March 29, 2025 • 38 mins
The word doula in Ancient Greek might mean "female servant" but it's really not a great description of the 21st century job. Doulas are birth coaches who help women get through the process of childbirth as efficiently and painlessly as possible. They aren't midwives or nurses, but they can provide an invaluable service as advocates. Learn about the deal with doulas right now in this classic episode!
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Speaker 1 (00:01):
So what's the deal with doula's everybody?
Speaker 2 (00:03):
That's my question to you on this wonderful Saturday morning.
This one goes back to December twelfth, twenty seventeen. Doula's
do great work. They're wonderful people, and they bring babies
into the world. So I hope you enjoy the deal
with doula's.
Speaker 1 (00:24):
Welcome to Stuff You Should Know, a production of iHeartRadio.
Speaker 3 (00:34):
Hey, and welcome to the podcast. I'm Josh Clark, and
there's Charles w Chuck Bryant, and there's Jerry over there,
and this is Stuff you Should Know, the podcast Childbirth Edition. Yeah,
we are trapsing into more territory.
Speaker 1 (00:50):
What does that mean?
Speaker 4 (00:51):
I don't know.
Speaker 3 (00:51):
I mean we've done two on you know, feeding babies,
done female puberty. Yeah, this will get into childbirth, will
little bit. So yeah, we're not afraid. I don't care. Yeah,
I guess is what I'm trying to say.
Speaker 1 (01:06):
You can be a male doula.
Speaker 4 (01:08):
You can.
Speaker 3 (01:09):
Although this is the only article I ran across that,
and did you find anything about that anywhere else?
Speaker 1 (01:15):
I mean, it happens. It's just super rare. It happens.
Speaker 2 (01:20):
Because I mean, we'll go ahead and spoil it. Generally,
doulas are well, let's just get into this.
Speaker 1 (01:29):
Generally, dula's are women who have already had a baby.
Speaker 2 (01:32):
Yes, not even just women, but women who have had
a baby so they can really know how to help
another lady have a baby.
Speaker 4 (01:38):
Yeah.
Speaker 3 (01:39):
Yeah, And this is actually so, this is an ancient
thing that's kind of come back around full circle. And
even the name doula is a Greek term used way
back in the classical Greek days when a woman giving
birth would have female servants attending to her during birth,
(01:59):
helping with it, probably feeding her some grapes, waving palm
fronds on her, that kind of thing. So doula means
female servant or female slave, depending on who you're talking about.
Speaker 4 (02:11):
Right, and after, you.
Speaker 3 (02:15):
Know, ancient Greece fell to Rome and the Roman Empire fell,
and all of civilization took this weird course. Throughout it
all women were helped by other women while they were
giving birth. Basically up until about the first third, first
half of the twentieth century in the West, where hospitals
(02:39):
entered and all of a sudden, it was just the
mom giving birth surrounded by a bunch of nurses and doctors.
Speaker 4 (02:46):
Is that true, Yeah.
Speaker 2 (02:49):
Because I could see scenarios where there were women in
the birthroom helping along.
Speaker 3 (02:57):
I think once you started to get into hospital and
the physicians in the hospital starting asserting their authority more
and more, especially through drugs. Like I saw that when
hospitals kind of took over the birthing process or took
responsibility for it from the family and from midwives and
(03:17):
moved it into the hospital. They used to administer a
lot of sedatives as part of the birthing process, as
part of labor.
Speaker 4 (03:25):
You know, you can.
Speaker 3 (03:26):
Understand why they would, but then there were all sorts
of complications from it, problems from it, so they stopped giving.
Speaker 4 (03:34):
Sedatives as much.
Speaker 3 (03:35):
And about that time, women who were giving birth started
to like kind of come out of it and look
around and say, whoa, it's just me and you guys
in here. I need some family members in here. And
at the time, like if you were a dad, you
were not in there, You were not in the.
Speaker 4 (03:51):
Delivery room at all.
Speaker 3 (03:52):
You were out in what was called the stork club,
handing out cigars maybe pacing. And the reason why it
was because to the doctors involved, it was just another
medical procedure, right, so you're not going to have randos
who have nothing to do with the actual procedure in
the room during a procedure. They treated childbirth the same way,
(04:13):
but women started to say, no, I need more than
just you, people who I've never met before, really attending
to the birth of my child, And so dads started
to come in, and then more family members and then
now doulas have definitely kind of come back like they
were originally.
Speaker 4 (04:30):
That's my understanding of the whole thing.
Speaker 2 (04:32):
Yeah, so doula's, we haven't even said what that is yet,
and that would probably help clear it up if you
don't know. Dula's are people, like we said, generally women
but not always who are childbirth coaches.
Speaker 1 (04:44):
They coach you through the process.
Speaker 2 (04:45):
They will, depending on the service they offer, will come
on before obviously you give birth and kind of prep
you for what's going to happen. And this I mean
it kind of depends on when your doula will come
aboard in the process, but at the very least they
will help you in the delivery room and they are
(05:06):
your advocate to kind of coach you through this whole thing.
And that term actually started in an article in nineteen
sixty nine by a woman named Dana Raphael and then
later on in a book in nineteen seventy three called
The Tender Gift Breastfeeding. And that's when she brought this
term back and said, you know, we're going to start
calling these women doulas and it's going to be a
(05:28):
real job, right.
Speaker 4 (05:30):
And I think at first, what was the name of
the woman.
Speaker 1 (05:33):
Who brought it back, Dana Raphael.
Speaker 3 (05:35):
So she had like a pretty good idea that was
actually ahead of its time. When doula's really started to
come into use and come into their own as a
profession was in the eighties. And the reason why they
came into wider use was because hospitals were going to
see sections a lot.
Speaker 4 (05:52):
Ce sections went up.
Speaker 3 (05:53):
From nineteen seventy four point two percent of live births
in the US involved C sections. Teen years later, in
nineteen eighty six, a quarter of live births.
Speaker 4 (06:03):
In the US involved C sections.
Speaker 3 (06:05):
And there are a lot of complications with C sections,
and so you could have your husband in there, you
could have your mom in there, you could have friends,
but they're just there for you. One of the first
services that doulas started offering was to say, whoa, whoa,
Does she really need that C section? Are you sure
(06:27):
about that or are you just doing it because you
can charge more money. I think that was overstating exactly
the interaction they had, but that was the role they had,
was to basically provide a barrier between a doctor who
wanted to just give a sea section because he wanted
to go home and the mom who really didn't want
a C section.
Speaker 1 (06:46):
Yeah, and it's not just c sections.
Speaker 2 (06:48):
They're your advocate, they're your birth advocate to make sure
or at least as best they can to try to
ensure that the birth plan that you feel best about
is the one that you end up with. Things always change,
of course, and ADULO would never put you in danger
by insisting on something.
Speaker 1 (07:05):
In fact, they can't.
Speaker 2 (07:06):
But they are there to speak for you on your
behalf because as a mother in labor, you're going through
a lot on your own. So it's nice to have
someone that is just there to do that job.
Speaker 4 (07:19):
Yeah, and.
Speaker 3 (07:21):
Is coming from a place of empathy and sympathy and
most importantly experienced. Like you said, most doulas have had
children of their own, but they've also, after a while,
attended other berths. Too, so they know what they're talking about,
they know what to expect, and they can tell you
what to expect, which can make the whole process easier,
I would imagine for any mother giving birth.
Speaker 2 (07:42):
Yeah, it's definitely gained popularity in the two thousands. I
think I tried to find more recent statistics than twenty twelve,
but I couldn't. But in twenty twelve there were six percent.
And this is in the United States. It's very much
happen all over the world some but it's sort of
(08:02):
an American thing. Six percent of people in twenty twelve
years to doula versus three percent in two thousand and six.
And in that same survey, twenty seven percent of people
said they would they would like to use a dula.
So you know, at least they're they're wishing or hopeful
that they can.
Speaker 3 (08:21):
Yeah, that was question eight, would you like to use
a doula? Yeah, twenty seven percent said And so if
you get the impression that, like a a doctor would
not really prefer a doula to be in the labor
and delivery room, you've kind of read between the lines there.
Especially at first, the medical community saw doulas as they
(08:42):
were starting to really kind of come into use in
the eighties as basically meddling busy bodies who could potentially
put their patient's life in jeopardy.
Speaker 4 (08:51):
Right.
Speaker 3 (08:52):
But then in nineteen ninety two, DULAS of North America
was found at DONA. It's like the first DULA license body,
certification and training and licensing body, and they were founded.
It was founded by medical professionals, which kind of created
a bridge. It bridged the gap or kind of got
(09:13):
smoothed over the rough feelings between the medical community and
the doula community. And it also added a real air
of legitimacy to the profession of being a doula.
Speaker 2 (09:23):
Yeah, and the impression I get now is that if
you have a good doula who is good with people,
which is ideally what your doula is, if your deal
is not a people person, that's probably not going to
be a good thing. But the idea I get is
that doctors and nurses like having dulas there now because
they can just concentrate on They don't have to be
(09:44):
the ones providing emotional empathetic support, although they can still
do death they want, they can just concentrate on the
medical aspects of it. And they know that they have
a trained, hopefully licensed dula, and we'll get into that
later on hand to sort of say, you know what,
I don't have to deal with that part of things.
(10:04):
You're in good hands with this doula and I can
just concentrate on the medical parts.
Speaker 3 (10:08):
Yeah, now, all love doula, that's right. One of the
other reasons or functions that doulas provide you kind of
hit on, is that they they provide a service that
hospitals used to provide through nurses, right where if you
had a nurse in a labor and delivery room, they
(10:30):
wouldn't spend as much time or give you as much
attention as, say, like your mom would or a friend
or your husband even but they gave you a lot
more early on than they did. As surveillance of patients
moved to electronics right to where somebody could just kind
of sit at the nurses station and check on everybody
(10:50):
and they didn't have to.
Speaker 4 (10:50):
Go into the rooms.
Speaker 3 (10:52):
And now you nurses were charged with watching even more
people at once, right, So the personal attention dropped dramatic
as electronic surveillance of patients increased, and the dula's kind
of came in to fill that role as well.
Speaker 2 (11:09):
Yeah, Like they're sitting in the room with you and
hanging out. They don't get called in like twenty minutes
before you give birth. They're with you, you know, sometimes
days and weeks before hand, coaching you and what to
expect and how you're going to go about this and
what your plan is. And then on the day, like
even if dad is in there and the husband is
(11:30):
in there providing support, that's great, But the dula is
just that extra step and that extra measure of support
that is super knowledgeable about what it's going to be like,
where the husband might not exactly you know, be able
to lend the most insightful ear there, you know what
I mean. Yeah, so you want to take a break.
Speaker 3 (11:52):
Yeah, let's take a break and then we'll come back
and talk about what to expect when you're expecting to
work with a doula.
Speaker 1 (12:15):
Saish all right, So.
Speaker 2 (12:21):
Here's a misconception some people get. Some people think that
doulas are authorized or trained to give birth.
Speaker 1 (12:30):
That is not true.
Speaker 2 (12:30):
They don't deliver babies, they don't perform any sort of
medical procedures. They don't put an IV in your arm,
They don't work the heart rate monitor. Most times, they
don't even work for the hospital. You have hired them independently,
and again they're just there to coach you. They're not
even midwives. Midwives can deliver a baby.
Speaker 3 (12:50):
Right, Yeah, they're not allowed anywhere near the medical stuff,
but they need to know what the medical stuff is
so that they can say, well, this is what they're
about to do, or this is what they're suggesting right now,
and here are your options. And then also when they're
administering the medical stuff, which can be pretty uncomfortable pretty frequently,
(13:11):
I would imagine the duela is there to kind of
tell the mom what to expect and the comforter her
in all sorts of ways.
Speaker 2 (13:19):
Yeah, and maybe not even offer advice, like I think
the idea is that adula will lay it all out
there so you can make an informed decision and not
necessarily say well, if I were you, this is what
I would do.
Speaker 3 (13:30):
Well, yeah, that's a slippery slope right there, because then
all of a sudden, if things go wrong, you can say, well,
the DULA told me to do that, and the dula
is like, I'm toast.
Speaker 2 (13:42):
Duelas have to be great listeners. We already talked about
the empathy piece. They have to be very empathetic and
they will, like I said, start meeting before birth to
answer any kind of questions, come up with that birth plan,
and really listen a lot to the wife and the
husband so everybody is on the same page. And like
(14:03):
I said, on the day, things can change. But going
in you generally want to have a pretty good idea
of everything from medications you might want to use, if any.
Speaker 1 (14:14):
To where you want to have the baby.
Speaker 2 (14:17):
The dula can come on board and kind of explain
if they're knowledgeable, which hopefully they are, about the hospitals
around you, and maybe even help you pick out where
you're going to give birth.
Speaker 3 (14:28):
Yeah, and I mean, if you already have an idea
of what you want, the doula can, you know, kind
of tell you how to make that happen. Or if
you have no idea what you want, the doula can
also tell you some other alternatives that you might not
have thought of. And I saw a Parent's magazine article
about doula's They laid out what basically what you can
expect from the average doula for the doula's fees one
(14:51):
to two in person pre natal visits and then access
to the doula for follow up questions through email or
or phone calls. They're full attention and presence during your
labor and then sometimes frequently I get the idea a
follow up visit in at your house after the baby
(15:15):
comes home. That typically if you hire a doula, this
is this is about the average you can expect to them.
There's definitely a lot of differences. There's some will give
you a little more, some will give you a little less,
some will charge more, some will do it for free.
It's just all over the place as far as you
know what you're actually going to shell out and what
(15:35):
you're going to get from a doula. But for the
most part, you the dula is going to have met
you before you give birth, and then the doula will
be there throughout the whole labor and delivery process.
Speaker 2 (15:49):
Yeah, and it says in this article that there are
specialist dulas like antipartum doulas and postpartum doulas and labor doulas.
That if you want an antipartum doula to be if
you want more than those two meetings, you might want
to hire someone who will be with you for several
weeks beforehand, or if you want someone postpartum to be
(16:10):
with you to coach you through breastfeeding or you know,
changing diapers or just any of that kind of coaching,
you can hire someone to do that. But I get
the sense that doula's generally will sort of work with
you on whatever kind of plan you want.
Speaker 4 (16:26):
Right.
Speaker 2 (16:26):
It may may cost a little extra, but I get
the sense of adula wouldn't say like, Nope, you get
two meetings and that's it. They might be like, no,
I'll come in for a third and fourth meeting. It'll
be an extra of this much money, and I can
hang with you for a week or two afterward.
Speaker 3 (16:41):
Here and there I found I think it was through
a BuzzFeed article. I stumbled upon a there's a huge
rift in the doula community actually between the typical traditional approach.
Speaker 4 (16:54):
To being a doula, which is.
Speaker 3 (16:58):
I'll work with you on a sliding scale for how
much you can afford, or this is my fee, but
I'll throw in an extra visit just to you know,
make you feel like you're getting your money's worth.
Speaker 4 (17:07):
Or I'll do it for free.
Speaker 3 (17:10):
I just want to help you, because Donah's mission is
that a doula for every every mother who wants one,
Like every mother should have a doula basically, right. And
then there's this other group called pro doula and there
they can't stand doulas who who charge less than like
(17:31):
a decent amount for their services or do it for free.
They actually call dulas who do this for free oxytocin vampires,
like they're just there to to bask in the reflective
glow of this this amazing experience that the mother just
went through, the parents just went through.
Speaker 4 (17:49):
And they're really kind of.
Speaker 3 (17:52):
Kicking other doulas around and they're kind of bullies. It's
in a really weird way. But there's like the big
debate over whether doulas are undervalued or underselling themselves.
Speaker 4 (18:07):
But I mean, I definitely get.
Speaker 3 (18:09):
The idea that every woman who wants to have a
doula should be able to have a dula regardless of
her income.
Speaker 4 (18:16):
You know. Yeah, that makes sense to me.
Speaker 1 (18:19):
Like a pro bono for people that don't have as
much money.
Speaker 4 (18:24):
Yeah.
Speaker 3 (18:24):
On the other hand, I also get that if you
are a doula and you're doing your job really well, then.
Speaker 4 (18:28):
Yeah, you should expect to be paid. I think there's
a happy medium.
Speaker 3 (18:32):
I don't think has to be like, Nope, this is
the price, and anybody who goes underneath it should be
ostracized from the doula community.
Speaker 1 (18:39):
Yeah.
Speaker 2 (18:40):
The other thing about doula's another misconception a lot of
people think is that it's just some hippie dippy thing
that if you don't want to if you only want
to have like a natural childbirth, then you get the
doula in there, and that they're not there for anything
other than that.
Speaker 1 (18:55):
And that's not the case.
Speaker 2 (18:56):
They are there to support you in whatever kind of
birth you want to have, whether it's a home birth
or water birth, or whether or not you want to
get an epidural or be loaded up on every pharmaceutical
they offer mothers in labor. Uh, they're there just to
have knowledge of all that stuff, so you know what
you're getting into.
Speaker 4 (19:15):
Yeah.
Speaker 3 (19:16):
And then so during labor, this is where this is
where the doodless shines.
Speaker 4 (19:19):
Right.
Speaker 3 (19:19):
They're there to help with alternatives to pain treatment.
Speaker 4 (19:25):
Right.
Speaker 3 (19:26):
So again, they can't administer any kind of drugs or anything.
I would guess that they could even get in trouble
for giving you an advil, but they can do other things,
like they can massage you in ways that you had
not ever heard of before that helps with labor pains.
I came across this one technique where they pull on
a couple of toes, specific toes, and it helps actually
(19:51):
move the labor along if you're if you have a
slow labor. There's kneading techniques, there's stroking techniques, pressure on
the bottom of your feet, There's all sorts of stuff
they can do at various times throughout the labor and
delivery process. They can help alleviate the pain that you're
going through, and that's one of the big roles that
they played during labor.
Speaker 2 (20:12):
Yeah, when my kid was born, I was shocked at
how many people were in the room.
Speaker 3 (20:17):
First of all, how many oh Man Baker's dozen, I
mean twenty.
Speaker 1 (20:23):
Emily and I birth mom.
Speaker 2 (20:27):
Obviously our adoption counselor who was a licensed dulist, so
she really served that function for the birth mom, which.
Speaker 1 (20:35):
Was really a great great plus. The doctor, I guess.
Speaker 2 (20:43):
I'm not even sure what the roles are, what their
technical titles are, but the doctor came in when it
was go time and basically just checked things out and said, well,
I think it's go time. And then he stepped out
of the way and these two nurses came in there,
and ninety seconds later there was a baby, so it
was and those were so it was two nurses that
(21:06):
that was probably like, there's probably at least twelve people
in that room.
Speaker 4 (21:09):
Wow, that's a lot of people.
Speaker 2 (21:11):
It was crowded and fast and surreal and weird and amazing.
Speaker 4 (21:16):
Even weirder, they brought in.
Speaker 1 (21:18):
Carrot Top to cut the cord, but no, Emily cut
the cord.
Speaker 4 (21:22):
Okay, cool.
Speaker 2 (21:22):
Emily actually helped sort of deliver in a way, because
you know, they like to bring in I guess you know,
in a in a regular biological birth, that would be
the husband probably in there saying.
Speaker 1 (21:34):
Hey, do you want to help hold the legs or
do whatever.
Speaker 2 (21:37):
In this case, it was Emily and I just took
a respectful position by the birth mom's head right, sort
of looking looking down that way. I was like, you know,
she was She was like, you can go wherever you
want to go. But I was like, you know, I'll
just hang right.
Speaker 4 (21:53):
Here, right, And Emily's like that's right.
Speaker 2 (21:56):
Yeah, I just I wanted to be there, and you
know I was. I was helping support her as well, uh,
holding her hand and patting her on the head and
all that all that nice stuff.
Speaker 4 (22:05):
That's cool, man, Yeah, it was.
Speaker 1 (22:06):
It was amazing.
Speaker 3 (22:07):
Did I ever tell you the story for when my
niece Mila was born and my sister in law was
giving birth and she let everybody in the in the
labor room.
Speaker 1 (22:17):
I was surprised, you can have a party in there.
Speaker 4 (22:19):
Yeah.
Speaker 3 (22:20):
And when she really was going into into she was delivering.
I stood back behind this curtain, right and the doctor
comes in and walks past me and kind of gives
me a nod, and I hear him go to the crowd.
He's like, you know, there's like some guy standing behind
that curtain right, Like, yeah, he's supposed to be there.
Speaker 4 (22:41):
It was pretty bud.
Speaker 1 (22:42):
He's the He's the ward creeper.
Speaker 4 (22:44):
Right exactly. I'm like, Okay, I've heard enough here.
Speaker 3 (22:46):
I'm going to the next room.
Speaker 1 (22:49):
All right, Well, let's take another break.
Speaker 2 (22:52):
Now that we've shared our stories, we'll come back and
talk a little bit about how you become a doula.
Speaker 3 (22:56):
Right for this, all right, Chuck, So, if you wanted
(23:19):
to become a doula, basically, you start in training. At
age three, you're sent off to Europe to apprentice at
the one DULA school in the world and they make
you eat a lot of magic cake. And then when
you're sixty you get to actually start out on your own.
Speaker 1 (23:37):
That's exactly right.
Speaker 2 (23:39):
Okay, Well, before you decide to become adula, you need
to give a lot of thought on what you're going
to be getting into. You know, the hours are long
at birth job. Birth is very stressful, and especially if
there are complications, that can be super stressful in a
matter of life or death. So you've got to be
able to deal with that stuff in the moment and
(24:00):
hang in there and be the birth coach that mom needs,
you know, in the most stressful of situations. But then
on the plus side, you get to see little bebies
coming out on the rag and what's better than that,
you know.
Speaker 3 (24:15):
I can't think of too many things talk about an
oxytocin hit maybe magic cake, magic cake.
Speaker 1 (24:23):
You do you not have to have a college degree.
Speaker 2 (24:26):
You don't have to have a high school degree.
Speaker 4 (24:30):
You you don't even have to be certified. It's not
law that you have to be certified.
Speaker 2 (24:35):
Yeah you don't, but it is there are more and
more programs now and more certification and licensing programs out there.
So if you want to be a duela, my advice
is to go that route. You probably just get more
work that way.
Speaker 3 (24:49):
Right, So when you're when you're starting out, you would
go to if you wanted to get certified, you would
go to one of the certifying bodies like DONA or
what are what are the other two that are mentioned
in here. There's one called c Appa Kappa Sure and
then the American Pregnancy Association. All three of those certify
and train doulas. Don't, from what I could tell, is
(25:13):
the oldest. Obviously, it was the first one and it
seems to be the most respected. But I would guess
if you get your training from any of those three,
you're probably doing pretty good. They'll offer online classes, in
person classes, self pace study.
Speaker 4 (25:28):
And.
Speaker 3 (25:30):
You typically need to go take a birthing class, a
breastfeeding class because again you need to know, like you
need to be current on all the stuff that's going
on with labor and delivery. Right, if you took these
classes ten years ago and then did it again today,
you would probably find some real differences in new stuff
that's been discovered in the last ten years, so you
(25:51):
would need to be pretty current, even if you've had kids.
Speaker 4 (25:54):
Of your own before.
Speaker 3 (25:55):
Sure, and then you also need to attend at least
one I have the impression that multiple berths under the
apprenticeship of another doula who's already certified or trained or
experienced before you really go off on your own to
become certified.
Speaker 4 (26:13):
Yeah, and that's.
Speaker 3 (26:15):
I mean, that's just I would I would say, how
many berths have you been a part of, you know,
already before I hired a doula. That's a pretty big
question if you ask me, so they would want to say, well,
I've been you know, I've assisted in like three or
five or however many.
Speaker 4 (26:32):
But you're going to be my first solo.
Speaker 1 (26:35):
Your perst solo flight.
Speaker 4 (26:36):
Yep, you will.
Speaker 2 (26:38):
It depends on where you live, on how much you're
going to pay. If you if you live in a
big fancy city like New York City, you're gonna be
paying top dollar for your doula. If you live in
Los Angeles, canna be paying top dollar for your doula.
Speaker 4 (26:50):
I saw like thirty five hundred at least for each
of those cities.
Speaker 2 (26:54):
Yeah, but that that scale can go all the way
down to zero. Well, sure, all the way to zero,
but if you were paying a doula, that number can
go all the way down to six hundred to eight hundred,
one thousand dollars and you know in the fly ower states, right.
Speaker 3 (27:12):
But again, I mean like, if if this is the
doula's first time on their own, you're probably not going
to be paying top dollar. And if you say, look,
I really really really want to have a doula at
my at my child's birth, but I really genuinely don't
have this money. I actually got a lift once from
(27:33):
a doula and she was talking about having to deal
with this family who clearly was very well off but
was pleading poverty. And she was like, I'm the one
who's a doula and driving a lift here, and these
guys are trying to like short change me.
Speaker 4 (27:47):
Interesting, so she said she told them no.
Speaker 3 (27:50):
She said she tried to work with them, but they
wouldn't they wouldn't budge about whatever they thought her services.
Speaker 4 (27:56):
Were worth, so she had to just walk on.
Speaker 2 (27:58):
But why would a family that's well off not paid
eight hundred dollars.
Speaker 3 (28:04):
I don't know, because I remember thinking like Wow, that's
that's all it costs for a doula. She might have
even been quoting them less than eight hundred dollars. Yeah,
so there is definitely like there seems to be a
tension between the desire to have a doula and the
sense of non obligation to pay a doula a decent wage,
(28:26):
which I think is where.
Speaker 4 (28:27):
That pro doula group pulls their hair out right.
Speaker 2 (28:31):
You know, well, you may get it covered by insurance.
There are more and more cases in insurance companies that
will let something like this be covered. But it never
hurts to ask. This article points out you can. You
can always ask, You can always file a claim and
just see if you'll get a little assistance there.
Speaker 3 (28:51):
Yeah, if you live in Oregon and Minnesota, though, Medicaid
will reimburse your full doula expenses for a certified doula,
which is pretty awesome. Like, that's huge in groundbreaking that
those two states have that for sure. The reason why
they would pay anything for a doula rather than just
being like just burn some sage or something and you know,
(29:13):
spend five bucks, is because there has been studies about
doulas and they have come out quite positive in some
pretty good peer reviewed studies in peer reviewed journals.
Speaker 4 (29:25):
Right, have you seen any of this?
Speaker 2 (29:28):
Well, yeah, I saw the one fifteen thousand people. That's
a pretty decent study size.
Speaker 1 (29:34):
And they said.
Speaker 2 (29:37):
In the study size, there were some women who had
dulas and some women who did not have dulas or
any kind of support like that. And then outcomes for
women with continuous support were better than those without, meaning
their labors were shorter by about forty minutes on average.
Their babies had higher Appgar scores. Which Appgar are these
tests they give your baby, Like the first thing your
(29:59):
kid has to.
Speaker 1 (29:59):
Do, take a test.
Speaker 2 (30:01):
No seconds later they're given your kid their first test.
Speaker 4 (30:05):
Yeah, activity, pulse, grimace, appearance, and respiration.
Speaker 1 (30:08):
That's right.
Speaker 2 (30:09):
Yeah, And so higher Appcar scores, fewer negative feelings about childbirth,
like this is the emotional component. They required, less pain medication,
fewer uses of forceps or vacuum assisted interventions see sections.
Speaker 1 (30:25):
Across the board, dula's helped.
Speaker 2 (30:28):
And what was really interesting was there was basically nothing
that could point at that said having a DULA was
a negative in any way.
Speaker 3 (30:36):
Yeah, and even when they look just at doulas rather
than just all types of continuous support just at dula's.
Speaker 4 (30:43):
The dula's they held up too.
Speaker 3 (30:45):
There was less use of pitocin, less sea section, more
spontaneous vaginal deliveries, less of a risk of being admitted
to a special care nursery, four times less likely in
one study to have a low birth weight child, two
times less likely to have complications, and they were significantly
more likely to initiate breastfeeding when cared for by ADULA. Right,
(31:07):
So there's all these like like demonstrably positive outcomes, and
then you hit upon the other thing too, that they
they make the harsh hospital environment. There's something called harsh environment.
Speaker 4 (31:20):
Theory, where the bright lights.
Speaker 3 (31:23):
And the people you don't know coming in and out
and treating you like a piece of meat that they
need to get this thing out of that it can
actually produce a traumatic experience. I suspect in more women
than you would think, having birth or giving birth in
a hospital is kind of traumatic, and for some women,
from what I read, it's like deeply traumatic. And that's
(31:47):
been a huge reason that doulas have really come into
use lately. It is because they mellow everything out for
you a lot more. And there's actually I read there's
a group of renegade dulas who are acting as midwives
out in the pot growing country of northern California.
Speaker 1 (32:08):
What's the relationship there to the pot growing.
Speaker 3 (32:13):
I would guess they probably do both. They grow the
pot and deliver the babies nice. I think it's kind
of like a whole back to the earth, to hell
with the man's establishment hospitals. Apparently it's illegal to give
birth like this without like a certified someone from the
medical community being there to assist in the delivery, saying.
(32:34):
They're saying nuts to that, which I would guess is
pretty dangerous but also illegal. And if there's anything that
screams Northern California more than dangerous and illegal, I don't know.
Speaker 2 (32:45):
Yeah, if you want to use a doula, and I'm
officially endorsing this, I say, don't say don't to say doula.
Speaker 1 (32:56):
Sorry, it couldn't resist on that one.
Speaker 4 (32:58):
It was worth it.
Speaker 1 (33:00):
You just get online. You know, the doulas are easy
to find in your area.
Speaker 2 (33:04):
Do a little Google search and get a reference, of
personal reference if you can, would be great. Get online,
find a friend who has used to do they can recommend.
I mean, that's really the best way. I don't know
if I'd go on Yelp or anything like that or
Angie's List, although maybe who knows. But it's better if
(33:25):
a good friend says, hey, I use this doula and she's.
Speaker 4 (33:28):
Great, I think.
Speaker 3 (33:28):
Also, the certifying bodies have directories of certified dulas in
areas too.
Speaker 1 (33:35):
Yeah.
Speaker 2 (33:36):
I mean, you want it to be a good personality
match too, So you should talk to your dula on
the phone at the very least, but ideally have a
little in person meeting to make sure, like, is this
someone I want to I want to jump into the
foxhole with because they're going to be around a lot,
you know, and you have to have a good personality
match there.
Speaker 4 (33:53):
Well.
Speaker 3 (33:53):
Yeah, and your husband or co parent needs to like
them too. You don't want weird tension between those two
in the delivery room.
Speaker 4 (34:01):
True. They need to fit into your jam.
Speaker 3 (34:04):
Pretty well, yeah, or else it's just going to be
Especially if you're one of those people who can't stand conflict,
that would be awful.
Speaker 4 (34:12):
To have a doula who.
Speaker 3 (34:13):
Your husband or co parent or wife or whoever doesn't
like and butts heads within the delivery room. That would
just be bad. And then you have to pay them afterward.
That would just be terrible. So yeah, you want to
vet them pretty well ahead of time.
Speaker 2 (34:27):
Yeah, and while you while ADULA is there to support you.
So while they may have their own opinions on what
they might do in a given situation, their childbirth philosophy
is your childbirth philosophy is a mom is what matters, right,
you know, So a good DULA will get on board
(34:47):
with that, or if they aren't on board with that,
then they probably shouldn't be working with you.
Speaker 3 (34:53):
And yeah, I could see them being like, look, I
can recommend a couple of other people who are more
in line with what you're looking for them me, you know, yeah, instead.
Speaker 4 (35:03):
Of wrong wrong wrong, This is all wrong. This is
how we're going to do it.
Speaker 1 (35:06):
That's right.
Speaker 4 (35:08):
You got anything else on dula's just.
Speaker 2 (35:10):
This little bit on death doulas. We may have covered
this in our Jeez in our Dying episode.
Speaker 4 (35:17):
Yeah, that's what I was thinking.
Speaker 1 (35:18):
I feel like we've talked about it. But it is
a job.
Speaker 2 (35:21):
If you want to help a family or a person
or both through end of life care, there are people
you can hire just to do that, and it's not
the same as they can work in concert with hospice care.
But it's not like a hospice nurse. It's someone just
like a birth doula who is there to really just
emotionally kind of coach you through through the dying process
(35:44):
with a family member.
Speaker 3 (35:45):
And also to very concretely hold your hand, make.
Speaker 4 (35:49):
Sure you're comfortable.
Speaker 3 (35:50):
Yeah, move you around a little bit, listen to you talk,
tell you stories, whatever you're looking for to make the
whole thing better. That's right, pretty neat. Up with Doula's Yeah,
I'll put Dula's agreed. If you want to know more
about Up with Dula's this new organization that Chuck and
I just now founded, you can.
Speaker 4 (36:10):
I'll just wait a little while.
Speaker 3 (36:12):
We need to get to work on the website, and
in the meantime, let's listen to some listener mail.
Speaker 2 (36:19):
All right, I'm going to call this flu shot clarification
because that's what the subject line says. Okay, hey guys,
Avid listener wanted to comment on the flu episode. I'm
a graduate student and a few months away from completing
my degree to becoming a physician's assistant. Well never mind, then, buddy,
I don't want to hear it.
Speaker 1 (36:37):
No, I'm just kidding.
Speaker 2 (36:38):
I spent a lot of time seeing patients answering questions
about things like flu shots and who should receive them.
The CDC now recommends that everyone over the age of
six months receives a flu shot, even those who are
perfectly healthy, even those who are allergic to eggs.
Speaker 4 (36:53):
They're cuckoo for flu shots.
Speaker 1 (36:55):
The new flu shots are now being designed to.
Speaker 2 (36:58):
Be egg free, so they're egg free, gluten free, what else?
Speaker 1 (37:05):
Dare free?
Speaker 4 (37:06):
They contained ten percent en wah, and.
Speaker 2 (37:08):
There's no evidence to suggest flu shots in recent years
could cause reaction in those allergic to eggs.
Speaker 1 (37:15):
All right, that's interesting.
Speaker 2 (37:16):
Did not know that He said the benefits of the
flu shots far outweighed the risk in his opinion. This, guys, Yeah,
and it sounds like it's an informed opinion at the
very least.
Speaker 4 (37:27):
Sure.
Speaker 2 (37:28):
So that is from Devon from phil Philadelphia, Go Eagles.
Speaker 1 (37:36):
He thinks, So really, yeah, I mean why not? They're
doing great?
Speaker 3 (37:39):
Okay, Well, thanks a lot, Devin. I appreciate writing in.
That was nice of you. And if you out there
want to be like Devin, you can hang out with
us on email at stuff podcast at houstuffworks dot com
and as always, joined us at our home on the web,
Stuff you Should Know dot Com.
Speaker 1 (37:58):
Stuff you Should Know is a production of iHeartRadio.
Speaker 2 (38:01):
For more podcasts my heart Radio, visit the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.
So what's the deal with doula's everybody?
Speaker 2 (00:03):
That's my question to you on this wonderful Saturday morning.
This one goes back to December twelfth, twenty seventeen. Doula's
do great work. They're wonderful people, and they bring babies
into the world. So I hope you enjoy the deal
with doula's.
Speaker 1 (00:24):
Welcome to Stuff You Should Know, a production of iHeartRadio.
Speaker 3 (00:34):
Hey, and welcome to the podcast. I'm Josh Clark, and
there's Charles w Chuck Bryant, and there's Jerry over there,
and this is Stuff you Should Know, the podcast Childbirth Edition. Yeah,
we are trapsing into more territory.
Speaker 1 (00:50):
What does that mean?
Speaker 4 (00:51):
I don't know.
Speaker 3 (00:51):
I mean we've done two on you know, feeding babies,
done female puberty. Yeah, this will get into childbirth, will
little bit. So yeah, we're not afraid. I don't care. Yeah,
I guess is what I'm trying to say.
Speaker 1 (01:06):
You can be a male doula.
Speaker 4 (01:08):
You can.
Speaker 3 (01:09):
Although this is the only article I ran across that,
and did you find anything about that anywhere else?
Speaker 1 (01:15):
I mean, it happens. It's just super rare. It happens.
Speaker 2 (01:20):
Because I mean, we'll go ahead and spoil it. Generally,
doulas are well, let's just get into this.
Speaker 1 (01:29):
Generally, dula's are women who have already had a baby.
Speaker 2 (01:32):
Yes, not even just women, but women who have had
a baby so they can really know how to help
another lady have a baby.
Speaker 4 (01:38):
Yeah.
Speaker 3 (01:39):
Yeah, And this is actually so, this is an ancient
thing that's kind of come back around full circle. And
even the name doula is a Greek term used way
back in the classical Greek days when a woman giving
birth would have female servants attending to her during birth,
(01:59):
helping with it, probably feeding her some grapes, waving palm
fronds on her, that kind of thing. So doula means
female servant or female slave, depending on who you're talking about.
Speaker 4 (02:11):
Right, and after, you.
Speaker 3 (02:15):
Know, ancient Greece fell to Rome and the Roman Empire fell,
and all of civilization took this weird course. Throughout it
all women were helped by other women while they were
giving birth. Basically up until about the first third, first
half of the twentieth century in the West, where hospitals
(02:39):
entered and all of a sudden, it was just the
mom giving birth surrounded by a bunch of nurses and doctors.
Speaker 4 (02:46):
Is that true, Yeah.
Speaker 2 (02:49):
Because I could see scenarios where there were women in
the birthroom helping along.
Speaker 3 (02:57):
I think once you started to get into hospital and
the physicians in the hospital starting asserting their authority more
and more, especially through drugs. Like I saw that when
hospitals kind of took over the birthing process or took
responsibility for it from the family and from midwives and
(03:17):
moved it into the hospital. They used to administer a
lot of sedatives as part of the birthing process, as
part of labor.
Speaker 4 (03:25):
You know, you can.
Speaker 3 (03:26):
Understand why they would, but then there were all sorts
of complications from it, problems from it, so they stopped giving.
Speaker 4 (03:34):
Sedatives as much.
Speaker 3 (03:35):
And about that time, women who were giving birth started
to like kind of come out of it and look
around and say, whoa, it's just me and you guys
in here. I need some family members in here. And
at the time, like if you were a dad, you
were not in there, You were not in the.
Speaker 4 (03:51):
Delivery room at all.
Speaker 3 (03:52):
You were out in what was called the stork club,
handing out cigars maybe pacing. And the reason why it
was because to the doctors involved, it was just another
medical procedure, right, so you're not going to have randos
who have nothing to do with the actual procedure in
the room during a procedure. They treated childbirth the same way,
(04:13):
but women started to say, no, I need more than
just you, people who I've never met before, really attending
to the birth of my child, And so dads started
to come in, and then more family members and then
now doulas have definitely kind of come back like they
were originally.
Speaker 4 (04:30):
That's my understanding of the whole thing.
Speaker 2 (04:32):
Yeah, so doula's, we haven't even said what that is yet,
and that would probably help clear it up if you
don't know. Dula's are people, like we said, generally women
but not always who are childbirth coaches.
Speaker 1 (04:44):
They coach you through the process.
Speaker 2 (04:45):
They will, depending on the service they offer, will come
on before obviously you give birth and kind of prep
you for what's going to happen. And this I mean
it kind of depends on when your doula will come
aboard in the process, but at the very least they
will help you in the delivery room and they are
(05:06):
your advocate to kind of coach you through this whole thing.
And that term actually started in an article in nineteen
sixty nine by a woman named Dana Raphael and then
later on in a book in nineteen seventy three called
The Tender Gift Breastfeeding. And that's when she brought this
term back and said, you know, we're going to start
calling these women doulas and it's going to be a
(05:28):
real job, right.
Speaker 4 (05:30):
And I think at first, what was the name of
the woman.
Speaker 1 (05:33):
Who brought it back, Dana Raphael.
Speaker 3 (05:35):
So she had like a pretty good idea that was
actually ahead of its time. When doula's really started to
come into use and come into their own as a
profession was in the eighties. And the reason why they
came into wider use was because hospitals were going to
see sections a lot.
Speaker 4 (05:52):
Ce sections went up.
Speaker 3 (05:53):
From nineteen seventy four point two percent of live births
in the US involved C sections. Teen years later, in
nineteen eighty six, a quarter of live births.
Speaker 4 (06:03):
In the US involved C sections.
Speaker 3 (06:05):
And there are a lot of complications with C sections,
and so you could have your husband in there, you
could have your mom in there, you could have friends,
but they're just there for you. One of the first
services that doulas started offering was to say, whoa, whoa,
Does she really need that C section? Are you sure
(06:27):
about that or are you just doing it because you
can charge more money. I think that was overstating exactly
the interaction they had, but that was the role they had,
was to basically provide a barrier between a doctor who
wanted to just give a sea section because he wanted
to go home and the mom who really didn't want
a C section.
Speaker 1 (06:46):
Yeah, and it's not just c sections.
Speaker 2 (06:48):
They're your advocate, they're your birth advocate to make sure
or at least as best they can to try to
ensure that the birth plan that you feel best about
is the one that you end up with. Things always change,
of course, and ADULO would never put you in danger
by insisting on something.
Speaker 1 (07:05):
In fact, they can't.
Speaker 2 (07:06):
But they are there to speak for you on your
behalf because as a mother in labor, you're going through
a lot on your own. So it's nice to have
someone that is just there to do that job.
Speaker 4 (07:19):
Yeah, and.
Speaker 3 (07:21):
Is coming from a place of empathy and sympathy and
most importantly experienced. Like you said, most doulas have had
children of their own, but they've also, after a while,
attended other berths. Too, so they know what they're talking about,
they know what to expect, and they can tell you
what to expect, which can make the whole process easier,
I would imagine for any mother giving birth.
Speaker 2 (07:42):
Yeah, it's definitely gained popularity in the two thousands. I
think I tried to find more recent statistics than twenty twelve,
but I couldn't. But in twenty twelve there were six percent.
And this is in the United States. It's very much
happen all over the world some but it's sort of
(08:02):
an American thing. Six percent of people in twenty twelve
years to doula versus three percent in two thousand and six.
And in that same survey, twenty seven percent of people
said they would they would like to use a dula.
So you know, at least they're they're wishing or hopeful
that they can.
Speaker 3 (08:21):
Yeah, that was question eight, would you like to use
a doula? Yeah, twenty seven percent said And so if
you get the impression that, like a a doctor would
not really prefer a doula to be in the labor
and delivery room, you've kind of read between the lines there.
Especially at first, the medical community saw doulas as they
(08:42):
were starting to really kind of come into use in
the eighties as basically meddling busy bodies who could potentially
put their patient's life in jeopardy.
Speaker 4 (08:51):
Right.
Speaker 3 (08:52):
But then in nineteen ninety two, DULAS of North America
was found at DONA. It's like the first DULA license body,
certification and training and licensing body, and they were founded.
It was founded by medical professionals, which kind of created
a bridge. It bridged the gap or kind of got
(09:13):
smoothed over the rough feelings between the medical community and
the doula community. And it also added a real air
of legitimacy to the profession of being a doula.
Speaker 2 (09:23):
Yeah, and the impression I get now is that if
you have a good doula who is good with people,
which is ideally what your doula is, if your deal
is not a people person, that's probably not going to
be a good thing. But the idea I get is
that doctors and nurses like having dulas there now because
they can just concentrate on They don't have to be
(09:44):
the ones providing emotional empathetic support, although they can still
do death they want, they can just concentrate on the
medical aspects of it. And they know that they have
a trained, hopefully licensed dula, and we'll get into that
later on hand to sort of say, you know what,
I don't have to deal with that part of things.
(10:04):
You're in good hands with this doula and I can
just concentrate on the medical parts.
Speaker 3 (10:08):
Yeah, now, all love doula, that's right. One of the
other reasons or functions that doulas provide you kind of
hit on, is that they they provide a service that
hospitals used to provide through nurses, right where if you
had a nurse in a labor and delivery room, they
(10:30):
wouldn't spend as much time or give you as much
attention as, say, like your mom would or a friend
or your husband even but they gave you a lot
more early on than they did. As surveillance of patients
moved to electronics right to where somebody could just kind
of sit at the nurses station and check on everybody
(10:50):
and they didn't have to.
Speaker 4 (10:50):
Go into the rooms.
Speaker 3 (10:52):
And now you nurses were charged with watching even more
people at once, right, So the personal attention dropped dramatic
as electronic surveillance of patients increased, and the dula's kind
of came in to fill that role as well.
Speaker 2 (11:09):
Yeah, Like they're sitting in the room with you and
hanging out. They don't get called in like twenty minutes
before you give birth. They're with you, you know, sometimes
days and weeks before hand, coaching you and what to
expect and how you're going to go about this and
what your plan is. And then on the day, like
even if dad is in there and the husband is
(11:30):
in there providing support, that's great, But the dula is
just that extra step and that extra measure of support
that is super knowledgeable about what it's going to be like,
where the husband might not exactly you know, be able
to lend the most insightful ear there, you know what
I mean. Yeah, so you want to take a break.
Speaker 3 (11:52):
Yeah, let's take a break and then we'll come back
and talk about what to expect when you're expecting to
work with a doula.
Speaker 1 (12:15):
Saish all right, So.
Speaker 2 (12:21):
Here's a misconception some people get. Some people think that
doulas are authorized or trained to give birth.
Speaker 1 (12:30):
That is not true.
Speaker 2 (12:30):
They don't deliver babies, they don't perform any sort of
medical procedures. They don't put an IV in your arm,
They don't work the heart rate monitor. Most times, they
don't even work for the hospital. You have hired them independently,
and again they're just there to coach you. They're not
even midwives. Midwives can deliver a baby.
Speaker 3 (12:50):
Right, Yeah, they're not allowed anywhere near the medical stuff,
but they need to know what the medical stuff is
so that they can say, well, this is what they're
about to do, or this is what they're suggesting right now,
and here are your options. And then also when they're
administering the medical stuff, which can be pretty uncomfortable pretty frequently,
(13:11):
I would imagine the duela is there to kind of
tell the mom what to expect and the comforter her
in all sorts of ways.
Speaker 2 (13:19):
Yeah, and maybe not even offer advice, like I think
the idea is that adula will lay it all out
there so you can make an informed decision and not
necessarily say well, if I were you, this is what
I would do.
Speaker 3 (13:30):
Well, yeah, that's a slippery slope right there, because then
all of a sudden, if things go wrong, you can say, well,
the DULA told me to do that, and the dula
is like, I'm toast.
Speaker 2 (13:42):
Duelas have to be great listeners. We already talked about
the empathy piece. They have to be very empathetic and
they will, like I said, start meeting before birth to
answer any kind of questions, come up with that birth plan,
and really listen a lot to the wife and the
husband so everybody is on the same page. And like
(14:03):
I said, on the day, things can change. But going
in you generally want to have a pretty good idea
of everything from medications you might want to use, if any.
Speaker 1 (14:14):
To where you want to have the baby.
Speaker 2 (14:17):
The dula can come on board and kind of explain
if they're knowledgeable, which hopefully they are, about the hospitals
around you, and maybe even help you pick out where
you're going to give birth.
Speaker 3 (14:28):
Yeah, and I mean, if you already have an idea
of what you want, the doula can, you know, kind
of tell you how to make that happen. Or if
you have no idea what you want, the doula can
also tell you some other alternatives that you might not
have thought of. And I saw a Parent's magazine article
about doula's They laid out what basically what you can
expect from the average doula for the doula's fees one
(14:51):
to two in person pre natal visits and then access
to the doula for follow up questions through email or
or phone calls. They're full attention and presence during your
labor and then sometimes frequently I get the idea a
follow up visit in at your house after the baby
(15:15):
comes home. That typically if you hire a doula, this
is this is about the average you can expect to them.
There's definitely a lot of differences. There's some will give
you a little more, some will give you a little less,
some will charge more, some will do it for free.
It's just all over the place as far as you
know what you're actually going to shell out and what
(15:35):
you're going to get from a doula. But for the
most part, you the dula is going to have met
you before you give birth, and then the doula will
be there throughout the whole labor and delivery process.
Speaker 2 (15:49):
Yeah, and it says in this article that there are
specialist dulas like antipartum doulas and postpartum doulas and labor doulas.
That if you want an antipartum doula to be if
you want more than those two meetings, you might want
to hire someone who will be with you for several
weeks beforehand, or if you want someone postpartum to be
(16:10):
with you to coach you through breastfeeding or you know,
changing diapers or just any of that kind of coaching,
you can hire someone to do that. But I get
the sense that doula's generally will sort of work with
you on whatever kind of plan you want.
Speaker 4 (16:26):
Right.
Speaker 2 (16:26):
It may may cost a little extra, but I get
the sense of adula wouldn't say like, Nope, you get
two meetings and that's it. They might be like, no,
I'll come in for a third and fourth meeting. It'll
be an extra of this much money, and I can
hang with you for a week or two afterward.
Speaker 3 (16:41):
Here and there I found I think it was through
a BuzzFeed article. I stumbled upon a there's a huge
rift in the doula community actually between the typical traditional approach.
Speaker 4 (16:54):
To being a doula, which is.
Speaker 3 (16:58):
I'll work with you on a sliding scale for how
much you can afford, or this is my fee, but
I'll throw in an extra visit just to you know,
make you feel like you're getting your money's worth.
Speaker 4 (17:07):
Or I'll do it for free.
Speaker 3 (17:10):
I just want to help you, because Donah's mission is
that a doula for every every mother who wants one,
Like every mother should have a doula basically, right. And
then there's this other group called pro doula and there
they can't stand doulas who who charge less than like
(17:31):
a decent amount for their services or do it for free.
They actually call dulas who do this for free oxytocin vampires,
like they're just there to to bask in the reflective
glow of this this amazing experience that the mother just
went through, the parents just went through.
Speaker 4 (17:49):
And they're really kind of.
Speaker 3 (17:52):
Kicking other doulas around and they're kind of bullies. It's
in a really weird way. But there's like the big
debate over whether doulas are undervalued or underselling themselves.
Speaker 4 (18:07):
But I mean, I definitely get.
Speaker 3 (18:09):
The idea that every woman who wants to have a
doula should be able to have a dula regardless of
her income.
Speaker 4 (18:16):
You know. Yeah, that makes sense to me.
Speaker 1 (18:19):
Like a pro bono for people that don't have as
much money.
Speaker 4 (18:24):
Yeah.
Speaker 3 (18:24):
On the other hand, I also get that if you
are a doula and you're doing your job really well, then.
Speaker 4 (18:28):
Yeah, you should expect to be paid. I think there's
a happy medium.
Speaker 3 (18:32):
I don't think has to be like, Nope, this is
the price, and anybody who goes underneath it should be
ostracized from the doula community.
Speaker 1 (18:39):
Yeah.
Speaker 2 (18:40):
The other thing about doula's another misconception a lot of
people think is that it's just some hippie dippy thing
that if you don't want to if you only want
to have like a natural childbirth, then you get the
doula in there, and that they're not there for anything
other than that.
Speaker 1 (18:55):
And that's not the case.
Speaker 2 (18:56):
They are there to support you in whatever kind of
birth you want to have, whether it's a home birth
or water birth, or whether or not you want to
get an epidural or be loaded up on every pharmaceutical
they offer mothers in labor. Uh, they're there just to
have knowledge of all that stuff, so you know what
you're getting into.
Speaker 4 (19:15):
Yeah.
Speaker 3 (19:16):
And then so during labor, this is where this is
where the doodless shines.
Speaker 4 (19:19):
Right.
Speaker 3 (19:19):
They're there to help with alternatives to pain treatment.
Speaker 4 (19:25):
Right.
Speaker 3 (19:26):
So again, they can't administer any kind of drugs or anything.
I would guess that they could even get in trouble
for giving you an advil, but they can do other things,
like they can massage you in ways that you had
not ever heard of before that helps with labor pains.
I came across this one technique where they pull on
a couple of toes, specific toes, and it helps actually
(19:51):
move the labor along if you're if you have a
slow labor. There's kneading techniques, there's stroking techniques, pressure on
the bottom of your feet, There's all sorts of stuff
they can do at various times throughout the labor and
delivery process. They can help alleviate the pain that you're
going through, and that's one of the big roles that
they played during labor.
Speaker 2 (20:12):
Yeah, when my kid was born, I was shocked at
how many people were in the room.
Speaker 3 (20:17):
First of all, how many oh Man Baker's dozen, I
mean twenty.
Speaker 1 (20:23):
Emily and I birth mom.
Speaker 2 (20:27):
Obviously our adoption counselor who was a licensed dulist, so
she really served that function for the birth mom, which.
Speaker 1 (20:35):
Was really a great great plus. The doctor, I guess.
Speaker 2 (20:43):
I'm not even sure what the roles are, what their
technical titles are, but the doctor came in when it
was go time and basically just checked things out and said, well,
I think it's go time. And then he stepped out
of the way and these two nurses came in there,
and ninety seconds later there was a baby, so it
was and those were so it was two nurses that
(21:06):
that was probably like, there's probably at least twelve people
in that room.
Speaker 4 (21:09):
Wow, that's a lot of people.
Speaker 2 (21:11):
It was crowded and fast and surreal and weird and amazing.
Speaker 4 (21:16):
Even weirder, they brought in.
Speaker 1 (21:18):
Carrot Top to cut the cord, but no, Emily cut
the cord.
Speaker 4 (21:22):
Okay, cool.
Speaker 2 (21:22):
Emily actually helped sort of deliver in a way, because
you know, they like to bring in I guess you know,
in a in a regular biological birth, that would be
the husband probably in there saying.
Speaker 1 (21:34):
Hey, do you want to help hold the legs or
do whatever.
Speaker 2 (21:37):
In this case, it was Emily and I just took
a respectful position by the birth mom's head right, sort
of looking looking down that way. I was like, you know,
she was She was like, you can go wherever you
want to go. But I was like, you know, I'll
just hang right.
Speaker 4 (21:53):
Here, right, And Emily's like that's right.
Speaker 2 (21:56):
Yeah, I just I wanted to be there, and you
know I was. I was helping support her as well, uh,
holding her hand and patting her on the head and
all that all that nice stuff.
Speaker 4 (22:05):
That's cool, man, Yeah, it was.
Speaker 1 (22:06):
It was amazing.
Speaker 3 (22:07):
Did I ever tell you the story for when my
niece Mila was born and my sister in law was
giving birth and she let everybody in the in the
labor room.
Speaker 1 (22:17):
I was surprised, you can have a party in there.
Speaker 4 (22:19):
Yeah.
Speaker 3 (22:20):
And when she really was going into into she was delivering.
I stood back behind this curtain, right and the doctor
comes in and walks past me and kind of gives
me a nod, and I hear him go to the crowd.
He's like, you know, there's like some guy standing behind
that curtain right, Like, yeah, he's supposed to be there.
Speaker 4 (22:41):
It was pretty bud.
Speaker 1 (22:42):
He's the He's the ward creeper.
Speaker 4 (22:44):
Right exactly. I'm like, Okay, I've heard enough here.
Speaker 3 (22:46):
I'm going to the next room.
Speaker 1 (22:49):
All right, Well, let's take another break.
Speaker 2 (22:52):
Now that we've shared our stories, we'll come back and
talk a little bit about how you become a doula.
Speaker 3 (22:56):
Right for this, all right, Chuck, So, if you wanted
(23:19):
to become a doula, basically, you start in training. At
age three, you're sent off to Europe to apprentice at
the one DULA school in the world and they make
you eat a lot of magic cake. And then when
you're sixty you get to actually start out on your own.
Speaker 1 (23:37):
That's exactly right.
Speaker 2 (23:39):
Okay, Well, before you decide to become adula, you need
to give a lot of thought on what you're going
to be getting into. You know, the hours are long
at birth job. Birth is very stressful, and especially if
there are complications, that can be super stressful in a
matter of life or death. So you've got to be
able to deal with that stuff in the moment and
(24:00):
hang in there and be the birth coach that mom needs,
you know, in the most stressful of situations. But then
on the plus side, you get to see little bebies
coming out on the rag and what's better than that,
you know.
Speaker 3 (24:15):
I can't think of too many things talk about an
oxytocin hit maybe magic cake, magic cake.
Speaker 1 (24:23):
You do you not have to have a college degree.
Speaker 2 (24:26):
You don't have to have a high school degree.
Speaker 4 (24:30):
You you don't even have to be certified. It's not
law that you have to be certified.
Speaker 2 (24:35):
Yeah you don't, but it is there are more and
more programs now and more certification and licensing programs out there.
So if you want to be a duela, my advice
is to go that route. You probably just get more
work that way.
Speaker 3 (24:49):
Right, So when you're when you're starting out, you would
go to if you wanted to get certified, you would
go to one of the certifying bodies like DONA or
what are what are the other two that are mentioned
in here. There's one called c Appa Kappa Sure and
then the American Pregnancy Association. All three of those certify
and train doulas. Don't, from what I could tell, is
(25:13):
the oldest. Obviously, it was the first one and it
seems to be the most respected. But I would guess
if you get your training from any of those three,
you're probably doing pretty good. They'll offer online classes, in
person classes, self pace study.
Speaker 4 (25:28):
And.
Speaker 3 (25:30):
You typically need to go take a birthing class, a
breastfeeding class because again you need to know, like you
need to be current on all the stuff that's going
on with labor and delivery. Right, if you took these
classes ten years ago and then did it again today,
you would probably find some real differences in new stuff
that's been discovered in the last ten years, so you
(25:51):
would need to be pretty current, even if you've had kids.
Speaker 4 (25:54):
Of your own before.
Speaker 3 (25:55):
Sure, and then you also need to attend at least
one I have the impression that multiple berths under the
apprenticeship of another doula who's already certified or trained or
experienced before you really go off on your own to
become certified.
Speaker 4 (26:13):
Yeah, and that's.
Speaker 3 (26:15):
I mean, that's just I would I would say, how
many berths have you been a part of, you know,
already before I hired a doula. That's a pretty big
question if you ask me, so they would want to say, well,
I've been you know, I've assisted in like three or
five or however many.
Speaker 4 (26:32):
But you're going to be my first solo.
Speaker 1 (26:35):
Your perst solo flight.
Speaker 4 (26:36):
Yep, you will.
Speaker 2 (26:38):
It depends on where you live, on how much you're
going to pay. If you if you live in a
big fancy city like New York City, you're gonna be
paying top dollar for your doula. If you live in
Los Angeles, canna be paying top dollar for your doula.
Speaker 4 (26:50):
I saw like thirty five hundred at least for each
of those cities.
Speaker 2 (26:54):
Yeah, but that that scale can go all the way
down to zero. Well, sure, all the way to zero,
but if you were paying a doula, that number can
go all the way down to six hundred to eight hundred,
one thousand dollars and you know in the fly ower states, right.
Speaker 3 (27:12):
But again, I mean like, if if this is the
doula's first time on their own, you're probably not going
to be paying top dollar. And if you say, look,
I really really really want to have a doula at
my at my child's birth, but I really genuinely don't
have this money. I actually got a lift once from
(27:33):
a doula and she was talking about having to deal
with this family who clearly was very well off but
was pleading poverty. And she was like, I'm the one
who's a doula and driving a lift here, and these
guys are trying to like short change me.
Speaker 4 (27:47):
Interesting, so she said she told them no.
Speaker 3 (27:50):
She said she tried to work with them, but they
wouldn't they wouldn't budge about whatever they thought her services.
Speaker 4 (27:56):
Were worth, so she had to just walk on.
Speaker 2 (27:58):
But why would a family that's well off not paid
eight hundred dollars.
Speaker 3 (28:04):
I don't know, because I remember thinking like Wow, that's
that's all it costs for a doula. She might have
even been quoting them less than eight hundred dollars. Yeah,
so there is definitely like there seems to be a
tension between the desire to have a doula and the
sense of non obligation to pay a doula a decent wage,
(28:26):
which I think is where.
Speaker 4 (28:27):
That pro doula group pulls their hair out right.
Speaker 2 (28:31):
You know, well, you may get it covered by insurance.
There are more and more cases in insurance companies that
will let something like this be covered. But it never
hurts to ask. This article points out you can. You
can always ask, You can always file a claim and
just see if you'll get a little assistance there.
Speaker 3 (28:51):
Yeah, if you live in Oregon and Minnesota, though, Medicaid
will reimburse your full doula expenses for a certified doula,
which is pretty awesome. Like, that's huge in groundbreaking that
those two states have that for sure. The reason why
they would pay anything for a doula rather than just
being like just burn some sage or something and you know,
(29:13):
spend five bucks, is because there has been studies about
doulas and they have come out quite positive in some
pretty good peer reviewed studies in peer reviewed journals.
Speaker 4 (29:25):
Right, have you seen any of this?
Speaker 2 (29:28):
Well, yeah, I saw the one fifteen thousand people. That's
a pretty decent study size.
Speaker 1 (29:34):
And they said.
Speaker 2 (29:37):
In the study size, there were some women who had
dulas and some women who did not have dulas or
any kind of support like that. And then outcomes for
women with continuous support were better than those without, meaning
their labors were shorter by about forty minutes on average.
Their babies had higher Appgar scores. Which Appgar are these
tests they give your baby, Like the first thing your
(29:59):
kid has to.
Speaker 1 (29:59):
Do, take a test.
Speaker 2 (30:01):
No seconds later they're given your kid their first test.
Speaker 4 (30:05):
Yeah, activity, pulse, grimace, appearance, and respiration.
Speaker 1 (30:08):
That's right.
Speaker 2 (30:09):
Yeah, And so higher Appcar scores, fewer negative feelings about childbirth,
like this is the emotional component. They required, less pain medication,
fewer uses of forceps or vacuum assisted interventions see sections.
Speaker 1 (30:25):
Across the board, dula's helped.
Speaker 2 (30:28):
And what was really interesting was there was basically nothing
that could point at that said having a DULA was
a negative in any way.
Speaker 3 (30:36):
Yeah, and even when they look just at doulas rather
than just all types of continuous support just at dula's.
Speaker 4 (30:43):
The dula's they held up too.
Speaker 3 (30:45):
There was less use of pitocin, less sea section, more
spontaneous vaginal deliveries, less of a risk of being admitted
to a special care nursery, four times less likely in
one study to have a low birth weight child, two
times less likely to have complications, and they were significantly
more likely to initiate breastfeeding when cared for by ADULA. Right,
(31:07):
So there's all these like like demonstrably positive outcomes, and
then you hit upon the other thing too, that they
they make the harsh hospital environment. There's something called harsh environment.
Speaker 4 (31:20):
Theory, where the bright lights.
Speaker 3 (31:23):
And the people you don't know coming in and out
and treating you like a piece of meat that they
need to get this thing out of that it can
actually produce a traumatic experience. I suspect in more women
than you would think, having birth or giving birth in
a hospital is kind of traumatic, and for some women,
from what I read, it's like deeply traumatic. And that's
(31:47):
been a huge reason that doulas have really come into
use lately. It is because they mellow everything out for
you a lot more. And there's actually I read there's
a group of renegade dulas who are acting as midwives
out in the pot growing country of northern California.
Speaker 1 (32:08):
What's the relationship there to the pot growing.
Speaker 3 (32:13):
I would guess they probably do both. They grow the
pot and deliver the babies nice. I think it's kind
of like a whole back to the earth, to hell
with the man's establishment hospitals. Apparently it's illegal to give
birth like this without like a certified someone from the
medical community being there to assist in the delivery, saying.
(32:34):
They're saying nuts to that, which I would guess is
pretty dangerous but also illegal. And if there's anything that
screams Northern California more than dangerous and illegal, I don't know.
Speaker 2 (32:45):
Yeah, if you want to use a doula, and I'm
officially endorsing this, I say, don't say don't to say doula.
Speaker 1 (32:56):
Sorry, it couldn't resist on that one.
Speaker 4 (32:58):
It was worth it.
Speaker 1 (33:00):
You just get online. You know, the doulas are easy
to find in your area.
Speaker 2 (33:04):
Do a little Google search and get a reference, of
personal reference if you can, would be great. Get online,
find a friend who has used to do they can recommend.
I mean, that's really the best way. I don't know
if I'd go on Yelp or anything like that or
Angie's List, although maybe who knows. But it's better if
(33:25):
a good friend says, hey, I use this doula and she's.
Speaker 4 (33:28):
Great, I think.
Speaker 3 (33:28):
Also, the certifying bodies have directories of certified dulas in
areas too.
Speaker 1 (33:35):
Yeah.
Speaker 2 (33:36):
I mean, you want it to be a good personality
match too, So you should talk to your dula on
the phone at the very least, but ideally have a
little in person meeting to make sure, like, is this
someone I want to I want to jump into the
foxhole with because they're going to be around a lot,
you know, and you have to have a good personality
match there.
Speaker 4 (33:53):
Well.
Speaker 3 (33:53):
Yeah, and your husband or co parent needs to like
them too. You don't want weird tension between those two
in the delivery room.
Speaker 4 (34:01):
True. They need to fit into your jam.
Speaker 3 (34:04):
Pretty well, yeah, or else it's just going to be
Especially if you're one of those people who can't stand conflict,
that would be awful.
Speaker 4 (34:12):
To have a doula who.
Speaker 3 (34:13):
Your husband or co parent or wife or whoever doesn't
like and butts heads within the delivery room. That would
just be bad. And then you have to pay them afterward.
That would just be terrible. So yeah, you want to
vet them pretty well ahead of time.
Speaker 2 (34:27):
Yeah, and while you while ADULA is there to support you.
So while they may have their own opinions on what
they might do in a given situation, their childbirth philosophy
is your childbirth philosophy is a mom is what matters, right,
you know, So a good DULA will get on board
(34:47):
with that, or if they aren't on board with that,
then they probably shouldn't be working with you.
Speaker 3 (34:53):
And yeah, I could see them being like, look, I
can recommend a couple of other people who are more
in line with what you're looking for them me, you know, yeah, instead.
Speaker 4 (35:03):
Of wrong wrong wrong, This is all wrong. This is
how we're going to do it.
Speaker 1 (35:06):
That's right.
Speaker 4 (35:08):
You got anything else on dula's just.
Speaker 2 (35:10):
This little bit on death doulas. We may have covered
this in our Jeez in our Dying episode.
Speaker 4 (35:17):
Yeah, that's what I was thinking.
Speaker 1 (35:18):
I feel like we've talked about it. But it is
a job.
Speaker 2 (35:21):
If you want to help a family or a person
or both through end of life care, there are people
you can hire just to do that, and it's not
the same as they can work in concert with hospice care.
But it's not like a hospice nurse. It's someone just
like a birth doula who is there to really just
emotionally kind of coach you through through the dying process
(35:44):
with a family member.
Speaker 3 (35:45):
And also to very concretely hold your hand, make.
Speaker 4 (35:49):
Sure you're comfortable.
Speaker 3 (35:50):
Yeah, move you around a little bit, listen to you talk,
tell you stories, whatever you're looking for to make the
whole thing better. That's right, pretty neat. Up with Doula's Yeah,
I'll put Dula's agreed. If you want to know more
about Up with Dula's this new organization that Chuck and
I just now founded, you can.
Speaker 4 (36:10):
I'll just wait a little while.
Speaker 3 (36:12):
We need to get to work on the website, and
in the meantime, let's listen to some listener mail.
Speaker 2 (36:19):
All right, I'm going to call this flu shot clarification
because that's what the subject line says. Okay, hey guys,
Avid listener wanted to comment on the flu episode. I'm
a graduate student and a few months away from completing
my degree to becoming a physician's assistant. Well never mind, then, buddy,
I don't want to hear it.
Speaker 1 (36:37):
No, I'm just kidding.
Speaker 2 (36:38):
I spent a lot of time seeing patients answering questions
about things like flu shots and who should receive them.
The CDC now recommends that everyone over the age of
six months receives a flu shot, even those who are
perfectly healthy, even those who are allergic to eggs.
Speaker 4 (36:53):
They're cuckoo for flu shots.
Speaker 1 (36:55):
The new flu shots are now being designed to.
Speaker 2 (36:58):
Be egg free, so they're egg free, gluten free, what else?
Speaker 1 (37:05):
Dare free?
Speaker 4 (37:06):
They contained ten percent en wah, and.
Speaker 2 (37:08):
There's no evidence to suggest flu shots in recent years
could cause reaction in those allergic to eggs.
Speaker 1 (37:15):
All right, that's interesting.
Speaker 2 (37:16):
Did not know that He said the benefits of the
flu shots far outweighed the risk in his opinion. This, guys, Yeah,
and it sounds like it's an informed opinion at the
very least.
Speaker 4 (37:27):
Sure.
Speaker 2 (37:28):
So that is from Devon from phil Philadelphia, Go Eagles.
Speaker 1 (37:36):
He thinks, So really, yeah, I mean why not? They're
doing great?
Speaker 3 (37:39):
Okay, Well, thanks a lot, Devin. I appreciate writing in.
That was nice of you. And if you out there
want to be like Devin, you can hang out with
us on email at stuff podcast at houstuffworks dot com
and as always, joined us at our home on the web,
Stuff you Should Know dot Com.
Speaker 1 (37:58):
Stuff you Should Know is a production of iHeartRadio.
Speaker 2 (38:01):
For more podcasts my heart Radio, visit the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.
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