December 12, 2017 • 38 mins
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!
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Speaker 1 (00:01):
Welcome to Stuff you Should Know from house Stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh Clark,
and there's Charles W. Chuck Bryant, there's Jerry over there.
And this is Stuff you Should Know, the podcast Childbirth Edition. Yeah,
(00:23):
we we were trapsing into more territory. What does that mean?
I don't know. I mean we've done two on you know,
feeding babies, done female puberty. Uh, this will this will
get into childbirth a little bit. So yeah, we're not afraid.
I don't care. Yeah, I guess that's what I'm trying
to say. You can be a male doula. You can.
(00:46):
Although I this is the only article I ran across that,
and did you find anything about that anywhere else? I mean,
it happens. It's just super rare. It happens because I mean,
we'll go ahead and spoil it. Generally, Uh, doulas are well,
let's just get into this. Generally dulas or women who
(01:07):
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. Yeah. Yeah,
and this is actually so this this is an ancient thing.
That's kind of come back around full circle. And even
the names Doula is a Greek term used way back
(01:28):
in the classical Greek days when a woman giving birth
would have female servants attending to her during birth, helping
her with it, um probably feeding her some grapes, waving
palm fronds on her, that kind of thing. Um. So,
doula means female servant or female slave, depending on who
you're talking about. And after you know, ancient Greece, fellow
(01:54):
of Rome and the Roman Empire fell, and all of
civilization took this weird course through about at all women
were helped by other women while they were giving birth
basically up until about the first third, first half of
the twentieth century in the West, where hospitals entered and
(02:17):
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 women in the birth room helping along. Uh. I
think once you started to get into hospitals and the
(02:38):
physicians in the hospital starting asserting their authority more and more, um,
especially through drugs, like I saw that. Um when when
hospitals kind of took over the birthing processor, took responsibility
for it from the family and from midwives, and moved
it into the hospital. They used to administer a lot
(02:58):
of sedatives as part of the birthing process as part
of labor. You know, you could understand why they would,
but then there are all sorts of um complications from it,
problems from it, So they stopped giving um sedatives as much.
And about that time, women who were giving birth started
to like kind of come out of it and look
(03:18):
around and say, whoa, it's just me and you guys
in here. I need some family members in here. 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, um, handing out cigars, maybe pacing um.
And the reason why it was because to the doctors involved,
(03:40):
it was just another medical procedure, right, so you're not
gonna have rando's 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 dad started to come in and then more
family members and then now doulas have have um definitely
(04:04):
kind of come back like they were originally. That's my
understanding of the whole thing. Yes, so doula's uh, we
haven't even said what that is yet, and that would
probably help clear it up if you don't know. Dulas
are um 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 will
(04:27):
come on before 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 you're dula 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
(04:49):
in nineteen sixty nine by a woman named Dana Raphael
and then later on in a book in nineteen seventy
three called The Tender Gift Breastfeeding, And that's when she
brought this term and back and said, uh, you know,
we're gonna start calling these women dulas, and it's gonna
be a real job, right And and I think at first,
(05:10):
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 eighties and the reason
why they came into wider use was because hospitals were
going to c sections a lot um. C sections went up.
(05:31):
From nineteen seventy four point two percent of live births
in the US involved c sections sixteen years later, in
six a quarter of live births in the US involved
c sections. And there are a lot of complications with
c sections um and so you could have your husband
in there, you could have your mom in there, you
(05:52):
could have friends, but they're just there for you. One
of the first services that doulas started offering was to say, WHOA, WHOA,
does she really need that C section? I 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
(06:13):
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 to c section. Yeah, and and know it's
not just c sections there. Your advocate there, your birth
advocate UM to to make sure or at least as
best they can to try to ensure that the birth
(06:33):
plan that you feel best about is the one that
you end up with. Things always change, of course, and
ADULA would never put you in danger by insisting on something.
In fact, they can't. But they're 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
(06:55):
that job. Yeah, And and UM is coming from a
place of empathy and sympathy and most importantly experience. Like
you said, most dulas 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
(07:18):
for any mother giving birth. Yeah, it's definitely gained popularity
in the two thousand's. Um. I think I tried to
find more recent statistics than two thousand twelve, but I couldn't.
But in two thousand twelve there were six percent. And
this is in the United States. It's a it's very much. Yeah.
I know it does happen all over the world some
(07:38):
but it's sort of an American thing. Uh, six percent
of people in twenty twelve years to doula versus three
percent in two thousand six. And in that same survey,
twenty seven percent of people said they would they would
like to use a dulah. So, uh, you know, at
least they're they're wishing or hopeful that they can. Yeah,
(07:59):
that was question eight. Would you like to use a dulah? Yeah,
said um. 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 you've kind
of read between the lines there. Especially at first, the
medical community saw doulas as they were starting to really
(08:20):
kind of come into use in the eighties, as basically
meddling busybodies who could potentially put their patient's life in
in jeopardy, right, But then Duelas of North America was
found founded DONA. It's like the first DULA licensing UM
body Certification and Training and Licensing body UM and they
(08:42):
were founded. It was founded by medical professionals, which kind
of created a bridge. It bridged the gap or kind
of got smoothed over the rough feelings between the medical
community and the DULA community. And it also added a
real air of legitimacy to the profession of of being
your dulah. Yeah, And the the impression I get now
is that, UM, if you have a good dula who
(09:05):
is good with people, which is UM ideally what your
dula is. If you're do listen, not a people person,
that's probably not going to be a good thing. But
the idea I get is that doctors and nurses like
having duela is there now because they can just concentrate
on They don't have to be the ones uh providing
emotional empathetic support, although they can still do that they want.
(09:27):
They can just concentrate on the medical aspects of it,
and they know that they have a trained, uh hopefully
licensed dulah. 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. You're in good
hands with this, Dulah, and I can just concentrate on
the medical parts now, all love Doulah. That's right. And
(09:51):
one of one of the other reasons are functions that
doulas provide you kind of hit on is that they, um,
they provide a serv that hospitals used to provide through nurses,
right where if you had a nurse in a in
a labor and delivery room, they they wouldn't spend as
much time or or give you as much attention to say,
like your your mom would or a friend or your
(10:13):
husband even 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 nurses 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,
(10:34):
so the personal attention dropped dramatically um as as um
electronic surveillance of patients increased, and the duela is kind
of came in to fill that role as well. Yeah,
like they're they're sitting in the room with you and
hanging out. They don't get called in like twenty minutes
before you give birth. They're there with you, you know,
(10:56):
sometimes days and weeks beforehand, coaching you and what to
expect and how to how you're going to 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,
um that is super knowledgeable about what it's going to
(11:19):
be like, where the husband might not exactly you know,
be be able to lend the most insightful ear there,
you know what I mean. Uh, So you want to
take a break, 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. All right. So, uh,
(11:58):
here's a misconception some people get. Um, some people think
that dulas are are authorized or trained to give birth.
That is not true. They don't deliver babies. Uh, they
don't perform any sort of medical procedures. They don't put
an ivy in your arm, they don't work the heart
rate monitor. Uh. Most times, they don't even work for
(12:19):
the hospital. You have hired them independently, and again they're
just there to coach you. There not even midwives. Midwives
can deliver a baby, right, Yeah, they're 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. Um.
(12:42):
And then also when they're administering the medical stuff, which
can be pretty uncomfortable, pretty frequently, I would imagine, um,
the duela is there to kind of tell the mom
what to expect them to comforter in all sorts of ways. Yeah,
and maybe not even offer advice, like I think. The
idea is that adula will lay it all out there
so you can make an informed decision and not necessarily
(13:05):
say well, if I were you, this is what I
would do. Well, yeah, that's a that's a slippery slope
right there, because then all of a sudden, if things
go wrong, you can say, well, the dula told me
to do that, and the DULA was like, I'm I'm toast. Uh.
Dulas have to be great listeners. We already talked about
the the empathy piece. They have to be very empathetic
(13:26):
and they will, like I said, start meeting before birth
to answer any kind of questions come up with that
birth plan uh and really listen a lot to the
wife and the husband so everybody is on the same page. Um.
And like I said, on the day, things can change.
But going in you generally want to have a pretty
(13:46):
good idea of everything from medications you might want to use,
if any, to uh to where you want to have
the baby. But doula can come on board and kind
of explain if they're knowledgeable, which hopefully they are, about
the hospitals around you. Uh and maybe even help you
pick out where you're gonna give birth. Yeah. And I mean,
(14:07):
if you already have an idea of what you want,
the dula can you know, kind of tell you how
to make that happen. 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. UM.
And I saw a Parents Magazine article about dula's. They
laid out what basically what you can expect from the
average DULA for the dula's fees um one to two
(14:29):
in person prenatal visits and then access to the dulah
for follow up questions through email or phone calls, UM
their full attention in presence during your labor, and then
sometimes frequently I get the idea UM a follow up
visit in at your house after the baby comes home.
(14:53):
That typically if you hire a dula, this is this
is about the average you can expect to him. There's
definitely a lot of um differences. There's some will give
you a little more, some we'll give you a little less,
some will charge more, some will do it for free. Uh,
it's just all over the place as far as you
know what you're actually going to shell out and what
you're going to get from adula. But but for the
(15:15):
most part, you the duel is going to have met
you before you give birth, and then the doula will
be there throughout the whole labor and delivery process. Yeah.
And it says in this article that there are specialists
dulas like antipartum doulas and postpartum dulas and labor dula's
(15:36):
UM that if you want an antipartum doula to be too,
if you want more than those two meetings, you might
want to hire someone who will be with you for
several weeks beforehand, or if you want someone postpartum to
be with you to coach you through breastfeeding or you know,
changing diapers or just any of that kind of coaching,
you can hire someone to do that. But I get
the sense that dula's generally will sort of uh, work
(16:01):
with you on whatever kind of plan you want, right.
It may make cost little extra, but UM, I get
the sense of ave dula wouldn't say like, Nope, you
get two meetings and that's it. It might be like, no,
I'll come in for a third and fourth meeting. It'll
be an extra of this much money. Um, and I
can hang with you for a week or two afterward
here and there. UM I found I think it was
(16:21):
through a BuzzFeed article. I stumbled upon a there's a
huge rift in the doula community actually, um between the
typical traditional approach to being a dula, which is, uh,
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,
(16:43):
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 um mission is that a doula for
every every mother who wants one, Like every mother should
have a dula basically, right. And then there's this other
group called pro do la and there they can't stand
(17:05):
dulas who who charge less than like a decent amount
for their services or do it for free. They actually
call uh dulas 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
(17:26):
they're really kind of kicking other duelas around and and
they're they're kind of bullies. It's in a really weird way. Um.
But there's like this big debate over whether doulas are
undervalued or um underselling themselves. But I, I mean, I
definitely get the idea that every woman who wants to
(17:50):
have a dula should be able to have a duela
regardless of her income. You know, that makes sense to me,
like a pro bono for for people that don't have
as much money. Yeah. On the other hand, I also
get that if you are a duela and you're doing
your job really well, then 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
(18:12):
the price, and anybody who goes underneath it should be
ostracized from the DULA community. Yeah. The other thing about
dula's another misconception a lot of people think is that
it's just some hippie dippie 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
that they're not there for anything other than that. And
(18:32):
that's not the case. They 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 Eppord dural or
be loaded up on every pharmaceutical they offer mothers in labor. Uh,
they're they're just to have knowledge of all that stuff. Um,
so you know what you're getting into. And then so
(18:54):
during labor, this is where this is where the doula
shines right there there to um help with alternatives to
to pain 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 um.
But they can do other things like they can um
massage you in ways that you had not ever heard
(19:16):
of before that helps with labor pains. I came across
this one technique where they pull on a couple of toes,
um specific toes, and it helps actually UM move the
labor along if you're if you have a slow labor,
there's needing techniques, they're stroking techniques, UM pressure around the
bottom of your feet. There's all sorts of stuff they
(19:38):
can do at various times throughout the labor and delivery
process that can help alleviate the pain that you're going through. UM,
and that's one of the big roles that they played
during labor. Yeah, when my kid was born, it was
I was shocked at how many people were in the room.
First of all, how many oh Man Baker's doesn't I
(19:59):
mean Emily and I birth mom obviously our adoption counselor
who was a licensed duelist, so she really served that
function for the birth mom, which was really a great
great plus. UM the doctor, I guess the I'm not
(20:20):
even sure what the roles are what their technical titles are.
But um, the doctor came in when it was go
time and basically just check 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
and ninety seconds later there was a baby. So it
was and and those were so it was two nurses
(20:43):
that that was probably like there was probably at least
twelve people in that room. That's a lot of people.
It was crowded and fast and surreal and weird and amazing. Uh,
even even weirder. They brought in carrot top to cut
the cord, but no, Emily cut the cord. Emily actually
helps sort of deliver in a way because you know,
they like to bring in uh. I guess you know,
(21:06):
in a in a regular biological birth, that would be
the husband probably uh 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, uh by the birth mom's head, uh, sort
of looking looking down that way. I was like, you
(21:27):
know she was She was like, you can go wherever
you want to go. But it's like, you know, I'll
just hang right here, right, And Emily's like, that's right, 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 for when my niece Mila was born and um,
(21:49):
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 she was delivering, Um,
I stood back behind this curtain, right and um, the
doctor comes in and walks past me and kind of
(22:09):
gives me a nod, and I hear him go to
the crowd. He's like, you know, there's like some guy
standing behind that curtain right, Like, yeah, he's supposed to
be there. He's the he's the word creeper, right exactly.
I'm like, Okay, I've heard enough here. I'm going to
the next room. Uh all right, well, let's take another break.
Now that we've shared our stories, we'll come back and
(22:32):
talk a little bit about how you become a duela.
Right for this? All right, Chuck. So if you wanted
(22:57):
to become a duela, um, basically you're you start in
training at age three, you're sent off to Europe to
apprentice at the one do list school in the world
and they make you eat a lot of magic cake,
and then when you're sixty you get to actually start
out on your own. That's that's exactly right. Okay, Well,
(23:18):
before you decide to become a duela, you need to
give a lot of thought on what you're going to
be getting into. Uh. You know, the hours are long
at birth job birth, it's very stressful, and especially if
there are complications that can be super stressful in a
matter of life or death. 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,
(23:41):
you know, in the most stressful of situations. But then
on the plus side, you get to see little babies
coming out on the rag and what's better than that?
You know, I can't think of too many things talk
about an oxytocin hit maybe magic cake, magic cake. Uh.
You do not have to have a college degree, you
(24:04):
don't have to have a high school degree. UM. Now
even you don't even have to be certified. It's not
law that you have to be certified. Yeah you don't,
but it is UM. There are more and more programs
now and more certification and licensing programs out there. So
if you want to be a duela, my advice is
to go that route. You probably just get more work
(24:25):
that way, right, So when you're when you're starting out,
you would go to UM. If you wanted to get certified,
you would go to one of the certifying bodies like
DONA or UM. What are what are the other two
that are mentioned in here. There's one called c A
p p A, KAPPA Sure, and then the American Pregnancy Association.
All three of those certify and train dula's UM. DONA,
(24:48):
from what I could tell, 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. UM.
They'll offer online classes, in person classes, UH, self paced
study and UM. You typically need to go take a
(25:09):
birthing class, a breastfeeding class because again you need to know,
like you need to be current on all the stuff
that's going on with labor and delivery. Right if you
if you took these classes ten years ago and they
did it again today, you would probably find some real
differences and new stuff that's been discovered in the last
ten years. So you would need to be pretty current,
(25:30):
even if you've had kids of your own before. UM.
And then you also need to attend at least one
I have the impression that multiple births under the apprenticeship
of another doula who's already certified or trained or experienced
UM before you really go off on your own to
become certified. Uh. And And that's I mean, that's just
(25:54):
I would I would say, how many births have you
been a part of, you know, all ready before I
hired a dula. That's a pretty big question if you
ask me 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 gonna be my first solo
your first solo flight. Yep, Uh, you will. It depends
(26:16):
on where you live, on how much you're gonna pay. UM.
If you if you live in a big fancy city
like New York City, you're gonna be paying top dollar
for your dula. If you live in Los Angeles, gonna
be paying top dollar for your dula. I saw like
thirty five hundred at least for each of those cities. Yeah,
but that that scale can go all the way down
to uh zero, Well, sure, all the way to zero,
(26:37):
But if you're paying a doula, that number can go
all the way down to six hundred to eight hundred
thousand dollars. And you know, and in the fly over states, right.
But again, I mean like, if if this is the
duel is first time on their own, you're probably not
going to be paying top dollar. Um. And if you say, look,
(26:59):
I really really really want to have Adula at my
at my child's birth, but I really genuinely don't have
this money. Um. Actually got a lift once from Adula,
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 Adula and
(27:21):
driving a lift here, and these guys are trying to
like short change me. So she said she told them no.
She said she tried to work with them, but they
wouldn't they wouldn't budge about whatever they thought her services
were worth so she had to just walk on. But um,
I why would have family that's well off not paid
eight hundred dollars. I don't know. I don't know because
(27:43):
I remember thinking like, wow, that's that's all it costs
for adula. She might have even been quoting them less
than eight hundred dollars. Yeah, So there is definitely like
there seems to be a tension between the desire to
have a doula and the um the sense of non
obligation to pay a dula a decent wage, which I
(28:04):
think is where that produla um group pulls their hair out.
You know, uh, well, you you may get it covered
by insurance. Um. 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. You can always ask. You can always file
(28:24):
a claim, uh and just see if you'll get a
little assistance there. Yeah, if you live in Oregon and Minnesota, though,
Medicaid will reimburse your full DULA expenses for certified DULA,
which is pretty awesome. Like, that's huge in groundbreaking that
those two states have that um. The reason why they
(28:44):
would pay anything for a DULA rather than just being
like just burned some sage or something and and and
you know, spend five bucks. Is because there has been
studies about Dulah's and they have come out quite positive
in some pretty good period viewed studies in peer review
peer reviewed journals. Right, um, have you seen any of this? Well, yeah,
(29:06):
I saw the one, uh fifteen thousand people. That's a
pretty decent study size. And they said, in this study size,
there were some women who had dulas and some women
who did not have dulas or any kind of support
like that. And then outcomes for women with continuous support,
we're better than those without, meaning their labors or shorter
(29:28):
by about forty minutes on average. Their babies had higher
APCAR scores, which AFCAR these tests they give your baby,
Like the first thing your kid has to do is
take a test. No seconds later, they're giving your kid
their first test. Yeah, activity, pulse, grimace, appearance, and respiration.
That's right. Yeah, And so higher APCAR scores um a
(29:50):
fewer negative feelings about childbirth, like this is the emotional component.
They required, less pain medication, fewer uses of FORCETEP, sort
of vacuum assisted interventions c sections across the board. Dula's helped,
and what what was really interesting was there was basically
nothing that could point out that said having a duela
(30:12):
was a negative in anyway. Yeah, and even when they
look just at dulas rather than just all types of
continuous support, just at dulas, the duelas they held up
to there was less use of potos and less c section,
more spontaneous vaginal deliveries UM, less of a risk of
being admitted to a special care nursery, UM, four times
(30:34):
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 DULA. Right, So there's all these like
like demonstrably positive outcomes and then you hit upon the
other thing too that they um, they make the harsh
(30:55):
hospital environment. There's something called harsh environment theory UM 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 um,
that they can actually produce a traumatic experience. I suspect
him more women than than you would think having birth
(31:16):
or giving birth in a hospital is kind of traumatic
and for some women, from what I read, it's like
like deeply traumatic um. And that's that's been a huge
reason that dulas have really come into use lately, is
because they mellow everything out for you a lot more.
And there's actually I read there's a group of renegade
(31:36):
duelas who are acting as midwives out in the pot
growing country of northern California. Uh, what's the relationship there
to the pot growing I would guess they probably do both.
They grow the pot and deliver the babies. I think
it's kind of like a whole back to the earth,
(31:57):
to hell with the man's established meant hospitals. Apparently it's
illegal to give birth like this without like a certified
um someone from the medical community being there to assist
in the delivery. They're they're saying nuts to that, which
I would guess is pretty dangerous but also illegal. And
(32:18):
if there's anything that screams Northern California more than dangerous
and illegal, I don't know. Yeah, Uh, if you want
to use a dula, and and I'm officially endorsing this,
I say don't say don't say do la. Sorry, I
couldn't resist on that one. It was worth it. Um,
(32:38):
you just get online, you know, the dulas are easy
to find in your area. Do a little Google searching, UM,
get a reference, a personal reference if you can, would
be great. Get online, find a friend who was used
to DOLA they can recommend. I mean that's really the
best way. UM. I don't know if I'd go on
Yelp or anything like that or Angie's List though maybe
(33:00):
who knows, But it's better if a good friends says, hey,
I use this DULA and she's great. I think. Also
the certifying bodies UM have directories of certified dulas in
areas to Yeah. I mean you wanted to be a
good personality match too, so you should talk to your
DULA on the phone at the very least, UM, but
(33:20):
ideally you have a little in person meeting to make sure, like,
is this someone I want to I want to jump
into the foxhole with because they're gonna be around a lot,
you know, and you have to have a good personality
match there. 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. They need to
fit into your jam pretty well, yeah, or else it's
(33:43):
this gonna be Especially if you're one of those people
who can't stand conflict, that would be awful. To have
a duela 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. And then you
have to pay them afterwards, that would just be terrible.
So yeah, you want to vet them pretty well ahead
(34:04):
of time. Yeah, and while you um, while adula is
that aduela 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 your childbirth
philosophy as a mom is what matters, you know, So
a good duela will get on board with that um
(34:26):
or if they aren't on board with that, then they
probably shouldn't be working with you. And yeah, I can
see them being like, look, I I can recommend a
couple of other people who are more in line with
what you're looking for than me, you know, instead of
wrong wrong wrong, This is all wrong. This is how
we're gonna do right. That's right. Are you got anything
else on duels? Just this little bit on death duelas.
(34:49):
We may have covered this in our geeze in our
dying episode. Yeah, that's what I was thinking. I feel
like we've talked about it. But it is a job. Um,
if you want to help family or a person or
both through end of life care, Uh, there are people
you can hire just to do that, and it's not
the same as Uh they can work in concert with
(35:12):
hospice care. But it's not like a hospice nurse. It's
someone just like a birth dula who is there to
really just emotionally kind of coach you through through the
dying process with a family member, and also to to
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 you're looking for to make the
(35:33):
whole thing better. That's right, pretty pretty neat. Up with doulas, Yeah,
Up with dulas agreed. If you want to know more
about Up with Dula's this new organization that Chuck and
I just now founded, you can. I'll 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,
(35:56):
all right, I'm gonna call this flu shot clarification because
that's what the sub decline says. 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 now. I'm just kidding.
H I spent a lot of time seeing patients answering
(36:18):
questions about things like flu shots and who should receive them. Uh.
The CDC new recommends that everyone over the age of
six months receives a flu shot, even those who are
perfectly healthy, even those who are allergic to eggs. They're
cuckoo for flu shots. The flu shots are now being
designed to be egg free. Uh so their egg free,
(36:39):
gluten free? What else? Dare they contained teen percent keen
wa And there's no evidence to suggest flu shots in
recent years could cause a reaction. And those allergic to eggs,
all right, that's interesting. Did not know that he said
the benefits of the flu shots far outweighed the risk
in his opinion. This guy's opinion, Yeah, and it sounds
(37:02):
like it's an informed opinion at the very least sure so.
Uh that is from Devon from Philadelphia. Go Eagles do
you think so? Really? Yeah? I mean why not? They're
doing great? Okay, Well, thanks a lot, Devon. I appreciate
writing in. That was nice of you. And if you
out there want to be like Devon, you can tweet
(37:24):
to us at josh um Clark or s Y s
K podcast. You can join us on Facebook dot com,
slash Stuff you Should Know or slash Charles W. Chuck Bryant.
You can hang out with us at um on email,
at stuff podcast at how stuff Works dot com and
has always joined us at home on the web, Stuff
you Should Know dot com For more on this and
(37:48):
thousands of other topics. Is it how stuff Works dot
com th
Welcome to Stuff you Should Know from house Stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh Clark,
and there's Charles W. Chuck Bryant, there's Jerry over there.
And this is Stuff you Should Know, the podcast Childbirth Edition. Yeah,
(00:23):
we we were trapsing into more territory. What does that mean?
I don't know. I mean we've done two on you know,
feeding babies, done female puberty. Uh, this will this will
get into childbirth a little bit. So yeah, we're not afraid.
I don't care. Yeah, I guess that's what I'm trying
to say. You can be a male doula. You can.
(00:46):
Although I this is the only article I ran across that,
and did you find anything about that anywhere else? I mean,
it happens. It's just super rare. It happens because I mean,
we'll go ahead and spoil it. Generally, Uh, doulas are well,
let's just get into this. Generally dulas or women who
(01:07):
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. Yeah. Yeah,
and this is actually so this this is an ancient thing.
That's kind of come back around full circle. And even
the names Doula is a Greek term used way back
(01:28):
in the classical Greek days when a woman giving birth
would have female servants attending to her during birth, helping
her with it, um probably feeding her some grapes, waving
palm fronds on her, that kind of thing. Um. So,
doula means female servant or female slave, depending on who
you're talking about. And after you know, ancient Greece, fellow
(01:54):
of Rome and the Roman Empire fell, and all of
civilization took this weird course through about at all women
were helped by other women while they were giving birth
basically up until about the first third, first half of
the twentieth century in the West, where hospitals entered and
(02:17):
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 women in the birth room helping along. Uh. I
think once you started to get into hospitals and the
(02:38):
physicians in the hospital starting asserting their authority more and more, um,
especially through drugs, like I saw that. Um when when
hospitals kind of took over the birthing processor, took responsibility
for it from the family and from midwives, and moved
it into the hospital. They used to administer a lot
(02:58):
of sedatives as part of the birthing process as part
of labor. You know, you could understand why they would,
but then there are all sorts of um complications from it,
problems from it, So they stopped giving um sedatives as much.
And about that time, women who were giving birth started
to like kind of come out of it and look
(03:18):
around and say, whoa, it's just me and you guys
in here. I need some family members in here. 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, um, handing out cigars, maybe pacing um.
And the reason why it was because to the doctors involved,
(03:40):
it was just another medical procedure, right, so you're not
gonna have rando's 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 dad started to come in and then more
family members and then now doulas have have um definitely
(04:04):
kind of come back like they were originally. That's my
understanding of the whole thing. Yes, so doula's uh, we
haven't even said what that is yet, and that would
probably help clear it up if you don't know. Dulas
are um 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 will
(04:27):
come on before 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 you're dula 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
(04:49):
in nineteen sixty nine by a woman named Dana Raphael
and then later on in a book in nineteen seventy
three called The Tender Gift Breastfeeding, And that's when she
brought this term and back and said, uh, you know,
we're gonna start calling these women dulas, and it's gonna
be a real job, right And and I think at first,
(05:10):
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 eighties and the reason
why they came into wider use was because hospitals were
going to c sections a lot um. C sections went up.
(05:31):
From nineteen seventy four point two percent of live births
in the US involved c sections sixteen years later, in
six a quarter of live births in the US involved
c sections. And there are a lot of complications with
c sections um and so you could have your husband
in there, you could have your mom in there, you
(05:52):
could have friends, but they're just there for you. One
of the first services that doulas started offering was to say, WHOA, WHOA,
does she really need that C section? I 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
(06:13):
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 to c section. Yeah, and and know it's
not just c sections there. Your advocate there, your birth
advocate UM to to make sure or at least as
best they can to try to ensure that the birth
(06:33):
plan that you feel best about is the one that
you end up with. Things always change, of course, and
ADULA would never put you in danger by insisting on something.
In fact, they can't. But they're 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
(06:55):
that job. Yeah, And and UM is coming from a
place of empathy and sympathy and most importantly experience. Like
you said, most dulas 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
(07:18):
for any mother giving birth. Yeah, it's definitely gained popularity
in the two thousand's. Um. I think I tried to
find more recent statistics than two thousand twelve, but I couldn't.
But in two thousand twelve there were six percent. And
this is in the United States. It's a it's very much. Yeah.
I know it does happen all over the world some
(07:38):
but it's sort of an American thing. Uh, six percent
of people in twenty twelve years to doula versus three
percent in two thousand six. And in that same survey,
twenty seven percent of people said they would they would
like to use a dulah. So, uh, you know, at
least they're they're wishing or hopeful that they can. Yeah,
(07:59):
that was question eight. Would you like to use a dulah? Yeah,
said um. 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 you've kind
of read between the lines there. Especially at first, the
medical community saw doulas as they were starting to really
(08:20):
kind of come into use in the eighties, as basically
meddling busybodies who could potentially put their patient's life in
in jeopardy, right, But then Duelas of North America was
found founded DONA. It's like the first DULA licensing UM
body Certification and Training and Licensing body UM and they
(08:42):
were founded. It was founded by medical professionals, which kind
of created a bridge. It bridged the gap or kind
of got smoothed over the rough feelings between the medical
community and the DULA community. And it also added a
real air of legitimacy to the profession of of being
your dulah. Yeah, And the the impression I get now
is that, UM, if you have a good dula who
(09:05):
is good with people, which is UM ideally what your
dula is. If you're do listen, not a people person,
that's probably not going to be a good thing. But
the idea I get is that doctors and nurses like
having duela is there now because they can just concentrate
on They don't have to be the ones uh providing
emotional empathetic support, although they can still do that they want.
(09:27):
They can just concentrate on the medical aspects of it,
and they know that they have a trained, uh hopefully
licensed dulah. 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. You're in good
hands with this, Dulah, and I can just concentrate on
the medical parts now, all love Doulah. That's right. And
(09:51):
one of one of the other reasons are functions that
doulas provide you kind of hit on is that they, um,
they provide a serv that hospitals used to provide through nurses,
right where if you had a nurse in a in
a labor and delivery room, they they wouldn't spend as
much time or or give you as much attention to say,
like your your mom would or a friend or your
(10:13):
husband even 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 nurses 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,
(10:34):
so the personal attention dropped dramatically um as as um
electronic surveillance of patients increased, and the duela is kind
of came in to fill that role as well. Yeah,
like they're they're sitting in the room with you and
hanging out. They don't get called in like twenty minutes
before you give birth. They're there with you, you know,
(10:56):
sometimes days and weeks beforehand, coaching you and what to
expect and how to how you're going to 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,
um that is super knowledgeable about what it's going to
(11:19):
be like, where the husband might not exactly you know,
be be able to lend the most insightful ear there,
you know what I mean. Uh, So you want to
take a break, 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. All right. So, uh,
(11:58):
here's a misconception some people get. Um, some people think
that dulas are are authorized or trained to give birth.
That is not true. They don't deliver babies. Uh, they
don't perform any sort of medical procedures. They don't put
an ivy in your arm, they don't work the heart
rate monitor. Uh. Most times, they don't even work for
(12:19):
the hospital. You have hired them independently, and again they're
just there to coach you. There not even midwives. Midwives
can deliver a baby, right, Yeah, they're 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. Um.
(12:42):
And then also when they're administering the medical stuff, which
can be pretty uncomfortable, pretty frequently, I would imagine, um,
the duela is there to kind of tell the mom
what to expect them to comforter in all sorts of ways. Yeah,
and maybe not even offer advice, like I think. The
idea is that adula will lay it all out there
so you can make an informed decision and not necessarily
(13:05):
say well, if I were you, this is what I
would do. Well, yeah, that's a that's a slippery slope
right there, because then all of a sudden, if things
go wrong, you can say, well, the dula told me
to do that, and the DULA was like, I'm I'm toast. Uh.
Dulas have to be great listeners. We already talked about
the the empathy piece. They have to be very empathetic
(13:26):
and they will, like I said, start meeting before birth
to answer any kind of questions come up with that
birth plan uh and really listen a lot to the
wife and the husband so everybody is on the same page. Um.
And like I said, on the day, things can change.
But going in you generally want to have a pretty
(13:46):
good idea of everything from medications you might want to use,
if any, to uh to where you want to have
the baby. But doula can come on board and kind
of explain if they're knowledgeable, which hopefully they are, about
the hospitals around you. Uh and maybe even help you
pick out where you're gonna give birth. Yeah. And I mean,
(14:07):
if you already have an idea of what you want,
the dula can you know, kind of tell you how
to make that happen. 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. UM.
And I saw a Parents Magazine article about dula's. They
laid out what basically what you can expect from the
average DULA for the dula's fees um one to two
(14:29):
in person prenatal visits and then access to the dulah
for follow up questions through email or phone calls, UM
their full attention in presence during your labor, and then
sometimes frequently I get the idea UM a follow up
visit in at your house after the baby comes home.
(14:53):
That typically if you hire a dula, this is this
is about the average you can expect to him. There's
definitely a lot of um differences. There's some will give
you a little more, some we'll give you a little less,
some will charge more, some will do it for free. Uh,
it's just all over the place as far as you
know what you're actually going to shell out and what
you're going to get from adula. But but for the
(15:15):
most part, you the duel is going to have met
you before you give birth, and then the doula will
be there throughout the whole labor and delivery process. Yeah.
And it says in this article that there are specialists
dulas like antipartum doulas and postpartum dulas and labor dula's
(15:36):
UM that if you want an antipartum doula to be too,
if you want more than those two meetings, you might
want to hire someone who will be with you for
several weeks beforehand, or if you want someone postpartum to
be with you to coach you through breastfeeding or you know,
changing diapers or just any of that kind of coaching,
you can hire someone to do that. But I get
the sense that dula's generally will sort of uh, work
(16:01):
with you on whatever kind of plan you want, right.
It may make cost little extra, but UM, I get
the sense of ave dula wouldn't say like, Nope, you
get two meetings and that's it. It might be like, no,
I'll come in for a third and fourth meeting. It'll
be an extra of this much money. Um, and I
can hang with you for a week or two afterward
here and there. UM I found I think it was
(16:21):
through a BuzzFeed article. I stumbled upon a there's a
huge rift in the doula community actually, um between the
typical traditional approach to being a dula, which is, uh,
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,
(16:43):
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 um mission is that a doula for
every every mother who wants one, Like every mother should
have a dula basically, right. And then there's this other
group called pro do la and there they can't stand
(17:05):
dulas who who charge less than like a decent amount
for their services or do it for free. They actually
call uh dulas 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
(17:26):
they're really kind of kicking other duelas around and and
they're they're kind of bullies. It's in a really weird way. Um.
But there's like this big debate over whether doulas are
undervalued or um underselling themselves. But I, I mean, I
definitely get the idea that every woman who wants to
(17:50):
have a dula should be able to have a duela
regardless of her income. You know, that makes sense to me,
like a pro bono for for people that don't have
as much money. Yeah. On the other hand, I also
get that if you are a duela and you're doing
your job really well, then 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
(18:12):
the price, and anybody who goes underneath it should be
ostracized from the DULA community. Yeah. The other thing about
dula's another misconception a lot of people think is that
it's just some hippie dippie 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
that they're not there for anything other than that. And
(18:32):
that's not the case. They 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 Eppord dural or
be loaded up on every pharmaceutical they offer mothers in labor. Uh,
they're they're just to have knowledge of all that stuff. Um,
so you know what you're getting into. And then so
(18:54):
during labor, this is where this is where the doula
shines right there there to um help with alternatives to
to pain 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 um.
But they can do other things like they can um
massage you in ways that you had not ever heard
(19:16):
of before that helps with labor pains. I came across
this one technique where they pull on a couple of toes,
um specific toes, and it helps actually UM move the
labor along if you're if you have a slow labor,
there's needing techniques, they're stroking techniques, UM pressure around the
bottom of your feet. There's all sorts of stuff they
(19:38):
can do at various times throughout the labor and delivery
process that can help alleviate the pain that you're going through. UM,
and that's one of the big roles that they played
during labor. Yeah, when my kid was born, it was
I was shocked at how many people were in the room.
First of all, how many oh Man Baker's doesn't I
(19:59):
mean Emily and I birth mom obviously our adoption counselor
who was a licensed duelist, so she really served that
function for the birth mom, which was really a great
great plus. UM the doctor, I guess the I'm not
(20:20):
even sure what the roles are what their technical titles are.
But um, the doctor came in when it was go
time and basically just check 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
and ninety seconds later there was a baby. So it
was and and those were so it was two nurses
(20:43):
that that was probably like there was probably at least
twelve people in that room. That's a lot of people.
It was crowded and fast and surreal and weird and amazing. Uh,
even even weirder. They brought in carrot top to cut
the cord, but no, Emily cut the cord. Emily actually
helps sort of deliver in a way because you know,
they like to bring in uh. I guess you know,
(21:06):
in a in a regular biological birth, that would be
the husband probably uh 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, uh by the birth mom's head, uh, sort
of looking looking down that way. I was like, you
(21:27):
know she was She was like, you can go wherever
you want to go. But it's like, you know, I'll
just hang right here, right, And Emily's like, that's right, 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 for when my niece Mila was born and um,
(21:49):
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 she was delivering, Um,
I stood back behind this curtain, right and um, the
doctor comes in and walks past me and kind of
(22:09):
gives me a nod, and I hear him go to
the crowd. He's like, you know, there's like some guy
standing behind that curtain right, Like, yeah, he's supposed to
be there. He's the he's the word creeper, right exactly.
I'm like, Okay, I've heard enough here. I'm going to
the next room. Uh all right, well, let's take another break.
Now that we've shared our stories, we'll come back and
(22:32):
talk a little bit about how you become a duela.
Right for this? All right, Chuck. So if you wanted
(22:57):
to become a duela, um, basically you're you start in
training at age three, you're sent off to Europe to
apprentice at the one do list school in the world
and they make you eat a lot of magic cake,
and then when you're sixty you get to actually start
out on your own. That's that's exactly right. Okay, Well,
(23:18):
before you decide to become a duela, you need to
give a lot of thought on what you're going to
be getting into. Uh. You know, the hours are long
at birth job birth, it's very stressful, and especially if
there are complications that can be super stressful in a
matter of life or death. 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,
(23:41):
you know, in the most stressful of situations. But then
on the plus side, you get to see little babies
coming out on the rag and what's better than that?
You know, I can't think of too many things talk
about an oxytocin hit maybe magic cake, magic cake. Uh.
You do not have to have a college degree, you
(24:04):
don't have to have a high school degree. UM. Now
even you don't even have to be certified. It's not
law that you have to be certified. Yeah you don't,
but it is UM. There are more and more programs
now and more certification and licensing programs out there. So
if you want to be a duela, my advice is
to go that route. You probably just get more work
(24:25):
that way, right, So when you're when you're starting out,
you would go to UM. If you wanted to get certified,
you would go to one of the certifying bodies like
DONA or UM. What are what are the other two
that are mentioned in here. There's one called c A
p p A, KAPPA Sure, and then the American Pregnancy Association.
All three of those certify and train dula's UM. DONA,
(24:48):
from what I could tell, 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. UM.
They'll offer online classes, in person classes, UH, self paced
study and UM. You typically need to go take a
(25:09):
birthing class, a breastfeeding class because again you need to know,
like you need to be current on all the stuff
that's going on with labor and delivery. Right if you
if you took these classes ten years ago and they
did it again today, you would probably find some real
differences and new stuff that's been discovered in the last
ten years. So you would need to be pretty current,
(25:30):
even if you've had kids of your own before. UM.
And then you also need to attend at least one
I have the impression that multiple births under the apprenticeship
of another doula who's already certified or trained or experienced
UM before you really go off on your own to
become certified. Uh. And And that's I mean, that's just
(25:54):
I would I would say, how many births have you
been a part of, you know, all ready before I
hired a dula. That's a pretty big question if you
ask me 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 gonna be my first solo
your first solo flight. Yep, Uh, you will. It depends
(26:16):
on where you live, on how much you're gonna pay. UM.
If you if you live in a big fancy city
like New York City, you're gonna be paying top dollar
for your dula. If you live in Los Angeles, gonna
be paying top dollar for your dula. I saw like
thirty five hundred at least for each of those cities. Yeah,
but that that scale can go all the way down
to uh zero, Well, sure, all the way to zero,
(26:37):
But if you're paying a doula, that number can go
all the way down to six hundred to eight hundred
thousand dollars. And you know, and in the fly over states, right.
But again, I mean like, if if this is the
duel is first time on their own, you're probably not
going to be paying top dollar. Um. And if you say, look,
(26:59):
I really really really want to have Adula at my
at my child's birth, but I really genuinely don't have
this money. Um. Actually got a lift once from Adula,
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 Adula and
(27:21):
driving a lift here, and these guys are trying to
like short change me. So she said she told them no.
She said she tried to work with them, but they
wouldn't they wouldn't budge about whatever they thought her services
were worth so she had to just walk on. But um,
I why would have family that's well off not paid
eight hundred dollars. I don't know. I don't know because
(27:43):
I remember thinking like, wow, that's that's all it costs
for adula. She might have even been quoting them less
than eight hundred dollars. Yeah, So there is definitely like
there seems to be a tension between the desire to
have a doula and the um the sense of non
obligation to pay a dula a decent wage, which I
(28:04):
think is where that produla um group pulls their hair out.
You know, uh, well, you you may get it covered
by insurance. Um. 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. You can always ask. You can always file
(28:24):
a claim, uh and just see if you'll get a
little assistance there. Yeah, if you live in Oregon and Minnesota, though,
Medicaid will reimburse your full DULA expenses for certified DULA,
which is pretty awesome. Like, that's huge in groundbreaking that
those two states have that um. The reason why they
(28:44):
would pay anything for a DULA rather than just being
like just burned some sage or something and and and
you know, spend five bucks. Is because there has been
studies about Dulah's and they have come out quite positive
in some pretty good period viewed studies in peer review
peer reviewed journals. Right, um, have you seen any of this? Well, yeah,
(29:06):
I saw the one, uh fifteen thousand people. That's a
pretty decent study size. And they said, in this study size,
there were some women who had dulas and some women
who did not have dulas or any kind of support
like that. And then outcomes for women with continuous support,
we're better than those without, meaning their labors or shorter
(29:28):
by about forty minutes on average. Their babies had higher
APCAR scores, which AFCAR these tests they give your baby,
Like the first thing your kid has to do is
take a test. No seconds later, they're giving your kid
their first test. Yeah, activity, pulse, grimace, appearance, and respiration.
That's right. Yeah, And so higher APCAR scores um a
(29:50):
fewer negative feelings about childbirth, like this is the emotional component.
They required, less pain medication, fewer uses of FORCETEP, sort
of vacuum assisted interventions c sections across the board. Dula's helped,
and what what was really interesting was there was basically
nothing that could point out that said having a duela
(30:12):
was a negative in anyway. Yeah, and even when they
look just at dulas rather than just all types of
continuous support, just at dulas, the duelas they held up
to there was less use of potos and less c section,
more spontaneous vaginal deliveries UM, less of a risk of
being admitted to a special care nursery, UM, four times
(30:34):
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 DULA. Right, So there's all these like
like demonstrably positive outcomes and then you hit upon the
other thing too that they um, they make the harsh
(30:55):
hospital environment. There's something called harsh environment theory UM 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 um,
that they can actually produce a traumatic experience. I suspect
him more women than than you would think having birth
(31:16):
or giving birth in a hospital is kind of traumatic
and for some women, from what I read, it's like
like deeply traumatic um. And that's that's been a huge
reason that dulas have really come into use lately, is
because they mellow everything out for you a lot more.
And there's actually I read there's a group of renegade
(31:36):
duelas who are acting as midwives out in the pot
growing country of northern California. Uh, what's the relationship there
to the pot growing I would guess they probably do both.
They grow the pot and deliver the babies. I think
it's kind of like a whole back to the earth,
(31:57):
to hell with the man's established meant hospitals. Apparently it's
illegal to give birth like this without like a certified
um someone from the medical community being there to assist
in the delivery. They're they're saying nuts to that, which
I would guess is pretty dangerous but also illegal. And
(32:18):
if there's anything that screams Northern California more than dangerous
and illegal, I don't know. Yeah, Uh, if you want
to use a dula, and and I'm officially endorsing this,
I say don't say don't say do la. Sorry, I
couldn't resist on that one. It was worth it. Um,
(32:38):
you just get online, you know, the dulas are easy
to find in your area. Do a little Google searching, UM,
get a reference, a personal reference if you can, would
be great. Get online, find a friend who was used
to DOLA they can recommend. I mean that's really the
best way. UM. I don't know if I'd go on
Yelp or anything like that or Angie's List though maybe
(33:00):
who knows, But it's better if a good friends says, hey,
I use this DULA and she's great. I think. Also
the certifying bodies UM have directories of certified dulas in
areas to Yeah. I mean you wanted to be a
good personality match too, so you should talk to your
DULA on the phone at the very least, UM, but
(33:20):
ideally you have a little in person meeting to make sure, like,
is this someone I want to I want to jump
into the foxhole with because they're gonna be around a lot,
you know, and you have to have a good personality
match there. 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. They need to
fit into your jam pretty well, yeah, or else it's
(33:43):
this gonna be Especially if you're one of those people
who can't stand conflict, that would be awful. To have
a duela 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. And then you
have to pay them afterwards, that would just be terrible.
So yeah, you want to vet them pretty well ahead
(34:04):
of time. Yeah, and while you um, while adula is
that aduela 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 your childbirth
philosophy as a mom is what matters, you know, So
a good duela will get on board with that um
(34:26):
or if they aren't on board with that, then they
probably shouldn't be working with you. And yeah, I can
see them being like, look, I I can recommend a
couple of other people who are more in line with
what you're looking for than me, you know, instead of
wrong wrong wrong, This is all wrong. This is how
we're gonna do right. That's right. Are you got anything
else on duels? Just this little bit on death duelas.
(34:49):
We may have covered this in our geeze in our
dying episode. Yeah, that's what I was thinking. I feel
like we've talked about it. But it is a job. Um,
if you want to help family or a person or
both through end of life care, Uh, there are people
you can hire just to do that, and it's not
the same as Uh they can work in concert with
(35:12):
hospice care. But it's not like a hospice nurse. It's
someone just like a birth dula who is there to
really just emotionally kind of coach you through through the
dying process with a family member, and also to to
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 you're looking for to make the
(35:33):
whole thing better. That's right, pretty pretty neat. Up with doulas, Yeah,
Up with dulas agreed. If you want to know more
about Up with Dula's this new organization that Chuck and
I just now founded, you can. I'll 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,
(35:56):
all right, I'm gonna call this flu shot clarification because
that's what the sub decline says. 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 now. I'm just kidding.
H I spent a lot of time seeing patients answering
(36:18):
questions about things like flu shots and who should receive them. Uh.
The CDC new recommends that everyone over the age of
six months receives a flu shot, even those who are
perfectly healthy, even those who are allergic to eggs. They're
cuckoo for flu shots. The flu shots are now being
designed to be egg free. Uh so their egg free,
(36:39):
gluten free? What else? Dare they contained teen percent keen
wa And there's no evidence to suggest flu shots in
recent years could cause a reaction. And those allergic to eggs,
all right, that's interesting. Did not know that he said
the benefits of the flu shots far outweighed the risk
in his opinion. This guy's opinion, Yeah, and it sounds
(37:02):
like it's an informed opinion at the very least sure so.
Uh that is from Devon from Philadelphia. Go Eagles do
you think so? Really? Yeah? I mean why not? They're
doing great? Okay, Well, thanks a lot, Devon. I appreciate
writing in. That was nice of you. And if you
out there want to be like Devon, you can tweet
(37:24):
to us at josh um Clark or s Y s
K podcast. You can join us on Facebook dot com,
slash Stuff you Should Know or slash Charles W. Chuck Bryant.
You can hang out with us at um on email,
at stuff podcast at how stuff Works dot com and
has always joined us at home on the web, Stuff
you Should Know dot com For more on this and
(37:48):
thousands of other topics. Is it how stuff Works dot
com th
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Josh Clark
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