Is hiring a doula a rip off?

[Whyisthissohard96]

In the last few months I have noticed quite a lot of advertisements for Doulas in my local area.

I have an 8 month old daughter and whilst I was pregnant I was aware they existed, but thought they were just something celebrities got. I don’t live in a particularly affluent area. I am always out and about at pram walks and baby groups and none of the mums I have ever spoken to hired one either. I would think you would have to be really quite wealthy to consider getting one, or really nervous of birth and postpartum?

I was looking at a website and she charges £2k for the birth alone, obviously she would have to be on call for weeks, it could be a very long labour, and then I think some time postpartum was given to help establish breastfeeding. Any further sessions postpartum are an additional fee (obviously this is just one website, other Doulas could be priced totally differently). What happens if she has 2 clients giving birth at the same time?

My daughter was premature due to restricted growth, I had a c section so never experienced labour, if had paid for a doula I don’t think I would have got my money’s worth.

Has anyone had a doula? Are they worth the cost?

Not slagging off Doulas or anyone who has used them, just genuinely interested.

I hired a doula because my DH has a tendency to faint at the sight of blood or needles and I didn’t want to go through labour on my own, with him out cold on the floor! So there was an element of reassurance that, to me, was worth the money. In the event, DH did just fine, so she wasn’t strictly needed. However, she did get me the water birth I wanted. The midwife said that I couldn’t have one, but my doula asked to speak to the Director of Midwives, and then it magically became possible. So I was very grateful for that and don’t regret hiring her one bit!

I think I’d have felt the same as you had I known they existed before I got one! I had never even heard of a doula at the time (my kid is a teen now) and this hadn’t been the plan at all but my mum who lives in a different country within the U.K. and who was still working at the time, hired a postnatal doula for me after a very difficult birth. She’d come and look after the baby for me for a few hours, maybe bath him etc, and also put on some laundry and tidy up a bit etc, make me a cup of tea, get a few things from the shop for me etc. Basically do the things my mum wanted to be able to do for me to make life a bit easier but couldn’t do herself due to distance and work.

Despite her help, my mental health deteriorated and I actually ended up sectioned in the end as I had a full blown puerperal psychosis, but even then she would come to visit me in the psychiatric hospital and bring me what I needed, buy me new clothes (I put on weight with the psych medication and didn’t fit into mine anymore), bring me a book to read, bring me cards and presents people sent to the house for me or my son, paint my nails to cheer me up etc. She helped me a lot at the time and I don’t know what I’d have done without her! And I could see how she’d have been really useful during labor. After that I decided if I had another baby (I didn’t as it turns out as I ended up getting divorced), I’d make sure I’d set aside enough money to be able to hire a doula!

I think they sound like a wonderful idea. The more people on your side at such a vulnerable time can only be a good thing.

I hired a doula for both my births. I gave birth abroad and it felt great having someone advocate for me in quite an old fashioned system and mentality. I got the birth I wanted and I knew what was happening and was prepared for every step. She was brilliant and gave essential support before during and after the birth. I couldn't have done it without her. Especially by ourselves in a foreign country.

I always assumed they were for women who literally had no one else...so no mum, sister, aunty, friend combined with no/useless partner.

Postpartum doulas sound great to me. I always wonder if they are ‘on call’ in the weeks leading up to birth, must be hard.

How many women take their friends to give birth?

Probably ones who are single or have useless partners and no relatives able to be there.

It was worth it for me but wouldn’t be for everyone. I just had them for the birth bit. I had fairly strong views on what I wanted including home birth. DH wasn’t in a position to advocate fully for me (having less knowledge than I did).

As It turned out DH would have ended up delivering the baby if she hadn’t turned up! Given the speed she put him to work, organised the medical teams arriving, sorted out DC1 and allowed me to concentrate on the job in hand.

DH wasn’t entirely sure why I wanted one but afterwards thought it was the best idea ever. It significantly reduced the stress/pressure on him as well.

I know a doula. Her customers are from a wide variety of backgrounds and do usually have partners. So not the yummy mummy type I'd been imagining.

She says because she has been at a lot of births now she finds she can reassure the mothers about process, help with decision making etc but most importantly, help advocate for the mother as she now has a good feel for if they are being fobbed off. Most parents especially those going through it at the time will just trust what the medical professionals say, which isn't necessarily always the best thing for them.

For example my first birth was long. Strong contractions every 3 minutes for 3 days before anything happened. I kept going into hospital because I couldn't cope and they kept sending me home. By the time it came to admit me there were signs the baby was in distress, I was 2 minutes away from an ECS I was so so tired after no sleep for 4 days and retained the placenta etc. The same thing pretty much happened with my second, however this time my husband took me into hospital and told them we wernt going anywhere until I'd had some pain relief and sleep. They gave me pethidine and I actually had a few hours nap which made a huge difference. He also kept pushing for the hormone knowing that it was going in exactly the same way as my last birth which just stalled at 8cm as my body had had enough. So it was a bit less panicked at the end. Having someone with even a bit of knowledge, speaking up for you, can make a huge difference to your experience.

My friend has said she has insisted midwives examine women who are being sent away, only to find they are 10cm dilated and about to push.

My sister had our mum, and a doula and 2 midwives as well as her husband (home north) and had I been in the same city, she’d have had me in there as well. Some women love to be surrounded by support. Personally I would have liked to give birth all alone!

Home birth, that should say

I don’t think many men are necessarily useful with childbirth!

Are they even medically qualified? I don't get it.

It’s a nice idea for single Mum’s or Mum’s with husbands who work away for example, if they don’t have a suitable relative/friend to be with them. I wouldn’t pay it personally but I know someone who is a doula and she earns a killing. She supports them in the run up to the birth too and a bit afterwards.

I had a doula for both of mine. FiL actually recommended we look in to getting one with our first. We are by no means wealthy and iirc correctly it cost about £900 for her (2017), I went for a birth package so had support before birth which involved discussing birth preferences, general knowledge sharing on pregnancy and birth, suggestions/advice and having her at the birth and then a debrief meeting a week or two after birth. She was invaluable, her calm helped my husband when he thought I was dying and her knowledge helped us avoid both an unnecessary and unwanted early induction at 38weeks and emcs (not related to why my OH thought I was dying).

I was in Germany for the birth of my second son (2020), we didn't have a lot of spare money but I was very lucky to find a Doula in training, who was offering super cheap packages to build up her experience, so she only cost us around €400, she also threw in photos of the birth as she is also a photographer. Again invaluable, she spoke English and German fluently which took some strain off as well as understanding of the German birth system. Then of course we had covid and so I was only allowed 1 birthing partner, because we had her it meant my OH could stay home with our eldest and I still got to have my doula with me. I have no photos of myself with my first baby within the first couple of days, so I cherish having so many more of my youngest's birth. Same package deal again, meetings prior to birth, help with understanding the system and filling in German forms, present at the birth (gave me back massages while I bounced away, fetched me abendbrot (food) after he was born) and debrief after where she also asked if we needed anything from the shop before she came and so picked up a few supplies for us. I also booked her for a family photoshoot a while later :)

I would definitely recommend a doula, as long as (general) you can afford it and especially for a first birth.

My experience with a doula wasn’t a great one to be honest. So from personal experience I would save your money.

I was okay during the birth as I do stand up for myself. I would have spent the money on after care though. Someone to help with baby. Making bottles. Cook meals. That would have been a godsend . I would pay a lot for that again

I wish I'd known post-natal doulas were a thing. I had a shitty post labour time - baby keeping my up all night, no family support (all miles away and in poor health). Husband had to go back to work and, apart from the odd baby group, was on my own most of the time for 12 hours a day, five days a week. Would definitely have valued having some support for the first 6 weeks.

@dressedforcomfort I’m sorry that happened to you and the unpleasant digs about women who ‘have no one’ are really quite unkind.

I think they are a great idea. Like pp said, the more help you can get the better it is for mum and baby
Someone mentioned about them being qualified? Not sure what the criteria is to become one , but im sure ive heard of ex midwives/ nurses becoming a Doula.

TW discusses baby loss:

Doulas are an invaluable resource if you can afford them. They can help you at home to prepare for the birth, have birth support packages on offer and can also assist you postnatally.

Doulas are not medically trained however, so they can absolutely help you to advocate for yourself, but they are not licenced to, and must not offer medical advice. I would also suggest doing your own research around your birth choices, especially if they differ from NICE/local hospital guidance, so that you're fully informed of all risks and benefits of each decision, as well as the risks and benefits of choosing to 'do nothing' as an option.

I'm a midwife, and have worked alongside some amazing Doulas who were calm, thoughtful and respectful in that they knew their limitations, and would help us explain medical terms/procedures in a way that their clients understood.

I have however also worked alongside some downright dangerous Doulas, who actively encouraged a technical freebirth and refused midwives and paramedics entry to the bathroom where a mother was delivering her baby (which is actually illegal). Another where a mother was desperate for a waterbirth and refused all monitoring including monitoring of the fetal heart as the Doula had managed to persuade the mother she didn't need it, despite us explaining to her that there was thick meconium in the waters. By the time we got a CTG on we could see it was too late. Baby was born into the water, went up to mum and the Doula physically barred medical staff from cutting the cord and attempting to resuscitate the baby. The mum was obviously just so brainwashed by this woman that she let her. It was awful.

So they can absolutely be amazing as helpful aides but I would educate yourself on their roles and responsibilities and what they're legally allowed to offer, so you are adequately prepared to challenge them should the need ever arise.

Had one with my second due to horrendous care during my first including my DH being shouted down trying to advocate for me because a registrar assumed within seconds of entering the room that he was trying to stop me from speaking. I was in the middle of a contraction with a gas and air tube in my mouth. Everything went south from there.

Hired a doula for my second because she had experience with traumatic births and bad care so wouldn’t dismiss my feelings or make excuses for those who treated my DH and I so poorly (doctors are only human and make mistakes even when they’re coercing you into something that was unnecessary and caused more harm🙄). She also was a prenatal yoga teacher so could help me with movements during labour to help. It was wonderful having someone there who reminded me that I had choices and consent (again, huge issue with my first) and could advocate for me if needed. DH was with our oldest since we didn’t have anyone to watch him. Had a successful vbac and a calm, zen-like labour and birth, complete opposite of my first.

This.
If NHS maternity services were better funded, and if midwives actually listened to birthing mothers and respected their wishes, we might not need doulas.
However, my first birth was traumatic - mainly due to an unpleasant and unsupportive midwife - so I hired a doula for the second birth. It was money well spent.

"I do stand up for myself"

No, you were lucky. You were able to advocate for yourself and you had midwives/doctors who listened.
I'm an assertive person, and a lot of women I know are perfectly capable of standing up for themselves, but when you are in labour, you are vulnerable. For some, the pain is overwhelming, it can feel scary if unexpected things happen, etc. If you're in hospital, the HCPs are "in charge" - and it can be very difficult to go against them. It depends who you get, too, because while most are good, some may not be.