The word doula in Ancient Greek might mean "female servant" but it's really not a great description of the 21st century job. Doulas are birth coaches who help women get through the process of childbirth as efficiently and painlessly as possible. They aren't midwives or nurses, but they can provide an invaluable service as advocates. Learn about the deal with doulas right now in this classic episode!See omnystudio.com/listener for privacy information.
Chapter 1: What is the focus of this podcast episode?
So what's the deal with doulas, everybody? That's my question to you on this wonderful Saturday morning. 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.
Chapter 2: Who are Josh and Chuck?
Welcome to Stuff You Should Know, a production of iHeartRadio.
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, the podcast. Childbirth edition. 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. This will get into childbirth a little bit.
So, yeah, we're not afraid. I don't care.
Yeah.
I guess is what I'm trying to say. You can be a male doula. You can, although this is the only article I ran across that in. Did you find anything about that anywhere else? No, I mean, it happens. It's just super rare.
It happens. I mean, we'll go ahead and spoil it. Generally, doulas are, well, let's just get into this. 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.
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Chapter 3: What is a doula and what do they do?
Yeah, yeah. And this is actually, so this is an ancient thing that's kind of come back around full circle. 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.
So doula means female servant or female slave, depending on who you're talking about. And after, you know, ancient Greece fell, Rome and the Roman Empire fell, and all of civilization took this weird course, throughout it all, women were helped by other women while they were giving birth. Basically up until about the first third, first half of the 20th century in the West, where
hospitals entered and all of a sudden it was just the mom giving birth surrounded by a bunch of nurses and doctors is that true yeah because i could see scenarios where there were uh women in the birth room helping along
I think once you started to get into hospitals and the physicians in the hospital starting asserting their authority more and more, especially through drugs, like I saw that 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. You could understand why they would, but then there were all sorts of complications from it, problems from it. So they stopped giving sedatives as much. And about that time, women who were giving birth Started to like kind of come out of it and look around and say whoa.
It's just me and you guys in here I need some family members in here right 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 handing out cigars maybe pacing and And the reason why was because to the doctors involved, it was just another medical procedure, right?
So you're not going to have randos who have nothing to do with the actual procedure in the room during a procedure. 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. 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.
Yeah, so doulas, we haven't even said what that is yet, and that would probably help clear it up 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. They will, depending on the service they offer, will come on before, obviously, you give birth and kind of prep you for what's going to happen.
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Chapter 4: How did doulas become popular in modern times?
And this, I mean, it kind of depends on when your doula will come aboard in the process. 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. 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.
And that's when she brought this term back and said, you know, we're going to start calling these women doulas, and it's going to be a real job.
Right. And I think at first, what was the name of the woman who brought it back?
Dana Raphael.
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 was in the 80s. And the reason why they came into wider use was because hospitals were going to C-sections a lot earlier. 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. And there were a lot of complications with C-sections. 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. One of the first services that doulas started offering was to say, whoa, whoa, whoa, does she really need that C-section?
Are you sure about that or are you just doing it because you can charge more money? 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.
Yeah, and it's not just C-sections. They're your birth advocate 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.
Yeah.
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Chapter 5: What role do doulas play during childbirth?
Things always change, of course. And a doula would never put you in danger by insisting on something. In fact, they can't. 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.
Yeah, and 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. 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.
Yeah, it's definitely gained popularity in the 2000s. I think I tried to find more recent statistics than 2012, but I couldn't. But in 2012, there were 6%. And this is in the United States. It's very much... I know it does happen all over the world some, but it's sort of an American thing. Six percent of people in 2012 used a doula versus three percent in 2006.
And in that same survey, 27 percent of people said they would they would like to use a doula. So, you know, at least they're they're wishing or hopeful that they can.
Yeah, that was question eight. Would you like to use a doula?
Yeah.
Yeah. Twenty seven percent said yes. 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 patient's life in jeopardy, right? 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.
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Chapter 6: How do doulas interact with the medical community?
But they gave you a lot more early on than they did as surveillance of patients moved to electronics, right? to where somebody could just kind of sit at the nurse's station and check on everybody and they didn't have to go into the rooms. And now you nurses were charged with watching even more people at once, right?
So the personal attention dropped dramatically as electronic surveillance of patients increased and the doulas kind of came in to fill that role as well.
Yeah, like they're sitting in the room with you and hanging out. They don't get called in like 20 minutes before you give birth. They're with you sometimes days and weeks beforehand coaching you on what to expect and how you're gonna go about this and what your plan is. 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 that is super knowledgeable about what it's going to be like where the husband might not exactly be able to lend the most insightful ear there. You know what I mean?
Yeah.
So you want to take a break? 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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Chapter 7: Are doulas trained to perform medical procedures?
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Do, do, do, do, do, do, do, do, do.
All right, so here's a misconception. Some people think that doulas 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. They don't put an IV in your arm. They don't work the heart rate monitor. 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.
Right. Yeah, they're not allowed anywhere near the medical stuff. 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.
And then also, when they're administering the medical stuff, which can be pretty uncomfortable pretty frequently, I would imagine, the doula's there to kind of tell the mom what to expect and to comfort her in all sorts of ways.
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Chapter 8: What should you expect when working with a doula?
It may cost a little extra, but I get the sense that a doula wouldn't say like, nope, you get two meetings and that's it. They might be like, no, I'll come in for a third and fourth meeting. It'll be an extra of this much money and I can hang with you for a week or two afterward here and there.
I found, I think it was through a Buzzfeed article, I stumbled upon a, there's a huge rift in the doula community, actually, between the typical traditional approach to being a doula, which is, 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, you know, make you feel like you're getting your money's worth.
Or I'll do it for free. I just want to help you. Because Dona's mission is 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 are...
can't stand doulas who who charge less than like a a decent amount for their services or do it for free they actually call uh doulas who who do this for free oxytocin vampires like they're just there to to bask in the reflective glow of this this amazing experience that the mother just went through the parents just went through um and they're really kind of
kicking other doulas around and they're kind of bullies in a really weird way. But there's like this big debate over whether doulas are undervalued or underselling themselves. But 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 are a doula and you're doing your job really well that yeah you should expect to be paid um 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
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, 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.
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. They're there just to have knowledge of all that stuff so you know what you're getting into. Yep.
And then so during labor, this is where the doula shines, right? They're there to help with alternatives to pain, right? Treatment, right? So again, they can't administer any kind of drugs or anything. I would guess that they could even get in trouble for giving you an Advil. But they can do other things, like they can massage you in ways that you had not ever heard of before.
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