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Tuesday, March 29, 2016

Hiring a Doula

The first thing I did immediately after finding out I was pregnant was hire a doula. I knew I didn't have family out here in L.A. and I really wanted to create a good support system for myself and Kyle. After rave reviews, Kyle and I met with Katie Hamilton of Mama Nuture who is a certified doula, childbirth educator, and lactation consultant. We immediately knew she was going to be the right person to help us through this new, yet overwhelming ride we were about to embark on!

Now you may be asking yourself, what is a doula? Are they necessary? Do I really need one? Everyone is different. But Katie has so kindly answered some questions for our I Guess I'm Due readers to find out if hiring one is right for you!

1. Many of my friends have no clue what a 'doula' is when I say the word. The only reason I do is because I was told to watch The Business of Being Born. So first things first, what exactly is a doula? 

Women have been supporting women in pregnancy and birth long before modern hospital births. Today, this integral role of a compassionate, trained, professional by the mother's side is becoming increasingly popular. Birth doulas attend home, birth center, or hospital births and stay by the laboring couple's side during the most intense parts of labor and birth. Postpartum doulas support families in pregnancy and postpartum periods as they transition into their new roles. A doula provides physical, emotional, and informational support, in varying degrees, tailored to the individual family's needs. Many doulas are childbirth educators, some have additional skills that they bring to their craft such as lactation support, placenta encapsulation and birth photography. Simply put, doulas help protect their client's birth vision. 

2. Now is a doula covered by insurance or how does the pricing work? 

Katie: A doula's fees vary depending on their level of experience. Some of a doula's fee covers the time spent in labor, correspondence throughout pregnancy, and the commitment to always being on call during the "due" month. There are insurance companies that have now began to cover doulas. For the past 20 years, studies have cited that doula care can reduce the need for c-sections by up to 80%. A doula can provide women a shorter labor with fewer complications, reduced need for pitocin, less use of forceps, less use of epidural anesthesia and fewer cesarean births. Doulas benefit maternal and infant health and overall insurance costs. As this research becomes more widely accepted, we are likely to see an increase in insurance coverage. 

3. I've been strangely calm about this whole thing with no anxiety, which I think is in part to our visits where you make me feel educated and not alone. Would you say this investment is more like an investment in peace of mind? 

Katie: Yes! Peace of mind is a huge benefit of the doula investment. Being educated and gathering the right team is invaluable in helping the laboring woman let go and surrender. It's vital that she and her partner feel safe and supported. Research shows that fear leads to longer labors. Mental stress is associated with a heightened physiological state. High levels of stress hormones may also weaken uterine contractility, thereby prolonging labor.

4. So of course you provide services to the mother, but how does this help dad out too? 

Katie: Partners love doulas. A common myth is that the doula could take over the role of the partner. Especially in the hospital setting, the laboring woman often desires advocacy, emotional support, physical support, and sometimes even a bouncer at the door! Much of what a doula does is normalize birth through all it's various stages. This can be incredibly comforting for the partner. The support persons feel like they can participate at their own pace and in their own way. They know what to expect ahead of time, they have tools, and they can take a quick nap without feeling guilty. They can be present without taking on all the responsibility for labor support. Birth is a transformative experience for the partner as well as the mother, and the doula helps protect that experience. I've received some of my most grateful yelp reviews from Dads and partners. 

5. When it comes to "labor day", can you paint a picture of what that will look like for us and when you services are complete?

I attend home births, birth center births, and hospital births. While I have supported cesareans, inductions, preterm labor, most of my clients having hospital births have the opportunity to stay home as long as they like. In our prenatal meetings, I give my clients tools for early labor. The media depicts labor coming on painfully, and hard and fast. While this is a possibility, most first time mothers have a long early labor, and lots of warm up labor that can go on for days or even weeks. 

A big part of my role is teaching that labor is a process. If you can time your contractions yourself, you don't need to be timing them. Instead, sleep, nap, eat, walk, play, get intimate! It might be early labor, and it might not. Take each surge one at time. Trust the are not sick, you are having a baby. I come to the house when needed, which is most often a 3am phone call. Sometimes the family needs a pep talk, some massage or a game plan and then I come earlier in labor. Most of the time I arrive in active labor. I have a Mary Poppins sort of "bag of tricks". Sometimes I use them all, other times I'm just holding space as the mother labors silently or her partner sways with her. There are plenty of signposts in labor that help us understand that labor is progressing. Many of my clients arrive at the hospital between 6 and 10cm dilated. Of course L.A traffic plays a sometimes we leave early. Environment is so key to to maintaining peace. I like to make the transition from home to hospital as seamless as possible. What's been working at home we bring with us. 

Labor can change from minute to minute. What is supportive to a woman one minute isn't the next minute and so there is lots of intuition involved as we navigate the labor dance together. Along with the birth plan, I bring a birth ball, massage techniques, position suggestions, aromatherapy, and plenty of evidence-based information to the table. Having a doula is like having a "secret menu" in the hospital. After the birth, I stay until the family is settled for the night or day ahead. In the days postpartum I am available to answer any breastfeeding questions or concerns and I follow up with a postpartum visit. I have clients that still reach out in the months and even years after their birth. This year is in fact my year of repeat clients, and I'm loving it!

 Thanks for sharing Katie! Be sure to show her some love on Facebook as well! 

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