Tuesday, July 19, 2011

The Doula Dilemma, Part 2

The comments on yesterday’s post were great.  This is a big decision for me/us and I like hearing different points of view to help me think about which way I want to go.  To hire a doula or not to hire a doula, that is the question.

The “pros” of hiring a doula are as follows:
  • I won’t have the added frustration of The Prince not being supportive during labor, which means we can enjoy the experience more as a couple.
  • The Prince will get to take the back-seat role that he desires.
  • Massages!
  • I feel like I’ll be more prepared for the birth experience by speaking with the doula about the things that no one likes to talk about (ex., pooping during labor).
  • The hospital we will be using has a hydrotherapy pool, birthing balls, reiki and other alternative therapies available.  However, I’ve heard that a patient really has to be insistent to get the use of those therapies.  I’m not sure how much of an advocate I can be if I am in active labor, so I would like having someone there to advocate for me.
  • I see the doula as a type of hooker (I know how awful that sounds, but let me explain).  While I could possibly get the services she provides from someone I know, I like the idea of her seeing parts of me that I don’t want anyone to see, and then being gone from my life.  I feel weird about carrying on a relationship with someone who has seen my lady bits (or has seen me pooping on a table).  A doula goes away after the dust clears and what happened in the labor and delivery room stays in the labor and delivery room.
  • Supposedly, the use of a doula helps the mother at least wait longer before getting an epidural.  While my feelings could certainly change when the “birth day” rolls around, at this point, I would like to hold off on an epidural as long as I can, so that I can help the labor along by walking, standing, squatting, moving, etc.  Having someone encouraging that fits into my “ideal” scenario.

The “cons” of hiring a doula are as follows:
  • The cost – we could get a lot of baby stuff for $400-$600 dollars.
  • I know that I will likely get an epidural at some point during labor.  Doctor B already told me that labor is going to be a lot more painful for me because of the uterine suspensions I’ve had.  I don’t want to be made to feel guilty when the time for an epidural comes.
  • I am not interested in a home birth and I know that some people find that doulas strongly advocate for home births, leaving the mother feeling guilty about choosing to use a hospital.
  • As with any profession, not all doulas are created equal.  I would be really angry if I spent the money on a doula and didn’t feel like she fulfilled her duties.
  • If I haven’t gone into labor on my own by one week before my due date, Dr. B is going to induce me (in which case, I will be jumping straight to an epidural, as I know I can’t handle pittosin contractions) or do a C-section.  If I have a C-section, I don’t need a doula…but I won’t get my money back.
  • The Prince may be uncomfortable with a stranger in the room with us.  He is not good with new people and, even if he meets with the doula ahead of time, it is unlikely that he is going to bond with her.  He also hates hippy/ new age stuff, and (right or wrong) he puts the use of a doula in that category.  I want this to be a good experience for him too. 
  • I don’t want my doctor or nurses to feel like the doula is stepping on their toes, and there is generally some degree of animosity between healthcare professionals and doulas.  My doctor is pretty progressive, but if the doula is too pushy, that might tick off the doctor.  I definitely don’t want to tick off the doctor.

Some of these concerns could be resolved in the pre-screening interview of the doulas (like their feelings about hospitals, inductions, and epidural usage).  Some of them (like The Prince’s social phobia) can not.  I think I’m going to wait a little longer and hopefully I will get one of my famous “gut feelings” that will steer me in the right direction.  Thanks again for your comments…they definitely helped me to see the “pros” and “cons” more clearly.


Anonymous said...

Just a couple more thoughts, from someone who used a doula for a hospital birth after DE IVF:

If your doula makes you feel guilty about any of your choices, she is not the right person for you. You should get a sense of this from interviewing. Ask her if she would support you if you chose an epidural, or needed a c-section etc. The doula should *support* you in the whole experience, not just if you have a pain med free homebirth! Mine was totally fine with a hospital birth (I decided that ahead of time), and I wanted to not use pain meds, and thought I would need help with that. And that's the support she provided. But when I said I wanted the doctor to write orders for pain meds, she was supportive of that, and both she and my husband bargained with me on ways to postpone using the pain meds because they both knew that it was really important to me, because we had communicated about it beforehand. But had I used them, she would have supported that as well. You just need to be on the same page about your expectations beforehand.

Also, the bottom line reason I used a doula is because I wanted to feel good about the choices I made during labor, regardless of the outcome, and I felt having an experienced third party present was the best way to accomplish that. She did not interact with the doc or nurses at all; just pointed out to me if they were going to do things without consulting me, etc. Basically, she made me much more aware of what was going on, and therefore made me feel more in control, than I would have been without her.

As far as the Prince goes, of course you want it to be a good experience for him, too, but please put yourself first here. You're the one who's going to go through probably the most difficult physical experience of your life, and if the Prince has said that he cannot support you during it (and lots of husbands feel that way, I think), it seems unfair that he would also say he doesn't want anyone else to do the job! At least in my experience, our doula was both incredibly supportive to *me*, and nonintrusive with my husband and my medical providers. She had a ton of great suggestions that helped me feel better, but did not interfere with my medical care. So a happy medium is possible!

Good luck, whatever your choose to do!

China Doll said...

Oh, should've read this post before commenting on yesterdays! Very useful though - thanks for summarising for me :)