Ask Amma

Is it Necessary to Have a Doula?

In Yes / No on 26 May 2012 at 1:18 am

How necessary is it to have a doula in the delivery room?

mom-to-be in Maryland

You give birth, your baby comes forth into the world.  Strictly speaking, no one else is necessary.  But they can be helpful – if you need help.

I think someone who believes in you and builds your confidence is worth having close by while giving birth.  Someone who can give a good massage, suggest appropriate movement, positions, breathing, and other steps to reassure you and your family in times of doubt, pain and uncertainty can make an enormous difference during labour.  Unlike a doctor or nurse, a doula is prepared to do these things as needed and is dedicated to you throughout your labour.  A doula might also do nothing. They also serve who stand and wait – or as Midwife Pam England might say, who sit and knit.  A friend of mine in Srikakulam gave birth at home with physical and emotional support of her aunt, cousins and local midwife who had 17 years’ experience attending normal births without epidural or other pain-medication.

Eleven years ago, I knew few people who had normal and unmedicated births, so I was open to moral support from whoever was ready to offer.  My doula visited us three times before the birth to get to know us, talk about our wishes for the birth, and also to give me massages. During labour she lavished me with massage (day and night) and encouraging words. Were I to do it again, I would have a doula.

I yield the floor to Vimla Amma from Philadelphia, who did not have a doula:

Thanks for asking me the question, I am very happy to share my thoughts;

“how necessary is it to have a doula?”

This has to start with who is a doula and what does she/he do: a doula is someone who has extensive knowledge about childbirth and about the hospital practices, has been a part of a large number of childbirths (enough to know about most of the childbirth scenarios), speaks the language that doctors speak and can translate it to you in your language.

Alongside this knowledge doula is someone who has the ability to stay calm under extremely stressful situations like when there is a doctor, a nurse, a husband talking at the same time as you are yelling and screaming with labor pains. Has the physical strength and ability to support you, knows position, maneuvers to make the labor easier, speed up the labor if it is slow, or slow the process if it too fast. So, Doula is somebody who knows it all about birth, and who is also able to physically and emotionally support you during the most beautiful, magical and crucial time in your life. If you have a person like that at hand (like your husband), you don’t need a doula, if not, I think it is necessary to have a doula.

I my case, the first time I had no idea about the birth process and nobody to talk to about it. So, I did not have a doula. The second time around, my husband and I were very well equipped to speak the language of the doctors and nurses, and my husband was very well equipped to support me physically and emotionally (having read half a dozen books himself), so I did not have a doula.

Let us now hear from a couple who had a doula:

Sonika Amma from Virginia:

I will not dwell on the usual reasons you read in books about having a doula, but will summarize some points from the perspective of our experience.

– It was a great decision to have one as first time parents. However much you read about labor and hear about it from other moms, your own experience would almost always be unique and at times feel quite like going down a dark alley. As a mom, a supportive and calm person who is experienced in birthing (through her own and others’ recent births) is a must-have, especially the first time round. Most relatives (including spouse) cannot always be trusted to have that level of recent experience, objectivity as well as dependable information about the right steps to take at the right time.

In our particular case, given we had a long / difficult labor and birth …from when to offer a foot/ back massage, to the right words and support through a difficult contraction, to applying “midwife school” knowledge/ techniques to help labor along, to helping make decisions about when to go to the hospital/ when it was okay to say no to a vaginal exam.. I think we needed and used our doulas support all the way.

Given our situation of being by ourselves in the US (no immediate family in the near vicinity) we were almost certain we needed a doula – there was no doubt about it. The only worry was finding the right person (in our budget too). And despite my emphasis on the first time aspect, we’re thinking of having one the second time round as well.

This does not qualify as a generic reason, but we were also lucky to find a doula who was a Bradley instructor, was not the super-experienced (and hence super expensive) types, but had a decent amount of experience, good recommendations, and was well connected in the Bradley/ natural birth circle so that when in doubt she would not hesitate to call more senior doulas/ Bradley instructors etc. That was very reassuring to see that she was so thorough and not at all averse to second opinion….An added bonus was that she was a photographer and had a great portfolio of birth photography. That was a real plus.

I wouldn’t recommend getting someone totally inexperienced or under training for a doula. This is a job of real responsibility and you want someone you can not only trust in your most difficult / challenging time, but also trust with real big decisions if you get to that point.

– From the husband’s perspective what I could sense is that he also needs someone who is objective and calm and can reassure him of what is happening with the mom, who generally is not in a state to be reasoned and objective in her demands /reactions at the time…

And now for the perspective of proud Baba Dushyant:

Sonika has covered most of what I would have also said. The only thing I would like to add /emphasize is:

As someone who had very limited exposure to the hospital systems, having a doula was the best thing we ever did. It made me feel informed and confident about the whole process. Julia was someone I could ask stupid questions without feeling guilty of coming in the way of nurse and physician staff. Never the less nursing staff talks in language that is legally vetted- sometimes doesn’t answer your question.

Since we were alone having a doula gave us an extra set of hands to help out with logistics.

Getting some one totally inexperienced will only add real value in terms of logistics support which is not really needed for many people. Best is to have doula who has attended numerous births in your hospital in particular.

Doula provides good background information that will help you find and work with a doula.

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