Hiring a Doula for a Cesarean Birth

When people think of doula’s, they think natural birth. Some people even think homebirth, or birth center births, but did you know that most all doulas support hospital births? Did you know they can help you through a cesarean too?

The majority of my clients birth in a hospital, and I’d say that about 85% of them also want to go without medication (mainly wanting to avoid an epidural). Some of them don’t know if they want medication, while others hire me to get as far as they can without it. I support them all, no matter what their goals, planned or unplanned. For me, it doesn’t matter what kind of birth a mother wants as long as she is making an informed decision. My point is, that a doula will support a mother no matter WHAT kind of birth she wants, and furthermore she is still worth it. Maybe I will do a post sometime on how a doula can support a medicated birth, but today I want to focus on how a doula can help with a cesarean.

Some of my most precious births have been cesarean births. The mothers did not plan a cesarean, but circumstances did not make a vaginal birth an option. Most of the moms had time to process the situation, and we had time to cover the options they might still have some control over. I provided them prenatal support, birth support, breastfeeding support and postpartum visits in the home for those who wanted it.

So what does it look like when you hire me as your cesarean birth doula?

Prenatal support 24/7:

Just like any other pregnant mom, you’ll still have questions! From “I think I’m losing my mucous plug, but I was going to go swimming, is it okay?”, to “what can I do for this sciatic pain?” It’s nice to not have to bug your care provider for the small stuff, and your doula will let you know when a call is warranted! A doula also carries with her a list of trusted referrals for just about everything from acupuncture to postpartum depression.

Prenatal Education:

The doula that helps with cesareans can still provide a LOT of education. For me, this is where being a childbirth educator AND a doula comes in super handy!

I like to start my first prenatal visit off with collecting as much information about the pregnancy and situation as I can. I provide my clients with options they didn’t even know they had for their birth. We discuss family centered cesareans, delayed cord clamping, types of suturing available, as well as the procedure, and recovery. I listen to and address the fears, obstacles, and ideas they have to make the experience the best possible.

The next prenatal covers newborn care, because no matter HOW you give birth, you still have the same baby to take home :-) My clients get my full “Newborn Basics” class, complete with handouts and a book that provides access to videos on everything from cord care to bathing. We usually take some to talk about the pregnancy, and any other things that may have come up since our last visit.

Finally, to build a stronger rapport, I offer an additional class. For those who want to breastfeed, they take me up on my Breastfeeding Basics Class. We discuss how this will look for her cesarean birth, and the options that she might have depending on her unique situation. Since I am familiar with most all hospitals in the Fort Worth area, and some on the Dallas side, I can provide feedback on if her breastfeeding goals are in line with the hospital she is birthing at.

For those not breastfeeding, they make take me up on my Happiest Baby Class - because who DOESN’T want a happy baby?! Again, this is just another chance for mom and dad to get to know me better before I share such an intimate day with them.

Birth Support:

 I like to talk to mom the day before the cesarean via phone or Skype. We go over last minute jitters, concerns and questions. We talk about when they would like me arrive, and what they would like my support role to look like.

The day of the cesarean, I arrive an hour or two prior to the cesarean. If mom and dad want to keep it light, we laugh, if mom and dad want help calming nervous, I’m on it. If they want to pray, we pray. I want to be calming, and reassuring. I am sometimes the sounding board for the range of emotions that mom and dad might be feeling on that day. I might rub legs, feet, hands or do scalp massage. If the surgery is delayed and dad needs to eat, I can stay with mom so she isn’t left alone. We go over the plan one more time, and make sure that everyone’s role in the room is clear. I answer questions and provide information on what is coming next as nurses come and go. When mom goes back for her sugery, she is as ready as can be expected. I make sure dad gets suited up properly (as dad can’t go back for about 20 more minutes). If we are at a hospital where the doula cannot go back, I’m prepping him on comfort measures, and filling his pockets with all the things he needs to get through the next hour.

If I am allowed to go back to the OR, I provide the comfort techniques, and do my part as discussed previously. If baby has to go to NICU for any reason, dad can leave mom without worrying that she is being left alone. After the surgery is over, I help with breastfeeding (if that was in the plan), and help mom through the first hour of recovery. After mom, dad and baby are settled, I leave and tell them to call me if they need any help, and let me know when they would like a postpartum follow-up visit. For a scheduled cesarean, I am usually with my clients at least 4 hours, but have been there as long as 12 when needed.
 

Postpartum Support:

I offer mom and dad a postpartum visit. This looks different with each client. Some want to go over newborn care, some need help with breastfeeding. Some moms just want to talk about postpartum recovery ideas, while others need hands on help around the house. I provide them with a time line of their baby’s birthday, and I make sure they know that for the next six weeks, I’m still available 24/7 for questions or concerns.

My cesarean support varies from client to client just like a vaginal birth does! I might spend 8 hours total with one couple, and 36 total hours with another because everyone has different needs. Each doula will provide a different approach, so ask your doula what her support might look like for you :-)

If you are one of those people out there trying to decide if you should hire a doula for your cesarean birth - ask yourself if you would hire one for your vaginal delivery and why. You may have been able to justify the cost with a vaginal birth because you know that your partner may need time to eat, time to sleep and that the birth might be long and hard. There are many women out there that didn’t regret hiring a doula for their fast births. Don’t you deserve support no matter how your baby enters this world? If you want someone who can guide you through the process, and make it as smooth as possible, hire a doula! She is going to guide you through this unfamiliar territory, and make this the best experience possible. She’ll show you some things you didn’t know existed or were possible.

If you are one of those people out there shaking their heads, wondering why you should hire someone to comfort you through the most amazing day of your life - then you are probably good to go without one. Some women look forward to their cesareans, have no fears, or concerns, take newborn classes at the hospital, and will call a friend if they need a referral.

If I had the money, I would hire a doula to take me to the dentist (oh wait, I did that once!), to be their for my first (and hopefully only), colonoscopy, and I would have a doula with me when I die :-) My husband has always been there for me, and a doula could never replace him. However, he can’t take the place of my doula either!   Sometimes, it really does take a village.