I am often surprised when I talk to people about doulas. It seems that there are several misconceptions about what a doula's role is in the birth. Hopefully, todays blog post will help debunk some of those myths!
Myth: A doula will "take over" the role of the partner.
Truth: A doula is there to enhance the relationships between the hospital staff, the laboring couple and others present. Often times the partner will become more involved with a doula present. As Penny Simkin, P.T. states "While the doula probably knows more than the partner about birth, hospitals and maternity care, the partner knows more about the woman's personality, likes and dislikes, and needs. Moreover, he or she loves the woman more than anyone else there." A good doula will reinforce the fact that this is your birth, not hers. She will strengthen the pair bond by instilling confidence in the partner and facilitating open communication between the couple and others present.
Myth: Doulas are only for those “crunchy granola eating, Birkenstock wearing mamas” that want natural childbirth and she wouldn’t support me if I choose medication.
Truth: A doula recognizes that this is YOUR birth. She works for you. Her job is to ensure a satisfying birth experience as YOU define that. She is there to help you achieve the experience you desire. A doula will not make medical decisions for the laboring couple. A doula will not judge a couple's decision to have pain relief.
Myth: A doula will leave if the mother gets an epidural.
Truth: There seems to be an urban legend of sorts about the doula who left as soon as the mom got an epidural. This is not usual. A doula is there to support the laboring woman with any decisions she makes. She still needs continuous support even with an epidural. The doula can give dad/partner a break to go get something to eat or to take a nap if it's been a particularly long labor. She can take pictures, get ice-chips, do hand massage or just sit quietly while the woman rests.
Myth: A doula has a negative opinion about a hospital setting.
Truth: A doula has the utmost respect for the lifesaving technology available for unexpected circumstances in a hospital. While doulas have a strong belief in a woman's ability to birth her baby and always strive to ensure that the birthing process remains normal, doulas appreciate the judicious use of life saving technology when the situation becomes abnormal or complex.
Myth: Doulas only attend home births.
Truth: Doulas attend births at home, at the hospital and at birth centers. She will remain at home with the laboring woman until it is time to go to the hospital/birth center (where applicable). This can be very helpful as most women labor at home for several hours before going to the hospital. The fact is that the vast majority of women living in the United States birth in a hospital setting and therefore most of the births a doula attends are in the hospital.
Myth: A doula has her own 'birth agenda' and strives to make the couple follow it.
Truth: A good doula will help you formulate your own birth plan and then bend over backwards to follow it.
Myth: I don't need a doula, that’s what the nurse is for.
Truth: The reality is that the typical labor and delivery nurse in the hospital has multiple patients. She is required to keep extensive records on all of her patients at the same time. In fact, one study showed that only about 10% of the nurse's time was spent supporting the laboring woman with her physical or emotional needs. Doulas do not work in shifts or have multiple patients. They care for the individual needs of the mother and stay with her until the baby is born. Not only that, but the birth doula is not a stranger to the mother and therefore she can act as a familiar guide through the long and often challenging hours of labor. A doula does not perform clinical skills, is not encumbered by hospital procedures, and is not overwhelmed by caring for several women at the same time. She is the only member of the maternity care team who is focused completely on the mother's well being and will remain with the woman constantly from the beginning of labor to the end.
Myth: If you've met one doula, you've met them all.
Truth: Maybe you've met one doula and didn't click, or you found that her birth philosophy wasn't in line with yours. Even though every certified doula abides by the certifying body's 'scope of practice', each doula is unique. It is important to interview several doulas to find someone whose philosophy, personality and areas of specialty most closely meet your needs.
Myth: I have a midwife, I won’t need a doula too.
Truth: Midwives do provide wonderful, personalized care, but they sometimes have to be more involved with the clinical aspect of your delivery and may sometimes have to leave your side. Having a doula as well, ensures that you will have personalized care on the clinical, physical aspects of delivery, and personalized care from a doula who’s sole focus is on your well being and feelings about what is happening.
Myth: A doula will intrude on this intimate, private family moment.
Truth: Labor and delivery rooms can become very chaotic places with many people you don’t know running in and out. Doulas are often called "guardians of the space". A doula can can act as a guard on your privacy and facilitating communication between you and your caregivers so there is less need to check in on you unnecessarily. She can help you maintain a private, soothing atmosphere. A doula can also preserve your memories of these intimate moments by documenting them for you by taking photographs and/or birth notes.
Myth: We’ve been to a childbirth class, we’ve practiced our breathing, I know what to do.
Truth: When labor actually gets going it is very hard to remember everything you learned in class. Things may happen that you don’t understand. A doula understands the physiology of childbirth, she knows medical lingo and she knows ways to make labor easier and shorter. Having a doula with you is like taking your childbirth educator to the delivery room!
Myth: A doula is a stranger, I won’t be able to relax and be myself in front of her.
Truth: Doulas take the time to get to know their clients personally before labor ever begins. By meeting you in your home and answering questions, as well as providing loving touches in her prenatal care, a doula ensures that by the time you arrive in the delivery room, she will be the most familiar, comforting face you’ll see there.
Myth: The medical staff will automatically respect all my wishes.
Truth: Unlike a doula, they don’t work solely for you. There are many factors and routines that shape the medical care you receive in a hospital. Many times it is simpler for your hospital to follow standard procedure than to work with each individual birthing mom on their preferences regarding her options for childbirth.
Myth: A doula will interfere with medical advice.
Truth: A doula will not interfere with medical advice. She facilitates communication between all involved and encourages the couple to ask relevant questions so they can make informed choices. Doulas do not make decisions for their clients and doulas DO NOT offer medical advice.
Myth: I have already had a baby, I know what to expect.
Truth: Each pregnancy and childbirth comes with its own set of unique circumstances and issues. A mom who has already been through the process would especially benefit from the help of a doula because she knows from experience what she wants or doesn’t want this time and a doula can help her accomplish her goals. (This can be especially helpful if mom is having a VBAC (Vaginal Birth After C-section).
Myth: I can’t afford a doula.
Truth: Doulas fees vary from area to area and based on experience, may vary from doula to doula. With a little research and questioning you can find a doula in your price range. Also, many doulas in training offer their services for very little. If you have asked around and price is still a problem, many doulas can help you file for reimbursement through your insurance company. With the rising popularity of doula assisted births and the amazing statistics on how doulas can actually lower the cost of your childbirth, many insurance companies are getting on board. If you are still having trouble affording your doula, talk with her. In the spirit of encouraging doula supported birth most doulas will work out a financial plan with you that works best for everyone.
Myth: A doula shows up for the labor and birth then leaves.
Truth: Doulas strive to provide "continuity of care". This means the doula forms a relationship with the mother and her partner during pregnancy, cares for the couple during labor and birth, then provides follow up care to ensure that the mother, father and baby have adjusted to their new roles and their new environment. Part of the doula's responsibility is to the facilitate uninterrupted bonding time between baby and parents and to ensure that if a mother intends to breastfeed that she is able to do so. Additionally, most doulas offer at least one postpartum visit.
Despite the numerous studies in the last 25 years that have clearly demonstrated the value of a birth doula during the process of childbirth, there is still some negativity surrounding this profession. Help me spread the truth! Doula care is about helping to empower the woman to have a safe and satisfying birth experience as she defines it.
Some of the evidence has even shown that fewer mothers ask for medication or require medical intervention such as the use of pitocin to induce or speed up labor. Mothers who use doulas are more likely to have shorter labors and fewer cesareans compared to mothers who did not have a doula. Mothers also tend to breastfeed their babies longer and have a more satisfying birth experience if they have used a doula. In fact, a recent survey indicated that mothers gave the doulas the "highest rating" for the best supportive care over any other member of the birth team including nurses, doctors and nurse-midwives.
Some myths adapted from: