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Advice to moms-to-be on childbirth methods

In “The Birth That's Right for You,” doula Lisa Gould Rubin explains the different options and what's best for you and your baby. Read an excerpt.
/ Source: Weekend Today

Labor Support:  Is A Doula Right For You?
You want the epidural as soon as you get to the hospital. You want to labor in the tub at the birth center. And you are keeping your options open — you’ll see how you feel when you get there. However you picture it, you need to be able to rely on everyone who will be in that room with you to support your goals and meet your needs.

But when that big day comes, will the doctor you like be there or one of his or her five partners? Will the nurse on your shift be your lifeline or Nurse Ratchet? Do you want your mother, your sister or your best friend with you in the labor room or is that the last thing you’d want? Are all these variables leading you to consider hiring a doula?

“The Birth That’s Right For You: A Doctor and a Doula Help You Choose and Customize the Best Birth Option to Fit Your Needs” helps you figure out if a doula should be part of your labor support team. Here’s an excerpt:

OK, we think it's a strange word, too. Even though one of us is a doula, she still can't get used to calling herself that. But remember what we told you about most physicians not actually laboring with you and having whoever happens to be on call show up at your delivery? Remember what we said about it being just plain luck of the draw when it comes to who will be your labor nurse? Here's where the doula finds her niche. While a doctor's or midwife's primary responsibility is the medical well-being of both mom and baby, the addition of a doula brings continuous emotional and hands-on labor support throughout the entire labor and delivery. Studies show that this kind of support significantly shortens the length of labor and reduces the need for pain medication, medical interventions, and cesarean deliveries.

A labor doula is childbirth lingo for a person who gives continuous support throughout labor and delivery. While some doulas have gone through certification programs, others have not. Whether or not she's certified, in order to be a seamless member of your labor support team, a doula needs to have a firm understanding of what's going on clinically as well as enough experience working with doctors, midwives, and hospital staff.

A doula's support can begin before you even get to the hospital. She helps you figure out if you're in labor, helps you find ways to labor comfortably and effectively at home in early labor, and can help you decide when it's time to go to the hospital. Once you get there, she's with you all the way through your labor and delivery, providing many things: constant reassurance, strategies for both pain relief and keeping your labor progressing, keeping you and your partner aware of where you are in the process, and acting as a sounding board when it comes to making choices. Generally, most hospitals will allow two people at your birth. If your spouse or partner is one of them, your doula fills the other slot. Insurance companies do not as of yet cover doula services, although doula services can qualify under Flexible Spending Accounts. Check to see whether your employer offers this tax-free program for medical expenses.

Ask yourself these questions to figure out if having a doula at your birth is right for you and/or whether the doula you've selected matches up:

  • Is it important for you to know that you'll have one familiar person with you throughout labor and delivery?
  • If your doula is part of a group or works with back-up, are you comfortable with them?
  • Are you concerned that the doctor you like won't be on call or you'll wind up with a not-so-great labor nurse?
  • Are you worried that your spouse or partner might not know what to do for you? Or, do you want your spouse or partner to do what he or she is comfortable doing and have somebody else take care of the rest?
  • Are you hoping to avoid pain medication by relying on different comfort strategies? Or, do you want to make sure you get medication when you need it and have help figuring out what's right?

How to Find a Doula

  • Ask friends who've had babies.
  • Ask your doctor or midwife, who may have a list of doulas that they have worked with.
  • Contact Labor & Delivery at your hospital for referrals.
  • See if your hospital or birth center has doulas on call (you pay a set fee, which is generally less expensive than hiring an independent doula, and you get whichever doula is on call at the time you come in).
  • Check with national certifying organizations such as Doulas of North America (DONA) or Association of Labor Assistants & Childbirth Educators (ALACE) for doulas in your area.

If you do decide to hire a doula, it's imperative that she feel right for both you and your spouse or partner. It is also important that she see herself as part of a team, working together with you, your spouse/partner, and the hospital staff instead of promoting her own personal childbirth agenda. Her main role is to help you accomplish whatever it is that you want for yourself.

Excerpted from “The Birth That's Right For You: A Doctor and a Doula Help You Choose and Customize the Best Birth Option to Fit Your Needs,” by Amen Ness, M.D., Lisa Gould Rubin, CD, CCE and Jackie Frederick-Berner. Copyright 2006, Authors. All rights reserved. Published by McGraw-Hill. No part of this excerpt can be used without permission of the publisher.

For more information, check out .

For more information on doulas and/or to find one in your area:

Association of Labor Assistants and Childbirth Educators (ALACE)(888) 222-5223 or (617) 441-2500

Doulas of North America (DONA)(888)788-DONA

International Childbirth Education Association (ICEA)(952) 854-8660

Lamaze International(800) 368-4404 or (202)