Latest / Stuff You Should Know / The Deal With Doulas

Transcript

The Deal With Doulas · Stuff You Should Know

0:01
Speaker 1: Welcome to Stuff you Should Know from house Stuff Works
0:04
Speaker 1: dot com. Hey, and welcome to the podcast. I'm Josh Clark,
0:14
Speaker 1: and there's Charles W. Chuck Bryant, there's Jerry over there.
0:16
Speaker 1: And this is Stuff you Should Know, the podcast Childbirth Edition. Yeah,
0:23
Speaker 1: we we were trapsing into more territory. What does that mean?
0:28
Speaker 1: I don't know. I mean we've done two on you know,
0:31
Speaker 1: feeding babies, done female puberty. Uh, this will this will
0:36
Speaker 1: get into childbirth a little bit. So yeah, we're not afraid.
0:41
Speaker 1: I don't care. Yeah, I guess that's what I'm trying
0:43
Speaker 1: to say. You can be a male doula. You can.
0:46
Speaker 1: Although I this is the only article I ran across that,
0:50
Speaker 1: and did you find anything about that anywhere else? I mean,
0:53
Speaker 1: it happens. It's just super rare. It happens because I mean,
0:58
Speaker 1: we'll go ahead and spoil it. Generally, Uh, doulas are well,
1:05
Speaker 1: let's just get into this. Generally dulas or women who
1:07
Speaker 1: have already had a baby. Yes, not even just women,
1:11
Speaker 1: but women who have had a baby, so they can
1:13
Speaker 1: really know how to help another lady have a baby. Yeah. Yeah,
1:16
Speaker 1: and this is actually so this this is an ancient thing.
1:20
Speaker 1: That's kind of come back around full circle. And even
1:23
Speaker 1: the names Doula is a Greek term used way back
1:28
Speaker 1: in the classical Greek days when a woman giving birth
1:32
Speaker 1: would have female servants attending to her during birth, helping
1:37
Speaker 1: her with it, um probably feeding her some grapes, waving
1:41
Speaker 1: palm fronds on her, that kind of thing. Um. So,
1:44
Speaker 1: doula means female servant or female slave, depending on who
1:48
Speaker 1: you're talking about. And after you know, ancient Greece, fellow
1:54
Speaker 1: of Rome and the Roman Empire fell, and all of
1:57
Speaker 1: civilization took this weird course through about at all women
2:01
Speaker 1: were helped by other women while they were giving birth
2:05
Speaker 1: basically up until about the first third, first half of
2:11
Speaker 1: the twentieth century in the West, where hospitals entered and
2:17
Speaker 1: all of a sudden, it was just the mom giving
2:20
Speaker 1: birth surrounded by a bunch of nurses and doctors. Is
2:24
Speaker 1: that true? Yeah, because I could see scenarios where there
2:28
Speaker 1: were women in the birth room helping along. Uh. I
2:35
Speaker 1: think once you started to get into hospitals and the
2:38
Speaker 1: physicians in the hospital starting asserting their authority more and more, um,
2:44
Speaker 1: especially through drugs, like I saw that. Um when when
2:48
Speaker 1: hospitals kind of took over the birthing processor, took responsibility
2:51
Speaker 1: for it from the family and from midwives, and moved
2:55
Speaker 1: it into the hospital. They used to administer a lot
2:58
Speaker 1: of sedatives as part of the birthing process as part
3:02
Speaker 1: of labor. You know, you could understand why they would,
3:04
Speaker 1: but then there are all sorts of um complications from it,
3:07
Speaker 1: problems from it, So they stopped giving um sedatives as much.
3:13
Speaker 1: And about that time, women who were giving birth started
3:17
Speaker 1: to like kind of come out of it and look
3:18
Speaker 1: around and say, whoa, it's just me and you guys
3:21
Speaker 1: in here. I need some family members in here. And
3:24
Speaker 1: at the time, like if you were a dad, you
3:26
Speaker 1: were not in there. You were not in the delivery
3:29
Speaker 1: room at all. You were out in what was called
3:31
Speaker 1: the stork club, um, handing out cigars, maybe pacing um.
3:36
Speaker 1: And the reason why it was because to the doctors involved,
3:40
Speaker 1: it was just another medical procedure, right, so you're not
3:43
Speaker 1: gonna have rando's who have nothing to do with the
3:46
Speaker 1: actual procedure in the room during a procedure. They treated
3:50
Speaker 1: childbirth the same way. But women started to say, no,
3:52
Speaker 1: I need more than just you people who I've never
3:54
Speaker 1: met before, really attending to the birth of my child,
3:58
Speaker 1: and so dad started to come in and then more
4:00
Speaker 1: family members and then now doulas have have um definitely
4:04
Speaker 1: kind of come back like they were originally. That's my
4:08
Speaker 1: understanding of the whole thing. Yes, so doula's uh, we
4:11
Speaker 1: haven't even said what that is yet, and that would
4:13
Speaker 1: probably help clear it up if you don't know. Dulas
4:15
Speaker 1: are um people, like we said, generally women but not always,
4:19
Speaker 1: who are childbirth coaches. They coach you through the process.
4:23
Speaker 1: They will, depending on the service they offer, will will
4:27
Speaker 1: come on before obviously you give birth and kind of
4:31
Speaker 1: prep you for what's going to happen. And this I
4:34
Speaker 1: mean it kind of depends on when you're dula will
4:37
Speaker 1: come aboard in the process, but at the very least
4:40
Speaker 1: they will help you in the delivery room and they
4:43
Speaker 1: are your advocate to kind of coach you through this
4:45
Speaker 1: whole thing. And that term actually started in an article
4:49
Speaker 1: in nineteen sixty nine by a woman named Dana Raphael
4:53
Speaker 1: and then later on in a book in nineteen seventy
4:55
Speaker 1: three called The Tender Gift Breastfeeding, And that's when she
4:59
Speaker 1: brought this term and back and said, uh, you know,
5:02
Speaker 1: we're gonna start calling these women dulas, and it's gonna
5:05
Speaker 1: be a real job, right And and I think at first,
5:10
Speaker 1: what was the name of the woman who brought it back,
5:11
Speaker 1: Dana Raphael. So she had like a pretty good idea
5:14
Speaker 1: that was actually ahead of its time. When doulas really
5:17
Speaker 1: started to come into use and come into their own
5:20
Speaker 1: as a profession was in the eighties and the reason
5:23
Speaker 1: why they came into wider use was because hospitals were
5:26
Speaker 1: going to c sections a lot um. C sections went up.
5:31
Speaker 1: From nineteen seventy four point two percent of live births
5:34
Speaker 1: in the US involved c sections sixteen years later, in
5:38
Speaker 1: six a quarter of live births in the US involved
5:42
Speaker 1: c sections. And there are a lot of complications with
5:45
Speaker 1: c sections um and so you could have your husband
5:50
Speaker 1: in there, you could have your mom in there, you
5:52
Speaker 1: could have friends, but they're just there for you. One
5:55
Speaker 1: of the first services that doulas started offering was to say, WHOA, WHOA,
6:00
Speaker 1: does she really need that C section? I are you
6:04
Speaker 1: sure about that? Or are you just doing it because
6:06
Speaker 1: you can charge more money. I think that was overstating
6:10
Speaker 1: exactly the interaction they had, but that was the role
6:13
Speaker 1: they had, was to basically provide a barrier between a
6:16
Speaker 1: doctor who wanted to just give a C section because
6:19
Speaker 1: he wanted to go home and the mom who really
6:21
Speaker 1: didn't want to c section. Yeah, and and know it's
6:24
Speaker 1: not just c sections there. Your advocate there, your birth
6:27
Speaker 1: advocate UM to to make sure or at least as
6:31
Speaker 1: best they can to try to ensure that the birth
6:33
Speaker 1: plan that you feel best about is the one that
6:36
Speaker 1: you end up with. Things always change, of course, and
6:39
Speaker 1: ADULA would never put you in danger by insisting on something.
6:42
Speaker 1: In fact, they can't. But they're there to speak for
6:46
Speaker 1: you on your behalf because as a mother in labor,
6:49
Speaker 1: you're going through a lot on your own, so it's
6:51
Speaker 1: nice to have someone that is just there to do
6:55
Speaker 1: that job. Yeah, And and UM is coming from a
6:59
Speaker 1: place of empathy and sympathy and most importantly experience. Like
7:04
Speaker 1: you said, most dulas have had children of their own,
7:07
Speaker 1: but they've also, after a while, attended other births too,
7:10
Speaker 1: so they know what they're talking about, they know what
7:12
Speaker 1: to expect, and they can tell you what to expect,
7:15
Speaker 1: which can make the whole process easier I would imagine
7:18
Speaker 1: for any mother giving birth. Yeah, it's definitely gained popularity
7:22
Speaker 1: in the two thousand's. Um. I think I tried to
7:25
Speaker 1: find more recent statistics than two thousand twelve, but I couldn't.
7:29
Speaker 1: But in two thousand twelve there were six percent. And
7:32
Speaker 1: this is in the United States. It's a it's very much. Yeah.
7:37
Speaker 1: I know it does happen all over the world some
7:38
Speaker 1: but it's sort of an American thing. Uh, six percent
7:42
Speaker 1: of people in twenty twelve years to doula versus three
7:45
Speaker 1: percent in two thousand six. And in that same survey,
7:49
Speaker 1: twenty seven percent of people said they would they would
7:52
Speaker 1: like to use a dulah. So, uh, you know, at
7:55
Speaker 1: least they're they're wishing or hopeful that they can. Yeah,
7:59
Speaker 1: that was question eight. Would you like to use a dulah? Yeah,
8:03
Speaker 1: said um. And so if you get the impression that,
8:06
Speaker 1: like a doctor would not really prefer a doula to
8:10
Speaker 1: be in the labor and delivery room, you you've kind
8:14
Speaker 1: of read between the lines there. Especially at first, the
8:17
Speaker 1: medical community saw doulas as they were starting to really
8:20
Speaker 1: kind of come into use in the eighties, as basically
8:23
Speaker 1: meddling busybodies who could potentially put their patient's life in
8:27
Speaker 1: in jeopardy, right, But then Duelas of North America was
8:33
Speaker 1: found founded DONA. It's like the first DULA licensing UM
8:38
Speaker 1: body Certification and Training and Licensing body UM and they
8:42
Speaker 1: were founded. It was founded by medical professionals, which kind
8:46
Speaker 1: of created a bridge. It bridged the gap or kind
8:50
Speaker 1: of got smoothed over the rough feelings between the medical
8:53
Speaker 1: community and the DULA community. And it also added a
8:57
Speaker 1: real air of legitimacy to the profession of of being
9:00
Speaker 1: your dulah. Yeah, And the the impression I get now
9:02
Speaker 1: is that, UM, if you have a good dula who
9:05
Speaker 1: is good with people, which is UM ideally what your
9:08
Speaker 1: dula is. If you're do listen, not a people person,
9:11
Speaker 1: that's probably not going to be a good thing. But
9:14
Speaker 1: the idea I get is that doctors and nurses like
9:16
Speaker 1: having duela is there now because they can just concentrate
9:20
Speaker 1: on They don't have to be the ones uh providing
9:23
Speaker 1: emotional empathetic support, although they can still do that they want.
9:27
Speaker 1: They can just concentrate on the medical aspects of it,
9:30
Speaker 1: and they know that they have a trained, uh hopefully
9:33
Speaker 1: licensed dulah. And we'll get into that later on hand
9:37
Speaker 1: to sort of say, you know what I don't have
9:39
Speaker 1: to deal with that part of things. You're in good
9:42
Speaker 1: hands with this, Dulah, and I can just concentrate on
9:44
Speaker 1: the medical parts now, all love Doulah. That's right. And
9:51
Speaker 1: one of one of the other reasons are functions that
9:54
Speaker 1: doulas provide you kind of hit on is that they, um,
9:58
Speaker 1: they provide a serv that hospitals used to provide through nurses,
10:02
Speaker 1: right where if you had a nurse in a in
10:05
Speaker 1: a labor and delivery room, they they wouldn't spend as
10:08
Speaker 1: much time or or give you as much attention to say,
10:11
Speaker 1: like your your mom would or a friend or your
10:13
Speaker 1: husband even but they gave you a lot more early
10:16
Speaker 1: on than they did. As surveillance of patients moved to
10:21
Speaker 1: electronics right to where somebody could just kind of sit
10:25
Speaker 1: at the nurses station and check on everybody and they
10:27
Speaker 1: didn't have to go into the rooms. And now you
10:30
Speaker 1: nurses were charged with watching even more people at once, right,
10:34
Speaker 1: so the personal attention dropped dramatically um as as um
10:40
Speaker 1: electronic surveillance of patients increased, and the duela is kind
10:44
Speaker 1: of came in to fill that role as well. Yeah,
10:47
Speaker 1: like they're they're sitting in the room with you and
10:48
Speaker 1: hanging out. They don't get called in like twenty minutes
10:53
Speaker 1: before you give birth. They're there with you, you know,
10:56
Speaker 1: sometimes days and weeks beforehand, coaching you and what to
10:59
Speaker 1: expect and how to how you're going to go about
11:01
Speaker 1: this and what your plan is. And then on the day,
11:04
Speaker 1: like even if dad is in there and the husband
11:07
Speaker 1: is in there providing support, that's great, But the doula
11:11
Speaker 1: is just that extra step and that extra measure of support,
11:15
Speaker 1: um that is super knowledgeable about what it's going to
11:19
Speaker 1: be like, where the husband might not exactly you know,
11:23
Speaker 1: be be able to lend the most insightful ear there,
11:26
Speaker 1: you know what I mean. Uh, So you want to
11:29
Speaker 1: take a break, Let's take a break, and then we'll
11:31
Speaker 1: come back and talk about what to expect when you're
11:33
Speaker 1: expecting to work with a doula. All right. So, uh,
11:58
Speaker 1: here's a misconception some people get. Um, some people think
12:02
Speaker 1: that dulas are are authorized or trained to give birth.
12:07
Speaker 1: That is not true. They don't deliver babies. Uh, they
12:10
Speaker 1: don't perform any sort of medical procedures. They don't put
12:14
Speaker 1: an ivy in your arm, they don't work the heart
12:16
Speaker 1: rate monitor. Uh. Most times, they don't even work for
12:19
Speaker 1: the hospital. You have hired them independently, and again they're
12:22
Speaker 1: just there to coach you. There not even midwives. Midwives
12:25
Speaker 1: can deliver a baby, right, Yeah, they're they're not allowed
12:29
Speaker 1: anywhere near the medical stuff. But they need to know
12:32
Speaker 1: what the medical stuff is so that they can say, well,
12:36
Speaker 1: this is what they're about to do or this is
12:38
Speaker 1: what they're suggesting right now, and here are your options. Um.
12:42
Speaker 1: And then also when they're administering the medical stuff, which
12:46
Speaker 1: can be pretty uncomfortable, pretty frequently, I would imagine, um,
12:50
Speaker 1: the duela is there to kind of tell the mom
12:53
Speaker 1: what to expect them to comforter in all sorts of ways. Yeah,
12:56
Speaker 1: and maybe not even offer advice, like I think. The
12:59
Speaker 1: idea is that adula will lay it all out there
13:02
Speaker 1: so you can make an informed decision and not necessarily
13:05
Speaker 1: say well, if I were you, this is what I
13:07
Speaker 1: would do. Well, yeah, that's a that's a slippery slope
13:10
Speaker 1: right there, because then all of a sudden, if things
13:12
Speaker 1: go wrong, you can say, well, the dula told me
13:14
Speaker 1: to do that, and the DULA was like, I'm I'm toast. Uh.
13:20
Speaker 1: Dulas have to be great listeners. We already talked about
13:23
Speaker 1: the the empathy piece. They have to be very empathetic
13:26
Speaker 1: and they will, like I said, start meeting before birth
13:28
Speaker 1: to answer any kind of questions come up with that
13:31
Speaker 1: birth plan uh and really listen a lot to the
13:36
Speaker 1: wife and the husband so everybody is on the same page. Um.
13:40
Speaker 1: And like I said, on the day, things can change.
13:43
Speaker 1: But going in you generally want to have a pretty
13:46
Speaker 1: good idea of everything from medications you might want to use,
13:51
Speaker 1: if any, to uh to where you want to have
13:54
Speaker 1: the baby. But doula can come on board and kind
13:56
Speaker 1: of explain if they're knowledgeable, which hopefully they are, about
13:59
Speaker 1: the hospitals around you. Uh and maybe even help you
14:02
Speaker 1: pick out where you're gonna give birth. Yeah. And I mean,
14:07
Speaker 1: if you already have an idea of what you want,
14:09
Speaker 1: the dula can you know, kind of tell you how
14:11
Speaker 1: to make that happen. Or if you have no idea
14:13
Speaker 1: what you want, the doula can also tell you some
14:16
Speaker 1: other alternatives that you might not have thought of. UM.
14:19
Speaker 1: And I saw a Parents Magazine article about dula's. They
14:22
Speaker 1: laid out what basically what you can expect from the
14:25
Speaker 1: average DULA for the dula's fees um one to two
14:29
Speaker 1: in person prenatal visits and then access to the dulah
14:34
Speaker 1: for follow up questions through email or phone calls, UM
14:40
Speaker 1: their full attention in presence during your labor, and then
14:44
Speaker 1: sometimes frequently I get the idea UM a follow up
14:49
Speaker 1: visit in at your house after the baby comes home.
14:53
Speaker 1: That typically if you hire a dula, this is this
14:56
Speaker 1: is about the average you can expect to him. There's
14:58
Speaker 1: definitely a lot of um differences. There's some will give
15:03
Speaker 1: you a little more, some we'll give you a little less,
15:05
Speaker 1: some will charge more, some will do it for free. Uh,
15:08
Speaker 1: it's just all over the place as far as you
15:10
Speaker 1: know what you're actually going to shell out and what
15:12
Speaker 1: you're going to get from adula. But but for the
15:15
Speaker 1: most part, you the duel is going to have met
15:19
Speaker 1: you before you give birth, and then the doula will
15:23
Speaker 1: be there throughout the whole labor and delivery process. Yeah.
15:27
Speaker 1: And it says in this article that there are specialists
15:30
Speaker 1: dulas like antipartum doulas and postpartum dulas and labor dula's
15:36
Speaker 1: UM that if you want an antipartum doula to be too,
15:39
Speaker 1: if you want more than those two meetings, you might
15:42
Speaker 1: want to hire someone who will be with you for
15:44
Speaker 1: several weeks beforehand, or if you want someone postpartum to
15:47
Speaker 1: be with you to coach you through breastfeeding or you know,
15:51
Speaker 1: changing diapers or just any of that kind of coaching,
15:53
Speaker 1: you can hire someone to do that. But I get
15:56
Speaker 1: the sense that dula's generally will sort of uh, work
16:01
Speaker 1: with you on whatever kind of plan you want, right.
16:04
Speaker 1: It may make cost little extra, but UM, I get
16:07
Speaker 1: the sense of ave dula wouldn't say like, Nope, you
16:09
Speaker 1: get two meetings and that's it. It might be like, no,
16:12
Speaker 1: I'll come in for a third and fourth meeting. It'll
16:14
Speaker 1: be an extra of this much money. Um, and I
16:17
Speaker 1: can hang with you for a week or two afterward
16:19
Speaker 1: here and there. UM I found I think it was
16:21
Speaker 1: through a BuzzFeed article. I stumbled upon a there's a
16:25
Speaker 1: huge rift in the doula community actually, um between the
16:29
Speaker 1: typical traditional approach to being a dula, which is, uh,
16:35
Speaker 1: I'll work with you on a sliding scale for how
16:38
Speaker 1: much you can afford, or this is my fee, but
16:41
Speaker 1: I'll throw in an extra visit just to you know,
16:43
Speaker 1: make you feel like you're getting your money's worth, or
16:45
Speaker 1: I'll do it for free. I just want to help
16:48
Speaker 1: you because dona's um mission is that a doula for
16:55
Speaker 1: every every mother who wants one, Like every mother should
16:57
Speaker 1: have a dula basically, right. And then there's this other
17:00
Speaker 1: group called pro do la and there they can't stand
17:05
Speaker 1: dulas who who charge less than like a decent amount
17:10
Speaker 1: for their services or do it for free. They actually
17:13
Speaker 1: call uh dulas who who do this for free oxytocin
17:17
Speaker 1: vampires Like they're just there to to bask in the
17:19
Speaker 1: reflective glow of this this amazing experience that the mother
17:23
Speaker 1: just went through, the parents just went through. Um. And
17:26
Speaker 1: they're really kind of kicking other duelas around and and
17:32
Speaker 1: they're they're kind of bullies. It's in a really weird way. Um.
17:36
Speaker 1: But there's like this big debate over whether doulas are
17:40
Speaker 1: undervalued or um underselling themselves. But I, I mean, I
17:46
Speaker 1: definitely get the idea that every woman who wants to
17:50
Speaker 1: have a dula should be able to have a duela
17:52
Speaker 1: regardless of her income. You know, that makes sense to me,
17:57
Speaker 1: like a pro bono for for people that don't have
18:00
Speaker 1: as much money. Yeah. On the other hand, I also
18:03
Speaker 1: get that if you are a duela and you're doing
18:05
Speaker 1: your job really well, then yeah, you should expect to
18:07
Speaker 1: be paid. Um. I think there's a happy medium. I
18:09
Speaker 1: don't think it has to be like Nope, this is
18:12
Speaker 1: the price, and anybody who goes underneath it should be
18:14
Speaker 1: ostracized from the DULA community. Yeah. The other thing about
18:18
Speaker 1: dula's another misconception a lot of people think is that
18:22
Speaker 1: it's just some hippie dippie thing that if you don't
18:24
Speaker 1: want to if you only want to have like a
18:26
Speaker 1: natural childbirth, then you get the doula in there, and
18:30
Speaker 1: that they're not there for anything other than that. And
18:32
Speaker 1: that's not the case. They they are there to support
18:35
Speaker 1: you in whatever kind of birth you want to have,
18:37
Speaker 1: whether it's a home birth or water birth, or whether
18:40
Speaker 1: or not you want to get an Eppord dural or
18:42
Speaker 1: be loaded up on every pharmaceutical they offer mothers in labor. Uh,
18:48
Speaker 1: they're they're just to have knowledge of all that stuff. Um,
18:51
Speaker 1: so you know what you're getting into. And then so
18:54
Speaker 1: during labor, this is where this is where the doula
18:56
Speaker 1: shines right there there to um help with alternatives to
19:01
Speaker 1: to pain treatment. Right. So again, they can't administer any
19:05
Speaker 1: kind of drugs or anything. I would guess that they
19:06
Speaker 1: could even get in trouble for giving you an advil um.
19:10
Speaker 1: But they can do other things like they can um
19:13
Speaker 1: massage you in ways that you had not ever heard
19:16
Speaker 1: of before that helps with labor pains. I came across
19:20
Speaker 1: this one technique where they pull on a couple of toes,
19:24
Speaker 1: um specific toes, and it helps actually UM move the
19:29
Speaker 1: labor along if you're if you have a slow labor,
19:32
Speaker 1: there's needing techniques, they're stroking techniques, UM pressure around the
19:36
Speaker 1: bottom of your feet. There's all sorts of stuff they
19:38
Speaker 1: can do at various times throughout the labor and delivery
19:42
Speaker 1: process that can help alleviate the pain that you're going through. UM,
19:46
Speaker 1: and that's one of the big roles that they played
19:48
Speaker 1: during labor. Yeah, when my kid was born, it was
19:53
Speaker 1: I was shocked at how many people were in the room.
19:55
Speaker 1: First of all, how many oh Man Baker's doesn't I
19:59
Speaker 1: mean Emily and I birth mom obviously our adoption counselor
20:07
Speaker 1: who was a licensed duelist, so she really served that
20:10
Speaker 1: function for the birth mom, which was really a great
20:14
Speaker 1: great plus. UM the doctor, I guess the I'm not
20:20
Speaker 1: even sure what the roles are what their technical titles are.
20:23
Speaker 1: But um, the doctor came in when it was go
20:28
Speaker 1: time and basically just check things out and said, well,
20:31
Speaker 1: I think it's go time. And then he stepped out
20:33
Speaker 1: of the way, and these two nurses came in there
20:36
Speaker 1: and ninety seconds later there was a baby. So it
20:40
Speaker 1: was and and those were so it was two nurses
20:43
Speaker 1: that that was probably like there was probably at least
20:45
Speaker 1: twelve people in that room. That's a lot of people.
20:49
Speaker 1: It was crowded and fast and surreal and weird and amazing. Uh,
20:54
Speaker 1: even even weirder. They brought in carrot top to cut
20:57
Speaker 1: the cord, but no, Emily cut the cord. Emily actually
21:00
Speaker 1: helps sort of deliver in a way because you know,
21:02
Speaker 1: they like to bring in uh. I guess you know,
21:06
Speaker 1: in a in a regular biological birth, that would be
21:09
Speaker 1: the husband probably uh in there saying hey, do you
21:12
Speaker 1: want to help hold the legs or do whatever. In
21:15
Speaker 1: this case, it was Emily, and I just took a
21:17
Speaker 1: respectful position, uh by the birth mom's head, uh, sort
21:23
Speaker 1: of looking looking down that way. I was like, you
21:27
Speaker 1: know she was She was like, you can go wherever
21:29
Speaker 1: you want to go. But it's like, you know, I'll
21:30
Speaker 1: just hang right here, right, And Emily's like, that's right, Yeah,
21:34
Speaker 1: I just I wanted to be there, and you know
21:35
Speaker 1: I was. I was helping support her as well, uh,
21:38
Speaker 1: holding her hand and patting her on the head and
21:41
Speaker 1: all that all that nice stuff. That's cool, man, Yeah
21:43
Speaker 1: it was. It was amazing. Did I ever tell you
21:45
Speaker 1: the story for when my niece Mila was born and um,
21:49
Speaker 1: my sister in law was giving birth and she let
21:52
Speaker 1: everybody in the in the labor room. I was surprised,
21:55
Speaker 1: you can have a party in there. Yeah. And um,
21:58
Speaker 1: when she really was going into she was delivering, Um,
22:03
Speaker 1: I stood back behind this curtain, right and um, the
22:07
Speaker 1: doctor comes in and walks past me and kind of
22:09
Speaker 1: gives me a nod, and I hear him go to
22:11
Speaker 1: the crowd. He's like, you know, there's like some guy
22:13
Speaker 1: standing behind that curtain right, Like, yeah, he's supposed to
22:17
Speaker 1: be there. He's the he's the word creeper, right exactly.
22:22
Speaker 1: I'm like, Okay, I've heard enough here. I'm going to
22:24
Speaker 1: the next room. Uh all right, well, let's take another break.
22:29
Speaker 1: Now that we've shared our stories, we'll come back and
22:32
Speaker 1: talk a little bit about how you become a duela.
22:33
Speaker 1: Right for this? All right, Chuck. So if you wanted
22:57
Speaker 1: to become a duela, um, basically you're you start in
23:01
Speaker 1: training at age three, you're sent off to Europe to
23:05
Speaker 1: apprentice at the one do list school in the world
23:08
Speaker 1: and they make you eat a lot of magic cake,
23:10
Speaker 1: and then when you're sixty you get to actually start
23:13
Speaker 1: out on your own. That's that's exactly right. Okay, Well,
23:18
Speaker 1: before you decide to become a duela, you need to
23:20
Speaker 1: give a lot of thought on what you're going to
23:22
Speaker 1: be getting into. Uh. You know, the hours are long
23:25
Speaker 1: at birth job birth, it's very stressful, and especially if
23:29
Speaker 1: there are complications that can be super stressful in a
23:33
Speaker 1: matter of life or death. So you've got to be
23:34
Speaker 1: able to deal with that stuff in the moment and
23:37
Speaker 1: hang in there and be the birth coach that mom needs,
23:41
Speaker 1: you know, in the most stressful of situations. But then
23:44
Speaker 1: on the plus side, you get to see little babies
23:47
Speaker 1: coming out on the rag and what's better than that?
23:51
Speaker 1: You know, I can't think of too many things talk
23:54
Speaker 1: about an oxytocin hit maybe magic cake, magic cake. Uh.
24:00
Speaker 1: You do not have to have a college degree, you
24:04
Speaker 1: don't have to have a high school degree. UM. Now
24:08
Speaker 1: even you don't even have to be certified. It's not
24:10
Speaker 1: law that you have to be certified. Yeah you don't,
24:13
Speaker 1: but it is UM. There are more and more programs
24:16
Speaker 1: now and more certification and licensing programs out there. So
24:21
Speaker 1: if you want to be a duela, my advice is
24:23
Speaker 1: to go that route. You probably just get more work
24:25
Speaker 1: that way, right, So when you're when you're starting out,
24:28
Speaker 1: you would go to UM. If you wanted to get certified,
24:31
Speaker 1: you would go to one of the certifying bodies like
24:33
Speaker 1: DONA or UM. What are what are the other two
24:36
Speaker 1: that are mentioned in here. There's one called c A
24:38
Speaker 1: p p A, KAPPA Sure, and then the American Pregnancy Association.
24:43
Speaker 1: All three of those certify and train dula's UM. DONA,
24:48
Speaker 1: from what I could tell, is the oldest. Obviously it
24:52
Speaker 1: was the first one and it seems to be the
24:54
Speaker 1: most respected. But I would guess if you get your
24:56
Speaker 1: training from any of those three, you're probably doing pretty good. UM.
25:00
Speaker 1: They'll offer online classes, in person classes, UH, self paced
25:05
Speaker 1: study and UM. You typically need to go take a
25:09
Speaker 1: birthing class, a breastfeeding class because again you need to know,
25:14
Speaker 1: like you need to be current on all the stuff
25:16
Speaker 1: that's going on with labor and delivery. Right if you
25:20
Speaker 1: if you took these classes ten years ago and they
25:22
Speaker 1: did it again today, you would probably find some real
25:25
Speaker 1: differences and new stuff that's been discovered in the last
25:28
Speaker 1: ten years. So you would need to be pretty current,
25:30
Speaker 1: even if you've had kids of your own before. UM.
25:33
Speaker 1: And then you also need to attend at least one
25:36
Speaker 1: I have the impression that multiple births under the apprenticeship
25:42
Speaker 1: of another doula who's already certified or trained or experienced
25:47
Speaker 1: UM before you really go off on your own to
25:49
Speaker 1: become certified. Uh. And And that's I mean, that's just
25:54
Speaker 1: I would I would say, how many births have you
25:57
Speaker 1: been a part of, you know, all ready before I
26:01
Speaker 1: hired a dula. That's a pretty big question if you
26:03
Speaker 1: ask me so they would want to say, well, I've
26:05
Speaker 1: been you know, I've assisted in like three or five
26:08
Speaker 1: or however many. But you're gonna be my first solo
26:12
Speaker 1: your first solo flight. Yep, Uh, you will. It depends
26:16
Speaker 1: on where you live, on how much you're gonna pay. UM.
26:19
Speaker 1: If you if you live in a big fancy city
26:21
Speaker 1: like New York City, you're gonna be paying top dollar
26:24
Speaker 1: for your dula. If you live in Los Angeles, gonna
26:26
Speaker 1: be paying top dollar for your dula. I saw like
26:28
Speaker 1: thirty five hundred at least for each of those cities. Yeah,
26:32
Speaker 1: but that that scale can go all the way down
26:34
Speaker 1: to uh zero, Well, sure, all the way to zero,
26:37
Speaker 1: But if you're paying a doula, that number can go
26:40
Speaker 1: all the way down to six hundred to eight hundred
26:43
Speaker 1: thousand dollars. And you know, and in the fly over states, right.
26:50
Speaker 1: But again, I mean like, if if this is the
26:51
Speaker 1: duel is first time on their own, you're probably not
26:54
Speaker 1: going to be paying top dollar. Um. And if you say, look,
26:59
Speaker 1: I really really really want to have Adula at my
27:03
Speaker 1: at my child's birth, but I really genuinely don't have
27:07
Speaker 1: this money. Um. Actually got a lift once from Adula,
27:11
Speaker 1: and she was talking about having to deal with this
27:13
Speaker 1: family who clearly was very well off but was pleading poverty.
27:19
Speaker 1: And she was like, I'm the one who's Adula and
27:21
Speaker 1: driving a lift here, and these guys are trying to
27:24
Speaker 1: like short change me. So she said she told them no.
27:28
Speaker 1: She said she tried to work with them, but they
27:29
Speaker 1: wouldn't they wouldn't budge about whatever they thought her services
27:33
Speaker 1: were worth so she had to just walk on. But um,
27:37
Speaker 1: I why would have family that's well off not paid
27:40
Speaker 1: eight hundred dollars. I don't know. I don't know because
27:43
Speaker 1: I remember thinking like, wow, that's that's all it costs
27:45
Speaker 1: for adula. She might have even been quoting them less
27:48
Speaker 1: than eight hundred dollars. Yeah, So there is definitely like
27:53
Speaker 1: there seems to be a tension between the desire to
27:56
Speaker 1: have a doula and the um the sense of non
28:00
Speaker 1: obligation to pay a dula a decent wage, which I
28:04
Speaker 1: think is where that produla um group pulls their hair out.
28:09
Speaker 1: You know, uh, well, you you may get it covered
28:12
Speaker 1: by insurance. Um. There are more and more cases and
28:16
Speaker 1: insurance companies that will let something like this be covered.
28:20
Speaker 1: But it never hurts to ask. This article points out
28:22
Speaker 1: you can. You can always ask. You can always file
28:24
Speaker 1: a claim, uh and just see if you'll get a
28:27
Speaker 1: little assistance there. Yeah, if you live in Oregon and Minnesota, though,
28:31
Speaker 1: Medicaid will reimburse your full DULA expenses for certified DULA,
28:35
Speaker 1: which is pretty awesome. Like, that's huge in groundbreaking that
28:40
Speaker 1: those two states have that um. The reason why they
28:44
Speaker 1: would pay anything for a DULA rather than just being
28:48
Speaker 1: like just burned some sage or something and and and
28:50
Speaker 1: you know, spend five bucks. Is because there has been
28:54
Speaker 1: studies about Dulah's and they have come out quite positive
28:58
Speaker 1: in some pretty good period viewed studies in peer review
29:01
Speaker 1: peer reviewed journals. Right, um, have you seen any of this? Well, yeah,
29:06
Speaker 1: I saw the one, uh fifteen thousand people. That's a
29:09
Speaker 1: pretty decent study size. And they said, in this study size,
29:15
Speaker 1: there were some women who had dulas and some women
29:18
Speaker 1: who did not have dulas or any kind of support
29:21
Speaker 1: like that. And then outcomes for women with continuous support,
29:25
Speaker 1: we're better than those without, meaning their labors or shorter
29:28
Speaker 1: by about forty minutes on average. Their babies had higher
29:31
Speaker 1: APCAR scores, which AFCAR these tests they give your baby,
29:35
Speaker 1: Like the first thing your kid has to do is
29:37
Speaker 1: take a test. No seconds later, they're giving your kid
29:41
Speaker 1: their first test. Yeah, activity, pulse, grimace, appearance, and respiration.
29:46
Speaker 1: That's right. Yeah, And so higher APCAR scores um a
29:50
Speaker 1: fewer negative feelings about childbirth, like this is the emotional component.
29:54
Speaker 1: They required, less pain medication, fewer uses of FORCETEP, sort
30:00
Speaker 1: of vacuum assisted interventions c sections across the board. Dula's helped,
30:06
Speaker 1: and what what was really interesting was there was basically
30:10
Speaker 1: nothing that could point out that said having a duela
30:12
Speaker 1: was a negative in anyway. Yeah, and even when they
30:15
Speaker 1: look just at dulas rather than just all types of
30:18
Speaker 1: continuous support, just at dulas, the duelas they held up
30:22
Speaker 1: to there was less use of potos and less c section,
30:26
Speaker 1: more spontaneous vaginal deliveries UM, less of a risk of
30:29
Speaker 1: being admitted to a special care nursery, UM, four times
30:34
Speaker 1: less likely in one study to have a low birth
30:36
Speaker 1: weight child, two times less likely to have complications, and
30:39
Speaker 1: they were significantly more likely to initiate breastfeeding when cared
30:43
Speaker 1: for by a DULA. Right, So there's all these like
30:46
Speaker 1: like demonstrably positive outcomes and then you hit upon the
30:51
Speaker 1: other thing too that they um, they make the harsh
30:55
Speaker 1: hospital environment. There's something called harsh environment theory UM where
31:00
Speaker 1: the bright lights and the people you don't know coming
31:02
Speaker 1: in and out and treating you like a piece of
31:04
Speaker 1: meat that they need to get this thing out of um,
31:07
Speaker 1: that they can actually produce a traumatic experience. I suspect
31:11
Speaker 1: him more women than than you would think having birth
31:16
Speaker 1: or giving birth in a hospital is kind of traumatic
31:19
Speaker 1: and for some women, from what I read, it's like
31:21
Speaker 1: like deeply traumatic um. And that's that's been a huge
31:26
Speaker 1: reason that dulas have really come into use lately, is
31:29
Speaker 1: because they mellow everything out for you a lot more.
31:34
Speaker 1: And there's actually I read there's a group of renegade
31:36
Speaker 1: duelas who are acting as midwives out in the pot
31:39
Speaker 1: growing country of northern California. Uh, what's the relationship there
31:48
Speaker 1: to the pot growing I would guess they probably do both.
31:52
Speaker 1: They grow the pot and deliver the babies. I think
31:55
Speaker 1: it's kind of like a whole back to the earth,
31:57
Speaker 1: to hell with the man's established meant hospitals. Apparently it's
32:02
Speaker 1: illegal to give birth like this without like a certified
32:07
Speaker 1: um someone from the medical community being there to assist
32:10
Speaker 1: in the delivery. They're they're saying nuts to that, which
32:14
Speaker 1: I would guess is pretty dangerous but also illegal. And
32:18
Speaker 1: if there's anything that screams Northern California more than dangerous
32:21
Speaker 1: and illegal, I don't know. Yeah, Uh, if you want
32:25
Speaker 1: to use a dula, and and I'm officially endorsing this,
32:29
Speaker 1: I say don't say don't say do la. Sorry, I
32:34
Speaker 1: couldn't resist on that one. It was worth it. Um,
32:38
Speaker 1: you just get online, you know, the dulas are easy
32:40
Speaker 1: to find in your area. Do a little Google searching, UM,
32:44
Speaker 1: get a reference, a personal reference if you can, would
32:46
Speaker 1: be great. Get online, find a friend who was used
32:49
Speaker 1: to DOLA they can recommend. I mean that's really the
32:51
Speaker 1: best way. UM. I don't know if I'd go on
32:54
Speaker 1: Yelp or anything like that or Angie's List though maybe
33:00
Speaker 1: who knows, But it's better if a good friends says, hey,
33:04
Speaker 1: I use this DULA and she's great. I think. Also
33:06
Speaker 1: the certifying bodies UM have directories of certified dulas in
33:12
Speaker 1: areas to Yeah. I mean you wanted to be a
33:14
Speaker 1: good personality match too, so you should talk to your
33:18
Speaker 1: DULA on the phone at the very least, UM, but
33:20
Speaker 1: ideally you have a little in person meeting to make sure, like,
33:23
Speaker 1: is this someone I want to I want to jump
33:25
Speaker 1: into the foxhole with because they're gonna be around a lot,
33:28
Speaker 1: you know, and you have to have a good personality
33:30
Speaker 1: match there. Well. Yeah, and your husband or co parent
33:33
Speaker 1: needs to like them too. You don't want weird tension
33:36
Speaker 1: between those two in the delivery room. They need to
33:40
Speaker 1: fit into your jam pretty well, yeah, or else it's
33:43
Speaker 1: this gonna be Especially if you're one of those people
33:45
Speaker 1: who can't stand conflict, that would be awful. To have
33:49
Speaker 1: a duela who your husband or co parent or wife
33:54
Speaker 1: or whoever doesn't like and butts heads with in the
33:56
Speaker 1: delivery room. That would just be bad. And then you
33:59
Speaker 1: have to pay them afterwards, that would just be terrible.
34:01
Speaker 1: So yeah, you want to vet them pretty well ahead
34:04
Speaker 1: of time. Yeah, and while you um, while adula is
34:08
Speaker 1: that aduela is there to support you. So while they
34:11
Speaker 1: may have their own opinions on what they might do
34:14
Speaker 1: in a given situation, their childbirth philosophy is your childbirth
34:20
Speaker 1: philosophy as a mom is what matters, you know, So
34:23
Speaker 1: a good duela will get on board with that um
34:26
Speaker 1: or if they aren't on board with that, then they
34:29
Speaker 1: probably shouldn't be working with you. And yeah, I can
34:32
Speaker 1: see them being like, look, I I can recommend a
34:34
Speaker 1: couple of other people who are more in line with
34:36
Speaker 1: what you're looking for than me, you know, instead of
34:40
Speaker 1: wrong wrong wrong, This is all wrong. This is how
34:42
Speaker 1: we're gonna do right. That's right. Are you got anything
34:46
Speaker 1: else on duels? Just this little bit on death duelas.
34:49
Speaker 1: We may have covered this in our geeze in our
34:53
Speaker 1: dying episode. Yeah, that's what I was thinking. I feel
34:56
Speaker 1: like we've talked about it. But it is a job. Um,
34:59
Speaker 1: if you want to help family or a person or
35:03
Speaker 1: both through end of life care, Uh, there are people
35:06
Speaker 1: you can hire just to do that, and it's not
35:07
Speaker 1: the same as Uh they can work in concert with
35:12
Speaker 1: hospice care. But it's not like a hospice nurse. It's
35:14
Speaker 1: someone just like a birth dula who is there to
35:18
Speaker 1: really just emotionally kind of coach you through through the
35:20
Speaker 1: dying process with a family member, and also to to
35:25
Speaker 1: very concretely hold your hand, make sure you're comfortable, move
35:28
Speaker 1: you around a little bit, listen to you talk, tell
35:31
Speaker 1: you stories, whatever you're you're looking for to make the
35:33
Speaker 1: whole thing better. That's right, pretty pretty neat. Up with doulas, Yeah,
35:39
Speaker 1: Up with dulas agreed. If you want to know more
35:42
Speaker 1: about Up with Dula's this new organization that Chuck and
35:45
Speaker 1: I just now founded, you can. I'll just wait a
35:49
Speaker 1: little while. We need to get to work on the website,
35:51
Speaker 1: and in the meantime, let's listen to some listener mail,
35:56
Speaker 1: all right, I'm gonna call this flu shot clarification because
35:59
Speaker 1: that's what the sub decline says. Hey, guys, Avid Listener
36:02
Speaker 1: wanted to comment on the flu episode. I'm a graduate
36:06
Speaker 1: student and a few months away from completing my degree
36:08
Speaker 1: to becoming a physician's assistant. Well, never mind, then, buddy,
36:12
Speaker 1: I don't want to hear it now. I'm just kidding.
36:15
Speaker 1: H I spent a lot of time seeing patients answering
36:18
Speaker 1: questions about things like flu shots and who should receive them. Uh.
36:22
Speaker 1: The CDC new recommends that everyone over the age of
36:24
Speaker 1: six months receives a flu shot, even those who are
36:27
Speaker 1: perfectly healthy, even those who are allergic to eggs. They're
36:31
Speaker 1: cuckoo for flu shots. The flu shots are now being
36:35
Speaker 1: designed to be egg free. Uh so their egg free,
36:39
Speaker 1: gluten free? What else? Dare they contained teen percent keen
36:45
Speaker 1: wa And there's no evidence to suggest flu shots in
36:49
Speaker 1: recent years could cause a reaction. And those allergic to eggs,
36:52
Speaker 1: all right, that's interesting. Did not know that he said
36:55
Speaker 1: the benefits of the flu shots far outweighed the risk
36:59
Speaker 1: in his opinion. This guy's opinion, Yeah, and it sounds
37:02
Speaker 1: like it's an informed opinion at the very least sure so.
37:06
Speaker 1: Uh that is from Devon from Philadelphia. Go Eagles do
37:14
Speaker 1: you think so? Really? Yeah? I mean why not? They're
37:16
Speaker 1: doing great? Okay, Well, thanks a lot, Devon. I appreciate
37:20
Speaker 1: writing in. That was nice of you. And if you
37:22
Speaker 1: out there want to be like Devon, you can tweet
37:24
Speaker 1: to us at josh um Clark or s Y s
37:27
Speaker 1: K podcast. You can join us on Facebook dot com,
37:30
Speaker 1: slash Stuff you Should Know or slash Charles W. Chuck Bryant.
37:34
Speaker 1: You can hang out with us at um on email,
37:37
Speaker 1: at stuff podcast at how stuff Works dot com and
37:40
Speaker 1: has always joined us at home on the web, Stuff
37:42
Speaker 1: you Should Know dot com For more on this and
37:48
Speaker 1: thousands of other topics. Is it how stuff Works dot
37:51
Speaker 1: com th