Tuesday, March 17, 2009

Hiring a Doula

Instead of the obstetrician model of care, I am choosing the midwifery model of care; instead of a hospital birth, I am choosing a home birth; instead of taking the McMoyler Method childbirth class, I am taking Shelley Campbell's hypnobirth class; instead of no doula, I am hiring a doula.

Now that I know what I am up against, I want all the support that I can get. Having a midwife is not enough. I had a midwife for my first birth experience and she wasn't with me the whole labor like I thought that she would be. Most midwives are focused on vitals and technical things. They are very supportive and knowledgeable but work on the big picture rather than working with each surge. I understand this now and respect their role. They save their energy for catching the baby and any emergency that may come up.

A doula's only job is my comfort and to be by my side the whole time with each surge. I understand the difference between a doula and midwife now that I've experienced childbirth for myself and appreciate the importance of each of their roles during childbirth.

My childbirth experience could be fast since it's my second child. I might not need a doula, but I am thinking of it like insurance. If I need extra support to help me through transition or driving to the hospital or any other difficult situation that may arise, I want someone there to help me through it.

Mikey was pulled out of me via cesarean at the final hour, and I think that if a similar situation were to happen, a doula could help me better transition from labor to surgery to avoid some of the trauma that I suffered the first time around. Or she might be able to help me ask for more time to deliver my baby naturally. I now know that the power of birth and the hospital are so overwhelming that any bit of help is extremely valuable and could help to postpone or avoid surgery.

In their book, Mothering The Mother: How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth, Marshall Klaus, John Kennell and Phyllis Klaus summarize scientific studies which have been carried out on the advantages of doula-assisted births.

Benefits from the presence of a doula:

  • Reduced the overall cesarean rate by 50%
  • Reduced the length of labor by 25%
  • Reduced oxytocin use by 40%
  • Reduced the use of pain medication by 30%
  • Reduced forceps deliveries by 40%
  • Reduced requests for epidural pain medication by 60%
  • Reduced incidences of maternal fever
  • Reduced the number of days newborns spent in NICU (neo-natal infant care unit)
  • Reduced the amount of septic workups performed on newborns
  • Resulted in higher rates of breastfeeding
  • Resulted in more positive maternal assessments of maternal confidence
  • Resulted in more positive maternal assessments of maternal and newborn health
  • Resulted in decreased rates of postpartum depression

I want my only job to be birthing my baby. I don't want to worry about what is happening around me. I want my doula to filter out the drama and deliver the truth to me in raw form. I want the information to come from someone that I trust because I don't trust unknown medical professionals like the McMoyler Method taught me to do for the first birth. Her method didn't work out so well for me. I want a doula to help protect my environment while I focus on my baby.

Zack and I interviewed six doulas and they were all wonderful and more than qualified for the job. Each interview happened at 8pm in our living room and lasted about an hour. We didn't have a list of questions. We just chatted with each doula and got to know them. Zack and I liked them all. We wrote down all the things that stood out about each one while doing the dishes after they left.

Each doula has something unique to offer and they are all very bright and interesting people. Britt has had amazing success with hypnobirth and is a prenatal childbirth instructor. Esther was a midwife years ago and has a valuable appreciation for postpartum care. Reise is a Birthing from Within childbirth instructor and prenatal yoga instructor. Spring is an apprentice midwife and massage therapist. Jamae has had two home births herself. And, Kara has attended 150 births. The hardest part will be deciding which one of these amazing women is the best fit for us.

Please share your doula recommendations in the comment section.

Kara Engelbrecht

Spring Childers

Britt Fohrman

Esther Gallagher

Reise Tanner


Other resources:



My other posts on home birth:

On my blog:


On SFGate:

Read some of my other posts about birth here, here, here, here and here.


Anonymous said...

My first baby was born via a C section because she was breach. My 2nd baby was a VBAC. A nurse at the hospital told me that because the 1st was a C, as far as my body was concerned the 2nd baby was a first - because technically it didn't go through the normal birth process the 1st time. So they said for that reason it wasn't necessarily going to be a faster birth like most people expect with their 2nd child.

Spinach and Honey said...

Thank you Anonymous for sharing your story. So, glad to hear that you had a successful VBAC. For my first birth, I got to 10 cm and pushed for 3 hours, then had the cesarean. I hoping that will speed things up for the second, but I do know moms that had a natural birth the first time and still had a longer birth with the second. I can only set my intention and then surrender to birth when it happens.

Anonymous said...

You're welcome. I wish you all the best. I live in NYC, and many of my friends here have done natural (drug free) births, births in tubs, births at home etc... I desperately wanted to do a drug free VBAC, but VBAC worked, drug free did not. I realize now (after talking to my friends) that I wasn't relaxed/rested enough - once their contractions started they napped, read, lounged, bathed, met friends for lunch - I paced for 12-15 hours thinking I needed to walk to help move the baby down. I should have relaxed. Oh well next time :) I bet you'll do it this time.

Kalee said...

Can you point me in a direction of where to begin researching about doulas? My husband and I are planning on beginning our family within this next year, and I am interested to see if a doula would be an option for me. Thank you so much!

Spinach and Honey said...

Kalee: So glad that you are looking into your birth already. It is good to plan now because when you are pregnant, things become overwhelming. Maybe you could read some books to start:

The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth By Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus



The Thinking Woman's Guide to a Better Birth
By Henci Goer, Rhonda Wheeler



Ina May's Guide to Childbirth (start with Part II and then read Part I)


Best of luck to you!

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