Doulas, Birth Plans, and Perceptions of Labor

I’m 3 days away from being full-term (well more accurately, baby is) and my due date is fast approaching. We’ve also been taking a childbirth class that has us actively thinking about our wishes, goals, and strategies for labor and delivery. During our very first class, the instructor informed us that we’re allowed 2 support people at the hospital and that she strongly encourages it. She also mentioned doulas. I was familiar with what doulas are and what they offer, but I had thought of it as an unnecessary expense, a luxury. When I started thinking about how J will have to leave on occasion to tend to his diabetic needs, the idea of a second support person started to sound much more important. Because we don’t have family here and my closest friends live far, far away, a doula seemed like the best and most realistic option. Also, the fact that she’d be trained in how to help women (and their partners) through labor is a bonus because we are newbies to this whole experience and it may not go down how we’re anticipating it will.

I scoured the internet for local doulas and contacted a bunch to see if they are available (I was cutting it quite close to the due date so I was just hoping somebody would be). Five women responded saying they are available and, based on what I had read, we interviewed the first 3 who had responded (they were 3 that appealed to me most from their websites as well). We just had our last interview last night and now I’m trying to decide. J said the decision is completely up to me because he wants me to be as comfortable as possible and he doesn’t want to sway me. Of the 3, I’m really trying to decide between 2 and ironically they are each other’s primary back up doula in the event that they couldn’t attend the birth for some reason. It’s hard to decide though and the thought of “rejecting” the other 2 is also hard. They assured us that they are a close knit community of friends really and there’s no competition or hard feelings among them, but it’s still hard to explain to someone why you didn’t pick them, especially if the reason is that you just clicked with someone else (by default it sounds like you’re saying that the “rejectee’s” personality just wasn’t good enough). I personally clicked the best with Doula A. She was outgoing, friendly, and kind of bubbly. I could see her being really hands-on, positive, and vocal, but she is going on vacation 12 days after my due date so she wouldn’t actually be around for the typical promised 2 weeks on either side of the due date. At the same time, it’s customary to induce if a woman is 10 days late here. Doula B didn’t immediately stand out but I quickly warmed to the idea of her a few minutes after she left. She was the most professional of all 3, as she brought a folder with some general pamphlets on doula services, as well as samples of her contract and confidentiality agreement. The folders were printed with her logo, which was a nice touch. I definitely appreciate professionalism. She was very kind, but more soft-spoken. So I was a bit concerned that she might not be as assertive in suggesting new strategies or changes to what we were trying. I emailed her with follow-up questions though and she seems willing and able to change up her approach based on our preferences and she stated that her approach might even change throughout labor depending on what I need from her at a given stage. That seems reasonable. So now I’m a bit torn, but I’m leaning toward Doula B. She also has a TENS unit, which keeps being brought up when I read about natural labor comfort measures and, as a physiatrist, it’s something my dad recommends to patients dealing with pain from their injuries. Doula C who I have 99.9% ruled out (not because there was anything wrong with her, but she just didn’t stick out to me and I felt much more reserved with her) has the most experience (34 births attended compared to 6 and 7), but as the doula isn’t the one delivering the baby, I’m not really fussed about that. Also, Doula C is certified whereas Doulas A and B are in the process of getting their certification (although it’s just a matter of paper work for them both). As a result, Doula C costs as much as Doulas A and B combined. Although it’s not the deciding factor, it definitely plays a role when I’m just not feeling Doula C as much.

Part of having a doula is discussing your birth preferences. I wasn’t originally planning to make a Birth Plan because unlike my typical type A approach, I was comfortable with the fact that you just can’t control birth. But, a friend mentioned her Birth Plan, which she called Birth Preferences, and offered to share it with me. I figured it couldn’t hurt to look at it and then I realized the value in specifying our preferences but also recognizing that everything might go out the window if there is an emergency. I modeled my preferences off my friend’s. My main goal, aside from a safe and healthy delivery, is to do skin-to-skin immediately and breastfeed as soon as possible after delivery. Anything that helps that is a pro and anything that hinders it is a con. I would like to try natural labor, but having NO clue what it will actually feel like, I might ask for an epidural fairly quickly. I’m not going to beat myself up if I do, but I want to see if I can cope by other means first. There are a few risks and downsides to the epidural that it would be nice to avoid, but they are pretty mild or extremely rare. I always thought I would jump right on the epidural train, but when we were TTC, I watched The Business of Being Born and it made me think of labor and delivery as an experience rather than something to endure, so it got me re-thinking what I would want from the birth process. I guess that’s why I want to see what it’s like without the epidural first. I also try to remind myself that many women all over the world have no choice but to deliver without medication or other modern supports and they survive. I remember this book I had to read for an anthropology course (Nisa: The Life and Words of a !Kung Woman) and the woman quietly went away from her tribe, leaned against a tree, and delivered her baby on her own, before carrying her baby back to her people like it was no big deal. I certainly won’t be taking that approach, but it helps calm my fears and restore faith in my body’s ability when I think about it. In the moment though I might tell Nisa to go f*ck herself!

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2 thoughts on “Doulas, Birth Plans, and Perceptions of Labor

  1. Go with the flow was my birth plan, too. I ended up with an epidural, but I don’t beat myself up over it. You know what you can handle.

    Good luck choosing a doula!

  2. Developing some sort of birth plan is always helpful, even if nothing goes according to plan. In my book, I discuss creating a “dream birth plan” aka a plan that incorporates all of your hopes and dreams for an ideal birth. Whether that means laboring on a beach or maybe having a deceased relative present, it will allow you to realize the parts of your dream birth that are most important to you. That way, even if many of the dream birth ideas seem impossible, you can take elements from the plan that give you inspiration during your actual birth, such as aspects of nature or mementos of important people in your life.

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