To Do Or Not To Doula

either way, it's coming.

either way, it’s coming.

With documentaries like The Business of Being Born highlighting not-so-settling birthing practices in the United States, many women who prefer natural childbirth are erring on the side of caution and hiring a doula to ensure a happy labor.

Birth is no speedy process (unless you’re of the lucky few), and something I certainly didn’t realize pre-pregnancy is that you’re alone for the majority of your labor. Your OB shows up when it’s time to push, but hers (or his) isn’t the voice coaching you or the person rubbing your back when contractions feel like they will rip you life from limb. A doula, on the other hand is present the entire time. A doula will help you navigate the unfamiliar territory of childbirth and labor. They will advocate on your behalf every step of they way. Sounds good, right? At first I thought there is no question, I need a doula.

Here are the top five reasons I’ve found to hire a doula:

1. They reduce the rate of C-section. As a diabetic woman, I am faced with the reality that 45%-70% of our pregnancies result in cesarean births. That’s inordinately high, and something I’d like to avoid if possible. Recent studies show that women with diabetes have impaired uterine contractions, hence the seeming C-section anomaly. Now a doula has no way of knowing what kind of shape your uterus is in before you give birth, but many have aided in natural delivery with diabetic women.

2. In-labor support. As much as I trust my man to hold my hand and keep calm under pressure, he’s not trained to coach this laboring mama in breathing, relaxation, movement, positioning, massage and counter-pressure during labor.

3. Moms who work with doulas report greater satisfaction with childbirth, fewer incidences of postpartum depression, increased self-esteem, better mother-infant interaction, and improved breastfeeding success. They also report shorter labor. I want to be present, but I don’t need it to last three days.

4. If I don’t go into spontaneous labor by 39 weeks, my OB has made it clear she wants to induce me. This isn’t surprising. It is common to induce women with diabetes on medications around 39 weeks gestation. The reason for this is that women with diabetes are at a greater risk for stillbirth, and 39 weeks has been shown to be the time when the fetus is fully developed. It is harder to give birth naturally once induced, as the contractions become much stronger. I feel like having a doula by my side, might make this easier to bear.

5. The choice is mine. I get to decide who and why. I get to trust my instinct.

Here are the only two I can think of to not:

1. The cost. I know no amount of money can compare to the healthy and happy birth of your baby, but Los Angeles doulas are pricey. Most services that I’ve found come with a price tag of about $1400. Do you know how many diapers that is?

2.  I am surrounded by friends and family who have done this before. The doula explained that one of her services is converting the placenta into capsule vitamins, which is said to severely reduce the risk of postpartum depression. I have a friend (who is qualified) who offered to do this for free. I have a mother who has given birth naturally three times, without anyone but my not-so-calm under pressure dad to hold her hand. A mother-in-law who has done it twice. It seems slightly contrary to pay someone to do the job that mothers and friends and have done for years and years before.

The doula that I met with, and who came highly recommended, was nothing short of wonderful. She was calm and reassuring. Even over dinner her presence reminded me and gave me the confidence that I am in charge of my birth and that there are steps to take to ensure a happy labor. She talked about birth as a natural process, that being informed was a huge part of it, and that my body was made to do this.

So somewhere in the back of my mind was/is the lingering question: what exactly am I paying for? Birthing classes are one thing (my hospital offers these for free) but doulas can be really costly and only add to the already heavy cost of my high-risk pregnancy.

Does anyone have experience to share? Did you do the doula or not?–Arianna Schioldager

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