DOULAS: Why Aren’t They the Standard in Our Medical System?
Bringing a baby earth side is magical. Women LITERALLY have the capabilities of growing a human inside them and birthing them into existence(duh, right?). No shade to the papas out there since we wouldn’t be able to have babies without your seed. Grateful for you too! But… no one REALLY talks about WTF women go through or NEED during pregnancy, when it’s time to give birth, and most importantly postpartum.
The entire journey of having a baby is SO intimate and SO unique to all (from conception, delivery and to adjusting to your new life). My question is .. why do we make this whole process loud, uncomfortable, awkward, scary and overwhelming? The western medical system IMO is very black and white. A=B, so we do C to get results. I mean.. I get it.. but.. humans aren’t black and white. Our experience with anything isn’t black or white. So why do we assume that having a baby (and post) is a one-size-fits-all?
Even though I had my daughter in the middle of the pandemic, I didn’t really know any other options other than the traditional western way to have a baby. I knew home births existed, but that wasn’t the route I wanted to take. If you missed my newsletter explaining my pre and postpartum journey click here to get caught up.
Now, almost three years after having my first child, I am so grateful for the access of information we have to know our options IN EVERY STEP of our baby journey.
I’ve learned that we can say NO when something doesn’t feel or sound right, to SPEAK UP when we are uncomfortable with a medical suggestion, and most of all understanding our OPTIONS when it comes to HOW we want to bring a baby earth side and the access for help post baby.
I sat down with Melissa Merlos, a So Cal Doula, about her journey of becoming a Doula and what services they can provide.
Email me at info@aryretreats.com on your thoughts or if you have more tips to share!
What is your name?
My name is Melissa Merlos, I'm 29 and from Los Angeles, CA
How long have you been a Doula?
I have been studying to become a Doula for the past two years, I also have my Breastfeeding Educator Certification as well. I'm just starting to step into my business and work with clients.
What made you want to become a Doula?
I had a really rough postpartum time. I had my son during peak time in COVID and I had no support. No visitors, no one really called to check with me and my own mother had a very different viewpoint of what support would look like. I'd ask her if she could watch my son so I could shower or eat and her response was, "You're a mom now Melissa, you need to figure out to do this all on your own." I felt so unknowledgeable in so many areas. My milk took a few days to come in and my son was not gaining any weight. He was losing weight and had jaundice so the nurses were pushing me to supplement with formula right away and kept blaming me and my body for not producing enough milk.
My partner was trying his best to be supportive but he really didn't know what to do. I started falling into postpartum depression and anxiety. I felt like I was losing myself. I was barely eating, barely sleeping- exhausted beyond belief. My partner really held me up and without him, I would have spiraled so much deeper. We eventually moved out of my parents and got our own home and that helped tremendously. I started joining postpartum groups, seeking therapy, and reaching out to other mothers I'd met online- and that helped a lot. I learned really fast that our society is baby centered. Meaning all the appointments during pregnancy revolve around the baby's health first, then the mother. There's no preventive care in our system. Just acute emergency care.
If the mother has a "healthy/normal" labor and delivery so is not seen or spoken to until 6 weeks later..and that is to clear her for sex and exercise. My experience was so frustrating. My six-week check-up was done over the phone and my doctor literally told me, "Sounds like you're ready to have sex and workout if that's what you want to do" WHAT?! I was so mad. They insisted I did not need to be seen in person as at might be a risk of exposure to covid. I had to schedule a pap smear and ask the doctor to make sure my cervix was fully closed, to check on my pelvic floor, and to see if where my placenta detached from was closed and healed. Any time I’d call for breastfeeding support they would just offer me new latching positions and never really helped. I was sick of the "care" I received. I then decided that I wanted to become a support person for mothers because there is such a lack of support and care for postpartum women. My specialty is working with postpartum women so I can help support mothers to receive better care than I did.
What is the job/purpose of a Doula?
According to DONA International (a doula organization), doulas are trained, experienced professionals who provide continuous emotional, physical, and informational support to mothers before, during, and after childbirth. There are different types of doulas. Doulas can specialize in birth, postpartum care, and/or miscarriages. They can be focused more in Western care- helping out with cleaning the house, doing laundry, and making meals for the family or mamas. More holistic doulas will specialize in herbal therapies and diet. Cultural doulas practice more traditional care/therapies that they've learned from their culture. Doulas are not medical professionals who can treat, diagnose or prescribe any medications.
How does a momma-to-be (MTB) find one?
DONA International is a worldwide Doula Hub where MTB can find certified doulas:
https://www.dona.org/what-is-a-doula/how-to-hire-a-doula/
- Looking up birth centers, naturopathic doctor offices, and chiropractors that specialize in moms and babies in your area is always a good start.
- Many doulas are on social media- Instagram is always a great place to look as well
Are they covered by insurance?
Most doulas are out of pocket unless they are contracted with a birth center or hospital/clinic- they may accept insurance.
What is a Doula's usual rate? How are they paid?
Every doula's rate will be slightly different depending on what they specialize in and the services they offer. Some doulas offer a sliding scale and may charge per hour, per service or have a package plan. Most doulas offer payment plans and may collect payment through their preferred method- their website, PayPal, Zelle etc. Prices can range anywhere from a few hundred dollars to a few thousand depending on how many services their providing and for how long. The standard care is for 6 weeks but most doulas offer different plans to accommodate finances.
Are Doulas only for home births or hospital births? both?
Doulas can be for either home or hospital births. Most hospitals now allow for more than one person (since covid) and are supportive of Doulas in the hospital setting. It's always great to check with mamas specific hospital and check their policy for how many people are allowed during their birth.
What advice would you give to any MTB that is nervous about the birthing experience?
Nerves are totally normal and expected! Surrender to this experience. Sometimes our birth experience calls us to fully surrender into the experience and let go of control. Sometimes we get to have more say in what we do want or don't want. Our bodies created our babies and are capable of bringing our babies earth side. Women have been bringing babies into this world for hundred of thousands of years. The epidural only became popular in the 1980's! So nerves are normal, but take some classes on what to expect, listen to a podcast or read a book on how powerful our bodies are. Unfortunately, western medicine instills a lot of fear. The best advice I can give to any expecting family is do some research into the type of birth experience they want, and ask questions & communicate to your providers on what you want. Bringing a baby earth side is so beautiful, and empowering. But when you lack the knowledge and education in your rights and possible outcomes- things can get really scary, really fast.
If MTB decides to have a hospital birth, what advice would you give them?
Ask your providers what medical interventions do they have for pain, for emergencies etc. Can you bring your yoga ball to bounce on it? Can you take a shower or get into a pool? What positions can you deliver in? Can you walk around? Who can you have in the room. Create a birth plan and make sure every provider who walk in has read it. Do you want them to check babies weight immediately or can they wait until you bond with you baby first and breast feed within in the first hour. Can you allow all the blood from the placenta to go to baby first before they cut and clasp? Its important for parents to be to ask questions and know what the hospital polices are so if there is anything they don't want (like a c-section for example) what are all the possible interventions we can exhaust first before that becomes an option.
Are all c-sections necessary?
Sadly, no. Sometimes C-sections are scheduled so accommodate the doctor’s schedule. If the hospital needs to make more beds available for incoming mothers, sometimes they'll start pressuring mom to start pushing before she is ready which might put baby in stress and may become a reason now to have a c-section. The honest truth is that c-sections are more profitable, quicker and allow hospitals to schedule and have control of the labor and delivery versus traditional vaginal birth can go on for hours or days. There are definitely times were c-sections are life saving and important interventions. A good thing to google would be your hospitals rate of c-sections. Some hospitals have a 30-40% rate of live births being delivered via c-section- which is on the low end.
Can breech babies flip back into a normal position?
With a trained professional, breech babies can be turned into position. A doula, midwife or chiropractor can turn a breech baby. Many babies have been born breached successfully, but it does increase the risk for baby if the cord is wrapped around their neck or for mom to tear. It takes a trained professional to asses the risk and be willing to deliver a breached baby
Can MTB protest any medical advice that is given (aka c-section)?
Yes MTB can protest any medical advice, interventions, medication and policies. For example, most hospitals do not allow mothers to eat while in labor so that if they need to have an emergency c-section, there is no food in their system. Mothers can sign papers and not agree to that. What happens most of the time is doctors/nurses will communicate in a sense of urgency and push for medical interventions immediately as the first option for liabilies- usually instilling fear for life and death for either mom or baby. Mothers have the right to ask questions, ask for alternative interventions
Any other tips or comments you would like to give?
Birth is such a beautiful portal that mom gets to move through. Her womb has created physical life and married in a soul to bring earth side. Her body knows what to do. Labor and delivery is not like Hollywood movies where a women's water breaks and 2 minutes later shes yelling "get this thing out of me". There are 3 stages of labor and it is important to become familiar with each so that she is informed and educated on what to expect. Some women have full out of body births where they can experience orgasmic-like sensations. Regardless if a woman chooses to have an epidural or birth fully naturally- labor and delivery takes a lot of energy. When a woman gives birth, she is also birthing a whole new version of herself. It takes a mimunm of 40 days for a woman’s body to recover from labor and delivery. She requires lots of rest, support, warmth and gentleness afterwards. Women are warriors and birth is a reminder of thier power. Sometimes we cannot control what is happening and it is important to remind mamas to surrender into the pain, into the ebbs and flows and allow herself to rest.
How can MTB's reach you?
I can be reached at my email: Merlos.Mel@gmail.com or phone number (323)518-7737
How long should MTB's begin working with a Doula?
Doulas typically can begin working with mom during their last trimester- educate parents on what to expect, creating a birth plan, breastfeeding plan, and what medical interventions they do or don’t want. Birth doulas can assist during birth and a few hours afterwards. Postpartum doulas will typically provide services to mom for the first 6 weeks after birth.