What does birth support involve?
Giving birth is a crucial experience in a woman's life, and while pregnancy and childbirth are topics that we're more comfortable with now than ever before, there is still a great deal of mystery and fear that surround the beginnings of life. Birth support means having an experienced professional there with you throughout the entire labor, someone whose only job is to be there with you, providing an atmosphere of calm and reassurance and empathy.
Birth professionals, also called doulas, share these characteristics:
- Recognizes birth as a key experience the mother will remember all her life
- Understands the physiology of birth and the emotional needs of a woman in labor
- Assists the woman in preparing for and carrying out her plans for birth
- Stays with the woman throughout the labor
- Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decisions
- Facilitates communication between the laboring woman, her partner and her clinical care providers
- Perceives her role as nurturing and protecting the woman's memory of the birth experience
- Allows the woman's partner to participate at his/her comfort level
What about the father? Isn't that what he's there for?
Most mothers have partners there to support them emotionally, and that's exactly as it should be. No one can replace the people you're close to- no doula could love you the way your husband or your mother does. However, as emotional as birthing is for you, it's just as emotional for the one you love. I'll never forget my brother's reaction to his wife's first birth, which was just six hours long and which she described as much better than she expected and fairly painless- but if you asked him, it was harrowing!
In my experience, I make it easier on both mother and partner; I can fill any role that they need, and the partner can be right where the mother needs him or her. Having someone there who's been trained for birth and attended many births can be a big weight off the mind of both mom and dad. Doulas and dads complement one another and together, provide a stable, nurturing environment for the mother to birth in peace.
How much does it cost to have a doula attend a birth?
Generally between $500 and $1000, depending on where you are and who is attending you. Some insurance plans have begun covering some or all of the costs of hiring a doula, and I'm pursuing coverage even now. Until then, my standard price is $650 per birth, which includes meeting before the birth, working up a birth plan together, going to prenatal visits with you, all of labor, and one postnatal visit. My fee is payable in two installments: one deposit put down at the first prenatal visit, and one due at the first postnatal visit.
What if I can't afford the standard fee?
There are several classes of clients that I provide low-cost service to: single women with no support structure, women under 18 years without parental financial support, low-income women, military widows and women undergoing a crisis pregnancy. If you think you might fall into one of these categories, please contact me. I'm always willing to work with clients and installment plans are available. I can also take credit and debit cards, which provides more flexibility for many people.
Are you a medical professional?
Birth support is a non-medical practice; I am not a midwife, a nurse or a doctor. I don't take blood pressure, do vaginal exams, or administer epidurals. The care I provide is primarily emotional and physical comfort measures and information about the medical procedures involved. Because I am not a medical professional, I am not comfortable attending unassisted homebirths at this time; not to mention, I can't afford the liability.
I do, however, provide what are known as "paraprofessional" services, that is, services alongside the medical professionals. What I offer to laboring mothers is professional expertise and experience, which has a huge impact on care. Although birth support is not medical in nature, that doesn't mean that it hasn't been shown to have real effects on labor and birth. Here are some of the studies that support doula care during labor.
I'm not planning to have a natural birth. Do I still need a doula?
Definitely! Although many doulas practice primarily in the natural childbirth community, women have all types of births and benefit from support during all of them. There are even doulas who support women during abortions, believing that women's choices deserve respect. Being stuck in bed with your epidural can make having a doula an even more attractive choice, believe me!
How did you get into this? Who would want a job like this?
Well, I come from a family of doctors and nurses. My mom was a doctor for many years, and she taught me that people need both physical and emotional care from their providers. When I married, she and I started talking about having children, and since I'd always been afraid of giving birth, I told her that I'd have an epidural as soon as I had a contraction. I imagined that when I got pregnant, the joy of having a baby would be overshadowed by the fear of childbirth- that I'd feel like I was on the slow ride to the top of a roller coaster. My mom told me that it didn't have to be like that, and she dug out Henci Goer's The Thinking Woman's Guide to a Better Birth and Ina May Gaskin's Ina May's Guide to Childbirth for me to read.
I got hooked and realized that although I wasn't going to have babies any time soon, I was fascinated by birth. I asked her about her births, and she told me about my oldest brother's birth, where she had an C-section. “As soon as he was born,” she told me, “the doctors rushed him away to the nursery. Your father followed him, and there I was, all alone with no belly, no baby and no husband. I felt so alone- it was just me and the surgeons sewing me back up, talking over me.” That's one reason I attend C-sections- because no woman should feel like that.
People ask me all the time about attending births. I think they think I'm a masochist- after all, the idea is that women in labor are in such agony that they lose their reason and politeness and abuse everyone around them. I've never experienced that, but even if one of my clients needed to do that, it wouldn't be a problem for me. It's not about me in the delivery room, and I'm okay with that. After all, I'm lucky enough to get a miracle every time at my job- and believe me, I get completely emotional every time, too. It's really a blessing to be there for these moments in people's lives. It takes a special kind of person to support birth: someone with great empathy, but retains their calm through everything. I'm lucky to be that person.