Selects: The Deal With Doulas

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Speaker 3 So, what's the deal with doulas, everybody? That's my question to you on this wonderful Saturday morning.

Speaker 3 This one goes back to December 12th, 2017. Doulas do great work, they're wonderful people, and they bring babies into the world.
So, I hope you enjoy the deal with doulas.

Speaker 1 Welcome to Stuff You Should Know, a production of iHeartRadio.

Speaker 4 Hey, and welcome to the podcast. I'm Josh Clark, and there's Charles W.
Chuck Bryant, and there's Jerry over there. And this is Stuff You Should Know,

Speaker 4 the podcast.

Speaker 5 Childbirth Edition.

Speaker 4 Yeah, we are traipsing into more territory. What does that mean? I don't know.
I mean, we've done two on, you know, feeding babies. Yeah.
Done female puberty. Yeah.

Speaker 4 This will get into childbirth a little bit.

Speaker 4 So, yeah, we're not afraid. I don't care.
Yeah. I guess is what I'm trying to say.

Speaker 5 You can be a male doula.

Speaker 4 You can, although this is the only article I ran across that in. Did you find anything about that anywhere else?

Speaker 5 No, I mean, it happens. It's just super rare.

Speaker 4 It happens.

Speaker 5 Because I mean, we'll go ahead and spoil it. Generally,

Speaker 4 doulas are,

Speaker 5 well, let's just get into this.

Speaker 5 Generally, doulas are women who have already had a baby. Yes.
Not even just women, but women who have had a baby, so they can really know how to help another lady have a baby.

Speaker 4 Yeah, yeah. And this is actually, so this is an ancient thing that's kind of come back around full circle.

Speaker 4 And even the name doula is a Greek term used way back in the classical Greek days when a woman giving birth would have female servants attending to her during birth, helping her with it, probably feeding her some grapes, waving palm fronds on her, that kind of thing.

Speaker 4 So doula means female servant or female slave, depending on who you're talking about. Right.

Speaker 5 And

Speaker 4 after

Speaker 4 ancient Greece fell to Rome and the Roman Empire fell, and

Speaker 4 all of civilization took this weird course, throughout it all, women were helped by other women while they were giving giving birth.

Speaker 4 Basically, up until about the first third, first half of the 20th century in the West, where

Speaker 4 hospitals entered, and all of a sudden, it was just the mom giving birth surrounded by a bunch of nurses and doctors.

Speaker 4 Is that true? Yeah.

Speaker 5 Because I could see scenarios where there were

Speaker 5 women in the birthroom helping along.

Speaker 4 I think once you started to get into hospitals and the physicians in the hospital starting asserting their authority more and more,

Speaker 4 especially through drugs, like I saw that

Speaker 4 when hospitals kind of took over the birthing process or took responsibility for it from the family and from midwives and moved it into the hospital, they used to administer a lot of sedatives as part of the birthing process, as part of labor.

Speaker 4 You know, you could understand why they would, but then there were all sorts of complications from it, problems from it. So they stopped giving

Speaker 4 sedatives as much. And about that time, women who were giving birth started to kind of come out of it and look around and say, Whoa, it's just me and you guys in here.

Speaker 4 I need some family members in here.

Speaker 4 And at the time, like, if you were a dad, you were not in there. You were not in the delivery room at all.
You were out in what was called the Stork Club,

Speaker 4 handing out cigars, maybe pacing.

Speaker 4 And the reason why was because

Speaker 4 to the doctors involved, it was just another medical procedure.

Speaker 4 So you're not going to have randos who have nothing to do with the actual procedure in the room during a procedure.

Speaker 4 They treated childbirth the same way, but women started to say, no, I need more than just you people who I've never met before, really, attending to the birth of my child.

Speaker 4 And so dads started to come in, and then more family members. And then now, doulas have definitely kind of come back like they were originally.
That's my understanding of the whole thing.

Speaker 5 Yeah, so doulas, we haven't even said what that is yet, and that would probably help clear it up.

Speaker 5 If you don't know, doulas are people, like we said, generally women, but not always, who are childbirth coaches. They coach you through the process.

Speaker 5 They will, depending on the service they offer, will come on before,

Speaker 5 obviously, you give birth and kind of prep you for what's going to happen. And this, I mean, it kind of depends on when your doula will come aboard in the process.

Speaker 5 But at the very least, they will help you in the delivery room, and they are your advocate to kind of coach you through this whole thing.

Speaker 5 And that term actually started in an article in 1969 by a woman named Dana Raphael, and then later on in a book in 1973 called The Tender Gift, Breastfeeding.

Speaker 5 And that's when she brought this term back and said,

Speaker 5 you know, we're going to start calling these women doulas, and it's going to be a real job.

Speaker 4 Right. And

Speaker 4 I think at first, what was the name of the woman who brought it back?

Speaker 5 Dana Raphael.

Speaker 4 So she had like a pretty good idea that was actually ahead of its time. When doulas really started to come into use and come into their own as a profession, it was in the 80s.

Speaker 4 And the reason why they came into wider use was because hospitals were going to C-sections a lot.

Speaker 4 C-sections went up from 1970, 4.2% of live births in the U.S. involved C-sections.
16 years later, in 1986, a quarter of live births in the U.S. involved C-sections.

Speaker 4 And there are a lot of complications with C-sections.

Speaker 4 And so you could have your husband in there, you could have your mom in there, you could have friends, but they're just there for you.

Speaker 4 One of the first services that Doulas started offering was to say, whoa, whoa, whoa, does she really need that C-section?

Speaker 4 Are Are you sure about that? Or are you just doing it because you can charge more money?

Speaker 4 I think that was overstating exactly the interaction they had, but that was the role they had, was to basically provide a barrier between a doctor who wanted to just give a C-section because he wanted to go home and the mom who really didn't want a C-section.

Speaker 5 Yeah, and it's not just C-sections.

Speaker 5 They're your birth advocate

Speaker 5 to make sure, or at least as best they can, to try to ensure that the birth plan that you feel best about is the one that you end up with.

Speaker 5 Things always change, of course, and a doula would never put you in danger by insisting on something.

Speaker 4 In fact, they can't.

Speaker 5 But they are there to speak for you on your behalf because as a mother in labor, you're going through a lot on your own. So it's nice to have someone that is just there to do that job.

Speaker 4 Yeah, and

Speaker 4 is coming from a place of empathy and sympathy and most importantly, experience. Like you said, most doulas have had children of their own, but they've also, after a while, attended other births too.

Speaker 4 So they know what they're talking about. They know what to expect, and they can tell you what to expect, which can make the whole process easier, I would imagine, for any mother giving birth.

Speaker 5 Yeah, it's definitely gained popularity in the 2000s.

Speaker 5 I think I tried to find more recent statistics than 2012, but I couldn't. But in 2012, there were 6%,

Speaker 5 and this is in the United States. It's a,

Speaker 5 It's very much,

Speaker 5 I know it does happen all over the world, some, but it's sort of an American thing.

Speaker 5 6% of people in 2012 used a doula versus 3% in 2006. And in that same survey, 27% of people said

Speaker 5 they would like to use a doula. So,

Speaker 5 you know, at least they're wishing or hopeful that they can.

Speaker 4 Yeah, that was question eight. Would you like to use a doula?

Speaker 4 Yeah,

Speaker 4 27% said.

Speaker 4 And so, if you get the impression that like a doctor would not really prefer a doula to be in the labor and delivery room, you've kind of read between the lines there, especially at first, the medical community saw doulas as they were starting to really kind of come into use in the 80s as basically meddling busybodies who could potentially put their patients' life in jeopardy, right?

Speaker 4 But then in 1992, doulas of North America was founded, DONA. It's like the first doula licensing body, certification and training and licensing body.

Speaker 4 And they were founded, it was founded by medical professionals, which kind of created a bridge.

Speaker 4 It bridged the gap or kind of smoothed over the rough feelings between the medical community and the doula community. And it also added a real air of legitimacy to the profession of being a doula.

Speaker 5 Yeah, and the impression I get now is that

Speaker 5 if you have a good doula who is good with people, which is ideally what your doula is,

Speaker 5 if your doula is not a people person, it's probably not going to be a good thing.

Speaker 5 But the idea I get is that doctors and nurses like having doulas there now because they can just concentrate on, they don't have to be the ones

Speaker 5 providing emotional, empathetic support, although they can still do that if they want. They can just concentrate on the medical aspects of it, and they know that they have a trained,

Speaker 5 hopefully licensed doula, and we'll get into that later, on hand to sort of say, you know what, I don't have to deal with that part of things.

Speaker 5 You're in good hands with this doula, and I can just concentrate on the medical parts.

Speaker 4 Yeah.

Speaker 4 Now all love doula.

Speaker 4 That's right.

Speaker 4 One of the other reasons or functions that doulas provide, you kind of hit on, is that they

Speaker 4 provide a service that hospitals used to provide through nurses, right? Where if you had a nurse in a labor and delivery room,

Speaker 4 they wouldn't spend as much time or give you as much attention as, say, like your mom would, or a friend, or your husband, even.

Speaker 4 But they gave you a lot more early on than they did as surveillance of patients moved to electronics, right?

Speaker 4 To where somebody could just kind of sit at the nurses station and check on everybody and didn't have to go into the rooms.

Speaker 4 And now you nurses were charged with watching even more people at once, right? So the personal attention dropped dramatically

Speaker 4 as

Speaker 4 electronic surveillance of patients increased. And the doulas kind of came in to fill that role as well.

Speaker 5 Yeah, like they're sitting in the room with you and hanging out. They don't get called in

Speaker 5 like 20 minutes before you give birth. They're with you, you know, sometimes days and weeks beforehand, coaching you on what to expect and how you're going to go about this and what your plan is.

Speaker 5 And then on the day, like even if dad is in there and the husband is in there providing support, that's great. But the doula is just that extra step and that extra measure of support

Speaker 5 that is super knowledgeable about what it's going to be like where the husband might not exactly, you know, be able to lend the most insightful ear there.

Speaker 4 You know what I mean? Yeah.

Speaker 5 So you want to take a break?

Speaker 4 Yeah, let's take a break and then we'll come back and talk about what to expect when you're expecting to work with a doula

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Speaker 5 All right, so

Speaker 5 here's a misconception.

Speaker 5 Some people think that doulas are are authorized or trained to give birth. That is not true.
They don't deliver babies. They don't perform any sort of medical procedures.

Speaker 5 They don't put an IV in your arm. They don't work the heart rate monitor.

Speaker 5 Most times they don't even work for the hospital. You have hired them independently.
And again, they're just there to coach you. They're not even midwives.
Midwives can deliver a baby.

Speaker 4 Right. Yeah, they're not allowed anywhere near the medical stuff.

Speaker 4 But they need to know what the medical stuff is so that they can say, well, this is what they're about to do or this is what they're suggesting right now and here are your options.

Speaker 4 And then also when they're administering the medical stuff, which can be pretty uncomfortable pretty frequently, I would imagine, the doula is there to kind of tell the mom what to expect and to comfort her in all sorts of ways.

Speaker 5 Yeah, and maybe not even offer advice.

Speaker 5 Like, I think the idea is that a doula will lay it all out there so you can make an informed decision and not necessarily say, well, if I were you, this is what I would do.

Speaker 4 Well, yeah, that's a slippery slope right there because then all of a sudden, if things go wrong, you can say, well, the doula told me to do that. And the doula's like,

Speaker 4 I'm toast.

Speaker 5 Adoulas have to be great listeners.

Speaker 5 We already talked about the empathy piece. They have to be very empathetic.

Speaker 5 And they will, like I said, start meeting before birth to answer any kind of questions, come up with that birth plan,

Speaker 5 and really listen a lot to the wife and the husband so everybody is on the same page. And like I said, on the day, things can change.

Speaker 5 But going in, you generally want to have a pretty good idea of everything from medications you might want to use, if any, to

Speaker 5 where you want to have the baby.

Speaker 5 The Adula can come on board and kind of explain if they're knowledgeable, which hopefully they are about the hospitals around you, and maybe even help you pick out where you're going going to give birth.

Speaker 5 Yeah.

Speaker 4 And I mean, if you already have an idea of what you want, the doula can kind of tell you how to make that happen.

Speaker 4 Or if you have no idea what you want, the doula can also tell you some other alternatives that you might not have thought of.

Speaker 4 And I saw a Parents Magazine article about doulas. They laid out what, basically, what you can expect from the average doula for the doula's fees.

Speaker 4 One to two in-person prenatal visits, and then access to the doula for follow-up questions through email or phone calls.

Speaker 4 Their full attention and presence during your labor, and then sometimes frequently I get the idea,

Speaker 4 a follow-up visit at your house after the baby comes home.

Speaker 4 Typically, if you hire a doula, this is about the average you can expect to him. There's definitely a lot of differences.

Speaker 4 Some will give you a little more, some some will give you a little less. Some will charge more, some will do it for free.

Speaker 4 It's just all over the place as far as what you're actually going to shell out and what you're going to get from a doula. But for the most part,

Speaker 4 the doula is going to have met you before you give birth, and then the doula will be there throughout the whole labor and delivery process.

Speaker 5 Yeah, and it says in this article that there are specialist doulas like antipartum doulas and postpartum doulas and labor doulas.

Speaker 5 That if you want an antipartum doula to be,

Speaker 5 if you want more than those two meetings, you might want to hire someone who will be with you for several weeks beforehand.

Speaker 5 Or if you want someone postpartum to be with you to coach you through breastfeeding or changing diapers or just any of that kind of coaching, you can hire someone to do that.

Speaker 5 But I get the sense that doulas generally will sort of

Speaker 5 work with you on whatever kind of plan you want. Right.
It may cost a little extra, but

Speaker 5 I get the sense that a doula wouldn't say, like, nope, you get two meetings, and that's it.

Speaker 5 They might be like, no, I'll come in for a third and fourth meeting. It'll be an extra of this much money,

Speaker 5 and I can hang with you for a week or two afterward here and there.

Speaker 4 I found, I think it was through a BuzzFeed article, I stumbled upon a, there's a huge rift in the doula community, actually,

Speaker 4 between the typical traditional approach to being a doula, which is

Speaker 4 I'll work with you on a sliding scale for how much you can afford, or this is my fee, but I'll throw in an extra visit just to make you feel like you're getting your money's worth, or I'll do it for free.

Speaker 4 I just want to help you because Dona's

Speaker 4 mission is that a doula for every mother who wants one. Like every mother should have a doula, basically, right? And then there's this other group called Pro Doula, and they can't stand doulas

Speaker 4 who charge less than a decent amount for their services or do it for free. They actually call doulas who do this for free oxytocin vampires.

Speaker 4 Like they're just there to bask in the reflective glow of this amazing experience that the mother just went through, the parents just went through.

Speaker 4 And they're really kind of

Speaker 4 kicking other doulas around, and

Speaker 4 they're kind of bullies in a really weird way um but there's like this big debate over whether doulas are undervalued or um underselling themselves huh but i i i mean i definitely get the idea that every woman who wants to have a doula should be able to have a doula regardless of her income you know yeah that makes sense to me like a pro bono for uh for people that don't have as much money yeah on the other hand i also get that if you you are a doula and you're doing your job really well, that yeah, you should expect to be paid.

Speaker 4 I think there's a happy medium. I don't think it has to be like, nope, this is the price and anybody who goes underneath it should be ostracized from the doula community.

Speaker 5 Yeah. The other thing about doulas, another misconception a lot of people think is that it's just some hippy-dippy thing that if you don't want to

Speaker 5 if you only want to have like a natural childbirth, then you get the doula in there and they're not there for anything other than that. And that's not the case.

Speaker 5 They are there to support you in whatever kind of birth you want to have, whether it's a home birth or water birth or whether or not you want to get an epidural or be loaded up on every pharmaceutical they offer mothers in labor.

Speaker 5 They're there just to have knowledge of all that stuff so you know what you're getting into. Yep.

Speaker 4 And then so during labor,

Speaker 4 this is where the doula shines, right? They're there to help with alternatives to pain treatment, right? So again, again, they can't administer any kind of drugs or anything.

Speaker 4 I would guess that they could even get in trouble for giving you an Advil.

Speaker 4 But they can do other things, like they can massage you in ways that you had not ever heard of before. That helps with labor pains.

Speaker 4 I came across this one technique where they pull on a couple of toes,

Speaker 4 specific toes, and it helps actually

Speaker 4 move the labor along if you have a slow labor. There's kneading techniques, there's stroking techniques, pressure on the bottom of your feet.

Speaker 4 There's all sorts of stuff they can do at various times throughout the labor and delivery process that can help alleviate the pain that you're going through.

Speaker 4 And that's one of the big roles that they played during labor.

Speaker 5 Yeah, when my kid was born, it was

Speaker 5 I was shocked at how many people were in the room, first of all.

Speaker 4 How many?

Speaker 4 Oh, man. Baker's dozen?

Speaker 5 I mean, 20. Emily and I.

Speaker 5 Birth mom,

Speaker 5 obviously. Our adoption counselor, who was a licensed doula, so she really served that function for the birth mom, which was really a great, great plus.

Speaker 5 The doctor,

Speaker 5 I guess

Speaker 5 I'm not even sure what the roles are, what their technical titles are, but

Speaker 5 the doctor came in when it was go time and basically just checked things out and said, well, I think it's go time. And then he stepped out of the way.
And these two nurses came in there.

Speaker 5 And 90 seconds later, there was a baby. Wow.
So it was, and those were, so it was two nurses. There was probably like, there was probably at least 12 people in that room.

Speaker 4 Wow. That's a lot of people.

Speaker 5 It was crowded and fast and surreal and weird and amazing.

Speaker 4 Even weirder, they brought in Carrot Top to cut the cord, right?

Speaker 5 No, Emily cut the cord. Okay, cool.
Emily actually helped sort of deliver in a way because, you know, they like to bring in,

Speaker 5 I guess, you know, in a regular biological birth, it would be the husband probably

Speaker 5 in there saying, hey, do you want to help hold the legs or do whatever? In this case, it was Emily. And I just took a respectful position

Speaker 5 by the birth mom's head. Right.

Speaker 5 Sort of

Speaker 5 looking down that way.

Speaker 5 I was like, you know,

Speaker 5 she was like, you can go wherever you want to go. But I was like, you know, I'll just hang right here.

Speaker 4 Right. And Emily's like, that's right.

Speaker 4 Yeah, i just i wanted to be there and you know i was i was helping support her as well uh holding her hand and patting her on the head and all that all that nice stuff that's cool man yeah it was it was amazing did i ever tell you the story uh for when my niece mila was born and um my sister-in-law was giving birth and she let everybody in the in the labor room i was surprised you can have a party in there yeah and um when she really was going into into

Speaker 4 she was delivering um i stood back behind this curtain, right? And the doctor comes in and walks past me and kind of gives me a nod. And I hear him go to the crowd.

Speaker 4 He's like, you know, there's like some guy standing behind that curtain, right?

Speaker 4 They're like, yeah, he's supposed to be there.

Speaker 5 It was pretty funny.

Speaker 5 He's the ward creeper.

Speaker 4 Right, exactly. I'm like, okay, I've heard enough here.
I'm going to the next room.

Speaker 5 All right, well, let's take another break. Now that we've shared our stories, we'll come back and talk a little bit about how you become a doula right after this.

Speaker 3 Support for the show today comes from Public.com. You're thoughtful about where your money goes.

Speaker 3 You've got core holdings, some recurring crypto buys, maybe even a few strategic options plays on the side. The point is, you're engaged with your investments, and Public gets that.

Speaker 1 Yeah, that's why they built an investing platform for those who take it seriously. On public, you can put together a multi-asset portfolio for the long haul.

Speaker 1 Stocks, bonds, options, crypto, it's all there. Plus an industry-leading 3.6% APY high-yield cash account.

Speaker 3 Switch to the platform built for those who take investing seriously. Go to public.com slash SYSK and earn an uncapped 1% bonus when you transfer your portfolio.
That's public.com slash SYSK.

Speaker 2 Paid for by Public Investing. All investing involves risk of loss, including loss of principal.

Speaker 2 Brokerage services for U.S.-listed registered securities, options, and bonds in a self-directed account are offered by Public Investing Inc., member FINRA and SIPC.

Speaker 2 Crypto trading provided by ZeroHash. Complete disclosures available at public.com slash disclosures.

Speaker 6 Let's talk about something you probably haven't thought about. Your couch.

Speaker 7 Yeah, that thing you nap on, eat on, cry on.

Speaker 6 Turns out that most silfas are basically bacteria playgrounds.

Speaker 9 It's true.

Speaker 7 We looked it up. It's not good.

Speaker 6 But Anibay changes that. It's washable, like fully washable.
Take the covers off, throw them in the machine, boom, clean.

Speaker 7 Also, it's actually affordable, which is surprisingly rare.

Speaker 6 So yeah, if you're going to sit on something every day, maybe you don't make it a biohazard. And here's the kicker.
It's not just practical, it's affordable.

Speaker 6 Starting at just $699, you can make your sofa as clean as it is comfy.

Speaker 7 Plus, with their Black Friday sale, you can even get up to 60% off your Anibay sofa right now.

Speaker 6 Because, let's be real, you deserve better than a germ factory for a place to rest your head. Check out washable sofas.com now and give your couch the upgrade it's begging for.

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Speaker 4 All right, Chuck, So if you wanted to become a doula,

Speaker 4 basically you start in training at age three.

Speaker 4 You're sent off to Europe to apprentice at the one doula school in the world, and they make you eat a lot of magic cake. And then when you're 60, you get to actually start out on your own.

Speaker 5 That's exactly right. Okay.

Speaker 5 Well, before you decide to become a doula, you need to give a lot of thought on what you're going to be getting into.

Speaker 5 You know, the hours are long. At birth, childbirth, it's very stressful.
And especially if there are complications, it can be super stressful and a matter of life or death.

Speaker 5 So you've got to be able to deal with that stuff in the moment and hang in there and be the birth coach that mom needs

Speaker 5 in the most stressful of situations.

Speaker 5 But then on the plus side, you get to see little BBs coming out on the reg.

Speaker 5 And what's better than that, you know?

Speaker 4 I can't think of too many things.

Speaker 5 Talk about an oxytocin hit.

Speaker 4 Maybe magic cake.

Speaker 4 Magic cake?

Speaker 5 You do not have to have a college degree. You don't have to have a high school degree.

Speaker 4 You don't even have to be certified. It's not law that you have to be certified.
Yeah, you don't.

Speaker 5 But

Speaker 5 there are more and more programs now and more certification and licensing programs out there. So if you want to be a doula, my advice is to go that route.
You probably just get more work that way.

Speaker 4 Right. So when you're starting out, you would go to, if you wanted to get certified, you would go to one of the certifying bodies like Dona or

Speaker 4 what are the other two that are mentioned in here?

Speaker 5 There's one called CAPPA.

Speaker 4 CAPPA.

Speaker 5 Sure.

Speaker 4 And then the American Pregnancy Association. All three of those certify and train doulas.

Speaker 4 Dona, from what I could tell,

Speaker 4 is the oldest, obviously. It was the first one, and it seems to be the most respected, but I would guess if you get your training from any of those three, you're probably doing pretty good.

Speaker 4 They'll offer online classes, in-person classes,

Speaker 4 self-paced study, and

Speaker 4 you typically need to go take a birthing class, a breastfeeding class, because again, you need to know,

Speaker 4 like, you need to be current on all the stuff that's going on with labor and delivery, right?

Speaker 4 If you took these classes 10 years ago and then did it again today, you would probably find some real differences in new stuff that's been discovered in the last 10 years.

Speaker 4 So you would need to be pretty current, even if you've had kids of your own before. Sure.

Speaker 4 And then you also need to attend at least one.

Speaker 4 I have the impression that multiple births under the apprenticeship of another doula who's already certified or trained or experienced before you really go off on your own to become certified. Yeah.

Speaker 4 And that's, I mean, that's just,

Speaker 4 I would say, how many births have you been a part of,

Speaker 4 you know, already before I hired a doula? That's a pretty big question, if you ask me.

Speaker 4 So they would want to say, well, I've been, you know, I've assisted in like three or five or however many, but you're going to be my first solo.

Speaker 5 Your first solo flight? Yep.

Speaker 5 You will, it depends on where you live on how much you're going to pay.

Speaker 5 If you live in a big fancy city like New York City,

Speaker 5 you're going to be paying top dollar for your doula. If you live in Los Angeles, you're going to be paying top dollar for your doula.

Speaker 4 I saw like 3,500 at least for each of those cities.

Speaker 5 Yeah, but that scale can go all the way down to

Speaker 4 zero.

Speaker 5 Well, sure, all the way to zero. But if you're paying a doula, that number can go all the way down to $600 to $800, $1,000

Speaker 5 in the flyover states.

Speaker 4 Right.

Speaker 4 But again, I mean, like, if this is the doula's first time on their own, you're probably not going to be paying top dollar.

Speaker 4 And if you say, look, I really, really, really want to have a doula at

Speaker 4 my child's birth, but I really genuinely don't have this money.

Speaker 4 I actually got a lift once from Adoul, and she was talking about having to deal with this family who clearly was very well off, but was pleading poverty. And she was like, I'm the one who's...

Speaker 4 a doula and driving a lift here and these guys are trying to like shortchange me. Interesting.
So she said, she told them no.

Speaker 4 She said she tried to work with them, but they wouldn't budge about whatever they thought her services were worth. So, she had to just walk on.
But

Speaker 5 why would a family that's well off not paid $800?

Speaker 4 I don't know. I don't know, because I remember thinking, like, wow, that's all it costs for a doula.
She might have even been quoting them less than $800.

Speaker 4 Yeah. So, there is definitely like there seems to be a tension between the desire to have a doula and the

Speaker 4 sense of non-obligation to pay a doula a decent wage, which I think is where that pro-doula

Speaker 4 group pulls their hair out. Right.
Yeah.

Speaker 5 Well, you may get it covered by insurance.

Speaker 5 There are more and more cases and insurance companies that will let something like this be covered, but it never hurts to ask. This article points out.
You can always ask.

Speaker 5 You can always file a claim and just see if if you'll get a little assistance there.

Speaker 4 Yeah, if you live in Oregon and Minnesota, though, Medicaid will reimburse your full doula expenses for a certified doula, which is pretty awesome.

Speaker 4 Like, that's huge and groundbreaking that those two states have that. For sure.

Speaker 4 The reason why they would pay anything for a doula rather than just being like, just burn some sage or something and, you know, spend five bucks is because there has been studies about doulas and they have come out quite positive in some pretty good peer-reviewed studies and

Speaker 4 peer-reviewed journals, right?

Speaker 4 Have you seen any of this?

Speaker 5 Well, yeah, I saw the one 15,000 people.

Speaker 4 That's a pretty decent study size.

Speaker 5 And they said

Speaker 5 in this study size, there were some women who had doulas and some women who did not have doulas or any kind of support like that.

Speaker 5 And then outcomes for women with continuous support were better than those without, meaning their labors were shorter by about 40 minutes on average.

Speaker 5 Their babies had higher Apgar scores, which Apgar, these tests they give your baby, like the first thing your kid has to do is take a test.

Speaker 4 I know.

Speaker 5 Seconds later, they're giving your kid their first test.

Speaker 4 Yeah, activity, pulse, grimace, appearance, and respiration. That's right.

Speaker 5 Yep. And so higher Apgar scores,

Speaker 5 fewer negative feelings about childbirth, like this is the emotional component. They required less pain medication.
medication, fewer uses of forceps or vacuum-assisted interventions, C-sections.

Speaker 5 Across the board, doulas helped.

Speaker 4 And

Speaker 5 what was really interesting was there was basically nothing that could point at that said having a doula was a negative in any way.

Speaker 4 Yeah, and even when they looked just at doulas rather than just all types of continuous support, just at doulas, the doulas, they held up too.

Speaker 4 There was less use of pitocin, less C-section, more spontaneous vaginal deliveries, less of a risk of being admitted to a special care nursery,

Speaker 4 four times less likely in one study to have a low birth weight child, two times less likely to have complications, and they were significantly more likely to initiate breastfeeding when cared for by a doula, right?

Speaker 4 So there's all these like

Speaker 4 demonstrably positive outcomes. And then you hit upon the other thing too, that they

Speaker 4 make the harsh hospital environment. There's something called harsh environment theory,

Speaker 4 where the bright lights and the people you don't know coming in and out and treating you like a piece of meat that they need to get this thing out of,

Speaker 4 that it can actually produce a traumatic experience. I suspect, in more women than you would think, having birth or giving birth in a hospital is kind of traumatic.

Speaker 4 And for some women, from what I read, it's like deeply traumatic.

Speaker 4 And that's been a huge reason that doulas have really come into use lately is because they mellow everything out for you a lot more.

Speaker 4 And there's actually, I read there's a group of renegade doulas who are acting as midwives out in the pot-growing country of Northern California. Oh, yeah?

Speaker 5 What's the relationship there?

Speaker 5 To the pot growing?

Speaker 4 I would guess they probably do both. They grow the pot and deliver the babies.
Nice. I think it's kind of like a whole back to the earth to hell with the man's establishment hospitals.

Speaker 4 Apparently, it's illegal to give birth like this without like a certified

Speaker 4 someone from the medical community being there to assist in the delivery.

Speaker 4 They're saying nuts to that, which I would guess is pretty dangerous, but also illegal. And if there's anything that screams Northern California more than dangerous and illegal, I don't know.
Yeah.

Speaker 5 If you want to use a doula, and and I'm officially endorsing this, I say, don't say don't to say doula.

Speaker 5 Sorry, couldn't resist on that one.

Speaker 4 It was worth it.

Speaker 5 Um, you just get online, you know, the doulas are easy to find in your area. Do a little Google searching,

Speaker 5 um, get a reference, a personal reference if you can, would be great. Uh, get online, find a friend who has used a doula that they can recommend.
I mean, that's really the best way.

Speaker 5 Um, I don't know if I'd go on uh Yelp or anything like that that or Angie's list.

Speaker 5 Although, maybe, who knows? But

Speaker 5 it's better if a good friend says, hey, I use this doula, and she's great.

Speaker 4 I think also the certifying bodies have directories of certified doulas in areas, too.

Speaker 5 Yeah, I mean, you want it to be a good personality match, too. So you should talk to your doula on the phone at the very least.

Speaker 5 But ideally, you have a little in-person meeting to make sure, like, is this someone

Speaker 5 I want to jump into the foxhole with? Because they're going to be around a lot, you know, and you have to have a good personality match there.

Speaker 4 Well, yeah, and your husband or co-parent needs to like them too. You don't want weird tension between those two in the delivery room.
True. They need to fit into your jam pretty well.
Yeah.

Speaker 4 Or else it's just going to be, especially if you're one of those people who can't stand conflict, that would be awful to have a doula who your husband or co-parent or wife or whoever doesn't like and butts heads with in the delivery room, that would just be bad.

Speaker 4 And then you have to pay them afterward. That would just be terrible.
So yeah, you want to vet them pretty well ahead of time.

Speaker 5 Yeah, and while you,

Speaker 5 while

Speaker 5 Adula is there to support you, so while they may have their own opinions on what they might do in a given situation, their childbirth philosophy is

Speaker 5 your childbirth philosophy as a mom is what matters. Right.
You know, so a good doula will get on board with that.

Speaker 5 Or if they aren't on board with that, then they probably shouldn't be working with you.

Speaker 4 And yeah, I could see them being like, look, I can recommend a couple of other people who are more in line with what you're looking for than me.

Speaker 4 You know? Yeah.

Speaker 4 Instead of wrong, wrong, wrong. This is all wrong.
This is how we're going to do it. That's right.

Speaker 4 You got anything else on doulas?

Speaker 5 Just this little bit on death doulas. We may have covered this in our,

Speaker 5 geez, in our dying episode.

Speaker 4 Yeah, that's what I was thinking.

Speaker 5 I feel like we've talked about it, but it is a job.

Speaker 5 If you want to help a family or a person or both through end-of-life care, there are people you can hire just to do that. And it's not the same as

Speaker 5 they can work in concert with hospice care, but it's not like a hospice nurse. It's someone just like a birth doula who is there to really just emotionally kind of coach you through the dying.

Speaker 5 process with a family member.

Speaker 4 And also to

Speaker 4 very concretely hold your hand, make sure you're comfortable, move you around a little bit, listen to you talk, tell you stories, whatever you're looking for to make the whole thing better.

Speaker 4 That's right.

Speaker 4 Pretty neat.

Speaker 4 Up with Doulas. Yeah, up with Doulas, agreed.
If you want to know more about Up with Doulas, this new organization that Chuck and I just now founded,

Speaker 4 you can

Speaker 4 just wait a little while. We need to get to work on the website.
And in the meantime, let's listen to some listener mail.

Speaker 5 All right I'm gonna call this flu shot clarification because that's what the subject line says okay hey guys avid listener wanted to comment on the flu episode I'm a graduate student and a few months away from completing my degree to becoming a physician's assistant well never mind then buddy I don't want to hear it

Speaker 5 no I'm just kidding I spent a lot of time seeing patients answering questions about things like flu shots and who should receive them The CDC now recommends that everyone over the age of six months receives a flu shot.

Speaker 5 Even those who are perfectly healthy. Even those who are allergic to eggs.

Speaker 4 They're cuckoo for flu shots.

Speaker 5 The new flu shots are now being designed to be egg-free.

Speaker 4 So they're egg-free, gluten-free.

Speaker 4 What else? Dairy-free. They contain 10% quinoa.

Speaker 5 And there's no evidence to suggest flu shots in recent years could cause a reaction in those allergic to eggs. All right, that's interesting.
Did not know that.

Speaker 5 He said the benefits of the flu shots far outweighed the risk, in his opinion.

Speaker 4 This guy's opinion.

Speaker 5 Yeah, and it sounds like it's an informed opinion at the very least.

Speaker 4 Sure.

Speaker 5 So

Speaker 5 that is from Devin from Philadelphia.

Speaker 4 Go, Eagles.

Speaker 4 He thinks so, really? Yeah, I mean, why not?

Speaker 5 They're doing great.

Speaker 4 Okay. Well, thanks a lot, Devin.
I appreciate writing in. That was nice of you.
And if you out there want to be like Devin, you can hang out with us

Speaker 4 on email at stuffpodcast at houseuffworks.com. And as always, join us at our home on the web, stuffyushouldn't know.com.

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