Advice about Using a Doula

Parent Q&A

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  • Hi, 

    For those of who have hired night doula, how common is to have the doula sleep through while caring for the baby? Like full on snoring? 

    Obviously I don't expect them to be awake every single minute if the night. I want to hear other parents' opinion. 

    Our slept through the night. It didn't bother me at all since she was in the room next to the baby and would get up as soon as the baby was awake. I don't know how common that is. 

    I think this is fairly common, from my experience. We’ve worked with three night doulas with our two daughters and all would sleep when the baby was sleeping. I didn’t find it would disrupt their ability to care for the baby, but if you think it does, I would say something. 

  • I'm planning to give birth with midwives at a birth center (Pacifica), and my husband and I are trying to decide whether we want a doula as part of our team. We're a little worried that a doula might have too much overlap with the midwives, and we want to keep our birth team as streamlined as possible. Has anyone out there given birth at a birth center and...

    • ... wished they had a doula?
    • ... loved having their doula?
    • ... wished they hadn't had a doula there?

    Would love to hear your perspectives!

    I had my first child at Pacifica and we are very happy we had our doula there. The doula helps comfort and get through much of active labor before you arrive, and then the doula can help not just you but your husband as well during labor and post-partum. A very long story short but our doula helped after I had some complications after delivery, and she was able to hold my little one when my husband slept, she stroked my hair when they did all the after stuff, and she came around to support after we went home. If you can afford it, do it. Feel free to message me directly if you would like more information.   

    I did not deliver at a birth center, but I did *plan* to deliver at a birth center and risk out.  At 36+6 I went in for a routine appointment and got diagnosed with gestational hypertension (not a complete surprise since it requires two readings and I'd been monitoring my blood pressure.) So I went right to triage, got induced two days later, and instead of delivering at a birth center where I'd met all the midwives, I delivered in a hospital with a new person on duty every 12 hours from a large pool, none of whom I'd ever met. 

    I was so happy to have a doula lined up.  The doula is the only person who promises to be there with *you* regardless of how your birth goes.  My doula stayed with me throughout active labor (midwife and nurse had to pop in and out), helped contextualize what was going on, coordinated with my partner when I was kind of out of my gourd - it was great.  

    Hi there and congratulations! 
    I worked with Pacifica for my first birth (2 years ago) and am preparing to deliver there again with my second this summer. 

    I did not use a doula and found the support of the midwives (as well as my husband) to be very present, hands on, and exactly what I needed during active labor. 

    I would ask yourself what kind of additional support you are hoping a doula could provide for you to determine if it might be useful —

    for example, would you like someone to be with you at home during early labor? Is your partner not super into hands- on support and having a doula to offer a little more care in his stead useful? Do you want extra postpartum support once you are home?

    Please feel free to message me if you would like to jam further.

    Wishing you a beautiful birth that may be exactly what you need! 

    We faced this exact dilemma, interviewed a bunch of doulas/the midwives (at SFBC), and ended up going with no doula. Our rationale was, one of the major benefits cited was that the doula would provide support to my partner/be an extra pair of hands. But my mother was also visiting, so we didn't need that. 

    Well, in the end I was in labor mostly at home--got to the birth center just 40 minutes before the baby came out. And if I could do it again I think having an extra person would have been useful, especially since my labor was overnight, and everyone involved was very tired & needed sleep. I did not feel it was important to have a doula once we got to the birth center, though ymmv depending on how long you end up being in the facility.

    That being said, having no doula was definitely totally OK because we had read the book The Birth Partner and so were relatively prepared, plus also had my mom around--if we hadn't had both of those things I think it would have been a much worse experience. Also, the few contractions that a midwife helped me with were noticeably smoother and more pleasant than the ones my husband helped me with, which were also better than the ones my mom helped me with--so experience+strength can definitely make a difference to your comfort.

    I gave birth at Pacifica (love them!) with a Doula and I'm really glad I did. The biggest thing is that she came to our house while I was laboring *before* we went to the birth center and helped me (and the midwives on the phone) decide when we needed to go. And she was a wonderful grounding supportive presence at the birth. She didn't need to be an advocate the way I read about doulas in a hospital, but she did actually have some moments of helping guide the midwives help me even better. And she was just a nice person to talk to leading up to the birth as well, she was helpful for preparing in a different way than the midwives. So yes! :) 

    I have given birth at a hospital with no doula, given birth at a birth center (not Pacifica) with a doula, at Pacifica without a doula and at the hospital with a Pacifica midwife as my second support person (Thanks, gestational hypertension.)

    For my hospital birth I definitely wished I had a doula, especially since it was my first. I needed more coaching and help than my medical team could provide. Thankfully my husband is a really good birth partner but we could have both used some more support.

    With our second it looked possible we'd have an early delivery and be in the hospital again and so hired a doula. She was excellent but our birth center birth we had her, a birth assistant and three midwives. It was too many people in the room. I wouldn't say I wished we hadn't had her but she was definitely extra. (It was also my easiest labor.) The midwives at a birth center are just there for you and aren't juggling a ton of cases at once. They can coach and present as much as your want them to be. 

    So with our Pacifica births we didn't even consider it. The midwives were great and very present. When with our last pregnancy we risked out of Pacifica and ended up at Alta Bates, one of the midwives came to support us and did many doula type things. It was great and made the hospital birth much less anxiety producing.

    Hi! I gave birth at Pacifica without a doula. I felt unsure about it too, but I was happy with my choice in the end. I didn't feel like I was missing anything. But my early labor was pretty short, so we didn't spend much time laboring at home. I think a doula would've been helpful if we had a lot of time to get through before getting to the birth center. Happy to chat more if you'd like!

    Whether to include a doula along with the midwives should  be decided based on two factors:

    1. The expected scope of responsibility of the midwives at the birth center; and

    2. Your personal rapport with any of the individuals involved.

    Let me explain.

    Back in the 1980s, when the medical industry relented from its prior stance that all births were to be overseen only by (predominately white male) obstetricians, the title "Certified Nurse Midwife" was created.  This was partly in reaction to the hippie mothers of my generation who eschewed the medical industry and gave birth at home with lay midwives.  Someone with the title CNM is highly educated and skilled.professional.

    But midwifery is a challenging career path. Babies do not decide to be born on a reasonable schedule, and they often come in the middle of the might. Midwifes need career-life balance just like any other working woman.

    Anecdote: Our son was born at home in Oakland, at 4 a.m. on UC Berkeley Big Game Day. Our midwife, Peggy, was scheduled to drive to Monterey that day for her SCUBA diving certification. She did the delivery, and got the SCUBA certificate, but she was very tired afterward!

    So you can see how over the years midwifery practices have evolved to be more like doctors' practices.  You may discover that your preferred doctor or midwife is not scheduled to be working at the time your baby comes. That's where having a doula with whom you have a rapport would be a good thing.

    My advice:  check with the birth center about their policies, and try to plan so that your preferred birth attendant will be present, whether it is a staff midwife or a doula you have selected.

    I have had 2 children. The first began w midwife care at Pacifica without a doula, and ended w a hospital c section. The second was a hospital birth w doula that resulted in successful vbac. I loved the care I received from the Pacifica midwives for kid 1 and also from the doula for kid 2. Knowing what my wonderful doula provided for me in the hospital setting, I don't think I would have needed it/was redundant with the midwives. Good luck!

    I had my first baby at Pacifica without a doula. On the one hand, it didn't feel like we needed an extra person as we had a senior midwife + a student midwife with us at all times. But on the other hand, my husband couldn't rest at all during my 24 hour labor as he was my immediate support person. For my second (which was not at Pacifica), we had a doula and it was great - allowed my husband to sleep overnight while I labored, and I think it helped contribute to a successful vbac for various reasons.

    In short, I do think it is worth it.

    Hi and congrats on your pregnancy. 

    I had a doula for both of my births- which were both with midwives- one in a birth center, and one at a hospital. I had similar questions to those you are mentioning. I'm was so glad I had a doula at both births. For me the huge positives were: 

    - doula will come to your home, so if you would like to labor at home for a while, it can be really nice to have that extra support for both you and a partner (so they don't feel alone in supporting you). doula really helped us remove the stress around the decision making part of labor (when to go to the hospital, what was normal, what to try next) 

    - depends on the doula and the midwives, but in best case scenario, it can be a super collaborative team; both my labors were long, especially in the pushing phase; for my 2nd labor especially, our doula had a lot of good ideas about different positions to try, and ultimately, made the suggestion that I think was most helpful to ultimately having a vaginal birth 

    - doula usually stays with you throughout labor, while midwives may need to come and go, depending on how many folks they are supporting; we found it super helpful to have someone who was 100% in it with us

    - most doulas do some amount of pre and post visits, and I really appreciated these as a way to prepare, and also process after the fact 

    Good luck with it all! 

    My wife gave birth with a midwife and we had a doula. It was easily one of the better decisions we made. The midwife focused on the actual birth but the doula was with us for most of the time during the ‘build-up’.  She was a great help providing support (for both of us), giving advice and showing me useful massages, pressure points etc. She also alternated with me and allowed me to do other tasks for my wife. 

  • Doula for planned C-section

    Apr 18, 2020

    In a planned C-section, what is the role of the doula? Have other women found it helpful to have a doula, or not really necessary? I’ll have my husband and in-laws for help, but wondering if I should also try to have a doula...

    I had a doula for what ended up being a planned c-section and I have mixed feelings about it. I gave birth at Kaiser Oakland which was overflowing with birthing women when my birth was scheduled. They only have about 8 birthing rooms which is often not enough for their capacity. Because of that I wasn’t brought into surgery until 4:00am almost 48 hours after I had begun the required fast. It was really hard to not eat for two days at 9 months pregnant and that was when I found our doula most helpful. Just having her there rubbing my head and feet, supporting me to advocate for myself, dealing with my waiting family was really helpful. But other than moral support while waiting  she had no other purpose. Only one person is allowed in the surgical room with you, which I imagine will be your husband. If I had it to do again I would keep her for the prenatal support but not the birth. PS Even though the wait was crazy the experience was still an ok one. Congratulations!!!!!!! Im happy to answer more questions if you would like.

    I had a planned c-section, and was originally planning to have a doula, but once we realized we were on this route we chose not to use her for the delivery. Looking back on it I wouldn't have had a need for her.

    We got to the hospital about 2 hours (I think?) before the planned delivery, did a bunch of prep things, then made our way to the OR, and soon thereafter I had a baby! :) It was very easy. And the two nurses I had were hugely supportive as well. 

    Save the money for a night nurse ;)

    I have had a planned c-section, and I can only speak from the perspective of not having a doula. It went fine just having my partner and all of the wonderful medical staff/team at Kaiser. I never felt like I needed a doula. 

    I had a scheduled c-section with my second child last summer. I didn't have a doula (though I didn't with my first either, and that birth wasn't a c-section). I think the only part where a doula could help is if you go into labor before the c-section. Otherwise, once you go to the hospital, they prep you for the OR, and the surgery is relatively quick. Consider saving the money for a birth doula, and spending it on a post-partum doula instead. Good luck!

  • I work for a clinic and was contacted by a patient who has no one to be with her when she is due to deliver on Dec 31st. It seems that Alameda county has no resources I can discover that would be available for her and I thought to reach out to the larger community to see if someone knew of something or if someone might be willing to be on hand to be of support during the labor and delivery.

    please feel free to call me at 415-264-0564 if you have any questions and are available to do this or know of someplace I might contact. Thank you.

    Not exactly what you had asked, but depending on where she is delivering, I would encourage the woman to ask to see a chaplain. At Alta Bates, Kaiser, John Muir, etc, this should bring a kind and emotionally-grounded person who will support her throughout the birth and the hospitalization. She does not need to be religious in any way — unless she is somewhere that has an outdated spiritual care department, modern day chaplains are interfaith and are there to support not proselytize. 

  • I went to a “Meet the Doulas” event and have read plenty on why a doula is great. But there's little on why you'd opt out, so I’d love to understand why a doula could be LESS necessary / helpful / applicable, and NOT the right choice for me — want to make a decision with both sides in mind.

    In considering positive data, I'm skeptical about studies on the benefits of doulas (lower Cesarean and unmedicated birth rates) b/c 1) studies often look at overall impact of having a SUPPORTIVE, FEMALE presence including hospital staff AND loved ones, which obviously muddies the data and makes attribution to just a doula impossible 2) self-selection; if you believe you need and want a doula, and have one, you’re likelier to report higher levels of satisfaction with the birth experience as a result of said doula. Also someone who has a holistic view on birth / invests in a doula is more likely to have other things contributing to a lower C-section rate, and probably leans toward wanting an unmedicated birth. True for me at least. ;) 3) positive anecdotes don't mention other support aside from the partner, so can’t get a full picture.

    Context:

    • I have a loving & even-keeled husband
    • Strongly considering having my mother (who I'm close to, is a retired NICU RN, & would easily do the little things that people rave about in reviews e.g. repositioning, washcloths, etc.)
    • Considering having my mother-in-law who we're close to
    • Delivering at Alta Bates, whose nurses have a stellar reputation; one reviewer was more impressed by them than her doula
    • I'm an introvert and love the idea of creating inner resiliency; planning to learn HypnoBirthing (with husband)

    In a vacuum / with no consideration of cost, having the RIGHT doula seems better than no doula. But there’s no guarantee I could find the right doula in time. At that point, seems that no doula would be preferable to an “okay” doula, given the presence of my partner and mother(s).

    • If you had partner + other loved ones AND a doula:
      • What value did she deliver that was unique and not redundant?
      • How was the dynamic of partner + family + doula?
    • If you had partner + other loved ones and NO doula:
      • How did it go / how supported did you feel?
      • What, if anything, slipped through the cracks?
    • What benefits - aka TRUE medical advocacy (which seems like a gray area given they are not medical professionals) - does a doula provide that neither husband nor my retired nurse mom could? Looking for beyond what I’ve come across in reviews (yes, partly because I feel $2k+ is a lot to pay for the below):
      • “The little things” - setting up delivery room (candles, lighting, decor), fetching coffee, etc.
      • Physical touch (one doula I met pitched “being loved on” both by her and my husband at the same time, and frankly that doesn’t appeal to me)
      • Verbal support (one example was repeating what my husband says - sounds weird and annoying, not necessarily helpful)

    Thank you!

    With the caveat that I have not yet given birth, it seems to me like you’ve clearly laid out a case where it doesn’t make sense for you to have a doula. You have a supportive partner, and several female relatives who have some experience with childbirth who you feel would be supportive.

    For me, the biggest reason to have a doula is to have an additional support person besides my husband. There is no way I would consider having my mother in the room, as much as I love her. We have very different approaches to stress, and medical situations, and her support would not be helpful for labor. There are no other female relatives or friends who I think would be helpful. I’m sure my husband will be a help, but he has a hard time seeing me in pain, and he needs someone who can reassure him that this is normal. I think the big push for doulas is because today, many gestational parents don’t feel comfortable having mothers/sisters/aunts/mother-in-laws in the labor and delivery room.

    It doesn’t sound like there is a ton of support a doula could offer that your mom or mother in law couldn’t, with a little research into support measures (like counterpressure and such), and some conversations about what kind of support you want.

    I had a doula at each of my two births. One was at Alta Bates and one was at Kaiser. My husband and I wanted to try to have a natural birth if possible but were open to whatever was needed at the time. My first birth at Alta Bates I managed with no meds, but it took me 3 days in labor, and I had a vacuum unexpectedly at the end. Although we liked lots of things at Alta Bates, I ended up having a nurse that we did not like and who was rude. Our doula was able to help support me at home during my early labor issues and then advocate for us and help us think through our options when we had to decide whether to do a vacuum or go straight to c section. Having her there helped my husband relax and gave him a support person. We felt that we were well prepared and educated but having someone else in the room to help us with thinking through options and coping through the pain was super helpful. My second birth was at Kaiser and we had a different doula because the one we used before is now a midwife. I ended up needing an epidural because I could not handle the pain, and then I had a vacuum. Because I waited so long to have the epidural, the doula was by my side (with my husband) supporting me physically and mentally through the pain. The Kaiser staff was great, but I couldn't squeeze their arms for literally 7 hours straight like I did with the doula. So all that being said, I think the main thing is to have a good support system with you just in case. You just won't know what kind of birth you will have. Could be easy, could be hard, could be something in between. If you have family that can serve that role that each of you really like and trust and won't annoy you, I think that can take the place of a doula, particularly if they know a lot about giving birth. However, if you have some second thoughts about having family in the room, and you can find a doula that you "click with" then I think it's worth it if you can afford it. Each of them will have similar ways to support you (physical, verbal, things in the room) but honestly you really aren't going to know what you want or need until you are going through it. My advice is have support in the room and go with the flow as much as you can. Congrats!

    Congrats! I did not have a doula and didn’t consider it, I only wanted my partner, doctor and nurses at the delivery room. I even excluded kaiser because I knew sometimes they have students to watch the delivery. I had my baby at Alta Bates and loved it! I knew I didn’t want any medication and wanted a natural birth. To prepare for the birth my partner and I took one of the lectures offered by Alta bates about coping with pain during labor and it really helped! We used all the techniques provided plus the advices from my doctor of taking a warm bath when contractions came. I stayed at home as long as possible because I didn’t want to be too early at the hospital, when I arrived at Alta Bates I was already 8 cm dilated and it took just one hour from the moment I arrived until my baby was born (could have been shorter but we had to wait until for my doctor to arrive), no medication, very easy delivery but of course those contractions were super painful! Luckily they were short. 

    One great advice from my primary physician was to exercise during my pregnancy, she said that the womb does a lot of work during delivery and my muscles should be ready for that, I enrolled in Bar method Berkeley and was going on average 4 days a week.

    I didn't use a doula for any of my 3 births. I guess mainly because a) I felt like I could handle things myself (I did a lot of research so I knew what to expect, plus I'm pretty stubborn and didn't feel like I was going to get pushed around) and b) I'm not a terribly touchy-feely person (like you, I'm an introvert) and doulas didn't seem fit well with my personality. I didn't want candles and music and all that. But that's just me; I know lots of people rave about doulas, and of course every birth is different. I had 3 totally unmedicated births at Alta Bates with just the hospital staff (who were fabulous) and my husband present, and didn't feel like I was missing anything. Having your mom and her RN training there as additional support sounds like a great resource. I used Hynobirthing and highly recommend it - although I used the actual hypnosis to different degrees with different births, I felt like it really prepped me for the physical and mental processes the body goes through during birth, and I came out of all 3 births feeling really empowered. So, I guess the summary is that it's very possible to have a positive non-doula birth experience - don't feel pressured to have a doula (or do anything else about your birth a certain way) just because "everyone else is." What's right for you is right for you.

    I didn’t use a birth doula for either of my two births at Alta Bates and have no regrets. I have a very calm, un-squeamish, helpful and supportive husband. He was the only person present other than hospital staff and that was fine. I had one nurse who was a truly bad fit for me, and my husband did a great job asking for a replacement nurse and it was all handled without drama by everyone involved. 

    I saved my doula budget for postpartum doulas and that was worth every single penny. I had very little anxiety about labor and birth and generally feel pretty trusting of medical professionals, but I knew I would need support after birth since I don’t have much family support. 

    In sum, I’m glad I didn’t spend money on a birth doula. Consider postpartum support instead, especially if you are particularly sensitive to sleep deprivation. 

    I've had two unplanned c-sections and two doulas (one each time). Neither (highly recommended, experienced) doula turned out to be a good fit. The nurses I encountered while in labor were almost across the board amazing and provided much more meaningful support to me than the doulas. Between my partner, who was my main support person, and the nurses, the doulas felt unnecessary and even to my detriment. My take away is that doula fit is extremely important - and maybe some people (like me) aren't "doula people" for one reason or another. 

    For what its worth, it sounds like you have a wonderful support team assembled between your mom and husband. I could personally see that sort of situation working wonderfully without a doula! 

    I went to a meet the doula event as well and considered hiring one, but was undecided. There are also many medically related outcomes outside of our control, that a doula would not be able to change. If you have specific desires in this area, I would write them down and communicate them ahead of time. I saw the doula role as potentially helpful, but also potentially unnecessary. I decided to only have my partner present. He is not particularly squeamish and is very loving and encouraging, he made a great birthing coach. We also attended birthing classes together which I felt were helpful. To add to this, I gave birth at Alta Bates twice, and the nurses there were incredible. Both times they proved to be very attentive and provided what I think a doula might have. I am also not interested in the physical touch, being loved on by someone type of care. Everything I asked for I received and more. I hope this info is helpful. Feel free to reach out with any questions. 

    We did not have a doula for either delivery (now 3yo and 9mo girls). We considered it for the first one and opted not to because we weren’t sold on needing one. First delivery was at Alta Bates and the nurses were fantastic. Second delivery at Kaiser during the nursing strike last year (worst timing ever!) but the traveler/strike nurses were also awesome.

    I wanted deliveries without drugs and for the first one had a 24 hour stay at Alta Bates before delivering (not yet in labor, wanted to avoid induction). The nurses knew my preferences and set me up with the right next nurse on shift change who aligned well with what I wanted. That was amazing!

    I did not feel like I missed out on anything not having a doula. Having a written birth vision helped them understand what I was about and find the right fit for me. Knowing I’d be at the hospital for a while before delivering, I had one nurse switch my room when a bigger one became available so I’d have more space. 

    Similar experience at Kaiser, though shorter labor and strike nurses as an extra variable. In both cases the nurses really got me through it. I’ve heard they take a step back of you have a doula, but they are an incredible resource.

    Both births ended up being really straightforward for me. Both of my babies ended up with complications we’ll post delivery (both were fine within days), but I don’t think handling that is part of what a doula helps with. I personally don’t think there’s a need to have a doula with such mother and child supportive hospitals here. But just my experience!

    Hmmmm... I am also an introvert and would have hated having a doula. Birth seems like such a private, sacred event to me-- I just wanted my husband and sister there the two times that I gave birth. And I was at my sister's two births, along with her husband, and it was a special privilege. Perhaps a lot depends on the nature of the relationships among those involved and their level of comfort with those kinds of situations.  In the absence of a supportive partner and/or caring female relative/friend, I think a doula could be really helpful. I do agree the nurses at Alta Bates are awesome but they are not always able to give you their full, ongoing focus since they have other duties. You might also want to get your partner's perspective on the matter. 

    Best wishes !

    The reasons I appreciated having a doula are not the ones you mention. The benefit for me was that when something came up, I had someone who had been through it before there with me. Everything from when to go to the hospital to helping me navigate when my water broke but I didn't go into labor. The doc wanted to induce right away and she helped me delay that to see if I would go into labor on my own. My doula didn't light candles or love on me instead she was an advocate for me. Maybe talk to different doulas? The nurses are great at Alta Bates but they won't be there when you are laboring at home or after the baby is born and they can go off shift in the middle and then you need to get to know new nurses. But if it isn't for you, it isn't for you. That's ok too. I wouldn't convince yourself you need a doula if you aren't feeling it. 

    Hi there. I did hire a doula for my first labor and delivery (where my husband and mom were also present) and did not feel it was worth the money. However, I did not do nearly as much research as you have and I only interviewed the one doula, so take this with a grain of salt... maybe it was just a miss-match of personalities. I was induced and had excruciating back labor, so pretty much everyone except my husband and the nurses annoyed me. I am also an introvert and I found it very awkward to have a complete stranger in the room with us while I was at one of the most vulnerable points in my life. She tried to help with positioning and massage, but after a while I just didn't want her to touch me. After 8-10 hours of back labor, I had only dilated 2 inches, so I requested an epidural. After that, she wasn't particularly helpful, though she did hold my legs during the 4 hours of pushing the next day. Basically, the one thing I got out of it that I didn't with my second delivery was a book with the birth story and pictures afterwards. Hope this helps? Good luck to you and congratulations!

    If you have a team of loved ones that aren’t afraid to get their hands dirty, and you’re receptive to having them do it, there is nothing a doula can provide that they can not. Especially, if you’re planning a hypno birth where essentially you’re coaching yourself. Please practice techniques regularly and frequently throughout your pregnancy. Doulas can offer they’re experience. Although you’re mom is a nicu nurse she probably isn’t very familiar with the labor process (only a guess); but as you’ve acknowledge doulas are not medical professionals and I believe Alta bates has you sign a form reiterating that. Alta bates is an excellent place to have a baby. Please trust your doctor & nurses. There is nothing more dangerous than families deferring medical decisions to consult with their doula. Excellent doulas know when to step back and should be a question you ask during your interview process. 

    good luck and congratulations in advance.

    Oh boy. You asked. I first want to say you should go with your gut. If you don't want a doula, don't have a doula. I had a doula for my first child because I wanted a natural birth and wanted to do hypnobirthing as well. I had my husband, my sister, and a doula at the hospital with me. Long story short it was a complete nightmare. It became comical at one point, with me screaming in agony during contractions and her misting me with aerosol water or something and trying to guide me through mindfullness or mediation or I don't know what. Hypnobirthing, I guess?

    While I'm screaming in pain, she's waving her hands around me and then spraying the water at me, and talking about rivers and breathing and lord knows what else. I just remember wanting to punch her in the face. And wanting to punch my sister and my partner in the face for getting the giggles while I was in agony. They weren't laughing at me in pain, they were laughing at my reaction to her. At the time, I was pissed, but now, it's a funny part of my child's birth story. Maybe I'm just not a doula kind of person--I kind of knew it wasn't my style during our 'get to know you' sessions. I would have been just fine and actually much more comfortable without the doula there. 

    And wait, it's a funny story only if you ignore the fact that I almost died from preeclampsia because neither my doula nor my midwives thought they needed to consult a doctor about my dangerously high blood pressure and failing kidneys and what ever else led to an emergency C section. It was my husband who finally said, Ok, she doesn't look right. You're all fired, get out of here, and get a doctor. They delivered my baby via c-section within a couple of hours of us asking for a doctor and it saved my life. It wasn't a "well, this is taking too long, we'll just cut the baby out" kind of situation. My organs were literally starting to shut down and it was life or death. I don't think my doula with her aerosol water knew anything about the medical side of birth. Maybe I picked a bad one? Probably, but just sharing my experience.   

    Not a knock on doulas and midwives. I know they are wonderful for many if not most people who choose them. But my son's birth was traumatic for me, to say the least. The doula didn't cause it, but she sure didn't help. Hope my story helps you in any way. :) 

    I delivered at Alta Bates last November. I met with half a dozen doulas in my second trimester because I had some fear of the unknown. I was not dead set on an unmedicated birth but I wanted to give it my best shot. I ultimately decided NOT to hire one, as I felt that it would be distracting to have this additional person in the room (who even after weeks of working together might still feel like a stranger). I still think that was the right call, and for me at least, less is more in a high stakes situation like that. It was just my partner and I and the incredible nurses at Alta Bates. I felt the experience was extremely intimate and memorable for my partner and I having it be just us. My parents were waiting at home for us and popped in to see us at the beginning of labor but left when contractions started picking up. And FWIW I was certain I was going to want constant massage during labor—got a custom oil made, forced my partner to practice for weeks :) — and when the day came, I didn’t want to be touched at all. Everyone is different, but there were lots of aspects of birth that were not at all as I expected. I do sometimes wonder if there are some aspects of my birth that would have gone smoother if I didn’t have that subconscious fear and anxiety. But at the end of the day, it was my first baby and i had no point of reference. I came away understanding that you have very little control over what kind of birth you are dealt, but the best thing you can do is surrender to that reality, make the best decisions you can given the circumstances, and let your medical team guide you. 

    This is such a great question. It's so interesting that this is now the question, as opposed to "why have a doula". I'd love to respond from the category of "had a partner (only) and NO doula" - I never felt like I needed or wanted or would benefit from a doula. A little background - I'm a pediatric nurse practitioner with lots of nursery RN experience and have worked adjacent the L&D nurses, so I never understood why anyone would pay so much money for someone to do what is essentially the job of the L&D nurse. They are there to support you. And get you ice, and dim the lights, and provide counter pressure for back labor, and tell you what's happening. If you have a supportive partner (or two!), then all the better! Perhaps other people come to the birth experience with less familiarity with (or outright distrust?) of the hospital environment and nurses, but of course I feel comfortable talking to nurses and doctors and feel like I absolutely can advocate for myself. It sounds like, with a nurse mom, and an even-keeled husband, you might be in the same situation. I only wanted my husband with me for my 2 births and he was amazing. It's OK to lean on your L&D nurse. I wonder if people who say "she wasn't in the room all the time" only say that because they had a doula, so the nurse felt like maybe they could step back on some of the tasks the doula was being paid to do? From my 2 experiences, I can share that with no doula, the L&D nurses were present for me when I needed them, and they also knew when to let me be - who wants to be touched and talked to and hovered over their entire labor? Not me. My 1st birth was at CPMC in SF, 2nd at Kaiser Oakland. I have L&D nurse friends at Alta Bates and can confirm - you're in great hands. Good luck with your decision and with your birth! 

    I did not have a doula. I had a delivery at Alta Bates that was just fine. In fact, and maybe I am just clueless, I had never heard of doulas before taking a child-birth class. When the other moms-to-be in the class were discussing doulas, I thought to myself, why? Like you, I predicted my husband would be great (and he was; I did not need another support person at all). I have no trouble speaking up for myself. I trusted my doctor and the Alta Bates team. Nothing slipped through the cracks. Another person in the room probably would have been more of an annoyance than a help. I told my mom to wait until I was out of the delivery room.

    If you had partner + other loved ones and NO doula:

    • How did it go / how supported did you feel?
    • What, if anything, slipped through the cracks?

    I delivered at Alta Bates with my "even-keeled" husband and loving mom. The nurses there definitely provided additional support that my loved ones could not. In addition to suggestions on various birthing positions, it also felt nice to have verbal encouragement and good humor from someone not emotionally invested in me (I had a long and difficult labor followed by a c-section... which was hard to smile through for my family). TL; DR: If it weren't for the amazing nurses at the hospital, I'd recommend a doula. The only other thing I would consider is the energy level of your family members: both my mom and my husband could manage on little sleep through my labor, but if that may not be the case for you, it would help to have another pair of hands for the "little things".

    Good luck!

    I share your thought that no doula might be better than the wrong doula, especially given your description of your partner and mother.

    We worked with the same doula for two births. Both were hospital births; one was a completely unmedicated vaginal birth and the other wound up being an unplanned c-section. Here's what our doula provided that no one else could... she had 25 years of experience and had attended dozens (if not hundreds?) of births at Alta Bates, the hospital where I delivered. So this meant she had excellent, mutually respectful relationships with the L&D nurses and the doctors. But her focus was different/complementary to the medical professionals' focus. So while the nurses/doctor are focused on the baby as the primary patient, our doula was focused on me and my experience. She didn't do any of the woo-woo stuff; I had zero interest in massage, aromatherapy candles, or even verbal support. But what she did do was carefully observe me. So when we got to hour 12 of labor and the baby's heart rate began to drop during contractions, the nurse was about to pick up the phone to call in the doctor, but our doula asked her to wait a moment before calling the doctor. She had noticed that I had spent most of labor on my feet, and she noticed that the baby's heart rate had dropped when I had a contraction after lying down. So she asked the nurse to wait one more contraction and she asked me to stand up. And indeed, when I stood up, it must have relieved some pressure on the umbilical cord in some way, because the baby's heart rate stayed normal during the next contraction. Possible c-section averted because she was just very observant, very experienced, and was able to communicate respectfully with our L&D nurse, whom she had known and trusted for years. This is the absolutely irreplaceable value that a doula can provide.

    Generally speaking, I found it incredibly calming and reassuring to have someone in the room who had attended hundreds of births. Have L&D nurses and your doctor attended hundreds of births too? Of course. But they may or may not be there with you for the whole time. Your doula will be there with you the whole time, through nursing shift changes and through having a doctor you've never met before deliver your baby because they happen to be on call, etc. My mom, partner and friend who attended the birth are all fabulous, supportive, wonderful human beings. But there is no substitute for having someone experienced in the room whose focus in on mom's health and experience.

    In my second birth (the c-section), it was incredibly valuable to have her there because when it finally got to the point where a c-section became necessary, it was much, much easier for me to trust and accept that that was the right decision because of her. I knew how much she prized natural childbirth and knew how many births she had attended and knew that she would not just go along with it if there was any safe way to avoid it. So I didn't struggle after the birth (the way other mothers I know sometimes did) with wondering if I had been pushed into a medically unnecessary c-section. What a relief.

    Our doula was Linda Jones, based here in the east bay. I have so much love and gratitude for her to this day - 10+ years later. And I haven't even mentioned how wonderful she was during the post-partum visits, when she helped me get nursing going. She is the best of the best.

    Congratulations on your upcoming birth. I had midwives for both of my deliveries and no doulas. I also had very good support from my husband. With my first, there was concern about the extremely long period of pushing and my midwife was able to work with the hospital staff to avoid a C-Section. I'm also an introvert. I didn't want lots of people around me as I felt that might inhibit the birth process. I would absolutely not have wanted to be "loved on" by anyone! I didn't have medicated births, also supported by my midwives and husband. There was a lot of pressure from each nurse at change of shift to use pain meds and I was able to advocate for myself just fine. Had I not been able to, my husband would have stepped in. You have great support and trust the nurses at Alta Bates...I think you've answered your question already. All the best to you for a positive delivery and healthy baby.

    Congrats on your pregnancy! I hope it has been fun for you! I just have to comment that you are WAY overthinking this. I'm exhausted just reading your question! The 'right answer' is for you to have whoever makes you feel supported there for your baby's birth, period.

    For example, I had a doula, because my mom had passed away and my girlfriends were not yet mothers. I wanted to have a woman with me that would help (mine was also a massage therapist which was a big help the second birth) and make me feel she was advocating for me and our birthing plan if I didn't feel like doing that for myself.

    But if I had had my mom or another woman with me that I loved and trusted that would have been fine and I probably wouldn't have hired a doula. I also have a great husband who was there and helpful.

    You will have SO many bigger decisions once your baby is born, I hope you might learn to go with your 'gut' on this one and future decisions, realize that you WILL make the wrong choice sometimes, and most likely it won't be the end of the world. It's fine to consider things deeply, but a lot of parenting can come naturally if you let go and let it. Wishing you a wonderful and healthy birth!

    I think if you your mom (or another woman) was with you and she is informed about how to encourage labor progression and you're on the fence about a doula, you would be better not to have one. My husband embodies "loving & even-keeled" but that isn't the same as having someone who is informed and educated on improving birthing outcomes via repositioning, "female centric encouragement" -- hard to quantify but in my experience, it was different hearing my doula (who is also a mother) say "you're doing a great job" and hearing my husband say the same thing -- and other things. My doula encouraged various positions that I believe helped progress labor, she offered focused and specific instructions for breathing and "centering" myself -- another thing my husband could have attempted but I believe it was different coming from another woman. I think it's also a gift to allow your partner to feel whatever emotion he might in the moment (anxiety, nervousness, panic, happiness, etc.) instead of relying solely on them for grounding -- if you don't have to... but again, if your mom or MIL can offer that to you, and you believe in their wisdom, go with them. (As an aside, check your insurance if they cover a doula... Mine did -- I was very surprised -- and we had to meet our deductible first, but in the end, they shelled out the $2k for us) Best of luck to you!

    Our midwives STRONGLY encouraged a doula, but we just knew it wasn't right for us. We recieved all the positive data you did about why we should, but I felt the same as you. I trust my husband to support me above anyone else, he is competent, memorized spinning babies techniques, how to labor at home and for as long as possible before going to Alta Bates, and knows when to push me and when to listen to me. He even knew when it was time to trust his instincts and insist to our midwife both times that we were going to the hospital when they were on the mindset I'd waiting a little longer (they fear the slowing of progress when you get to the hospital, which I never did both times). Also, my Midwives, who used to be nurses at Alta Bates, and the nurses still on staff ARE amazing.

    I am sure having a doula can benefit some people, but I say trust your gut. If you know the support you have are capable and trust them, you are probably right.

    Feel free to ask me for more info if needed. I gave birth to my first last September and my second a week and a half ago. Both at AB, with my midwife, no doula unless you could consider my husband as seudo-doula ;)

    If your mother is a retired NICU nurse and you want her to be there, that seems ideal. Do you feel she would be a good advocate for you and the baby? Does she have the energy? If you and her think it would work out, that seems like a great choice. The time I needed a doula was in early infancy to help with getting nursing established. 

  • Doula Recs

    Nov 28, 2018

    After reading up on doulas on this site, I'm convinced one is a great idea--but I don't know the best way to go about finding one.  Has anyone used one recently that they've thought was really great?  Did any of them include postpartum care (or do you have recs for someone for that as well?)  How far in advance is it best to find someone?

    I cannot recommend our doula Meadow Evans enough. She is by far the BEST, and trains other doulas too. She is so good she doesn't even have a website :o Her email: greycranewoman [at] gmail.com. Congrats! - Jed

    I am in the same boat--considering hiring a doula for the birth of our first child due in March. We are planning on attending "Meet the Doula Night" at BirthWays as a starting point.  The next one is December 16th and you can reserve spots on their website.  Look forward to hearing others' suggestions!

    I worked with a doula Meadow Leys, http://greycranembody.com . She is absolutely amazing! Very grounded, responsive, knowledgeable, and got me through 58 hours of labor.

    Other places to ask is Facebook group Main Street Mamas East Bay.

    We just had our baby with the support of Renata Provost. She was great and I highly recommend her. Her fees include 4 pre-delivery meetings and 3-4 postpartum visits. If you google her, there are some older recommendations for her in BPN and she's also highly reviewed on Yelp. https://www.theinnatedoula.com/

    Molly Haight is excellent for postpartum care. She also is a birth doula, but we used her 1x per week after our daughter was born 3 months ago. She was extremely reliable, always on time and had great, calming energy. https://mollyhaightyoga.com/thedoula/

    Highly recommend her!

    I'm working with Doula's by the Bay to interview a few right now. They offer tiered pricing based on how much experience the doula has. My interactions with them have been great so far!

    http://doulasbythebay.com/

    Birth doulas are clinically proven to improve health outcomes for moms and babies, they are a great addition to any birth team. Post-partum doulas support families in the days and weeks after birth, and can make a huge impact on the transition to motherhood and parenthood. Congrats on your pregnancy! 

    I am a postpartum doula who would be happy to help you after you bring your new little one home.  Many people line up doula care in the second trimester of pregnancy, or before. It is generally not to early to reach out to providers and start making plans. More information on my site: http://www.emilyhartlief.com/doula.html

    Best, Emily 

    I hired Jinny Pagle after interviewing several and she was fantastic. I think it's best to hire as early as possible to form a strong relationship. She does several post-partum visits, beyond that it's an additional charge. 

    My doula was Tora Spigner in Berkeley.  She is also a LND Nurse and Intactivist.  Amazing.  Just amazing.  If you're interested in her contact information, please let me know.

    We used doulamatch.com to find doulas to interview. We went with Renata Provost after interviewing several. We started interviewing at about 5 months, and all of the doulas really appreciated us looking on the early side of the birth.

    We had a WONDERFUL experience 2 years ago with the team of Shoshana Friedman-Hawk and Lori Jaffe. Lori also does PP care, though we didn't end up using that aspect of her skill set so can't speak to it directly. What we can say: we booked about 6 months out from our due date, found them through a Meet-the-Doula event at Birthways in Berkeley (basically like doula/client speed dating :)). They gave us a complementary first meeting to get a sense of each other's energy and whether we might work well together; their fees also included 1 additional prenatal visit (where we talked about things like how to use our space during early labor, when to call them, what we wanted our birth to be like, etc.), 1 postpartum visit (where they showed us how to use a baby carrier and reassured us that we really, truly would get on a schedule and that wearing clean underwear was a milestone for 2 weeks after bringing baby home!), and our labor. I was induced, so our labor was LONG (multi-day) and Lori was with us literally the whole time, sleeping in her car or in our hospital room. She gave me backrubs, ordered my husband to lie down and take a nap when things were slow, and took beautiful photos of our daughter in the first minutes of her life outside. Shoshana also came by despite not being "on duty" (they alternate on-call weeks, which gives you the benefit of knowing your "backup doula" [a pretty common aspect of the service given that doulas have private lives and commitments and etc.]), and was also available to chat with us on the phone after we freaked out a bit the night we brought our daughter home. We would use them again in a second. Highly, highly highly recommend :)

  • Doula Rates in Oakland

    Jul 31, 2018

    Hi There - 

    My husband and I found a Doula we really like. But we have no idea what a normal Doula rate is here....she is $1800 for the full package. 

    What we like about her is she used to work in a similar industry as us (advertising), used to be a sports coach, has a very strong commanding energy (which I like), and lots of experience. 

    Does the rate seem fair? Or anyone have any recos of someone who is similar to the above?

    Thanks! 

    We paid $1600 for our Doula in Berkeley April 2017.

    That is fair depending on how many births she has been involved in and certified through DONA. My doula a couple years ago was 2200 and she had a little over 300 births. A newbie doula who is still trying to get her certification may charge only $500. And I’ve met doulas who charged $3k. All depends on experience. Good luck! Having a doula was the best thing we did and would hire one again for a second birth. :)

    I think this rate seems fair. For me it depends on what she brings to the table, rather than her experience. My doula charges a sliding scale, and the top of the scale is $1600, plus $300 for placenta encapsulation, so we're paying a similar rate. 

    I know you can find doulas for cheaper, but I think it matters more that you get the doula you like. 

    We paid $1500 for our doula services 2 years ago and felt it was worth EVERY penny. We worked with Shoshana Friedman-Hawk and Lori Jaffe; they both attend prenatal and postpartum visits and then alternate "on-call" weeks for births. Shoshana has the more outgoing personality and did most of the talking in prenatal visits, and went a long way toward calming our anxieties. Lori was the one who attended our daughter's birth and was a rock for us through a LONG (multi-day) labor and delivery. We would use them again in a moment :) Happy to give more details if you're interested -- PM me!

    This is so helpful! We pulled the trigger and are doing it! Thanks for the advice!!! 

I am so sorry to hear about your prior birth experience. It sounds like you're doing absolutely the right thing by asking these questions.

I am currently pregnant and planning to deliver at a hospital, but my doula, Yula Paluy, whom I found through BPN reviews, mentioned at our prenatal meeting that she also works with home deliveries. She is an excellent communicator, evidence-based, responsive, kind, and thorough. I feel in extremely good hands with her. She is completely respectful of the birthing parent's wishes and wants to make your vision for birth happen; she will not push any birth choices on you. She expects partners (e.g., spouse) to be present at every prenatal meeting, which I absolutely love--even though she is my doula, I still want and expect my husband to be there as my birth partner, and I know that because of her guidance and presence, he will feel more confident, informed, and comfortable about how to help me. She is based in/near North Berkeley, so she should be a good fit for you in that regard, too!

Yula utilizes a sliding scale for her fees based on your gross household income, and has a fund that allows her to offer doula services to people with lower incomes, which I think speaks volumes about her thoughtful, community-based values. You can learn more at her website: https://yulapaluy.com/doula. I am really happy about my decision to hire Yula based on our prenatal meetings so far. Wishing you the best of luck!

Oh my goodness I can relate! Have you thought about a doula? I have been heard of some doulas that specifically focus on the sibling. Or, your in-laws could come and help with your son during that time until your partner can get back home. 

What ended up happening for us is that I went into labor, a friend from work ended up coming over to be with my daughter, my husband came to the hospital with me and our doula and he went home a few hours after the baby was born, out my daughter to sleep, etc. With baby number two and not much outside support I found it was just much different and I was solo at the hospital most of the time and was ok with it, it gave me lots of time to start bonding with the baby.

I wanted to mention too that my friend/co worker still talks about what an honor it was to help. I honestly think there are people who love to help in this way and accepting that help not only is ok, but they are truly happy to help. 

Archived Q&A and Reviews


Questions

What is a Doula?

A doula is a person who is present with the mom before, during, and after the labor. The doula's job is to take care of the mom. She helps you with your birth plan before the labor and helps you execute it during the labor. She suggests positions to try and has all kinds of tricks to help make labor easier. She can help you judge whether or not it is really time to go to the hospital. She is not a midwife; she is not medically trained. Her knowledge comes from having attended many births. She is a clear head during labor to help you when things get crazy; she can remind you about all the different things you learned in your birth class but cannot remember because you are in LABOR (and your husband is panicking)! She is like your best friend or your sister, but with a lot more knowledge about the birthing process. Invaluable. Laura 


A Doula is also known in many circles as a labor coach. Many times a Midwife is a Doula, and vice versa, but not always. In California, most Doulas have some training, but are not certified in the same strict manner as midwives. I had both a Doula and a Midwife for my hospital birth. A Doula is especially useful for an OB assisted birth in a hospital, since the doula will usually come to your house towards the beginning of labor, and stay with you until at least several hours afterward, a service doctors and most midwives are unable to provide. She will help you decide when to go to the hospital, run interference with the hospital staff, and do anything you request to help make you as comfortable as possible. Some doulas are also lactation consultants, which is a real bonus for getting breastfeeding off to a good start. She provides physical and emotional support to the mother. Even if your partner is with you, a doula is a help, since that allows the partner to get some sleep, take breaks, and focus on the mother.

One other way of looking at it is that the midwife/doctor's primary responsibility is the Baby. The Doula's primary responsibility is the Mother.

Hope that helps! Dawn


Why we like doulas

Doula's decrease the average first labor by 9 hours and the chance of C-sec by 19%. With statistics like that, invest in a good doula, it's worth it. Beth (Nov 2001)


I have to say that we found having a doula to be a wonderful thing and we certainly believe that it helped to make our daughter's birth a much easier, more enjoyable, rewarding and safe experience than we would have had if we had not had assistance from Linda Mixon-Jones. Good luck, Adam (Nov 2001)


To the person asking for doula recommendations... I'm not sure if I can be helpful in the reference department, since Janaki Costello was my doula, but I just want to encourage you to find a doula -- having that support made a huge difference to me in having a positive birth experience, and specifically a difference in my confidence before during and after. I also had superb nursing care at Alta Bates. I think they were making an effort (7/2000) to match women who wanted natural childbirth with nurses who were into it, so that may be something to pay attention to. I also was able to get a room with a bathtub, and laboring in the tub helped me a lot. Best of luck, Susan (Nov 2001)


If you're on the fence about hiring one, read Mothering the Mother by Marshall Klaus. There are listings of doulas at The Nurture Center in Lafayette and BirthWays in Berkeley. Meri (Nov 2001)


How to find a doula


Sept 2011

I am a 40 year old woman who is pregnant for the first time. CVS test showed fetus is thus far healthy at 14 weeks. I would probably give birth at Alta Bates. People have suggested I get a doula. How does one go about finding a doula? Do you interview different people? Does anyone have any suggestions? I am fairly agnostic on child birth. I would like to do things as naturally as possible, but I am not religiously opposed to drugs, if need be. The most important for me is safe delivery. anon


I highly recommend meeting a few doulas so you can find the one who is a good fit for what you are looking for. You can find some certified doulas at www.dona.org which is a very respected doula associaton. Renata


Having a doula is great. Especially true if you have not attended a few births of your friends or family, or if you mom and sisters cannot be with you during the birth, or have not themselves been at many births. Definitely worth the $1,000 that it costs.

I found doulas by asking friends and co-workers for their recommendations. Turns out half the people we know had doulas. And if a doula is full, she can recommend another doula in her backup group.

Also, Felicia Roche teaches the DONA classes, national certification of Doulas, in the east bay. Part of their training is attending many births before certification. And so many of them volunteer at births after their classwork is finished, therefore low or no cost.

If you plan a homebirth, many midwives will accompany you at the hospital in case of an emergency transfer and will act as your doula there. Ruby


If you haven't already asked your doctor at Alta Bates about a doula, then check there first. There are often doulas that specifically work with a hospital or that have signed up as volunteer doulas. If there is not already a resource for finding a doula through Alta Bates, I would try Birthways in Berkeley for referrals. loved having a doula


Doulas of North America have a website: http://www.dona.org/ On the left they have a search of certified doulas of all kinds (birth, postpartum, all doulas) based on your location. I was very happy with my postpartum doulas I found through that site. Best of luck, Victoria


First of all, congratulations on your pregnancy!! I think it is wonderful that you are considering hiring a doula. There are many wonderful doulas out there, especially in the east bay. I think the best way to find the right doula for you is to ask around for recommendations and look online (like you are doing) for doulas in your area. DONA International, www.dona.org, has a list of certified doulas all over the states, but there are many excellent doulas who are just starting out and working towards certification, like myself, who aren't listed.

Generally doulas begin working with women in their third trimester so you are getting a great, early start! After collecting a list of doulas in your area I highly recommend interviewing several. It's best if you find a doula that you connect with. This is the woman that will be supporting you through an intense, life-changing event. You want to feel comfortable around her. When interviewing her she can provide you with her information and background, cost and answer any questions you have. The doula can work with you to plan and prepare for your ideal birth experience, be it natural or not. The cost of a doula will vary, especially if you have a newer doula. But the truly important thing is how you feel around her. If you don't feel comfortable with her, then it doesn't matter if she has 20 years experience or you're her first client. If you have any further questions, feel free to contact me! Take care, congratulations and enjoy your new adventure to motherhood! Nicole


I'd suggest going to a free ''Meet the Doula'' event. Birthways (www.birthways.org) has these on an ongoing basis - check their calendar. Looks like the next one is October 16th. On a personal note I have two dear friends who've worked with Anna and Candace at Family Doula Services and they were wonderful. Definitely interview a few to make sure you and your partner both mesh well with them and are comfortable. Doulas are absolutely amazing, and in my opinion an essential part of the birth team. Happy Birthing! doula fan


November 2001

I am looking for a doula. I am due Jan. 15 and will be delivering at Alta Bates with an OB. My husband and I have heard that delevery can go much more smoothly with the assistance of a doula. We would like to hire a Doula by recommendation. The lists that are out there seem overwhelming. Also, can anyone tell me how much I should expect to pay for Doula services? Elizabeth


I'm new to the area but here are a few suggestions
Birthways in Oakland, on Santa Clara near the Grand Lake theater (www.birthways.org) DONA - Doulas of North America (www.dona.com or maybe org) ALACE -Association of Labor Assistants and Childbirth Educators www.childbirth.org CAPPA - http://www.childbirthprofessional.com/ 
I am a birth and postpartum doula just learning the ropes here in California. I was doing this work in Western Massachusetts for the past 5 years. If you have any other questions, feel free to contact me. in peace Samantha

How much does it cost?

A doula usually costs around $300 to $500, which includes one or more pre-birth visits in your home, full support during your labor, and one or more visits afterwards. This cost is occasionally reimbursable through insurance, though rarely. It's well worth it, though, especially if you cannot afford to have a midwife, and must have an OB-attended birth. (Dawn, 1999)


We used Linda Mixon-Jones (see review below). As for cost, I think it cost a total of $650 or so. Adam (Nov 2001)


For 2 pre-consultations (not including the in-person interview) and support during labor (at home and hospital) and up to 2 post-partum lactation consultations, we paid just under $500. Susan (Nov 2001)


Most doulas charge from $500 to $1,000 for the birth and a few pre- and post-partum visits, depending upon their degree of experience. Meri (Nov 2001)


Linda Almond-Nichols ... did a wonderful job. I believed she charged $600, and was worth it! Amzel (Nov 2001)


Lisa Moon's fee 2 1/2 years ago was $800. Half up front half after the birth. What was supposed to be included was 2-3 pre-birth visits, the birth and 2 post-partum visits. Beth (Nov 2001)


Meghan Lewis charged us $775 back in April 2001. Teresa


Linda Jones-Mixon charges in the upper end of the $500-1000 range that others have mentioned for doula services. (Nov 2001)


When I delivered in February 2001, my doula, Jennifer Starling, was charging a sliding scale of $4-700, whatever you can pay. That included two pre-labor visits, one post-labor visit, and of course, being there for the birth. Whitney


Questions to ask a doula

July 2002

I know there are labor doula recommendations on the web site but most of them are 1-2 years old now. I was wondering if I could get any recommendations or cautions from people who have used this service more recently. Also are there any questions you didn't ask your doula that you wish you had in restrospect? Thank you for any help you might have.


I wish I had made it more clear that I wanted my doula to help me breathe through my contractions, and to help my husband coach me through my breathing as well. During the interview I was sure I had made my needs clear, but during my labor she seemed to get caught up in the moment and forgot about mt request. Finally I exclaimed, ''will somebody please help me breathe through these!'' and she did, but by then it was too little too late. To be fair, she was wonderful in many other ways.

I would suggest that you ask the doula you are interviewing to list her strong points before you tell her what you want. If her strengths match your needs then you may have found a good doula for you. If you have to ask her to do something that she doesn't list as a strength, she may not be the right one. anonymous


My wife and I heartily recommend the doula we used to assist us with the birth of our daughter 18 months ago. Her name is Linda Jones Mixon. She's caring, funny, easy going and just fantastic. She was an immense help all the way around. You can reach her at 510-540-7210. Linda also is the proprietor of ''Pickles and Ice Cream'' - the infant / baby store in No. Berkeley on Shattuck at Cedar. You can usually find here there.

Two other recommendations I'd like to pass along are Janicke Costello and Carol-Shattuck Rice. You can reach them at 415-525-1155. They team teach a great 8-week long birthing class in El Cerrito and they are birthing doulas as well. Their class is quite good and we have heard from other folks that they are great doulas. Good luck, Adam.


I would highly recommend my doula, Constance Williams. She attended my daughter's birth 16 months ago. She was incredible. I really believe that I would have had a c-section if it weren't for her. She did exactly what I wanted her to do. She is very strong and she massaged my legs non-stop for 5 hours. I gave birth with out an epidural which was also nice. She also knows all the nurses at Alta Bates which is very helpful because she made sure that we got terrific nurses. Good luck! Madeleine


Not sure if you want specific doula recommendations or genral info. I can just tell you that we used a doula for my daughter's birth last year. We had other family present at the birth but I just wanted someone who ''knew'' what they were doing there as well. Our doula had been our childbirth prep class instructor and we had started to really like her and felt comfortable with her. She was a Godsend. I had a very long labor and some glitches with the hospital. She kept me calm when there were several times I could have freaked out. I opted for an epidural and she was supportive. She made sure my husband and other family were taken care of (rested, got food, fielded calls, etc.) and made sure that I had everything I needed (jello, water, quiet, footrubs, etc.). She asked questions of the nurses and doctors that I wouldn't have thought to ask and did it in a respectful way so the staff didn't feel threatened.All in all, it was a wonderful experience and she definitely made! a difference. I am sure I could have done it without her but I wouldn't have wanted to. Especially with my first baby. My friend is now using her for her birth next month. Nicole


I've replied off-line to posters in the past, and now I'm wondering why -- no reason to keep such a good doula a secret!

We chose Rebecca Husband for our daughter's birth. She was wonderful, thoughtful and respectful of our wishes. Our baby was several weeks overdue and though it became clear that it wasn't going to be the natural birth we'd hoped for, she helped keep it close to our ideal. The fact that she has a very good working relationship with Alta Bates staff was a plus (she also volunteers there for women who arrive without partners and whose births could be helped with a doula) -- our delivery nurse was herself a former doula and personal friend of Rebecca's. Our daughter happens to share Rebecca's birth date, which has kept us close - she came to her christening and recently to dinner with her beau.

The activities we did with her as we got our brains around the reality of birth were interesting, and her information dovetailed nicely with that we received from the instructor, Jennifer, at the Alta Bates Childbirth prep class. My baby brother was born at home, so I was quite familiar with natural childbirth - but when I became frustrated and demanded drugs, she was patient and supportive. They also managed to coax me into the shower instead and the baby was born just 2 hours later (6 hrs total).

The only thing I might have asked her to do was rub my back more - my husband was exhausted and could have maybe just held my hand a bit, but who knows?

She had a sliding scale for three visits and a post-partum follow up, and brought fresh roses from her garden for the delivery room which was really really nice! Happy to provide more details if you'd like. Deirdre


We used Maria Steinman for the birth of our baby boy 7 weeks ago, and were very happy with her. Our son was three weeks early, so we missed two of the three prenatal visits we'd scheduled, (and so I'm not sure what she would've taught us during them) but she made up for that by coming to the house two additional times after the birth to give me an hour-plus massage (she's a certified acupressure practitioner). She's a delight. I would use her again and highly recommend her. If you want more details feel free to email or call me. Or call Maria. Her phone number is (510) 594-2575 Kate Hand pkhand AT attbi.com


I gave birth on February 28, 2002, with my amazing doula Kim Lyons and my husband present. Kim was warm, loving, kind, and unbelievably supportive during a MOST difficult 22-hour labor. She is a masseuse and does some accupressure, both of which were very helpful during the labor. She has a very positive energy about her generally speaking. Additionally, she does infant massage, and teaches you how to do this on your own baby in your post-birth meeting. My baby has been very grateful for this!! Please contact her at birthmate AT yahoo.com or contact me for her phone number. Jennifer


Debi Raya (925-939-2534) was the doula for my birth five months ago for my son Jonah. She was WONDERFFUL! Knowledgable, calm, supportive, well-trained, competent. She is also a massage therapist, which really helped with 30 hours of back labor! She came to our home, where she can do exams to see how dialated you are if you want (she was a certified midwife in Texas I beleive). She stayed in the hospital all night. She's more often at natural births but was very supportive of me when I chose to have petocin and then an edidural for the pain. She was wonderful. My husband and I felt very close to one another during the entire delivery and I beleive it was because of her presence and knowledge. We felt ''accompanied'', supported, and safe. She's a good advocate if you're thinking of a hospital birth. She definately worth having a conversation with to see if it's a good fit for you. Blessings, Sarah


My husband and I would like to recommend our wonderful birth doula, Kathrin Smith, who was with us for the labor and birth of our 2-month-old son. We found Kathrin through Birth and Bonding on Solano. I am a 40-year-old first-time mother, and, though I very much wanted as natural a birth as possible, I was quite apprehensive about being able to go through it without a lot of medical intervention. With Kathrin's knowledge, encouragement and support, we were able to have a better birth experience than we had imagined possible--it was certainly the most moving, amazing and wonderful experience of our lives. I truly believe that without Kathrin's guidance, I would have had a much different, and less participative, experience giving birth to our son. (Most of the labor was at home, and our son was born at Alta Bates.) Kathrin is experienced, smart, warm, loving, grounded, AND has a good sense of humor. I was very inspired and encouraged by her, particularly by the fact that she had her own two daughters naturally at home. She was also very good at including and relating to my husband. She was always available when we called, and was at our home as soon as I needed her once labor began. Kathrin is currently in Marin, but I believe she is moving to the East Bay soon. (She had no trouble getting to our home in the East Bay quickly from Marin.) Please feel free to e-mail me, or call Kathrin at 415/459-4737. Elizabeth


ObGyn disapproves of having a doula

March 2006

March 2006

I recently thought about hiring a doula as this will be my first childbirth and felt more reassured by the thought of it, but when I brought this topic up with my OBGYN she had this look of disgust. I asked her why she was against doulas, and she explained that besides them not being medically trained they also interfere with the medical staff and can be overbearing. My dilemma is that my insurance will cover a doula if referred by my OBGYN, but after having that discussion do I even dare ask her for the referral? Christine


Are you sure you are comfortable with your ob/gyn? I ask this, because it is very important. I didn't follow my instints with this one, and ended up with a c-section. It turns out that the practice I went to has probably a 50% c-section rate (the hospital has a 25% c-section rate). I had a doula that got me through some tough times with my induction and c-section. The practice I used usually frowns on doulas as well. I know it might be late for this, but I would urge you to switch if you are not comfortable with your ob/gyn. I thought about switching a month before delivery, and now I wish I had. On the otherside, doulas are not legally allowed to give medical advice. Muriel


the fact is, this is your birth and not your OB/GYN's. you have the authority and the right to ask--and then demand--to have your birth the way you want. it is absolutely true that doulas interfere with doctors and are overbearing. that is exactly what you are paying one for. you are asking someone to help coach you through the birth, help you follow a birth plan (even when it is not what the doctors think is convenient) and advocate for you when you might not have the capacity to do so yourself. that certainly is not easy for doctors, who push meds, interventions and procedures that are expedient for them, may help protect them from lawsuits and are based on a time clock not necessarily what is good for you and your baby. i'm sure i sound negative and there are lots of great, supportive ob/gyns out there, but i would be suspicious of someone who does not want you to be fully supported in your birth. i have seen too many people pushed (or scared) by doctors--in the absence of doulas or midwives--into procedures that have resulted in c-sections. studies have shown that women who have doulas tend to have less interventions, less c-sections and less medicated births--whether or not that is easy for your doctor to deal with, it is certainly the best choice for you and your baby. stick to your guns, and good luck! ann


It sounds to me like you are in the market for a new OB-GYN! The statistics (and we're talking many, many studies here) speak for themselves: Having a trained doula at your labor/birth leads to: 
50% reduction in the cesarean rate 
25% shorter labor 
60% reduction in epidural requests 
40% reduction in oxytocin use 
30% reduction in analgesia use 
40% reduction in forceps delivery

Why would any competent doctor discourage their patient from receiving these multiple benefits? I suggest you speak with other OBs and labor/delivery nurses regarding their positions on doulas. I imagine you'll get many positive responses, because while doulas are Not medically trained, continous emotional support in labor is proven to remarkably reduce the need for medical interventions. Couples who use doulas also report more satisfying, empowering birth experiences, not to mention less PAIN. Most local hospitals have volunteer doula services as well. You are in control of your birth experience. Decide what it is that you want and choose wisely. Good luck! Doula Fan


I wonder what your Ob's C-section rate is? I would be very concerned about delivering with an Ob who doesn't like doulas. I had a doula at two of my deliveries and they were so supportive for both me and my husband. They kept us informed throughout the process and helped us make decisions mostly on pain management. They were never overbearing. If I were you I would start looking for another Ob. You are so lucky to have coverage for a doula. Happy Doula User


Yes, ask for the referral. This is your birth. When you ask you could acknowledge your doctor's concerns and let her know that you will speak with the doula. If you haven't chosen one, this issue could be discussed in your interviews. Also, if possible, have the doula go with you to one of your appointments so the two meet at a calmer time. Had a midwife and a doula


I feel very strongly about this issue, as a former doula and a midwife. First off, your doctor won't be in the room more than a half hour under the best of circumstances, and usually docs are pretty professionally courteous to doulas no matter what their opinions about them, so there probably wouldn't be a clash of any kind. What I feel stongly about is this: the doc is not going to be willing to stand by your bedside for hours and hours and do all the things a doula would, is she? A good doula will not give medical advice, either. It sounds as if she has had some wierd experiences with doulas that are atypical. If she won't give a referral, I'd wonder what else she is going to control during your birth. (if she is there at all). Be careful. wary


You are right to feel reassured by hiring a doula! Doulas can help make birth a much more calm, comfortable and gentle process. Research has shown that women who had doulas reported:


Breastfeeding more successful 
More maternal infant interaction 
Less postpartum depression, anxiety and low self esteem 
Perceives her baby to be above the standard baby 
Overall more satisfaction with her birth experience

Also, many studies show that having a doula improves obstetric outcomes across the board: 
Reduced need for medication by 35% 
Reduced need for forceps by 50% 
Reduced need for cesarean Section 51% 
Reduced the length of labor by an average of 98 minutes

''If a doula were a drug, it would be unethical not to use it.'' - - John H. Kennell, MD

These statistics have been published in several studies and most OBs in the Bay Area are aware of them. Many OBs support doulas because of them, and because of their personal positive experiences of working with doulas. Further, all these reductions in medical procedures equal a very beneficial cost reduction for hospitals. Everybody wins!

Doulas are not medically trained because our focus is on the mother's comfort and emotional needs. Certified doulas have pledged to uphold a code of ethics specifically to avoid the kind of situation your OB describes. It might be worth considering wether a doctor who opposes doulas so strongly is the right doctor for you.

Since you will be the one hiring her, you can make sure that you don't hire someone who will be overbearing or interfere with the medical staff. Most of us don't! But by hiring a good doula, you will ensure that you have an advocate in the hospital whose only goal is to ensure your comfort and emotional well being!

Best to you and your baby on this amazing journey to motherhood.


If having a doula is important to you then I would suggest looking for a provider who welcomes doulas and ask them for doula referrals. That's great that your insurance covers doulas. Can you please tell us the name of your insurance? Prenatal yoga teacher, whose students change doctors/midwives even in the last trimester because of reasons like yours.


I recently thought about hiring a doula as this will be my first childbirth and felt more reassured by the thought of it, but when I brought this topic up with my OBGYN she had this look of disgust. I asked her why she was against doulas, and she explained that besides them not being medically trained they also interfere with the medical staff and can be overbearing. My dilemma is that my insurance will cover a doula if referred by my OBGYN, but after having that discussion do I even dare ask her for the referral? Christine prenatal yoga teacher


You need to decide on your own if you want a doula. If you do, then you need an OB who is onboard. Either keep the OB and be intimidated into having no doula support, or decide that you will have a doula, and get another OB who will work with your needs. You don't need that kind of tension with your doctor. You need all the support you can get while pregnant/laboring.

The whole reason doulas are ''overbearing'' is because many times laboring women - in their vulnerable state - are manipulated by overbearing medical personnel to do things they disagree with. It's overwhelming to try to stand up for yourself while popping out a kid. Switch OBGYNs


I'd say get a new ob. I got reccomendations from my ob on doulas -- his words were something like ''she is one of my favorite doulas to work with'' -- my ob is Dr isenberg at obgyn partners in oakland & my doula was chris gonzalez. (he gave me three names)I cannot stress how much she MADE my birth experience. seriously. you spend hours with your doula -- not so with your ob. he/she is with you for a couple of hours at most. good luck


Hi, Not sure how far along you are, but to cut to the chase it sounds like you need to find a new OBGYN. I found one at 30 weeks with no problem when we moved to a new area. Doulas are great! Anon


If you're considering a doula you probably have a good idea of the benefits already, so I'll just say that I found having a doula there to provide reassurance that labor was proceeding normally to be a great advantage during labor. Ask your OBGYN for the reference, because this is your birth, not hers. A doula will be there the whole time for you and your partner, while the OBGYN will flit in/out or just come in at the very end. If you really like your OBGYN, find a doula that doesn't seem ''overbearing''. If you're not crazy about your OBGYN, consider switching to someone who will support your choices. Heather


Go ahead and ask for the referral, and simply reassure your OB that you are 1) Not expecting the doula to perform any medical duties, so her lack of medical background will not be an issue. 2) You will carefully interview and choose a doula who is dedicated to being diplomatic with the medical staff

Every doula is NOT ''overbearing.'' A professional, experienced doula will make a point to be diplomatic and cooperative with medical staff, because they want to be welcomed at hospitals, not spurned. My doula, Betsey Appell was wonderful in this way. She works expertly with the medical staff, while still advocating for your needs, when necessary (in a very non-confrontational, non-overbearing way). I highly recommend her, and I was so glad I hired her. You may want to suggest to your OB that she speak with the people you are considering to hire as doula's, so that she can be reassured and feel comfortable referring one for you.

If you're interested in talking to Betsey, she can be reached at betsy[AT]berkeleydoula.com (her website is www.berkeleydoula.com) Finally, I strongly urge you to go for the doula. Statistically, they make such a huge difference in how women feel about their births. I was so glad we had Betsey at mine!

Best of luck Alesia


Ive had 4 babies & 4 doulas; the doulas were FAR more valuable than the OB. Your OB is wrong: most staff highly appreciate doulas. Ive heard two L nurses tell each other ''doulas make my job so much easier. Avoid OBs & staff who are threatened, they are having turf wars instead of caring for you. You want a doula who can be firm but not confrontational; interview past clients and ask how the doula did with the staff.

A doula is your assistant; your partner will be busy providing emotional support & youll need an advocate in the hospital. Your OB will only see you briefly & again at delivery. Neither she nor the nurses will be your constant companion. The doula will, though, & will work with the staff, making sure allergens are avoided & your birth plan followed (one doula noticed a nurse about to give her patient an iodine rub despite allergy notes posted). When the doula conveys a need to the nurse/doctor, they listen better; she's not a freaked out mom or partner.

My first babies were born in a hospital (last 2 at home). I had back labor for my first 2, and it took 2 people: Id lean on one person & the other would jam her elbows into my back. One helper couldn't have done it alone.

There are things the doula will know that the partner & mom won't know:

1. The OB told my doula I was taking 3 hrs to dilate each cm. She started acupressure and my dilation tripled to 1 cm/hr.

2. The nurses wanted to do the fetal monitoring but we were laboring in the shower. My doula had the nurses unhook the cart and set it up in the bath to do the readings at the shower.

The emotional benefit is significant. After 12 hours of back labor, to find I was only at 5 cm, I thought the baby would never come & Id die from the pain. The pain can exhaust a person, conquer them, and without the doula, it might have beat me.

Our doula helped with our birth plan, planned her ''labor outfit'' to be my favorite color and avoided colors I disliked. She helped prepare DH to see me in pain & planned how many times theyd talk me out of drugs.

http://www.dona.org is Doulas of N. America. Your OB is here to serve YOU and if she wont refer a doula, youre better off with another OB. shannon


Oooh, that would be a red flag for me about the Ob/Gyn. Can you switch doctors? If she's negative about doulas, how does she feel about natural labor and delivery? How overbearing is she going to be about having your labor and delivery her way?

Good doulas are not ''interfering'' or ''overbearing.'' They understand that some things may be medically necessary, but they also try to help balance the wishes of the woman to have as natural a birth as possible, with the truly overmedicalized way that birth is treated in hospitals.

I am also pregnant right now, and I have talked with my doula about how she deals with the hospital staff and doctors/midwives. She understands that they have protocols that they have to follow, and she is really knowledgeable about the reasons for interventions, and the alternatives to them, and ways to work with the hospital staff without being overbearing. She talks about asking them to try other things first, before ''necessary interventions''.

I would really recommend having a doula. I did without one for my last delivery and would never do that again. I would have had a really different experience with a doula. no interventions for me please!


Get a new OB. She should support any decision you are making in regards to YOUR birth experience. If you really like the OB or don't want to change for any reason.... take a more aggressive/proactive position so that you are not influenced, or even bullied by her/him. This is your birth experience and you should be in control. Period. A doula is a wonderful support system for you, your spouse and your baby-- don't let anyone take that away from you. anon


personally, i would consider finding a different obgyn, i don't know how far along you are, or if this is feasible w/ your insurance...

i'm about to give birth any day now (my first), and have a friend who is a proffessional doula, who will be acting as mine. first off, doulas have medical training, just not as extensive as doctors. my doula took many of the same classes as the nurses in the hospital, and was a certified midwife for a while. it's a doula's job to know what her pregnant lady wants and doesn't want during her birth, and to advocate for her (during a time when it's very difficult to advocate for oneself) if the dr.s are pushing for things that aren't absolutely necessary. which i can understand might make some uptight western doctors annoyed if they just wantto tell the patient what to do and get on w/ the medical procedure of birth...

(i'm not really into dr.s, i'm having a home birth) anyway, the point is to make you comfortable, and i have found having a doula to be very comforting during this whole pregnancy, she's been very helpful to me in making decisions along the way, and supporting my decisions. she'll be the first person i call when i go into labor, and the first to come over, and help us know when to call the midwife.

incidentally, it works the same way if you're going to the hospital, she can come over and help with the pre-labor, so you don't go to the hospital too early (which often happens and can lead to more interventions and c-sections, when they feel you've been there too long)

i think if you feel it's important to have a doula, if you feel it will reassure you, you should have one elzza


Having a doula present is your choice, not your OBs! This is about you and not your OB's ego. A doula's role is to be you best advocate, but your role is to be your child's advocate. A good doula will help you evaluate your medical options as they arise, a good doula will not impose herself into the medical process. A good OB will let you know in no uncertain terms if and when a difficult decision need to be made, and their ultimate professional authority should be respected by you and the doula. If your delivery is typical, you will see your OB only a few times before the final pushing and emergence phase. The nurses will typically be in and out of the room as they will be attending to other women in labor as well. A doula is there for you alone. A doula's role is to be at _your_ side throughout the entire labor to encourage you and your. If you decide to have a doula you should ask where they have worked, are they familiar with and to the NURSING staff of where you intend to deliver. Check ''DONA'' and the doula comments on BPN. I believe WADDLE & SWADDLE on Shattuck Ave. has classes on choosing a doula. My doula was Linda Jones-Mixon, the owner of W She was absoluteley, a piller of quite, assured and assuring strength. The birth of my daughter was a very positive and empowering experience. On a related note, try to write a birth plan. A birth plan is a guideline for wishes, not a writ- in-stone action plan. The real power of a birth plan is that it allows you to state clearly who will and will not be allowed in the labor room with you, besides hospital staff, obviously. It's good to submit a birth plan early enough to get in included in yoru preadmission chart (about two weeks before due date) and to also have several printed copies to give to hospital staff on arrival and through transitions from labor to deliver. Make it NOT more than one page, and general in sara d


I'm sorry, but that is absolutely ridiculous for your dr. to be so short-sighted and self-centered. I had my doula at both of my children's births and she was a lifesaver! I don't think I could have done it naturally w/out her. And my husband was thrilled to have some of the pressure off of him. And I have to say, at the end of both births, I think the staff (nurses and midwife at Kaiser WC) were happy she was there! If your insurance will cover it, I would definitely talk to your dr. and assure her that your doula will be completely professional and not interfere, and offer to bring her along to your next appt. And remind her YOU could use the extra support. My experiences w/my sister's deliveries w/out a doula at Kaiser WC and Alta Bates are that you don't get even close to the kind of personal support from the nurses that you get from a doula. Plus, the chances of your grumpy dr. actually delivering your baby are slim unless she's always on call. Love, love, LOVE doulas!


DO NOT let your OBGYN talk you out of hiring a doula if that is what you want to do. It is your right to have the kind of birth experience that you want to have. It is also your right to find an OBGYN who will support you and who has your best interest at heart. Do not hesitate to change doctors if you don't feel that this person is the right fit for you and your family. I also recommend that you do some research for yourself on why doula's are beneficial. You could then share it with your OBGYN (if you decide to stay with her) and explain why it is you think it will benefit both you and your baby to have a doula. If she still gives you the same line about why she doesn't like doulas, ask her to back it up with real, scientific evidence and studies. If she's going to tell you not to do something, she better have good, solid evidence as to why it's not a good idea, not just circumstancial or anecdotal evidence. Here are some resources that should help:

1. Henci Goer's book, The Thinking Woman's Guide to a Better Birth. She also has a web site, www.hencigoer.com that has a lot of excellent resources, including several articles specifically detailing why doulas may be beneficial and how to go about deciding whether or not you should hire one (as well as how to hire one).

2. The Lamaze International website, www.lamaze.org, also has great resources.

3. BirthWays, www.birthways.org. They have a free doula info night every month and are located in Oakland. The phone # is 510-869-2797.

4. Ina May's Guide to Childbirth is also an excellent book. And there are many others. Locally, you could visit Waddle and Swaddle on Shattuck Ave. in Berkeley, which has a good resource library. Just doing a Google search on doulas or ''benefits of doulas'' (or something like that) will probably turn up a lot as well. I wish you the best. -Fight for your birth rights!


If you would like to have a doula you should definitely have one! And if your obgyn won't provide a referral, I honestly think you should consider finding a new doctor. I gave birth to my first baby in December and struggled with whether to hire a doula (I wanted one but was afraid it was an expensive indulgence that might not be necessary depending on how the labor went). I wound up choosing to have a doula and it was absolutely the right decision and well worth the money. The right doula will be invaluable during labor. In my case I was at the hospital (Alta Bates) in labor for over 30 hours and we went through 4 full nursing shifts by the time our baby was born. Our doula provided continous support throughout the shift changes. Plus the nurses are required to document every little thing that happens during labor (mom's blood pressure, baby's heartbeat etc) and are not available to stay by your side to help you breath, stay calm etc. And even though doulas are not medically trained they are very knowledgeable about childbirth. At one point during my labor there was concern that my cervix was swelling and also b/c the baby was turned sideways. It was my doula who suggested a strategy to take the pressure off my cervix and to turn the baby -- I credit my doula with the fact that I didn't need a cesarean. My husband was also very relieved and grateful to her, even though going in to the labor he was skeptical that we really needed her. As for my obgyn: she was not on call during my labor so I saw two other doctors from her practice for a total of about 15 minutes until I was ready to push. Most likely your doctor will only see you very briefly every few hours to check how far you are dilated and won't spend any time with you until pushing -- and so will not be much help to you. Finally a good doula is respectful and will not cause problems with the doctor even if she disagrees with the doctor's advice or approach. Definitely ask your doctor for the referral -- I think it is very wrong of her to discourage you from having all the help and support you can get during labor (especially since your insurance will pay for it!). I highly recommend our doula Paula Santi if you are looking for someone. eve


Sounds like your OB has had some bad experiences with doulas (or maybe just one) I wonder if she would lighten up if you could arrange for your doula to come to one of your prenatal appointments to meet her before the rubber meets the road. You may also want to ask your OB how what percentage of her patients does she actually deliver the babies for. for mine it was something like 30%. after all if you give birth at night or on a weekend or holiday the only way you'll get your OB is if he or she happens to be on call. In any case your doula will be there for you all through the labor - that's the hard part. in an uncomplcated birth, the OB just pops in to catch the baby and stitch you back u if you need it. if she still in obstinant about not wanting a doula I'd consider changing doctors. doula fan


Oh, definitely get a doula!! And certainly try to get your OB's buy-in. My OB (Dr. Honegger) was cautious when I first told her I was going to use a doula (Treesa Mclean), but I reassured her that I was going to hire someone who would be supportive of all types of birth, not just natural. And then the OB was pleased, and said, ''With a normal labor and enough support, there's no reason why you can't have a natural birth.'' And I did!

You might tell your OB that although doulas might have a bad reputation as overbearing anti-interventionists, you would never hire one like that (most aren't, anyway). Tell the OB that you don't want the doula to provide medical advice (they don't, anyway) , explain your uncertainty about labor, and point out that you'd feel reassured by having the same caregiver at your side for the entire labor. That's something the OB can't offer you, so hopefully she won't feel threatened.

But even if your OB still frowns, you know what? Chances are she won't deliver your baby anyway, and even if she does, you'll only see her at the very end. Loved My Doula


Hi, I had a baby last year and having a doula really helped my husband and I during my labor. Doula's are there to convey your wishes during childbirth. I am assuming you had made a birthplan. Doulas meet with you several times before the actual childbirth to discuss what you want and don't want to happen. Doulas are great because during the actual birth you and your husband are not quite yourselves and can't remember anything and doctors tend to say things and sometimes will ask you to make a decision and believe me, you will not really comprehend what they are saying, so doulas will give you scenarios on what might come up that doctors would want your decision on. So, what I am trying to say is, if you want a Doula have one or have a consultation to get an idea on what they do because I believe in how helpful they are. Yes, most doctors don't like them but if they are helping you get through the labor mentally and not have to worry about anything they are great. They allow husbands to help you focus on the pushing and being just focussed on you. That's my two cents. Hope this helps. Emily


Sept 2003

I recently mentioned to my OB that my husband and I are considering hiring a doula to assist us during my VBAC labor a few months from now. My doctor had a less-than-positive reaction, and while that won't sway me from having a doula if that's my choice, I'm curious: Why would a doctor not encourage me to hire a doula? Why might he believe a doula isn't helpful? Are there legitimate reasons he may have negative feelings about doulas? Is there commonly a tension between doctors and doulas, and if so, what is the source of the tension? Did anyone else have this issue, and how did you handle it? My reason for wanting a doula is just in case the labor nurse on duty is too busy to focus on me, or unkind, or simply not to my taste, I'll have chosen a labor attendant I know I'll feel supported by. (Please don't ask me to change doctors; I have a high-risk pregnancy and my doctor is an excellent and caring physician, albeit one with strong opinions.) Thanks for any thoughts you can share with me. anon


I have heard that some OBs feel that doulas are too anti- medical, and that they think that doulas try to take over, or try to make it their scene. I think you should bring your list of doulas in to the doctor and ask that he tell you if there are any that he has worked with that he absolutely does not like, any that he loves, and any that he's neutral on. Let him know you respect his opinion (it sounds like you do), but that you know that he's only going to be there at the end of the process (when the baby is crowning), and that you need someone to help you throughout (or whatever you feel). You will not let the doula take over, you just need more support than your family can provide, and you know that labor nurses aren't always to be counted on.

That should at least open up a dialog, during which you can hopefully come to some sort of agreement. Jen


My OB, whom I adore and who shall remain unnamed, thinks doulas areunnecessary and a terrible waste of money. When my OB told me this, I laughed and told my OB I'd be having a doula at my labor and delivery notwithstanding my OB's opinion. My decision was fine with my OB. There are ''legitimate'' reasons for both sides of (almost) every issue, depending on how one thinks about the issue. I sensed a little bit of tension between my doula and certain members of the medical staff during my labor and delivery at Alta Bates, but my feeling was that the tension was not my problem -- it was for the doula and the medical staff to work out. We really appreciated our doula. Could be have had a lovely labor and delivery without her? Sure. Were we glad we hired her anyway? Yes. But we also had two fabulous L & D nurses, a great delivery OB (not mine, who was not on call) and a great anesthesiologist. anon


The doctor may have had a bad experience with a doula in the past and had negative opinions about it and has no one to come along and change their mindset. As a doula, I try to work WITH the doctors instead of getting in their way, but its hard to know what his or her past experience was. No matter what, though, keep your doula if you feel comfortable w/ her and don't let your doc tell you otherwise. Doulas do a great service to families expecting a baby and sometimes docs and nurses don't realize how important they can be. congratulations and I hope your birth is one you will always celebrate. Shaana Keller Celebrations Doula Services


When I mentioned to my OB that I wanted to have a doula at our birth (not VBAC, just our first) he said great, if I wanted he would give me some names of doula's he has worked with. He was very positive. He is in a practice with a couple of midwives (and ob's) and maybe is simply more open. Good luck.


Your doctor might possibly be against a doula if he/she is not supportive of natural- non-medicated childbirth. That is a doula's main focus- how to help the laboring mother get through childbirth with as few medical interventions as are possible (and realistic). They provide emotional as well as physical and even spiritual assistance during labor. I don't know what your doctor's ideal labor is but it seems like many doctors would prefer a pain medicated birth with labor speeding medications and procedures to hurry the whole process up. That seems to be what many doctors learn is standard in their medical training these days. Doulas, on the other hand, focus on letting nature take it's course and helping the mother through the process which may mean a longer, less ''pretty'' labor than one with interventions. If your doctor leans towards medicated labors, then that may be why he/she is at odds with the whole idea of a doula. I was very dedicated to the idea of a natural birth for both of my labors and was able to have two drug-free labors- one with twins. I would not, however, have been able to do it without the support of a doula. I would highly recommend getting a doula- just make sure she feels like a good ''fit'' for you and your partner. I think my husband really appreciated the doulas as well becuase it took a lot of the pressure off of him to help me when things got rough. He was able to concentrate on comforting me just by holding my hand and being with me rather than having to remember all the the labor aids that we had studied. Best of luck with your birth and new baby. fellow mom


I know from experience that the doctor somehow feels that there will not be enough communication between her/him and the patient. And yes, a bit threatened.

I assured our doctor that there would be communication between she and I, but as first time Moms, I felt it was important for my partner and I to have someone completely focused on me throughout the labor and delivery. Our labor nurse was also great, but I knew she would not be able to be present for all aspects of the labor. I spent the first hour or so of my labor in the bathroom with a hot shower on my back with my partner and our doula, Judy.

In the end, I think my doc, and the labor nurse, were glad I had the doula (and a good friend) there to help me through the tough pushing of getting my daughter in position for the ''real'' pushing.

Hang in there. I think you're on the right track with the doula!! :=} Kathy