Over the years I've served many different types of clients..all who have different motivation for hiring professional birth support. It's funny, sometimes clients seem to think out loud through the hiring process, almost feeling the need to justify the reasons for it.
Obviously, I believe in doula support because it's my profession, but sometimes it's a difficult concept for people to swallow. They have supportive partners, family and OBs and feel strange bringing in outside help. They don't necessarily need education so what can a doula really do for them?
A lot of them time, I am hired because people have done some research and just want some extra guidance to avoid unwanted interventions including cesarean. Maybe they are familiar with the maternal and infant mortality statistics in the US and that the use of routine interventions are the biggest contributor to that.
ACOG and The Society for Maternal Fetal Medicine recognize this benefit and made this statement:
Most of my clients are not opposed to all interventions, they just want to cut out what isn't totally needed. Sometimes that's an epidural, or pitocin, or an episiotomy. Priorities are different for everyone. Obviously, even the best doula cannot control this and knows labor is unpredictable, but we can discuss techniques and communication tools to lessen the possibility.
On the spot education is a big comfort for lots of people. They don't want to be overwhelmed with the "possibility" of what can happen, they just want to keep their head in the game as it's happening... Maybe they didn't have time for birth classes, or just didn't want to take them. AND, no matter how comprehensive your birth class, sometimes things happen that just are not covered (or are forgotten) I'm happy to help these couples have amazing support regardless of their knowledge base leading up to birth.
Education isn't always needed during delivery. I've been hired by tons of medical professionals, including an Obstetrician, Pediatrician, Orthopedic Surgeons, Physician's Assistants, Nurse Practitioners, Chiropractors (specializing in pregnancy), Registered Nurses, physical therapists...as well as Doulas and Childbirth Educators themselves. AS a doula, I also had a doula myself.
Again, motivation was different for each one. Some of these families wanted to avoid repeats of their first births (long, difficult labors with many interventions, some planned VBAC- vaginal birth after cesarean) Some of them wanted epidurals (and I fully supported them)
I wanted doula because I KNOW the pain relieving benefits of knee presses and would have paid someone JUST to do that even with no other purpose. I don't have words to express how much it alleviated my pain. That's not something, in my opinion, that can be learned by practicing a few times. I wanted someone with real life experience who I knew would know exactly what to do and when. I can do REAL physical things to make this process less painful.
Some people are very confident about their abilities and what they want. They feel strong and capable and hare a very clear vision for what support looks like.
Some people are scared shitless and have a history of anxiety and/or depression. They know they need all the help they can get because they do NOT feel confident about the physical, mental or emotional journey they are one.
Least commonly, I have a client with a non supportive partner, who needs me to step in. Sometimes I'm working with a military family who's spouse is deployed, a partner who is out of town and even single moms... but these have been rare cases in my client load. Most clients are in supportive, loving relationships and partners are thrilled to have my guidance and support.
NOW... there are some misconceptions about doulas and the most common stereotype of doulas is usually the opposite of what clients want.
I think when people first hear of a doula, they picture a woman who comes to the side of the laboring woman and pushes other support people out of the way. A woman who firmly plants herself next to the mother, never giving anyone else a chance to participate. OR they think doulas are some variation of witches like this scene from The Back Up Plan doing nothing that is really helpful or beneficial for the mother or family.
They think that doulas only help with home birth or birth center births...or natural births... when in reality, the vast majority of the deliveries I support are in hospitals. Most of my clients are regular people with realistic expectations about birth. The last thing they want is some crazy doula running around with a drum talking about their "flower" opening up.
Birth is raw, it's painful, it can be scary. There is comfort in being able to share these feelings with your doula. It's an intimate process and it's best to find someone who respects the delicate relationships intertwined, someone you can be real with.
I support ALL families, regardless of what they want for their birth or why they choose to hire me. The decisions we make about our births are multifaceted, there are many many layers as to why people birth and parent the way they do. I can provide information about choices and communication tools to help families they way they want to be helped.
Abbey is a birth and postpartum doula and placenta specialist in Dallas/Fort Worth and a mom to 4 children between the ages of 25 and 12.