Doulas, Dads, & Birth Partners.
By: Amanda Dodson CD(DONA), HBCE
Maybe you’ve heard of a doula. Maybe not. When I first meet a woman and begin to explain what my role as a doula is, I usually get the comments of, “So you’re like a midwife.” Or “My friend had a doula and she left because she got an epidural.” (Insert tounge in cheek and continue to kindly smile as I pull together my thoughts and prepare for a more in depth discussion of what a doulas role is).
After a delightful debrief on what my service entails, mom is now on a doula high, ready to move forward.
But wait. Here it comes. The response that usually leaves me hanging in the valance wondering if I will ever speak to this individual again. “I really want to do this BUT I need to talk to my husband/birth partner. I will get back to you soon.”
I agree wholeheartedly! I believe 100% both parents need to be on board with hiring a doula if that is the situation at hand. I think it's important they both understand and agree to what my role is. I may or may not ever hear back at this point. If I have the contact information I will follow up.
I want to use this opportunity to address dads, birth partners, or whoever is chosen to fill that role. I want to help you think outside the box after reading this.
*Disclaimer. I understand every situation and personality is different. Not everyone may need a doula at their birth.*
Scenario 1
Imagine you’ve taken all the childbirth classes and feel relatively prepared. Relaxation techniques have been rehearsed, bags are packed and your contraction app ready to go. Kind of like all the training done to prepare for a big basketball game. It’s 2:00 am in the morning and let say you've had a rough day at work. Let’s throw in a couple of visits to the hospital a few days prior for practice labor. It wasn’t progressing and they sent you home. Now she's waking you up saying it’s real deal. Reluctantly, you roll out of bed and start getting stuff together. Now momma is telling you to hurry! You’re trying to remember if her purse has been packed and if there are kids, they still need to wake up, get dressed and ready for the sitters. Out the door everyone goes. Finally making it to the hospital. Time to check into Triage. The questions start to ensue.
“Has her water broken?”
“How long are the contractions?”
“When did labor start?”
"When was the last time she went to the bathroom?" Dad is thinking,"What? Wait. You mean taking a crap? Is that even supposed to happen?"
"Have you seen any birth show?" Birth what! There's so much stuff! I don't remember being told about this.
*Insert- deer in the headlights look.*
Of course momma is able to answer theses questions. More than likely though she's not in the mood to be thinking about her last bowel movement. Labor is progressively getting more uncomfortable.
Nurse says, "Ma'am, we need you to stay laying down so we can get a good read on the monitors."
She's having a hard time staying in the bed. Now mom is asking to get something to drink or go to the bathroom. You’re still trying to wipe the sleep out of your eyes but high on an adrenaline rush. So much coming at once.
Mom gets admitted and depending on where baby is at delivery could be imminent or it may be hours. We will say in this case mama has some time to go. You get over to the delivery room and try to get settled but now paperwork to be filled out. (Yes some places parents have to fill out admission paperwork at the time of delivery.) Momma is working hard. She may be asking for medication at this point. You haven’t even had a chance to give anyone the Birthing Preferences aka Birth Plan. People have left the room and you were able to get the lights dimmed and review the plan with your staff. Things seem to be back on track. But now you, the dad or birth partner, has to go to the bathroom! Momma is begging you to stay to hold the counter pressure on her back. She starts getting to a point where she’s saying she can’t do it anymore. Asks for medication. Starts crying and saying she doesn’t know what to do. There’s some staff in the room and they are saying she can have the epidural but it was stated she didn’t want one. Your head is spinning. Trying to remember everything taught in class. Mom is tired. You’re tired. This didn’t happen how we planned.
If I run into mom again or I follow up with her about hiring a doula, often times the answer is, “We decided to not hire a doula because my husband didn’t want one.”
Deep down inside I was truly hoping that they would have at least entertained the idea of a interview. After all, it's free with no obligations. I feel like once I can sit down and have dad/birth partner ask me those difficult questions, we can now address any concerns. Then I hope they feel well informed about whether or not a doula would still be a good fit for their birth.
“ I’ve seen one too many sticky situations where a doula gets into a relationship with a mother who wants her at the birth, but dad is not on board. A lot of tension and division is created. That is not something we want for this birth experience.”
These reasons listed are legitimate concerns and great questions to ask. Partly why I insists on speaking with both parents at some point. If dad is unable to be present for an interview, I will be sure to let the mother know I do expect dad/birth partner to be on board. whether he wants to be really involved or not before moving forward. I want him to understand I value his presence, participation and thoughts too.
Let's review those reasons why a doula may not be hired.
I want to reiterate. I am not there to take the other parent's place or anyone else for that matter. The in-laws, family member or friend. I am hired as a trained birth professional in the room. To help provide you with information to make informed decision about your care. Assist in comfort measures, emotional support, or encourager to just name a few. I feel like it takes the pressure off of dad/birth partner feeling like they have to be the one stop shop for everything. I give him the space to take that much needed bathroom break while mom gets continual support. If he’s a really hands on kind of person, sometimes he needs to be reminded to rub moms back like a wave. We aren't sanding a block of wood. Let's be real. You can be just as nervous and scared. You might need someone to tell you this is normal and help talk you through some of the progress. I feel a doula can help dad/birth partner fit in where he is most comfortable.
The inevitable money topic. A lot goes into a doulas fee. Prenatal meetings that last 2-3 hours, presence at the birth from start to finish, follow up care. My longest labor was over 72 hours. This didn’t include the time spent with the family before the birth and after. So much knowledge and resources are shared. Giving the parents everything they need to feel prepared. From assitance in preparing and discussing birth preferences, to how to proactively address the hospital staff if situations should arise that parents would need to have more information on. Sometimes the medical staff can say things parents don’t understand. We can break it down to the basics. Dad also needs to know he’s doing a good job and that what the mother is experiencing is completely normal. Words of encouragement really do pay off with a dad and birth partner. Fees for doulas vary and so do personalities. It’s important to have that good fit. Like birth, one size doesn’t fit all.
Heard about a bad experience? Unfortunately the stories are out there.. Just as with any other profession in life. I don’t always know the full story and do my best to guarantee to parents I will remain professional and uphold my end of the contract. Follow your gut on a person's intergrity. It's ok to ask for referrals. Keep in mind there are doulas starting off who won't have a list of people to put you in touch with. I think good business practices and a positive representation of their services speak volumes about an individual.
We are on baby number 4. I don't think she needs to have a doula. I’ve worked for several families who’ve never had a doula for the first couple children then decide to hire one for their 3rd, 4th or 6th baby. Maybe the experience from the mother’s prespective was traumatic or not fulfilling. Perhaps she didn’t feel like she had a voice or wasn’t able to have the birth she wanted and desired the extra support. Whatever the reason may be, many families have sought out doula support with subsequent children.
Scenario 2
You’ve hired a doula, taken all the childbirth classes and feel relatively prepared. You’ve got all the relaxation techniques down pat, bags packed and your contraction app ready to go. It’s 2:00 am in the morning and you’ve just had a long day at work. You’ve been in communication with your doula about the days prior. She’s given you and mom suggestions to relax at home and different suggestions for positions if warm up labor has been off and on. Mom wakes dad up saying it’s real deal. Dad collects himself and gauges what’s going on. He calls the doula and she comes to your home as agreed upon earlier. Your doula is now with the momma and you are able to get the bags packed, sitter called, while the doula is helping her through those contractions. It’s time to go! At the hospital everyone’s asking questions,
“Has there been any leaking water?”
"How long are the contractions?”
“When did labor start?”
"When was her last bowel movement?"
Oh yes, she has been pooping all night. Because you know that it's a normal part of labor as the doula reminded you of earlier. Your doula has been keeping tabs on what has taken place and can give you that information to tell the staff if you’ve forgotten.
You’re calm and excitedly standing by her bed and helping her breath through contractions. She’s admitted. The mood in the room is filled with commotion and more questions, but now the lights have been dimmed, mom is relaxing and breathing. Dad was able to answer questions from the staff and discuss birthing preferences. You take a quick bathroom break while the doula stayed in the room with momma. Everyone has left. Mom is asking to get something to drink and go to the bathroom. You and the doula can help mom move to the bathroom. You’re still trying to wipe the sleep out of your eyes but feel confident and at ease having that extra support. Things start to intensify. She may be asking for medication at this point. Your doula looks at you and tells you this is normal and suggests moving off the toilet, applies counter pressure while she leans into you. She starts getting to a point where she’s saying she can’t do it anymore. Starts crying and saying she doesn’t know what to do. Your doula reminds you to tell her what a good job she’s doing, where to massage her and continues to provide that emotional and phsycial support for the momma. The staff was mentioning an epidural earlier, you are able to politely refer back to your birth plan. Not too long after she start involuntarily pushing. The staff is notified. Baby is close to being born. You are in a daze and can't believe this is happening. You are about to meet you baby! Your doula asks you if you still wanted to help deliver the baby if the provider agrees. The provider says yes it's fine. You get into position and feel your new little baby greet your hands for the first time. Your doula is at the top of the bed taking pictures and helping mom through that last little moment. Deep breath. You did it! You both did it! You both are on cloud nine!
If there's anything to take away from this post. I don't want any parent to think they are just going to be spectators on the sidelines of the birthing experience. I meet a lot of dad's/birth partners who really want to be involved. Initially, it feels like when their partner tells them she would like to have a doula, they think this person is going to take the place of that emotional bond between them. Trust me. I'm not there to fill that spot. I know you want to be the one momma relys on during labor if that what best suites you. If it's a money issue, then ask what your options are. I do value what I offer and I know it's important for a family to value my services as well.
Want more information about doulas who support military in your area?
Visit www.militarybirthresourcenetwork.org to set up an interview with some of those amazing doulas. You're in good hands.