Which do I choose--birth or postpartum doula? When would I NOT need a doula?
While many would say both (who wouldn’t want support with two life changing experiences?) I also know many parents have a limited budget and still want great support for their transitions to parenting.
Here is what I have seen work for thousands of clients over the past 20 years of supporting families both who have professional doula care, and those who attend my classes and new parents groups (who generally don’t have doula support).
Reasons you really want to hire a birth doula:
You are looking for a peaceful birth experience.
You are worried or anxious about being in a hospital and not having autonomy about your birth decisions.
You are concerned about your partner being able to know what to do/be able to stay calm in a stressful situation.
You want an unmedicated birth and need someone with knowledge about comfort measures to help you.
You are having (or at risk for) a cesarean birth and want someone guiding you who has time, patience, and knowledge of the process to guide you through.
You are birthing alone.
You are birthing with partner or family support, but they are nervous and you aren’t sure how they will respond in a stressful situation.
You don’t cope well with pain, you are triggered by some of the laboring experiences, or you shut down when people are stressed around you.
You are a first-time parent.
You are welcoming a second baby and didn’t have a good first birth experience.
You are welcoming another baby and did have a good birth experience, and know you will need someone to help you have another!
Your mental health is better supported by a calm, knowledgeable guide who communicates well and uses their intuition so you don’t have to carry the mental load of telling them what to do when you are doing one of the hardest things you will ever do.
Sound like everyone, right? Personally I have had one birth without, and one with, and I can tell you I would not choose to birth without a doula if it was an option. Although I believe birth doulas are beneficial for almost everyone, there are a few reasons not to.
When do you NOT need a birth doula (IMO)?
When you have a supportive circle of people (who have given birth or supported others’ births) and know how to comfort you, aren’t offended by you being nude, screaming, or passing bodily fluid or sounds, and can be on call to attend you while laboring and birthing.
When you are having a planned cesarean birth and already have taken a class specifically about surgical birth, know the procedures and process, and understand your rights as a birthing parent (as well as your partner knowing the policies and their rights as a new parent) AND you are not afraid of the hospital or surgery.
When you are welcoming multiples with a supportive hospital team, and don’t have access to doulas who have experience with multiple births. While a birth doula is still valuable, the skill set needed for multiples is vastly different and doesn’t always translate through a highly medically-managed multiple birth.
Reasons you really want to hire a postpartum doula:
You live away from extended family and they aren’t planning to move in for the first 40 days to care for you.
You are a first-time parent with a million questions about newborns (or know you will have them later).
You had a rough pregnancy and are sleep deprived going into labor and birth.
You had a difficult birth or injuries to recover from including cesarean repair, 3rd or 4th degree tears, or other complications.
You are having multiples. (Just that. No other reasons needed.)
You don’t cope with lack of sleep well, don’t nap well, or in general aren’t flexible about sleeping when you can.
Your partner needs to return to work fairly soon (or you do).
You are concerned about experiencing a postpartum mood disorder, or already struggle with depression or anxiety.
Your partner, while a loving human who adores you, lacks the skills to care for you in a nurturing way. (Truly no offense meant here, I have seen the MOST loving partners be really clueless in postpartum care—and not catch on in time for healing to take place.)
You have other kids (or pets) with extensive needs while you are recovering from birth.
You are the main cook, cleaner, chore doer, and otherwise default person in your home (because if you are down, everything goes down).
If you are parenting solo. (You deserve support for doing such a big job.)
You are planning to breastfeed but lack people in your life who have experience feeding their baby human milk or the expertise needed for problem solving.
You lack people in your life you can process big and small experiences with.
You have people in your life but they are judgy and don’t make space for you.
You are the person that cares for others, but don’t have care in place for yourself.
You have a fussy baby that isn’t easily soothed by things you find out on the internet.
You are overwhelmed, exhausted, emotional, and generally just not getting the basic needs met of sleep, food, hygiene and company.
So again, almost everyone! 😊 But there are times when I think a postpartum doula is NOT needed:
When you have a circle of support in place of people who love you, cook for you, clean for you, support you emotionally AND they know babies and breastfeeding/chestfeeding/exclusive pumping/bottlefeeding.
When you can piece together such a team with care from many people, and your partner is nurturing, comforting, and not overwhelmed with all the added responsibilities.
When you have had a beautiful birth that has left you empowered, your healing goes quickly, and you have an easy baby that breastfeeds easily and sleeps well.
Ok, I know I am being a bit extreme here, but I do see people I see who really don’t need much help, usually because either they HAVE the help provided by their loved ones, or they have the easiest situations (which are still not EASY, but easier than the average) and they are thriving.
I still think a birth or postpartum doula can help almost any family, but I try to keep in mind (while still running a business that provides professional doula services so clearly I have a bias) that we are only FILLING THE GAP that used to not exist because the family (and midwives) provided it. Nanas and mamas and sisters and aunties and besties--and sometimes grandpas and uncles and brothers and of course husbands and partners—were always the ones who put things back together while birthing moms recovered and bonded with their babies. Currently most of our clients don’t have those who are available or have the knowledge or experience needed to support them, or they do but they aren’t available at night! Doulas are there for the families who don’t have this role filled elsewhere, and they do it well and without judgment.
So, if you have a big village already in place to support you after birth with cooking, child care, cleaning, pet care, and emotional support (as well as knowledge about babies and feeding) than skip the postpartum care and focus on having the best birth possible with a professional labor doula.
However, if you are on a short budget and have people in your circle who have experience with birth and you think they will be able to stay calm and support you through whatever birth holds for you, focus your budget on postpartum care.
And if you are lucky enough to have BOTH, celebrate the amazing people in your life, and once recovered, become those people to others! The world needs more of them.
You will remember both experiences for the rest of your life. Birth transforms you. Having support will empower you, help you to have a beautiful experience, and provide you with loving care during one of the biggest challenges and biggest celebrations you will ever have! Parenting also transforms you, and while it is longer and slower, your beginning will affect how you parent for the long haul. Having nurturing care will mean you can start parenting with many of your needs met, which makes you even more of the parent you planned to be.