learned what options I had! I didn't have a paid Doula, but my sister in law was a great lay Doula, at my midwife hospital birth. The cord prolapsed & I had an emergency csections, but the support, again, was tramendous! Every woman should gave that! My husband was so thankful too! He felt helpless with my first four, uneventful deliveries, but even in emergency...the support was a huge comfort & guide for HIM! :)

I loved this post! You are a near lady & I enjoy your passion for birth & women! Thanks for sharing it!

Caressa

Stacy said...

Great post Donna! I also have to dissent with Diana. I had a wonderful doula at my first birth, whom is now a midwife (CPM) and still hasn't given birth. She is an amazing birth professional and doesn't run into the "time limits doula" problem because she doesn't have children. This is her job. This was important during my epic labors! I can see it both ways, but haven given birth isn't a prereq for me choosing a doula... This post has some great tools for choosing a doula and I am going to repost!

Valerie said...

I understand that going through birth yourself gives you a certain level of credibility, but as an infertile woman who is a doula, I sure hope no one judges me on my inability to give birth or thinks I could never be a good doula because my body isn't capable of having a baby. I work so hard to be a good doula, and the thought that I could never be as good as a "real mother" is a constant worry of mine. Just something to keep in mind. (Also I have a 0% epidural and c-section rate. All my clients have given birth naturally.)

Amy Jones said...

Thanks for your comment Valerie. I am infertile also. I am just starting out as a labor doula. I have a lot of doubts. Even though I want to help and my massage experience really helps the moms I work on. And my years of being a care taker and the education I have received for that, and all the awards I got for being a great care taker. I still think, I don't know what she is feeling. I don't know how it feels. My clients have all said they couldn't have made it through without me. When I hear that giving birth should be a prereq It hurts my heart and makes me feel inferior, and makes me question myself even more.

Donna Ryan said...

OK, so I have to expand on a few things, apparently. So not wanting to hurt anyone's feelings. I do believe -- and I don't think anyone will disagree with me -- that you can better understand what someone is going through if you have been through the same thing yourself. With that being said, one of my doulas (the massage therapist I referred to in this post) was one of my preferred doulas long before she was even pregnant with her first baby. One of my midwives didn't have children. My 2 favorite CNMs don't have children either. I know more midwives that DON'T have children than do! Their role at a birth is also different than a doula. A male OB hasn't given birth either, and everyone's favorite OB in the Ft. Worth area is a man!

I guess it's really more about attitude towards birth. Are they excited? Do they have confidence in themselves and in this process? The doula I'm using most right now has had all her babies at home and didn't know squat (no pun intended!) about hospital birth. I had her sit in on my Bradley series so she knows what I teach and what my couples are learning. She has such a positive, uplifting outlook on not just birth, but life in general, I want her at my students' births. She brings POSITIVE energy to a situation that REQUIRES it. All of my doulas have done that.

Apparently, people are all fired up on Facebook (imagine that) about this post. My sister-in-law had 3 traumatic c-sections and became a doula. She was at my first birth. Had she not been there, I am certain I would have had a c-section myself. I'm so grateful she was there. I believe it's how people deal with things. And who am I to tell anyone how to deal with things that happen to them? Just a general observation about people in general: There are those that deal WELL with traumatic things in their lives, and then there are those who just cannot let those experiences go. It brings them down every day. It's sad, really. We all know people like this.

So, for my students, I would like to see them choose a doula who is upbeat and positive and excited about birth. Even if the outcome is not what is hoped for, having a POSITIVE doula, she will be able to put a positive spin on things instead of making the new mom a victim of a bad birth experience.

And just like with your care provider, you may click with someone who doesn't meet any of MY criteria. Don't pick your midwife or doula because that's who all your friends use. Pick her because you have a connection and know she's the one for you.

HAPPY BIRTHING!

Anonymous said...

I just read through this quickly, so I might have missed it, but I didn't read where it was a disqualifier if you haven't given birth. Just a question.

Kind of like, do you like strawberries? Some people may thing that liking strawberries is a good thing, while others may be unable to even look at you knowing that you like strawberries. To each their own.

It's just a question to ask.

Gina Phillips, mom and doula said...

Though I truly appreciate the doula plug here (wink-wink) I must say that we are going to have to agree to disagree on the “Has your doula given birth” line of questioning.

I feel like the single most important element in hiring a doula is that you AND your birth partner truly feel a deep connection with the doula and she with you. Obviously it works to everyone’s advantage that your doula have good qualifications and experience both personally and professionally, but not even those things can insure she will be the right doula for you.

In my opinion a woman and her birth partner should follow their God given intuition when hiring a doula. I tell couples all the time not to hire me because they might think I look good on paper, or because I’ve give birth 5 times (hospital, birth center, homebirth, and waterbirths), or because someone recommended me to them, but because they both feel a connection with me and they feel like they will be able to trust me and what I’m telling them. Otherwise I’m no use to them regardless if I meet all those “good doula” requirements. I am NOT the right doula for everyone and I DO pretty much meet all of the standards for a “good doula” on your blog post.

Being a doula is about loving, serving, and supporting women before, during, and after the birth of their babies. Any woman can do this and do it well if God has put it in her spirit to do so.

Anonymous said...

Giving birth may not have been a disqualifier, but it certainly made 4 or 5 other question irrelevant. That can make some women who doula without birth as a prereq feel inadequate... But this is a "Bradley" philosophy...people who haven't given birth shouldn't teach birth, especially if that birth wasn't 100% completely natural. These just seem to be the same rules applied to doulas as well....because you can't possibly understand, empathize or teach unless you've been there, right?

Amy Jones said...

I would like to apologize for my earlier post. I am having doubts because of me, because I need more education. You never said that a doula who had not given birth was a disqualifier. It was just a question and one for information. I would not want someone at my birth who was bored or unsupportive. I value what you do and I respect your opinion. And I really want to learn Bradly, I hope that the method doesn't change.

lsprad said...

I truly believe that there is the right doula for every woman--and I also believe that there are some "less than great" doulas out there..I mean come on--they are human...so not eveyrone is gonna be perfect. But there are many incredible doulas out there that would quickly be eliminated from a families choices if they abide by these hard lines questions.



Do I think doulas need to be asked questions so one can find out out how they feel about interventions, thoughts on birth philosophy, personal experience, etc... of course. But what really made me so sad about this blog post was the referring to the fact that a certain answer to certain questions would equate a good birth attendant for these parents.



How many of the incredible doulas out there would be so quickly eliminated because they gave birth a certain way, support women who choose to have a medicated birth, had a long OR short labor them self, chose to birth at home or in the hospital themself and more.

As someone who douled before I had kids, who had a home birth that was not "perfect" , who had a really long labor, who did not go overdue of my due date, who has kids now who do require me to pump for them, and who believes passionately that women should be supported NO MATTER what type of birth they desire to have... I could be quickly dismissed from some peoples list of doulas according to these questions.



I do believe these questions could have merit if asked and presented in a more positive light, but this blog post made it seem that only certain answers were correct and basically any answer could be wrong!

AS a certified doula--I am trained that I am to support a mother no matter her choices...its not my birth so therefore her choices should not reflect badly on me.



It also made me sad that this blog post has made many great douals question their abilities...based on this persons criteria for a good doula for HER students. I am not perfect and according to this criteria I fall very short... but I also know that I am gifted to be doing this job as doula. I am not perfect and I am sure I have failed many times because I am not perfect...but I do believe I have the heart and passion to do this job well. I have worked with many clients who have blessed me with such confirmation that this is my calling and I am thankful for that when I have questioned my own abilities.



My hope is that no family desiring a doula stops at these questions---but goes with their gut instinct and their OWN criteria for what would make a good doula for them. Being reduced down to stats and ability to birth in certain birth locations seems in no way a good way to measure a doula's measure of support. Your thoughts??

Maria Pokluda, doula said...

I have a lot of thoughts pertaining to how couples may find the right doula for their situation. Some of the concerns are the same as the ones you mention and several are a bit different.

One of the things you don't include is experience. Training/new doulas are great and usually full of passion, however, I have found that the longer I do this job the more tricks I have up my sleeve so to speak. Especially when it comes to hospital births, a doula who can communicate well with the couple and with the careproviders/hospital staff is invaluable in helping couples achieve their goals. I find most doulas with a good amount of experience can handle that aspect with a bit more finesse...I know I do it a lot better than I did 100 births ago!

Most doulas, myself included, love doing homebirths more than anything. However the reality is that we find ourselves in hospitals often and we want to support our moms and help them have wonderful births there even though we know the roadblocks all too well.

We also work with couples that are not as 100% committed to a natural birth as I would expect to find in a Bradley class. Moms fully desiring epidurals and c-sections hire doulas, and I beleive doulas can make all births better, even when the doula would make completely different choices for herself (and her stats if she keeps them).

So perhaps one distinction between these questions and all the other questions is more a matter of the popluation you are addressing. Just a thought!

Donna Ryan said...

I AM PRO-DOULA! WHO DOESN'T GET THAT?


Seriously, I just cannot believe this day. Loved this post. Love my list. Contrary to what's been said about me today, I didn't think for a single second that it would cause this stir. I'm usually pretty aware of the posts that will be controversial! This wasn't one of them.


People often ask me how I pick my doulas I refer to. Thought I'd write a fun little post about it. Obviously, I adjust all kinds of things about it when I'm talking to a doula. I either feel good about her or I don't, even despite her experience level. This is a rough guideline that others can use if they find it helpful and I fully expect people to think for themselves and ask the questions that are important to them.


I cannot believe the things that have been said about me today. I've even been called an obnoxious snob! For writing this post! Wow.

Donna Ryan said...
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Donna Ryan said...
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Donna Ryan said...

Amy, I was not upset with you at all today. I'm sorry that you took it that way. I hope it has been made clear throughout the day that it's not all about having a baby or not that makes you a good doula -- just a good question to ask. Some couples care about this and others don't. I've had people in class that only wanted a midwife who had given birth. And other people simply don't care about this question. I don't have to tell people to ask "Have you given birth?" They will ask this on their own! But again, attitude is EVERYTHING to me.


Gina, thank you so much for coming to my blog and posting your thoughts here. I'm with you. I believe we are on the same page. I have so much respect for someone who goes to the source and doesn't talk behind someone's back. I am not that person, and I'm glad you and I have that understanding.


Lesley, there were a lot of hurtful things said on your post today. I am always happy to have a dialogue, but not under those extremely hostile conditions. (Not that I was invited, as we are not FB friends -- just heard all about it from a number of people.) I was really made out to be a horrible, attention-seeking, money-hungry, ignorant educator. The fact that it was even suggested that I would write this post as a way to increase traffic on my blog is an absolute joke. If I wanted to increase traffic, I would post something everyday! This is NOT the attention I want. Totally unbelievable that would be uttered.

Donna Ryan said...

I do want to thank the people that contacted me throughout the day in support of the post. They were nearly all people who have positive outlooks on birth, are excited about what they do, and aren't afraid of these questions. Just an observation.


Glad tomorrow is a new day.

Donna Ryan said...
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Donna Ryan said...

As a Bradley teacher -- good or bad -- I want a doula who will stand up for my students at a birth. If she's asking for drugs, remind her, encourage her, stay positive to help her achieve the birth she wanted before things got tough. I am not of the same philosophy of "It's their birth, I'm there to support whatever birth they want, even if that means an epidural or c-s." That's not my goal. I don't want that doula. That is offensive, apparently. If I have someone that wants to take my class, but is "married" to their doctor or on the fence with medication, I've been known to not let them in the class. My class is not the one for them. Yes, Anonymous, you are right about the Bradley mindset. You cannot be an instructor unless you have given birth without medication. That line of thinking, I admit, often spills over into other areas. Shoot me. But as I said earlier, one of my doulas was someone that had not given birth, and she was fantastic! To be honest, she had a baby recently, and her birth was very hard. Recovery was very hard. But again, it goes back to attitude. She doesn't wear it on her sleeve or even refer to it as a "traumatic birth". She will be a better doula because of her experience, but she is the first to admit that her perspective changed greatly after giving birth. Perspective changes with experience.

lsprad said...

I am glad you have addressed some of the concerns raised. I will say your answers here in the comments feel and sound soo different than your original post...if THIS had been what you had written, I am sure no one would have batted an eye!
AS far as what was said on FB...I can not be held responsible for what people write, just as I cant be held responsible for what type of birth people choose to have.
I posted my own thoughts on FB...as someone who was hurt by your post. I never said your name or even publicly linked to the blog...I was trying to take the "somewhat" high road with things even though they upset me so much.
The bottom line is you are allowed to have your opinion...we all are. But you are a trusted leader in the birth community--you head up the TCBN...people listen to what you say. And your original post made it sound like you were in favor of doulas...but only those you choose and that fit a certain criteria. It just seems unfair for someone that leads in our birth community to make such strong statements against others who are on YOUR side!! I felt like I was to be judged and critiqued like we do the care providers who cause harm to women.
I didnt tell people what to say about this post...but as you can probably see you really affected many of the doulas in the community...I dont think we ALL could have read your post wrong.

My intention was to never bash you...which is why I took my FB status down and started a note in another place on the subject for people to dialogue..not to bash.

Your list hit me personally because like I said...I feel my answers might easily make someone take your criteria and assume I am not a good doula... but know I am. There is not many things in my life I am truly confident in..but being a doula is one of them. I feel truly gifted to do this job...and I feel truly humbled that every time I do it...I learn even more.

I am a backup for one of "your" doulas...and I am not sure if you realized that or not. I imagine that will change after all this.

As doulas and childbirth educators we are supposed to work together...to achieve the same goal...helping families have great births. But this post caused us to divide...and we can never accomplish anything like that.

April said...

Thank you for such a great post!
As someone who has never hired a doula, I am grateful for it. I have given birth to 4 children and never felt the need to hire a doula. After reading your blog, I know that if I were ever to give birth again I would definitely be hiring a doula to attend my birth!

These questions are a wonderful starting point for me. Of course, having already given birth gives me knowledge about what I would prefer my doula to be like. I would ask all of these questions and more. :)

I find it humorous that so many seem to have taken offense to this post. Are they not confident enough to answer these questions and deal with what each individual family decides?

Each mother is different! We would not all want to hear the same answers to these questions. What is important to me is likely not as important to my neighbor.

Doulas provide a service and, as a service provider, they would have to sell me on it. Their answers would need to meet MY criteria.

Thanks again for sharing what you would ask.

Whittney said...

Hi there!

I started reading your blog several weeks ago when I picked up your card at the BIRTH play. I have enjoyed your articles and your passion for birth education. Thought I would jump in here and give you my view of your doula post.

I am not a birth professional. After 2 miscarriages, 2 home births, several midwives and one doula, one longish labor (breech birth) and one very short labor, I consider myself "seasoned" and a pretty no-nonsense kinda gal.

If I were a first time parent taking a childbirth class, I would be overwhelmed with your list of questions, mostly because it seems possible to eliminate EVERY doula based on your questions. Several of your interview questions require a doula to divulge personal information in excess. It is my opinion that a client isn't entitled to information about a doula's birth, whether she used medication, was overdue or how long she labored. It is possible that an unprofessional doula will bring "baggage" to her job, but I don't think it's always the case.

I can see that your goal is to give couples an extensive list of questions to find their perfect match. I also see that you're an advocate of doulas.

I just think that this particular list steps over some boundaries and might create undo anxiety when couples realize every doula they interview has some potential "issues."

I believe your heart was in the right place, it just came across authoritative and very black & white as so often happens with the written word.

Thanks for reading my feedback! I will continue to read and support your mission!

Regina said...

I am not involved in the 'birthing community' at all...just a mom who hired a doula (a great one for me, at that!) and had a wonderful birth.

As everybody has agreed, what is best for one mom is most certainly not the best for everyone. But I have to say, Donna, as I was reading thru these comments and before you even posted in the comments that you are not supportive of the mindset of "It's her birth, I'll support whatever she wants".....I was thinking the EXACT SAME thing!! I hired a doula for a reason, to help me have a natural birth! Some people may just want a friend, but I wanted someone to help me acheive my goal and not just anybody can do that.

When I hired my doula one of the things I made VERY clear was that when I was ready to give up I NEEDED her to remind me of my goals, encourage me and be my advocate. I'm sure if I mentioned drugs, even to my midwives, they would have obliged. So it was important to me that my doula support me in the decisions and goals I had made over the course of 9 months. Not a hasty decision made in a few hours after dealing with intense pain.

Again, this is just me, but the whole reason for me hiring a doula was because I needed her to do and say the things that I couldn't do and say myself. I knew I wouldnt be able to encourage myself, pump myself up, tell myself it would be over soon and keep myself focused on meeting and holding my baby. I had enough to do, what with all the contractions and such. :)

I also needed a doula to anticipate my needs. Having given birth herself would help her in this tremendously, but so would plain old experience. I remember my doula bringing me water and just putting the straw near my mouth. I don't remember saying I was thirsty, or even thinking it, but she anticipated my needs. And let me tell you it was the best water I ever drank!

Anyway, all this to say that I appreciated this post. I read the line where you said that these were the things YOU would want to know. I missed the line where you said that these are what every mom should ask and nothing else. Ha!

Mellanie S. said...

I have read this post several times now, and I just can't see where the list of possible questions to ask is a list of "requirements" to be a good doula. Maybe that is because I am not a doula, I don't know. I think that maybe because of all the drama surrounding this post, some people came to it expecting it to be offensive, and so it was. Is it a perfect list? No. It wasn't meant to be a complete list. It is simply a place to start. I didn't see it as a list of qualifiers at all, just a place to start for someone who has never hired a doula. I guess at the end of the day, we all need to understand that there are times when we disagree on things. However, I think we are all working towards the same goal - Mother Friendly Care in Tarrant County. If we all keep our eyes on that ultimate goal and come together on that point, we can make birth better for women.

Hannah said...

In reading the many comments associated with this post my heart was deeply saddened. There were so many mean and hurtful comments made toward her by women who do not even know her. She is one of the most caring, kind women I know. Her blog, of opinions, is there to help those who desire to have a safe satisfying natural birth experience. I believe that the words in her post were taken out of context in many instances. If you take her opinion out of the questions and fill in your own reason for asking, they are all wonderful questions to ask. I personally did not find her post to be offensive or harsh toward doulas. Bottom line, her blog gets people thinking about normal birth.

I am mentioned in this blog as one of her "go to" doulas. I became a doula in the fall of 2008 well before I had my first child. This in no way hindered several of her students to use me as a doula. In fact, I attended over 20 births before I became pregnant in 2009, many of them were referrals from her and I certainly do not meet her so called "criteria" if that is the box everyone seems to want to place this in. I eagerly await these questions, and many more, from my clients. This will give them some insight on how I feel about birth and what it means to me so that they can make the right choice of a doula to attend their birth.

Deep down, as doulas, we all have the desire to help women birth. Most of us feel we have the calling and such a passion for what we are doing that we want to help women in any setting with the birth they desire to have. I know I am not alone, though, when I say I have a favorite place to attend birth. It is a good question to ask your doula.

What I truly know is that Donna is a very good educator and in support of having doulas attend birth. She is one of the most passionate people I know and loves her involvement in the birth community in order to help educate families on having a better birth. Her classes prepare a family so much for labor and birth that she fills up quite quickly and THAT is the reason she has her classes on DVD.

When my husband comes home from work, no matter what kind of crazy day it has been, I put on a happy face and make sure that the first things that come out of our mouths are thoughtful. We even try and greet Daddy in the driveway when he pulls in. This sets the tone for the rest of the evening. The power of suggestion can be very strong. It makes me wonder how many people read into things they may not have in her post because they were lead to believe so by the comments of others.

My heart is sad at the thought that this has could cause a division in the birth community. I believe people should feel free to post on blogs and facebook without retaliation and backlash from people who are supposed to be united for one cause - better birth.

Maria Pokluda, Doula said...

I don’t disagree with your post,and though I would add a few questions and reword others, that is semantics.

I meet all your good doula requirements and I would do all home/birth center births if given the choice. However, I also feel called to work with moms in the hospital, especially those seeking natural birth. Couples receiving care from a midwife should be getting a lot of support from their careprovider. This is often not the case with hospital birthing couples and the doula may often be the only other person in the room who believes in the possibility of normal birth. At times, attending those births makes me want to bash my head against a wall but I know that having someone there who believes in birth can make all the difference for that couple.

I do keep stats. I was surprised to find out that most doulas don't. Maybe it is all the stats class I took in grad school, but I feel that if I say on my website that doulas lower the chance of having a surgical birth by whatever percent, I ought to have the stats to back that up! However, I do keep separate stats for those who want a natural birth and those that don’t and I felt your post didn't addres this. I have no issue with the dichotomy of having a set of numbers for my moms who wanted to give birth naturally and one for those who didn't(though my stats do show that both groups have a much higher vaginal birth rate than the general population).

As doulas, we get hired by all types. Just recently I attended a birth where mom had scheduled an elective c-section but after hiring me decided to birth vaginally. Mom had no desire for a natural birth, and was pretty well informed, but that was not what she wanted. However she did want continuous labor support and with my doula hat firmly in place I supported this mom, epidural and all. I would say it is not uncommon for me or for other doulas to work with couples who want continuous labor support but not a natural birth. I am OK with that, but I respect a doula choosing not to attend this type of birth.

When I say I support mom in her choices, I mean I support the informed choices she has made prenatally, not in the heat of labor. If we have talked about how a couple is seeking a natural birth I am not going to just support her asking for drugs at birth. That is *not* support in my opinion; instead I am going to work hard to help her remember and achieve her original goals.

Another point that I want to make is that I am a CBE and I am a doula. Sometimes those roles are mixed, but often I am one or the other. In doula mode we meet prenatally to discuss their needs and I give them info on their choices so that they can give informed consent. I also provide resources so they can dig deeper. However, when I have my CBE hat on, I am going to go into great detail about each intervention and routine that occurs in the hospital and will discuss at length the benefits and joys of normal birth. I have more time in this role and most couples are not as set in their birth plan at that point.

It would be interesting to have a discussion on the roles of doulas and CBEs in these areas and I think reasonable disagreement would exist on just how much a doula should be doing prenatally to help couples make choices regarding their birth plans. I know at times I find myself questioning myself in this area and at times I find myself torn as a doula mostly b/c I want to give couples more information than a doula’s role is set up to give. Ideally I would have all my couples take a Bradley class because I feel they are the most comprehensive class and prepare couples extremely well for birth. Alas, as a doula I can only encourage couples, I can’t enroll them in a class and make them attend.

I have found the thoughts and discussion that have occurred in the aftermath of your post to be thought provoking…which is always a good thing.

Maria Pokluda, Doula said...

I don’t disagree with your post,and though I would add a few questions and reword others, that is semantics.

I meet all your good doula requirements and I would do all home/birth center births if given the choice. However, I also feel called to work with moms in the hospital, especially those seeking natural birth. Couples receiving care from a midwife should be getting a lot of support from their careprovider. This is often not the case with hospital birthing couples and the doula may often be the only other person in the room who believes in the possibility of normal birth. At times, attending those births makes me want to bash my head against a wall but I know that having someone there who believes in birth can make all the difference for that couple.

I do keep stats. I was surprised to find out that most doulas don't. Maybe it is all the stats class I took in grad school, but I feel that if I say on my website that doulas lower the chance of having a surgical birth by whatever percent, I ought to have the stats to back that up! However, I do keep separate stats for those who want a natural birth and those that don’t and I felt your post didn't addres this. I have no issue with the dichotomy of having a set of numbers for my moms who wanted to give birth naturally and one for those who didn't(though my stats do show that both groups have a much higher vaginal birth rate than the general population).

As doulas, we get hired by all types. Just recently I attended a birth where mom had scheduled an elective c-section but after hiring me decided to birth vaginally. Mom had no desire for a natural birth, and was pretty well informed, but that was not what she wanted. However she did want continuous labor support and with my doula hat firmly in place I supported this mom, epidural and all. I would say it is not uncommon for me or for other doulas to work with couples who want continuous labor support but not a natural birth. I am OK with that, but I respect a doula choosing not to attend this type of birth.

When I say I support mom in her choices, I mean I support the informed choices she has made prenatally, not in the heat of labor. If we have talked about how a couple is seeking a natural birth I am not going to just support her asking for drugs at birth. That is *not* support in my opinion; instead I am going to work hard to help her remember and achieve her original goals.

Another point that I want to make is that I am a CBE and I am a doula. Sometimes those roles are mixed, but often I am one or the other. In doula mode we meet prenatally to discuss their needs and I give them info on their choices so that they can give informed consent. I also provide resources so they can dig deeper. However, when I have my CBE hat on, I am going to go into great detail about each intervention and routine that occurs in the hospital and will discuss at length the benefits and joys of normal birth. I have more time in this role and most couples are not as set in their birth plan at that point.

It would be interesting to have a discussion on the roles of doulas and CBEs in these areas and I think reasonable disagreement would exist on just how much a doula should be doing prenatally to help couples make choices regarding their birth plans. I know at times I find myself questioning myself in this area and at times I find myself torn as a doula mostly b/c I want to give couples more information than a doula’s role is set up to give. Ideally I would have all my couples take a Bradley class because I feel they are the most comprehensive class and prepare couples extremely well for birth. Alas, as a doula I can only encourage couples, I can’t enroll them in a class and make them attend.

I have found the thoughts and discussion that have occurred in the aftermath of your post to be thought provoking…which is always a good thing.

Donna Ryan said...

Maria, loved your comments -- and many others left today -- thank you. I am actually needing another doula right now and I loved what you had to say and loved your pricing! After spending nearly $300 in my class, I like to have some really great doulas for my students to choose from for a really good price. I will be in touch with you.

Sarah said...

Donna, I am sorry that this post has been so offensive to some. I did not read it that way at all, but then again, I read it as if I were one of your natural birth students--of course someone who comes to natural birth classes would want a doula skilled in non-pharmalogic pain relief!

As an "untainted" reader (I read this post without knowing that it had people fired up), I don't see what the big deal is.

P.S. I love that you're opinionated!

Karen Joy said...

Ha! I have had this post open in one of my Firefox tabs since very shortly after you wrote it, when there were only two comments. (I found it via a FB link from Kathy Petersen at Woman to Woman Childbirth Education.) I find it ironic that I have been waiting to post a comment until I'd found the right words, but for the opposite reason of many of your commenters!

I found your list immensely confirming to me. I found it very, very encouraging, as someone who is starting study to become a doula (I'm working on the prerequisite reading for DONA).

I have given birth five times, all med-free, Bradley-style (more or less), in the hospital. They were all really, really good experiences, though some more "perfect" than others, for various reasons.

Until recently, I was always laissez-faire about birthing -- to each her own, I believed! However, this was under the assumption that all women did their own research and had come to their own decisions. I heart research, and it came as a surprise to me that most women don't. They just go with what's the cultural norm, or what their doc says, since "he knows best." As someone who isn't afraid to ask for what I need, I also thought that if a friend wanted me at her birth, she'd ask.

Well... suffice it to say that I've turned the corner, and realized that most women don't know where to turn to help them birth naturally, and they're afraid to ask for help. One friend, who'd had a traumatic hospital birth, burst into tears when I asked her, after the fact, if she would have allowed me to be there when her son was born, "I was hoping you'd ask!!" ~sigh~

That did it. I felt like I HAD to study to become a doula. I knew a fair bit about birth from reading various books and blogs, but now I'm stepping into officially educating myself.

The biggest thing that has SHOCKED me about the online natural birthing community is the sense that my births don't "count" because they've been too "easy" and I've never had a traumatic birth. I've been marginalized on some websites by other authors or commenters, because I haven't "been there" to know what it's like to weather mistreatment by an OB, or had a c-section, or been hopped up on pitocin against my will, or whatever. I've even heard that my births were not natural because they were in the hospital!! These were NO MED births, NO PITOCIN, NO IV, ambulatory laboring, upright pushing, et al, and yet they don't "count."

That has been so discouraging to me. "Should I even pursue becoming a doula?" I've asked myself.

Then... I read your blog post, and it instantly re-energized my motivation to become a doula. I ordered the next book on my reading list, and look forward to highlighting the heck out of it when it arrives. :)

So, I just wanted to say a heart-felt, "THANK YOU!" for posting this.

Donna Ryan said...

Karen, thank you for those comments. I had similar comments on my FB from Purple Lotus Doula in St. Louis. You'll be a great doula with a positive perspective on birth. I just wanted to wish you luck on this journey. Have you thought about a name? I'm liking Kare'N Joy Doula Services. What do you think?

Karen Joy said...

Oh, my goodness! I've never thought of a name for my doula business! I'm giggling over your suggestion. I just may use that!!!!!

sara r. said...

I really enjoyed this post; I also don't understand what all of the fuss is about.

Like Karen, I'm also starting on the doula path. Several of my friends have given birth since I had my daughter 10 months ago, and I feel a real NEED to help women have an empowering, wonderful experience giving birth (as I did). I'm sure that no matter what the answers are to these questions, a couple can find the right doula for them.

I haven't yet decided if I will put myself out there for women who, for instance, CHOOSE a c-section over a TOL, etc. NCB is just logical to me for a healthy woman. I'm sure that there are many doulas who will support the medical model of care, but I think that as I am interviewed by clients I will make it clear that I strongly prefer to work with a woman who researches and plans on birthing as naturally as possible given the circumstances.

I'm so excited to get my DONA certification packet and start on the reading! I get to take the cert. class in FEB. :)

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