“This is what my client needs to feel comfortable,” Mandee explained to staff when she presented them with Jenna’s prepared birth plan. “How can we make this a good experience for her?”
Jenna experienced PTSD related to a past hospital stay, so the idea of having her baby in a hospital caused anxiety she wasn’t prepared to face alone. But with Mandee as her doula, Jenna could begin to prepare herself for the birth of her new baby.
Mandee accompanied Jenna on three tours of the hospital, walked with her through the hallways, introduced her to nurses and other staff, and helped her explore the delivery rooms. She explained Jenna’s PTSD to the nursing staff and asked them to work together to make Jenna feel more comfortable in the hospital environment. Jenna’s birth plan requested that few people be present in the room at any time, that staff ask for consent before touching Jenna, even during routine procedures like checking monitors and IVs, and that a specific nurse with a particularly mellow personality be assigned to Jenna during her delivery.
It is a doula’s job to tactfully advocate for her client mom throughout her pregnancy and the birth of her child. Mandee spends time discussing options with her client moms and lets them make their own decisions about their birth experiences. Then Mandee helps communicate her clients’ wishes and expectations to medical staff.
Mandee often approaches the hospital staff to help negotiate during a mom’s labor and delivery. “What would it take to get Mom off the monitors for half an hour and take a walk?” Mandee suggests when walking may help speed up a mom’s slow labor. “What would it take to wait another hour before starting Pitocin?” But Mandee encourages each mom to express her own needs and expectations to staff so she feels she is the one in control of the situation.
“You are the client paying the health care provider for a service. It is your birth,” Mandee reminds her clients. “You have options. You can walk out anytime and go somewhere else. You can request a different doctor. You can transfer to a different hospital. You can refuse or accept any treatment.”
“If you went to a restaurant and didn’t like the food, you would ask for a manager or go to a different restaurant. You can switch to a different medical provider if you don’t feel confident in your level of care.”
Mandee approaches such conflicts in a graceful and tactful way during a time that can be scary and intimidating for a mom in labor.
This ability to resolve problems gracefully is an important trait for moms to identify when hiring a doula to help in the delivery room. Mandee describes several characteristics moms can look for when shopping for the right doula.
- The right doula will be tactful when handling conflicts and making suggestions.
- She will be able to offer solutions and ideas for any possible problems before they arise.
- A doula will listen to Mom’s preferences and not try to force her own agenda.
- She will work to maintain a pleasant, calming atmosphere.
- And a great doula will have a good reputation with hospital staff.
Mandee suggests several actions moms can take when interviewing and hiring a prospective doula.
- Ask for references, and call the doula’s former clients.
- Ask those former clients: “How was your birth experience with this doula?” “How did she interact with medical staff?”
- Take a prebirth tour of the hospital. Ask staff about their interactions with the prospective doula.
- Make a list of questions to ask the doula. Some questions to ask may be: “What relaxation techniques do you use during labor?” “How can you support me?” “How can I feel empowered throughout this process?”
- Ask about concerns specific to your situation. A doula should have the resources to work through problems and find possible solutions before arriving in the delivery room.
A doula is hired by the client mom, not the hospital, so payment for services is made directly to the doula. “A doula shouldn’t ask for the balance paid at the first meeting,” Mandee advises. Mandee meets with the mom for a free consultation, then asks that a deposit be paid when she and the mom agree to work together. She allows moms to make payments to her throughout the pregnancy, with the balance paid off by 36 weeks.
Doula services are generally covered by health savings accounts and by insurance programs in some states. Mandee requires that payment is made to her directly, then she provides paperwork for the mom to file a reimbursement claim with her insurance company.
Moms like Jenna can take many steps to relieve any worry and tension before labor and delivery. Talking with a doula, building a positive relationship, exploring hospital hallways, and connecting with hospital staff all contribute to making childbirth a more comfortable and positive experience.
“If you don’t know your options, you don’t have any,” Mandee explains. “Educate yourself. If you don’t know what you can change, you can’t change anything, so know your options and decide what’s right for you.”
Several online resources help moms make informed decisions and find the right doula for their childbirth experience. Check out: Doulamatch.net, Findadoula.com, and The International Childbirth Education Association.
What questions could you ask before hiring a doula? How will hiring a doula make a difference to your birth experience?