Folks, I have decided on a doula. I am actually pretty excited about it! A lot of people I’ve talked to have either never heard of a doula, or they don’t really know what a doula does. It’s easier to just post a link rather than try to explain myself, so here: doulafoundation.org/faq.php – FAQs and some basic info.
First time I ever heard of a doula was when I was in college, and my Mary Kay Director often talked about her doula since she was pregnant at the time. (Side note: I did the MK thing for a year or two…it was fun, and I made some extra $, but I just couldn’t manage my time to do it along with everything else.) After I got pregnant, I remembered hearing about doulas before, but I kind of dismissed the idea as just sort of an extra thing that I wouldn’t bother with. I guess I never totally shook the idea because, when a facebook friend (in another state) posted about her sister having a natural childbirth in the hospital with the help of a doula, I started looking for more information and thinking more seriously about it.
Kind of going on a tangent here, but yeah, I kinda want to try for the natural childbirth thing. I’ve kind of laid low about that because mentioning it usually gets me one of two responses:
1) “WHY??” / “There’s this thing called an epidural now, embrace the comforts of modern medicine!” / (look at me with raised eyebrow and/or like I have three heads);
2) “That’s what you say now….” (or something to that effect)
(And then there’s the smaller percentage of people who say yeah, it’s rough, but it CAN be done!)
I’ll address #2 first because it’s easier. Yeah, I say that now. I may change my mind in the middle of things, and I recognize that. I know a lot of pregnant chicks say they’re going to go med-free and then change their minds. I plan to keep my options open. I will still meet with an anesthesiologist, learn as much as I can, and go from there. There are a number of factors that might make me lose my resolve sooner than others, such as being induced, growing an enormous baby, etc. And I guess there are cases, depending on the situation, where an epidural actually helps the labor progress. And I’d certainly prefer epidural anesthesia if I end up needing a cesarean. So. I’m not closing the door on an epidural, but I’d like to avoid it if I can. Which brings me to #1….
Why on earth would I consider L&D without anesthesia when there are other options now (with widespread use)? I don’t know if I can even answer this in writing to do justice to the thoughts swirling around in my head. But I will try. I just can’t bring myself to be comfortable with the idea of an epidural, even though plenty of medical professionals (those I totally respect and trust) might tell me my thoughts are unfounded (if not ridiculous?). I’m not afraid of needles, but there are other issues with epidural anesthesia which kinda bother me.
– Sometimes they get you so numb, you can’t feel anything. Not even the urge to push. This is one of the first things that kinda got me thinking. Am I afraid of pain? Of course! What sane person isn’t at least a little afraid of pain…especially if she’s never experienced it before, it’s more intense than anything that has ever happened before, and there is nothing to compare it to? (Ok, the “pull your lower lip over your head…that’s what giving birth is like” analogy is pretty funny.) So yeah, being honest, of course I’m nervous about that. But the thing that scares me even more than guaranteed pain is not being able to feel my body’s clues as to what to do, when to do it, etc. I know not everyone gets anesthesia so strong that she can’t feel anything. Maybe it’s the exception to the rule. But it makes me nervous. I don’t want to have to rely on nurses and monitors just to know when to push. Without an epidural, from what I hear, the urge to push will be very strong.
– SOME folks say that epidural anesthesia increases the likelihood of a cesarean. I don’t really know for sure. My education is in science; I believe in science-based medicine. I have seen studies indicating yes and studies indicating no. Honestly, I’m too lazy to get down and thoroughly analyze the merit of the studies themselves. I just know I’d rather not take any chances. I mentioned in another post, I really really do not want a c-section. For a number of reasons, most of them admittedly selfish. One, the longer recovery time would present some challenges. Two, my specialist gynecologist in St. Louis (when I was still seeing her) pointed to some anecdotal evidence that my pain issue may be improved by the stretching that occurs with vaginal delivery (that got better, then worse again with pregnancy…always hoping and praying that will soon be a thing of the past). That’s the main thing, I admit. Three, someone feel free to educate me…I vaguely remember learning something in college about something possibly different in development for little ones born by cesarean.
– From what I can gather, studies pretty much agree that (in general) having an epidural increases the length of delivery, increases the risk of requiring a forceps or vacuum delivery, and can result in more severe perineal tearing. None of those sound especially awesome to me. Maybe the risk of some of these negatives I’ve mentioned is still pretty small. But…I’m not a gambler. At least when I’m sitting comfortably on my futon with childbirth (hopefully) weeks away, I am not a gambler.
– Even though millions of totally perfect, healthy, smart babies are born with an epidural, I just can’t make myself feel comfortable knowing some of the drug (really, any anesthesia) will cross the placenta, unnecessarily medicating my baby.
– Some folks say that epidural anesthesia results in a less alert baby who is harder to feed immediately after birth. I know many doctors and nurses believe otherwise. So I don’t know, that’s a question I suppose I need to ask more about.
So. Do I think anything less of people who choose the epidural? No way, I totally get why most people choose to have it. I might even end up being one of them. But these are some of the reasons why I really want to at least try to go without.
Wow, that was a really long tangent. Back to the doula thing. Maybe it can depend on who you ask, but apparently, having a doula present decreases the overall cesarean rate by 50%. Knowing this is part of what made me think more seriously about having a doula. If I still end up with a cesarean, that’s okay. Ultimately, I want a healthy baby. But if there’s anything about having a doula that might reduce that chance, I want to try it. Of course there’s never any guarantee. If I end up with a c-section, it’s not because I did something wrong, and it’s definitely not because the doula did something wrong. I just don’t want to end up with a cesarean, then reflect back on the birth and think, “Hmm, I wonder if it would have been different if I had the doula?”
After I started learning more about it, the more I liked the idea. I’m only going give birth to this child once, so if there’s anything I can do to make it a more positive experience, then why not do it? A doula can help with some pain management and comfort techniques. She can help with the emotional side of things as well. She can also help Pete by telling him “that’s normal” and getting him more involved with helping me. (I am confident Pete will be amazing support in L&D, but I don’t know if he fully grasps the extent to which he’ll be involved and how taxing it might be for him, even though I’m the one actually giving birth. =) So as awesome as I KNOW Pete is, it gives us both peace of mind to have someone like an “expert supporter” who has been there before (several times) to help us.
I also like the idea of having someone to help be my brain. I don’t exactly expect I’ll be at the top of my game after this is all over. I’ll be pooped, and my mind will probably be either completely dead or totally swirling. A doula will know what I hope the birth experience will be, at least under ideal circumstances, and she can help to see that my wishes are known and realized, at least as much as possible. She can help me get that “skin to skin” contact after the birth and help with breastfeeding at the beginning. Even following the birth, I can go to her with questions.
So after deciding all of that, I didn’t really see how I could NOT have a doula and feel as comfortable going in as I would having this child WITH a doula present. But there was one hangup: money. Doulas put in a lot of hours. A lot of consecutive hours. Odd hours at that. From the sounds of it, they are certainly deserving of their fee. And I have a feeling, after I have my little girl, I will think my doula is worth her weight in gold and then some. But still…with all the other essential expenses associated with having a baby, it can be hard to justify an expense that might be viewed as non-essential. Especially with an unemployed husband (though we are still very blessed to afford a house, the necessities, and a few fun things), medical insurance going haywire (at least part of it…I really hope that’s getting lined out with my agent), and no paid maternity leave. I had pretty much decided I was going to go for it anyway. Because, for all the aforementioned reasons, I just couldn’t imagine not having a doula anymore. But I was still a little restless about the decision.
I was planning to confirm with Pete (though he’s been on board since the beginning, he pretty much left the final decision up to me), then call the doula tonight. However, on my way home, our awesome doula called me and offered to take her fee down a bit since Pete is unemployed. When she said that, I felt so relieved. Like I finally felt totally at peace about the decision. I don’t question it even a little bit anymore. Though I do kind of feel a little guilty that she’s doing this for us. Because of my work, I know what it’s like to wish you could cut everyone a break. I enjoy my job, and I love helping people see. But in the end, it’s still a business, and you just can’t do that. If Pete gets a job between now and then, we will totally pay her the usual fee. But right now, her offer is a tremendous blessing.
Backtracking a bit…. When I was still looking for a doula, I actually facebook-messaged my former MK director asking her about it. This particular one came highly recommended. =) I spoke to the doula on the phone one night, and she was tremendously helpful, providing information about doulas in general. She encouraged me to interview other doulas before making a decision on one.
I looked on the DONA website to see about any other doulas in the area. But it is really hard to just choose from a list of names without knowing much else about them. So I did something some might find creepy…but I think it’s what most people would do in 2010! I looked everyone up on facebook, haha (I swear I’m not a stalker). A couple of them weren’t on there, and a couple of them (understandably) have their profiles pretty locked down. After doing that, there was one other person that stuck out to me, so I gave her a call. I really liked her, but she seemed extraordinarily busy, and I kind of got the feeling she was trying to talk me out of using her. So even though she’s probably a great person and a great doula, I didn’t feel as good about it. So we interviewed the first doula Monday night, felt great about it, and now here we are! I’m sure she will be awesome.
I was going to write about some other random things I forgot to write about before. But this is already WAY LONG, so I’ll save it for another time. =)