Pros and Cons of Doulas | Benefits of Hiring a Doula | Why Get a Doula?
Hi there!
Allow me to start off by saying I am biased as a doula of almost 7 years, but i also know doulas come in all shapes and sizes of experience/expertise/tact. I know doulas who I would never want to be in my birth room, and I know brand new doulas who haven’t been to more than a handful of births that I would love to have with me for my own.
I hired a doula myself, so when I was thinking about writing this article I tried to put myself back in those shoes.
I also have total compassion towards folks who do not want a doula in the room- I still hope you have an awesome birth.
Brass tax- what the studies say!
“Excerpt from Evidence Based Birth: In a 2017 Cochrane Reviewed Study looking at the Benefits of Doulas…
25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff”
Pros and Benefits of Doulas
Doulas:
Lower Anxiety
Decrease risk for cesarean section
Improve outcomes for mom and baby
Decrease risk for episiotomy, and need for pain relief
Lead to a more positive view/perception of birth experience
Decrease Pain
Improve contraction strength and effectiveness with their suggestions
Decrease stress reactions
Help labor to progress faster than someone without continuous support
(Evidence Based birth) “(Ravangard et al. 2017). They randomly assigned 150 first-time mothers to doula support or no doula support and used standard questionnaires to measure anxiety and pain levels. They found that on average, the mothers who received doula support had less anxiety and lower average pain scores during labor. The authors concluded that the doula’s presence has a clinically meaningful impact on anxiety and pain levels in first-time mothers giving birth. (Evidence Based birth)
(Evidence Based birth) Swedish oxytocin researcher Kristin Uvnas Moberg writes that the doula enhances oxytocin release which decreases stress reactions, fear, and anxiety, and increases contraction strength and effectiveness. In addition, the calming effect of the doula’s presence increases the mother’s own natural pain coping hormones (beta-endorphins), making labor feel less painful (Uvnas Moberg, 2014). (Evidence Based birth)
(Evidence Based birth) Doulas are a form of pain relief in themselves (Hofmeyr, 1991). With continuous support, laboring people are less likely to request epidurals or pain medication. It is thought that there is fewer use of medications because birthing people feel less pain when a doula is present. An additional benefit to the avoidance of epidural anesthesia is that women may avoid many medical interventions that often go along with an epidural, including Pitocin augmentation and continuous electronic fetal monitoring (Caton, Corry et al. 2002). “(Evidence Based birth)
Cons and Myths Of Doulas
First of all: I would like to address a popular pros and cons of doulas blogger (L&D Nurse) or if you are an L&D nurse or nurse/OB/someone who encourages people to not hire doulas just because they want an epidural.
First, I am sorry. I am not surprised at the hostility you show, it sounds like you've had some poor experiences with doulas and that you mostly compared your professional experience to doulas.
The experience of doulas varies greatly but it isn't more valuable or less professional than L&D nursing or OB or Midwifery it is different. Of course there is the absolutely important job of keeping everyone safe and healthy, we truly believe amazing medical providers are essential to this.
What we cannot do is speak to the experience across the board, doula trainings vary greatly, and as someone who loves continuing education- I can assure you that my training was maybe 3-5% of the knowledge I have.
Con/Myth: I don’t need a doula because i have a nurse or if my hospital has “staff doulas”
There is a small issue with a conflict of interest that we sometimes see with hospital doula groups and patients just relying on their nurse to support them- the hospital pays you to do your job. Which is full of bias and not always in the patients best interest (even though we think it may be the only option, have we offered alternatives, given choice and explanation?) how many times have you seen someone not given informed consent, or maybe you had to be quiet so that you don’t disturb your relationships professionally, maybe you or a colleague sat back and watched obstetrical abuse.
Con/Myth: A doula will question my care staff
A great doula encourages families to make decision for themselves, ask questions, get curious about options and benefits and risks. Great doulas do not sway the family away from the medical options- they help the patient get curious. Of course we will be firm and advocate if someone is going against consent or being harmful. We love being the doulas that providers know they can work well with. We encourage conversations, get the whole care team on the same page to meet your goals, and help you work together.
What makes a “Great doula” and how someone finds a great doula are the more important questions. We know that doulas improve outcomes, and create better experiences during birth for parents and healthier babies.