Choices in Childbirth

HOW MUCH DOES IT COST TO HAVE A DOULA AT OUR BIRTH?

In different areas of the United States and around the world, the fee for a birth doula varies. Some doulas charge an hourly rate, with a minimum and maximum amount determined ahead of time. Other doulas charge a flat fee, which covers all of the prenatal, labor and postpartum time spent with the couple. This rate varies, depending on the education and experience of the doula, and can range anywhere from $250-$1,500.

At CHOICES IN CHILDBIRTH, I charge a flat fee for my birth doula services. My fee covers all prenatal visits, the entire birth, 1-2 postpartum visits, birth and/or newborn photography and unlimited phone and email consultations.  If you would like specific information on the fee for my birth doula services and would like to find out if you are in my geographic range to utilize my services, please contact me here or email me.

DOULAS...HELPING WOMEN TO HAVE A JOYOUS BIRTH EXPERIENCE

Written by Victoria Macioce-Stumpf for DONA International

Since the beginning of time, women have assisted each other during the arduous process of labor and birth. When birth moved from the home into the hospital setting in the 1930-40's . . . many of the time-honored and traditional elements of giving birth were lost in this new medicalized setting. The first loss was displacing the midwife as the primary medical caregiver for the pregnant woman and replacing her with an obstetric specialist. The second loss was removing the loving assistance that female family members and friends used to give the pregnant woman during the birth.

There never used to be a formal name for these special women that assisted at births . . . and there certainly wasn’t an entire profession built around this concept as there is now. Doulas have always played a role in births, but many women were not even aware that they were providing this service until recent times.

Labor support is the time-honored tradition of loving and nurturing assistance for the laboring woman by a woman that is experienced in birth. As our society has evolved to recognize importance of emotional and physical support by the woman’s birth partner, it is slowly beginning to recognize the importance of the emotional, physical, informational and spiritual support that Doulas can offer, and the unique perspective that only knowledgeable, wise women experienced in birth can give the laboring woman.

This does not, in any way, downplay or diminish the role that the woman’s birth partner has at the birth. Quite frankly, the woman’s partner is irreplaceable in many ways. It is important to remember and appreciate the fact that no one in the labor setting knows the pregnant woman as well as her partner. No one else can love and cherish her like he does. No one else can replace the confidence, trust and knowledge of her that only he can have. After all, it is his baby that is being born as well as hers. This is the beginning of their family. Like the midwife or doctor, the doula’s role is a temporary one, the partner’s role is permanent.

With that in mind, it is up to the doula to find a common ground and create an atmosphere of confidence and trust that enables her to work together harmoniously with the pregnant woman’s partner. Sometimes, if the partner isn’t very knowledgeable about labor or birth, she can lead by example. Many of the physical comfort measures are simple to perform, but many men aren’t knowledgeable about what does or doesn’t feel good during painful uterine contractions. By utilizing position changes, massage, music, a calm and soothing voice, continuous emotional and physical support and verbal encouragement, a doula models the appropriate type of support that women need from their partners during labor and birth.

It is difficult for the woman’s partner to pick up a great many ideas for labor support from traditional hospital childbirth preparation classes. That is an additional benefit to having an experienced and knowledgeable doula at the birth. She is there to remind both the laboring woman and her partner of various coping mechanisms, which can relieve them of the burden of trying to remember everything.

The doula can also be a liaison between the hospital staff and the couple. Many people feel overwhelmed by the strangeness of the hospital setting--unfamiliar faces, different medical staff coming and going, the disinfectant smell, the bright lights, the various medical technology that may be used during the labor, and their surprise at being left alone in the birthing room for long periods of time while their nurse periodically checks in. Many couples assume that their nurse will be in their room continuously and provide the type of hands-on care that doulas provide. Because of staffing shortages and the volumes of paperwork their work entails, this is usually not the case, as most nurses typically have more than one patient to take care of and many responsibilities outside of the LDR room. The doula bridges this gap in care by being there continuously. In a typical birth, the doula is with the couple from early labor until an hour or two after the birth, regardless of how long the birth takes. The doula is rarely relieved of her duty, except for bathroom breaks. Because of this continuity, the laboring woman derives a great deal of comfort from the doula. There is no need to keep explaining her preferences for the birth or how she likes to have her back rubbed---her doula already knows because she has been there with her all along and she will stay until the baby comes.

With her expert knowledge of birth, the doula can also help the couple by providing explanations of medical procedures or terminology, including the pros and cons of various interventions if the couple is unsure of anything. If anything unexpected arises, the couple has an extra resource on hand to provide explanations and reassurance.

Indeed, much of the value of having a woman who is experienced in birth with you in labor is derived from her empathy and understanding of what the laboring woman is going through. She not only understands what the laboring woman is feeling, she is able to reassure her that the powerful and painful sensations of labor are normal and necessary for the baby to be born. She can reassure her that the pain of labor is for a unique purpose and will not last forever. She also helps to remind the new mother of the joy that is ahead. . . her baby.

When it is difficult to physically cope with contractions, a doula can create a safe haven for the woman to do whatever she needs to do to cope--dimming lights for relaxation, drawing the curtain across the door for privacy as medical staff enters and leaves frequently, putting on nice music to soothe the laboring woman and keep the hospital noises at bay, keeping visitors and phone calls to a minimum, and utilizing touch relaxation or massage to keep the laboring woman as relaxed as possible.

A doula provides other physical coping measures such as encouraging the woman to urinate frequently, helping her to change positions regularly, utilizing the shower or bath for comfort, reminders of drinking and eating to stay well-hydrated and nourished for strength, and helping the laboring woman to alternate between rest and activity to keep labor progressing.

The loving and nurturing care that a woman receives from her doula when she gives birth has been shown by research to have a positive impact on the type of mothering she gives her newborn baby and her sense of self-satisfaction after the birth. Other research findings: lowered cesarean rates, less requests for pain medications, reduction in the use of forceps or vacuum extraction and higher breastfeeding rates.

These are tangible benefits to the loving assistance that doulas provide. The other benefits that aren’t as noticeable but are just as important: strengthening the bond between the laboring woman and her partner, increasing the new mother’s satisfaction with her partner’s assistance, and encouraging the new mother to bond with her newborn, which creates many physical and emotional benefits for both the mother and the baby. In life, finding purpose and value in what we do every day is difficult. For myself, finding purpose and value in my work as a Doula is simple. Being a doula isn't just what I do...it is who I am.

Being a doula is so much more than providing continuous emotional and physical assistance to a laboring woman. To me, being a doula means helping to provide a foundation upon which a new generation of mothers and fathers can feel supported and confident in their roles as parents. I firmly believe that my work as a doula assists couples in having a more rewarding birth experience, and that is the greatest satisfaction of all.