VBAC Series: Interview with a Doula (in Training)

             Welcome back to the VBAC Series! I am so excited to not only be able to share information about doulas (see yesterday's post HERE), but getting to interview one as well! Michelle M. is very close to receiving her certification from CBI (Childbirth International). I hope the Q & A below helps you get a better understanding of what doulas do and why they do it!

 GGWB: What prompted you to become a doula?
 Michelle: Simply, my birth experiences. During my own labors I really wish I would have known about doulas. It could have helped me to get through the bullying, and interventions. Through every woman's pregnancy and childbirth, they want (and really need) someone to be there to support and help guide them through the experience. Doctors can do that from a medical standpoint, but often do not provide the emotional support that a mother needs. In the U.S birth has become a medical issue. Woman are taught to believe their pregnancy and birth is something that needs medical attention, and a hospital. This is far from the truth. Childbirth has happened since the beginning of time, and is a very personal and natural occurrence. Giving birth in a loving, peaceful, and supportive environment is my main goal. I want women to feel that the decisions they make during childbirth are coming from knowledge and empowerment. I want them to feel completely comfortable, educated, and supported on their decisions.
GGWB: Why do you think it is important for a pregnant woman, especially one who is trying for a VBAC, to hire a doula?
Michelle: I think having labor support can mean the difference between an empowering experience, and one of trauma. Ina May Gaskin has said that, “good maternity care actually requires attentive, well-trained, calm and compassionate humans who know a lot about the physiology of labor”. (Birth Matters, Gaskin) When a woman has the support she needs, she can overcome her fears and inhibitors to have a miraculous birthing experience.
VBACS can be very hard to accomplish in a regular hospital setting. There is this lingering thought that once a cesarean, always a cesarean. Although, the risks of a second cesarean outweigh the risks of a vaginal delivery. Still a lot of obstetricians fear uterine rupture, (even though) there is a very slim chance of it actually happening. This one fear holds them back from allowing women to have the birth they want. Doulas are there to help create and stick with your birthing plans, and to also work with your provider to give you the birth that you want.
GGWB: What services do doulas offer? (What do you do?)
Michelle: Doulas can offer many services. The basics of a birth doula are to establish a relationship with you, so that you will feel completely comfortable with them. They are there to help educate you, and to help you prepare a birth plan. When you are in labor, they will help keep you relaxed and calm, help manage pain and comfort levels, and make suggestions regarding labor and positions depending on how your labor is progressing. They will be there to help ensure you feel confident communicating your needs to your provider. Doulas also can provide other services as 'add ons', such as belly casting, pre/post-natal massage, placental encapsulation, and pool rentals.
GGWB: Generally, how much does it cost to hire a doula? 
Michelle: It honestly greatly depends on where you live, and/or how experienced the doula is in some cases. I have seen prices as high as $1200.00 and as low as free. A lot of doulas who are working on their certification offer free or discounted services, as they are required to attend so many births before becoming certified.
GGWB: What advice would you give to someone trying to avoid a cesarean at all costs?
Michelle: The best thing to do in the case of a low risk pregnancy, would be to hire a midwife, and have a home birth. Even high risk individuals can still avoid a cesarean in most circumstances, provided they choose the right provider. If going with an obstetrician, I would choose one who practices evidence based care.
Of course I would recommend a doula in any case. Doula support is shown to lower cesarean rates, shorten labor, and reduce the need for medications and medical procedures that carry risks, including forceps and vacuum extraction.