Transcription:
What is a Doula

Bill Klaproth (Host): So, imagine having someone with you before birth, during birth and after birth; someone to really take care of all of the details and be there for you. Well, that is a Doula. So, let's learn more about exactly what a Doula does before, during and after birth with Mollee Franklin, a Certified Doula and Lactation Educator at MarinHealth. This is the Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth. Mollee, thank you so much for your time. It is great to talk with you. So, let's start with this. Exactly what is a Doula?

Mollee Franklin, CD, CLE (Guest): Yeah, thanks for talking with me. So, a Doula is a birth professional who provides educational, emotional and physical support to birthing people and their families throughout pregnancy and childbirth. Important to remember that Doulas are non-medical support people. So, we don't deliver babies. We don't provide medical care. But what we do is normalize the birth process. We help people find resources through the community. Really we just help normalize this whole experience. There are things that happen in labor and in pregnancy that seem out of control or seem scary. Having a Doula there to help you through this process, answer questions for you and then in labor, to actually be there with you and your partner or your family every step of the way, can make a huge difference in how someone views their childbirth experience and how they get through it.

Host: Yeah really interesting. I like how you say you normalize the birth experience. So, talk to us about your training. What do you have to go through to become a Doula?

Mollee: So, there are various Doula training organizations. Two of the better known organizations are DTI which stands for Doula Trainings International and they offer online trainings and in-person I think right now. There's also DONA which stands for Doulas of North America. That's where I did my training, 17 years ago, a long time ago. These Doula organizations provide extensive trainings that teach people really just how to best support laboring people through pregnancy. Also how to help them find different resources in the community. But then there are also advanced Doula trainings where a Doula can learn more specialized skills like working with survivors of trauma or full spectrum Doulas where we help people from abortions to sometimes having a stillbirth. Then there are also trainings that focus on skills like baby positioning that can make a big difference for how your labor goes. Focusing on acupressure for labor. All of these different trainings can really help people have extra skills, and helping people get through labor. Also Doulas tend to take classes focused on extra education around breastfeeding help. That's a big part of what I do as a Doula, at a postpartum visit after someone's already had their baby. So, I became a Lactation Educator through UC San Diego, so I could really help my clients with breastfeeding after and also be able to teach breastfeeding classes.

Host: So, then let's talk about the birthing process. How do Doulas assist during birth?

Mollee: So, Doulas assist during birth, it really starts even well before the day of the actual birth. So, a Doula helps with helping people find different classes focused on different childbirth methods they may be interested in. Also helping people find chiropractors or acupressurists or people in the communities so that when it does down to the big day of labor, people are really well-prepared. What that actually looks like in labor, it's very hands-on. I help people through massage, through making different suggestions as far as I'm kind of always scanning somebody to see where they might be feeling a contraction. Based on that, I make different suggestions for positions as far as finding comfort. My practice as a Doula is to always try and keep labor progressing, to try and minimize the use of intervention. So, we're always trying to get to that final part of getting to pushing. And then after baby's born, helping with that. But the hands-on things that Doulas during labor, again just that support as far as massage, positioning, making different suggestions as far as using hydrotherapy with a birth tub or with a shower, also making sure that someone is staying hydrated and eating. And that goes for the partner too. Really making sure that the partner is taking care of themselves so that they can really help their partner who's birthing and in labor. The other things that we're doing are really just normalizing things. There are things that happen in labor that seem like they must be terrible. For example vomiting. Any other time in your life vomiting is terrible. In labor, it's actually pretty exciting that usually shows that there's progression being made, that someone is getting closer to being in that pushing phase, kind of like a dance in labor between myself as a Doula, between the person who's laboring and their partner. And then also the staff really bringing in the staff and creating just a team effort between all of us to help the person in labor have the best experience possible.

Host: Wow you really painted a great picture when you called it a dance. That really puts it in perspective about how you are in there helping not just the birth mother but you said the partner as well and the medical professionals. You're all in there together doing this. So, you painted a great picture and you said earlier you don't actually deliver babies but you are there. So, what types of births do Doulas attend? Are you at all of them or give us some insight into that?

Mollee: Yeah, birth Doulas attend all different types of birth from planned Cesarean birth, to unmedicated births, to births where someone is planning on having an epidural or pain medication. I think it's kind of a misnomer that people think they should only hire a birth Doula if they're planning on having an unmedicated labor. That's just not true. There's so much laboring that happens before it's time to have pain medication. And everyone deserves to have the support and encouragement that birth Doulas provide. But if someone is planning on having an unmedicated labor, Doula support can be hugely helpful in reaching that goal. It's really important for everybody to have lot of support during labor. Sometimes I have people hire me who are having their second baby who maybe didn't have a Doula the first time in labor. And the feedback that I get from them is that we didn't realize how alone we would be at times. When labor starts and you're at home, it can be very overwhelming especially for partners about when do we do it at a hospital? Where do we go? Who do we call? Being able to have your Doula as just that kind of sherpa almost on this journey; being able to have that comfort and support is hugely helpful.

Host: You know, as you say that, Mollee, I was just thinking on that example, you gave of a woman who's having her second child. And you mentioned kind of being a sherpa, someone there to take care of all of the details. I wonder if people hire you sometimes or as another benefit, they just enjoy the experience of having a baby more, because they're not worried about all the details they can just enjoy the pregnancy and the birth and not really have to worry about things that would take up all of their time. Is that a way to look at it as well?

Mollee: Absolutely. So, many times it will happen where someone hires me and then I do prenatal meetings. So, I meet with people prenatally, at least twice before they even go into labor. And so many times there are partners who say well why do you need a Doula, you have me. I'll be there. I'll be able to do this for you. And then I can tell you, every birth I've been at, afterwards the partner looks at me and says I don't know what I would've done without you being able to have that support. It's very hard to see your partner in pain, right? And feel like you want to fix it. And labor is painful. It just is. But having that comfort and support of knowing that there's going to be someone there just for you with a Doula, is huge.

Host: Well, it's easy to see the multiple benefits of having a Doula. No question about that. So, let's talk about COVID of course, pregnancy and COVID, that was really stressful for a lot of women giving birth. So, Doulas were allowed to help at MarinHealth and still are allowed to help at MarinHealth during COVID-19?

Mollee: Yes. So, I know COVID was so hard in the beginning, there was so much fear and Doulas for a little while, at the beginning of COVID were not allowed. At one point they weren't even allowing support people in the hospital in the form of partners or husbands, which very quickly changed because they realized how terrible that was for a person to have to labor alone and have their baby alone. So, Doulas have been allowed back at MarinHealth since the fall. And it's so nice to be able to be back and, out of all the hospitals that I've worked at as a Doula, MarinHealth is one of the best places for me to practice as a Doula. The staff there are so supportive and really, really appreciate the help that Doulas provide.

Host: So, Mollee at what point then in a pregnancy would a birthing person typically hire a Doula?

Mollee: I usually advise people to hire a Doula as early as 10 to 12 weeks of pregnancy. Doulas tend to book up months in advance and once a Doula's calendar is full, they're booked and not able to accept more clients. So, if having a Doula or working with a Doula is something that someone is interested in, it's great to find someone sooner than later and be able to just check that off your list. It's also great to start working with a Doula early on to be able to establish that relationship and really create that trust between the birthing family and their Doula. Also to be able to benefit from your Doula's knowledge and advice as you move through your pregnancy and questions come up. What I help my clients with during pregnancy is everything from suggesting resources as far as great childbirth books or even podcasts to listen to, or classes to take, also helping, them find a chiropractor if their back is hurting from sciatic pain or even perinatal therapists. There's a great community here. A lot of times pregnancy brings up a lot of emotional things. So, having your Doula there to talk with and then also having your Doula be able to recognize when maybe you need some more help and helping you find those resources.

Host: Yeah, it makes sense to establish that relationship early on, as you said. I could see where that would be beneficial. So, then what about afterbirth. Do Doulas also provide postpartum support?

Mollee: Yeah Part of birth Doula's this package usually includes at least one or two postpartum visits, where they come to your home after you've gotten home from the hospital with the baby. They help with breastfeeding, answer newborn care questions and then also help you process the birth and talk through the birth. With that, there are also postpartum Doulas specifically that are not Doulas but work only as postpartum support. And then even more specialized with that, there are postpartum Doulas that provide nighttime support. So, overnight Doula support and then also daytime support.

Host: Right. Wow, this has really been fascinating. And thank you so much for your time. So, how can a birthing person find a Doula? How does somebody go about finding someone like you?

Mollee: The best way to find a Doula is to ask your midwife or obstetrician for recommendations. You can also ask friends who they've worked with and there are usually local Doula groups that can be found with a web search. I do think that most important thing to remember is that there's a Doula for everybody. Some people really prefer more of a peer, while other people would like to have someone that is maybe more of a maternal presence. Here in Marin, we have a very diverse group of Doulas. So, there really is a Doula for everybody. My website is marindoulaservices.com and that's a great place to connect with me or also find out more information about what a Doula does and the support that they provide.

Host: So, when you say there is a Doula for everyone, Mollee, I would imagine there is a Duola then that would fit for varying budgets as well, as far as the cost of a Doula. How does that work?  

Mollee: Absolutely. So, there actually it runs the spectrum. But there are groups that provide pro bono Doula services to low-income people. So, that's available in our community as well in Marin. And then as far as cost of the Doula, it really depends on a Doula's experience, the years that they've been working as a Doula, the advanced trainings that they provide. So, kind of like more experience and more training, you could expect to spend a little bit more money. It also really depends on the area that you're in.

Host: Well, that's really good information, Mollee. And thank you so much for your time. Once again, if somebody wants to get ahold of you, please go to Marindoulaservices.com. Mollee, this has really been informative. Thank you so much for your time.

Mollee: Of course. Thanks so much.

Host: And once again, that's Mollee Franklin. And to learn more about pregnancy and maternity care at MarinHealth, just visit maternity@mymarinhealth.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Healing Podcast, brought to you by MarinHealth. I'm Bill Klaproth. Thanks for listening.