Stef writes:
I recently attended a "meeting" with a sleep doula with a group of friends... I have 2 questions for you because none of my friends can answer them for me:
1. what exactly is a doula? is there any training, school, certification etc. required to call yourself a doula or can anyone wake up one day, print some business cards and start charging ridiculous amounts of money to dole out sleep advice to weary parents?
2. Have you ever heard of any actual medical research studies that link pacifier use in babies under 3 to drug addiction later in life? (Yes, this is the advice given out by the doula...)
Hahahahahahahahaha. Let me address the second question first (as I'm wont to do): No, I've never heard of this, and I call bullshit. Really? Drug addiction from using pacifiers? If there's anyone out there with actual research backing this up, please post a link, as I'd be very interested in seeing this (as would the organizations that have been recommending pacifier use as correlating with lower incidence of SIDS, I'm sure).
From a practical standpoint, some babies just have a really strong sucking need. And it's either the thumb or the pacifier, and some kids won't find their thumbs.
Honestly, of all the things you have to worry about as a parent, pacifier use or non-use doesn't even rank as something worth spending your time on. How much sleep you're getting, the state of your marriage/partnership/singlehood, childcare, just how contaminated and unsafe every thing we eat is, global warming, unsafe toys, child labor and exploitation, skateboarding injuries, bullies at school, whether your child's hitting appropriate milestones, how the heck you're going to save for retirement, how you're going to pay your rent or mortgage next month, what's going to happen to the extra 5 pounds on your belly that won't budge since you had a baby, how to help that mom in your playgroup who seems to be flirting with the edge of PPD, the economy--all this stuff is worth thinking about. Pacifier use, notsomuch.
Now, on to doulas. "Doula" is a Greek word meaning "woman who serves" and in its modern meaning it's someone you pay (usually) to help you with something. There are two types of doulas in common usage. the first is a birth doula, who is a woman (usually) who stays with you during labor and delivery to act as your advocate. She has to go through training in common and uncommon birth situations, and makes it so that your partner can be with you, while she helps interpret the medical stuff and helps you evaluate any choices you have to make without being biased or hampered by hospital practice.
If I hadn't had my mother with me (who is pretty educated about birth stuff and also a strong advocate for me) I'd have hired a doula for my births, and cannot recommend them enough as a way to make sure decisions are made in your best interest. Doulas are helpful whether you're having a scheduled C-section, a homebirth, a hospital birth with an epidural, or any kind of situation. They are certified by DONA International and you can read all about their standards of practice here.
The other kind of doula is a postpartum doula. Her job is to come for 3-5 hours a few days a week for a week or two or three (or six) after you have the baby to help you set up routines and get back on your feet so you can take care of your baby. She does NOT take care of the baby (except for holding the baby while you nap or shower), but instead takes care of you so you can start being the mom with more confidence. They are required to take classes in common breastfeeding problems (so they can help you know when to call in a lactation consultant or if it's something normal like cluster-feeding), newborn health issues, PPD symptoms, etc. They also do things for you like laundry, cooking (including making meals and sticking them in your freezer), cleaning, addressing thank-you cards, helping you figure out where to put all your supplies for maximum efficiency, being another adult human in the house during the day, and buffering you from people who could cause you stress in that hormone-addled newborn period.
Again, my mom served that function for me, but I would consider the money absolutely well-spent to hire a postpartum doula if I didn't have a relative or friend I could trust to help me out without adding to my stress. Postpartum doulas are also certified by DONA International, and you can read about their standards and practices here.
I have never heard of a sleep doula. My suspicion is that this is a new way of referring to someone who considers him or herself an expert in baby sleep and helping parents to get their babies to sleep. Which is a good thing. The problem, as I see it, is if a sleep doula/helper thinks that all babies can or should sleep the same way and tells parents that. Because, honestly, you could get the same guilt-inducing line by buying one of the sleep dogma books (you know the ones I mean--Weissbluth, Sears, Hogg, etc.) for a whole lot less money. If, however, the sleep doula is helping you through the process of figuring out how your particular kid is inclined to sleep and how you can work with that, then that's going to be a useful help for you.
I'd be really hesitant about trusting advice from anyone who is so anti-pacifier that they tell you pacifier use is correlated to drug use without and serious research. So, as usual, the moral of the story is Do Your Research, and if it sounds like crap to you, just say "That's interesting advice--thank you" and move on until you find something that makes sense for your particular child.
Anyone want to comment on doulas in general, or specific kinds of doulas? And, again, if there is any actual research-based evidence on pacifier use and drug use please post it.
We had a sibling doula for my son's birth. She was a birth doula whose job was to take care of my daughter during the birth. She was on call 24 hours a day around my due date (like a birth doula) and she was around to make sure my daughter's needs were met and her questions about birth were answered. Of course, I ended up not wanting my daughter around when I was in labor, so we could have used a sitter, but we only knew that after.
I do sort of wonder what pacifier use in children OVER three is linked to.
Posted by: Brooke | February 16, 2009 at 10:20 AM
I've never heard of a drug addiction link, but I've heard people make asinine claims like, "The kid will develop an oral fixation and will either take up smoking or overeating in order to fulfill that need later in life."
Yes. That makes perfect sense. Oy.
Posted by: Diane | February 16, 2009 at 10:34 AM
Regarding the pacifier/addiction link. I really don't think that pacifiers create an addictive personality. It is, however, possible that a person with a genetic predisposition toward addiction might be likely to rely on a pacifier, but I really don't think that the paci causes anything!
Posted by: Kathy B. | February 16, 2009 at 10:45 AM
Moxie, I loved your answer!!! I wonder if the v. interesting "sleep doula" the OP references might be something the rest of the country might currently refer to as a "baby nurse" or "night nurse." I use the term "nurse" not in reference to an actual Registered Nurse - but to mean something more like a babysitter or a nanny.
Some insanely rich folks I used to work for would apparently hire these "night nurses" from a service to come into to their homes from like 6pm- 8am every night and basically handle all of the nighttime parenting the first 12 weeks to 6+months or so, or longer, depending on the limitlessness of their family's vast financial resources.
This one wealthy woman recommended a night nurse to me when I was expecting, and I just laughed (cackled actually) because it was so impossible for us financially & kind of a ridiculous concept for us given our humble roots. We couldn't even afford cable at that point, and to be honest, DH & I wouldn't have been comfortable with a stranger spending nights in our home. In hindsight though, to not have to lose so much sleep taking care of a newborn at night sounds like something straight out of a frickin' fairytale. If one has the means, I guess!!
I've also read some newspaper articles about night nurses that can "sleep train," but again, you wonder about actual credentials, actual tactics, and at what age would even be appropriate to start such a thing.
Posted by: hush | February 16, 2009 at 10:45 AM
We had a doula; and we use pacifiers; and all I can say is thank the lord for both. My long difficult labor was eased, nurtured and affirmed by this extraordinary woman. She came and gave me lactation support and talked me through the first couple of days. She was not however the kind of lady to tell me not to use a pacifier. Had she been; I probably wouldn't have hired her. That comment about drug abuse and pacifiers is the kind of nutso fear mongering that a new mother does not need. Along with those people who tell you not to nurse to sleep; that if your child doesn't sleep through the night at 3 months he never will ; ad nauseam. A sleep doula, unless she and you are going to work through things together and she is NOT going to tell you what normal is, or force you into a regime you are uncomfortable with sounds a little dubious to me. But if she is getting up with the baby so that you get some sleep, that's different. And sounds great!
And as Moxie always says, its doubtful your baby will be sneaking pacifiers into his/her college dormitory. Drugs may be a different matter. You may prefer the former. I would be astonished if they were linked; but I won't be throwing out my sons pacifiers any time soon. (They could probably say the same of my son's little rag which he holds over his nose and inhales wildly on ala Dennis Hopper in Blue Velvet.)
Posted by: lucy | February 16, 2009 at 10:46 AM
Just to add my two bits: in Canada anyway, doulas are not regulated yet (they're working on it to my understanding) but at this point anyone can call themselves a doula. So as you were saying Moxie, research! Ask what courses they've taken, (Dona is not the only training/certifing body, but they are the main one, how much experience they have. And you should be able to meet with them first at no cost to see how well you click
Posted by: Carabeth | February 16, 2009 at 10:55 AM
Aww, poor new mommies being told pacifiers are bad. :( I wish the little one would have taken a pacifier! I sucked my thumb with a passion until I self-weaned at some age that I can only guess at but probably 5 or 6 since I don't remember much before that and I do remember sucking my thumb and being asked what flavor it was. My teeth and bite are fine, btw. I no longer suck my thumb and I don't have a drug problem, I don't smoke and I don't over eat - often. :) I also used to bite my nails and I don't do that anymore either. I do other self-comforting things like compulsively check my email and insist the toilet paper go over, not under.
Seriously, there so many things to stress over like Moxie said and for new moms - adding on guilt to pacifier use is just, well, not helpful in the least.
I would have paid money for someone to just tell me that it was all normal - the chaos of the first few months with a newborn. No one told me. That was the hardest part. Long term sleep solutions or not, just knowing you aren't alone is priceless.
Posted by: mom2boys | February 16, 2009 at 10:59 AM
Had an awesome birth doula! She came over to our house at 4:30 in the morning when labor was escalating, accompanied us to the hospital and through the whole thing and then came back to help out with breastfeeding at infant massage at home. Highly recommend one, but make sure she's a fit for you and your partner.
Never heard of a sleep doula, though I have heard of sleep consultants and sleep trainers...and maybe it's just where I live but all the ones my friends have encountered all seemed to come from one school of sleep management. This one sounds like a crank with the pacifier stuff--I'd steer clear.
Posted by: Charisse | February 16, 2009 at 11:09 AM
Good for you Moxie. I agree this sounds like B.S.
Posted by: Badger | February 16, 2009 at 11:11 AM
I LOVED having a doula. She was there for me throughout the last 20 hours of my labour, rubbing my back (I had back labour), informing me of my choices as far as the drugs I was being offered- doctors don't often tell you, at least in my experience, about what the side effects are of the drugs they're about to administer you (ie Fentanyl), and Doulas have all of that information and can easily explain it to you so you can make an informed choice (I'd done hours of research, but after a 35 hour labour, I couldn't remember any of it).
My doula yelled at me when I wasn't pushing hard enough, my doula helped show my husband how to rub my back or how to massage me so that I could relax. She was the best person to tell me how to do things, she was caring and loving and yet was still a "medical professional" so was able to be with me when my epidural was administered.
I cannot recommend having a doula enough. They're an amazing support.
The only thing I can say about being anti-pacifier is that you should hold off until BF is established because it CAN confuse the baby.
Posted by: Gillian | February 16, 2009 at 11:12 AM
As a gal who spent 350 of my hard-earned dollars on a NYC-based sleep "expert" who swore to tailor her advice to fit our needs, then proceeded to spend the entire visit spouting excerpts from "Healthy Sleep Habits" before telling us to let our 4-month-old cry it out, I say stick with Moxie.
Posted by: Alisha McKinney | February 16, 2009 at 11:30 AM
A great reference about doulas (including all the certifying organizations) is here: http://www.birthingnaturally.net/directory/doula/index.html
Our doula was not certified, but had gone through all the training for a DONA certification, but did pay for her stamp, so to speak. Some certification programs put huge restrictions on what a doula can and can not recommend to their clients (our doula could not recommend I exercise, for example, because she is not a doctor and if something went wrong as a result of my exercising, she and DONA would be at risk). So, like Moxie said, just do your research and understand that no two doulas/doctors/mechanics/pools boys are the same, and it's up to you to find someone you trust.
That said, sleep doula sounds like BS. If she were there to hand me water and a book at 3am, while reminding me that no newborn sleeps through the night, maybe I would call her a doula. :)
Posted by: ivy | February 16, 2009 at 12:00 PM
My data point on doulas: We had narrowed our choices down to 2. We liked both of them a lot, but ended up choosing the earthy/crunchy one - very serene and mellow - because that's the kind of attitude I wanted around me while in labor. The other woman was really great - just a lot more matter of fact.
Only problem? I delivered at 34 weeks in a not-quite-emergency c-section. The hippie doula had come to meet with us in the hospital and so knew that there were possible medical complications. But she proved utterly useless when the surgery actually occurred. In fact, she was so freaked out by the turn of events that my husband ended up calming *her* down.... which obviously was not a good use of his time at that particular moment.
She had to leave a day or so later on a long-planned international trip that none of us had imagined would interfere with our birth. And her backup was the woman who had been our second choice... who ended up being absolutely perfect for our situation and our personalities.
The interesting thing is that the replacement, J, was the one my husband had preferred all along. I don't know if this info is useful to anyone else... but I guess my point is that with a birth doula in particular it may be hard to anticipate the right match between the individual doula and your particular circumstances.
Posted by: michaela | February 16, 2009 at 12:12 PM
I wasn't comfortable having my mom with me when I gave birth -- not because I don't have a good relationship with her (I do!) but because I felt, and still feel, that I would have to be "good" if she was there. So we got a doula. In my particular circumstances (very fast, very intense labor) she wasn't a lot of help, but I was glad she was there. I wish I'd had a postpartum doula instead. I like ivy's comment about someone to be there at 3am with water and a book!
Posted by: Jenny | February 16, 2009 at 12:33 PM
We're not the sort of insanely rich people with limitless resources that a PP describes, but we did have a night nurse/post-partum doula. She cared for me, did some light housekeeping, and was a good source of information about choices, options, etc - having experienced 100s of newborns & observed many kinds of issues around them. She really helped with lactation support, and when BFing didn't ultimately work out, despite MUCH effort on my part, helped me to accept that and embrace formula as a lifesaver for my baby.
Having her here also allowed me to get some sleep. We met with her before the birth to see if she felt like a good fit with us, as she would be in our home 8 hours a night for several weeks. And we saved for almost a year be able to afford it.
What we got for our money was MORE than worth it. I don't have the kind of mom that Moxie does, and no other comparable person who could step in and be a calm, knowledgeable helper to me, my husband, and our baby. And the sleep---my experience of my son's first weeks was made immeasurably better due to the fact that I could savor and enjoy being with him without the hampering, deadening effect of sleep deprivation brain fog. Just being able to count on 4-5 hours per night meant that I was ready to be present (and patient) with my son all day, and not completely worn to a ragged end. That experience was priceless to me and to my husband.
She didn't purport to be a sleep doula, or sleep trainer, but did have observations to offer, based on her 15 years' of experience as a night nurse/doula, if asked.
Things like this are always caveat emptor - and people drawn to personal service work are as mixed a bag as found in any other profession. Some are wonderful and can really make a difference. Some are kooks with a perverse need to push an agenda to validate some kind of choice they've made in their own life. Detailed personal references, background checking, get-to-know-you interviews, etc are the only way to separate the wheat from the chaff.
Posted by: eccentriclibertarian | February 16, 2009 at 12:43 PM
Just to provide a counter-point, I found my birth doula to be utterly useless. I think it really depends on your personality. Although to be fair, I was induced at 36.5 weeks due to placenta issues and ended up with a c-section due to a short cord. Maybe I would feel different if I had proceeded with labor and pushing.
The most useful thing she did was calm my husband down after the c-section was indicated. I was fine but hubby...not so much.
I have no problem advocating for myself and luckily the L&D staff were all very respectful and not pushy at all.
YMMV of course but just wanted to provide a dissenting point that depending on the person, doulas aren't always the greatest thing since sliced bread.
Posted by: Michelle | February 16, 2009 at 12:53 PM
This post is the epitome of why I LOVELOVELOVE moxie. I'll say it again I love moxie.
Posted by: beezwax | February 16, 2009 at 12:57 PM
Man, I really question the idea that pacifiers are somehow linked to drug addiction. It may be, as a PP said, that babies who have a high need to suck develop into adults who are (very slightly, I'd guess) more prone to addiction, but I truly doubt the pacifier has anything to do with that. Correlation not being causation and all that.
I'm not sure I like the sound of this doula -- somebody that spouts a stat like that without backup seems as though they think they know the One True Way of parenting.
But as many have said, the support of a good doula can be wonderful to have, before, during and after the birth. No personal experience, but doulas were literally lifesaving for a friend of mine who wound up being hospitalized for severe PPD.
Posted by: Shelley | February 16, 2009 at 01:02 PM
Hopefully, I'm in the minority here, but we hired a birth doula and it was a very disappointing experience. I can't totally blame her--I picked her because she had a real take-charge attitude, which is exactly what I thought I wanted for our natural birth.
However, that attitude became near constant hectoring in the weeks leading up to birth. Her belief that the birth was entirely within my control if I was just strong enough caused me endless guilt and stress. (I'm sure she meant it to be empowering.)
Post-delivery, she called me several times a day to question what I was doing. Eventually my husband ran interference for me.
In the end, I am glad to have hired her because she pushed me into changing doctors, which was a truly excellent thing as my doctor immediately diagnosed me with issues my previous OB had missed, and she hooked me with up the IBCLC who saved my bacon when it came to breastfeeding. But as far as "mothering the mother"? Not so much.
Posted by: Keri | February 16, 2009 at 01:06 PM
Doulas and PPD doulas are wonderful. I had a terrific doula for my son's birth, since we had no family or close friends nearby to help w/ labor. I am expecting again, and she's going to be our doula for son #2. I can't recommend them highly enough if you either don't have, or aren't comfortable with friends/family being there to support you and help you through labor and post-delivery issues like breastfeeding and general insecurity.
Totally agree w/ Moxie and many of the commentors about pacifiers and sleep. I say hooray for pacifiers because it's either that, your finger, or hours on your boob if your baby isn't interested in his own thumb (mine wasn't, and desperately needed to suck). Getting rid of pacifiers later (like when they're 1 or 2) is really not a big deal and not worth worrying about.
Regarding sleep, I think Moxie and all the readers here have contributed a LOT of good advice--do your research, figure out what is working/not working for you and your child, and keep trying if the first "solution" doesn't work out. And take all those books and throw them in the trash at some point, because inevitably you'll just feel like you're being judged and doing it all wrong based on all the professional advice.
@ beezwax, ditto! This is why I love Moxie and the terrific community of readers/posters. You are all fantastic and a dependable source of sanity, laughter, and relief :D
Posted by: Margot | February 16, 2009 at 01:10 PM
@eccentriclibertarian - Thanks for sharing your experience w/ the PP doula.
I'm considering getting a PP doula for when we have our 2nd child. I know every baby is different; but V was a hard baby, and I'm fearful of what will happen if the new baby is as difficult as she was. She was on my person about 12-14 hours every day for the first 4 months or so, sleeping on me and BF'ing were pretty much the only things that made her quiet. If I get another baby like that; I don't know what I'll do with a 3yo, not to mention myself.
I haven't even mentioned it to my husband yet, nor my mother; who I think will be freaked out that I'd consider it, but while she's very very helpful with V, she has already said that she also cannot manage 2 in her house, and she's also taking a lot of time now to care for her mother and older sister, so coming to my house a few days a week is probably not in the cards. I guess part of me is feeling like it's ridiculously spoiled of me to think that it's acceptable to spend money on that kind of extra help.
Moxie - I know you said that the doula doesn't care for the baby; what about toddlers? I could really take a nap with a doula there? they really help with housework? I wouldn't want anyone doing my laundry, but just having someone to feed my daughter and let the dogs in and out would be a huge help.
We are not even going to start trying for baby #2 until late spring, and already I'm finding myself a bit panicked about how I'm going to manage to do the whole newborn thing again, with a toddler on top of that.
So if anyone else can tell me about how their experience w/ a PP doula went, I'd appreciate it. Hope this isn't too much of a hijack of the main topic.
Posted by: Cecily T | February 16, 2009 at 01:14 PM
There is a local postpartum doula group that has a specialty in sleep consultancy. I've posted here about the good that they did for us in sorting out my son's sleep, and I've also seen one of them posting here. (Love you guys! Smooch!) So that is what I think of when I see "sleep doula"--but I've never heard that phrase used before. I would certainly echo your recommendation to 1) research a doula's background and 2) not take advice from someone who gave out alarmist information as this one did--at least not unless she could cite scientific literature chapter and verse proving her point. I'm not a big believer in pacifiers, but sheesh.
Also, I find the whole idea of a group meeting with this person kind of peculiar. Typically I think of a doula as someone who provides individual services tailored to a particular family's needs.
I had a birth doula who was recommended by my fabulous, woman-friendly OB/GYN office (they have a midwife on staff, who happened to be the one to deliver me, and are very midwife-like in their overall philosophy). Any time I mentioned her name to anyone, the response would be, "Oh, with X there, you're going to do great!" And, indeed, she was wonderful. I didn't make use of her as much as I expected, I had a very swift labor (and in general I didn't require much advocacy *because* the midwife was so lovely) but her help with massage and positioning and support, and just having her voice cheering me on and reassuring me, was invaluable. I expect my next labor will be even shorter, who knows if she'll have time to get there, but if she'll sign on again, I'll certainly be happy to pay her!
So, for those interested in the idea, I would recommend a good birth doula, and I would also recommend using not only certifications but also word of mouth within the woman-friendly labor/birth community, if you're able to suss out some good people to talk to.
Posted by: L. | February 16, 2009 at 01:15 PM
While I had a great birth doula, who helped me have a med-free delivery, in hindsight, I think my money would have been better spent on a post-partum doula. All my prep and research for the birth was of no moment once DS came out -- screaming, and screaming, and screaming...for weeks. Our family was in chaos and having someone around to be a fly on the wall and help us sort things out would have been priceless. We had no reliable family to help keep our sanity. If we do it again, I'm definately hiring a post-partum doula.
Sleep doula? My instincts say it's just another person trying to profit on our vulnerability during that first year.
Posted by: taggie | February 16, 2009 at 01:16 PM
Anti-drug literature for parents will sometimes call out pacifiers as being a potential sign of club drug use. In teenagers, duh. A teen with a pacifier around his neck is a little different than an infant using one and growing up to be some sort of fiend. I wonder if that lady simply misunderstood some aspect of this advice? Otherwise, she's twisting some association to further her own agenda.
I had a post-partum doula, and she was lovely. Did not volunteer advice until asked. Hired a birth doula, but we ended up forgetting to call her when we transferred to the hospital for a c-section. Whoops.
I have never heard of a sleep doula. I wonder if that's just a kinder way of phrasing "sleep trainer," as that term may be off-putting to some parents. Maybe Elizabeth Pantley would make a good sleep doula.
Posted by: Helen | February 16, 2009 at 01:23 PM
I had a birth doula (who was really my midwife's assistant but she was also an RN and because of the crazy laws in our state she wasn't allowed to act as a midwife. She was GREAT. Much better than my midwife at getting me through the fear and confusion of labor.
I also had a post partum doula, and it was ok, but I wasn't comfortable being 'done for' and so I didn't really take advantage of it that much. She made me great meals, but I didn't like them and I was too embarrassed to tell her. So that was my fault. Oh well.
Posted by: maria | February 16, 2009 at 01:42 PM
@eccentriclibrarian - I hope you didn't take offense at my comment! Sometimes I'm jealous of the wealthy and I sound mean when I talk about them, so I'm sorry. I'm so glad to hear that middle class folks are able to save up to afford the services of a night nurse/post-partum doula & that she was worth her weight in gold. Amen to that!
@Cecily T - You wrote "I guess part of me is feeling like it's ridiculously spoiled of me to think that it's acceptable to spend money on that kind of extra help." You know what, you & your family are worth it. (FWIW, I often succumb to that same kind of thinking.) If I could afford it, and found someone vouched for like eccentriclibrarian's helper, I'd be all over that night nurse/post-partum doula action. ;)
Posted by: hush | February 16, 2009 at 02:18 PM
PubMed returns no results when searching for pacifier and addiction together. Just FYI.
Posted by: Brooke | February 16, 2009 at 02:25 PM
I used a birth doula b/c my husband is a notorious passer-outer, and we thought it would be good idea to have back-up. She wasn't as good as we had hoped, and it really underscored for me the importance of interviewing and checking references. For anyone thinking of hiring a birth doula, it's worthwhile to ask them how much work they are doing as a post-partum doula, so that you get an idea of if they are going to be dragging-ass tired when they show up for your birth.
I've noticed a couple of ways that birth doulas are available for free or reduced fees - one is for military families (a program here in San Diego) and the other is some birth centers/hospitals have volunteer doula programs. Just didn't want anyone to think that doulas are only available for lots of money.
I also consulted with a sleep doula by phone and email, and I thought she was great. In the end her advice was just a combo of Weissbluth/Pantley/Happiest baby, but it kept me sane during the 4 mo sleep regression (not like K was sleeping much anyways). What worked so well was that her advice was given out of love for babies and sympathy for me - not out of dogmatic practice or the desire to sell books. I would be very wary of any sleep doula that is running around spouting off BS statistics like that, the problem is she probably actually believes her own lies...
Posted by: CaliBoo | February 16, 2009 at 02:33 PM
Yes, research your doulas. My birth doula was great through labor & birth, which ended in c section. I think the c section upset her because she avoided me after the birth when I really needed some kind advice or even listening to what was happening with the crying baby. Now I never hear from her, which in the first few months post partum really added to my blues.
I also had a post partum doula for a few weeks, she gossiped about other mothers and told me that I would probably have another child, I would just have to decide to try for VBAC or schedule another c section...disturbing words that I was not ready to hear.
Thinking back, I thought I had done a thorough job of choosing my doulas, and in hindsight, I think I did the best that I could with the knowledge that I had, I would choose differently in the future now that I know more, isn't that always the way!
Posted by: sudru | February 16, 2009 at 02:35 PM
Regarding the fear-mongering suggestion that pacifier use is linked to drug addiction, I have to agree with Moxie and the posters...sounds like BS to me.
Assuming it's the repetitive sucking that is thought to lead to the drug addiction (ridiculous...I can barely type it without scoffing), I will just give this anecdotal bit of info:
I sucked my two middle fingers for a long time. I mean, A LONG TIME. Like until my early teens (in private of course after it was socially unacceptable to do it in public), and I would even say on the rarest occasion until my late teens. I always knew I shouldn't do it (overbite not withstanding) but looking back on it now, I think I just needed to be soothed, and that's what did it for me.
I should also say that I do not have an addictive personality. I have never smoked. Never (not even tried it). I don't do drugs (OK, well the occasional round of mushrooms in my 20's). I drink moderately (less now than ever). Overall, I think my friends and family would agree that I'm a well rounded, well adjusted, high functioning, responsible, happy, successful person.
So, if that pacifier link to drug addiction is based on sucking. Um, yeah. Whatever. I agree with Moxie...so many other things are more worthy of your thoughts.
Our 8 month DS does use a pacifier. And I must admit, I was hesitant at first (he started around 10 weeks). But we just follow his lead (i.e. don't automatically just give it to him if he doesn't seem to want/need it) and so far so good. He's already started to wean himself off of it somewhat. He only uses now it to fall asleep, and if he's ultra cranky. He used to always need it for car rides (now only sometimes) and often in the day- which he doesn't now.
I say go with your gut (yes or no on pacifiers) and everything will work out in the end...even if he does use it occasionally in college ;).
Posted by: anon for this | February 16, 2009 at 03:10 PM
@Helen, that's what I thought of - pacifier use in TEENS is linked to drug behavior.
I had zero pacifier babies out of four. Which isn't to say I didn't try! Actually, one (Mr G) took a pacifier for about a month during the 4.5 month fussy stage. GOD.SEND. And then at the end of the stage he promptly refused it again. I wish I'd known about the stages at that point, because I might have put 2 and 2 together and offered it again at the next stage. It might not have worked then, but...
The only downside I know of with pacifiers is that IF you have an existing underlying breastfeeding issue (latch problem, supply issue, thrush, whathaveyou), AND are using pacifiers at the same time, there's an increase in earlier weaning age. Essentially, the pacifier added to an existing problem complicates matters enough to make people potentially wean sooner. Either that or the people who use pacifiers when there is a problem are less likely to call an LC, and therefore will wean sooner. Or some other confounding behavior pattern associated loosely with both situations (moms whose bfing isn't going well and who are desperate will use pacifiers to get a break, etc., etc., etc.).
Anyway, I thought of night nurse/night PP doula on the 'sleep doula' thing. I presumed they were there to help ME sleep (by taking on whatever at night), not to help baby sleep. :)
My experience with doulas - They seriously ROCK. I had two with my first birth (mainly because I couldn't decide between two, both friends, both free, both experienced natural birthers, one a birth profesional). And given that labor was 80 hours long, they were worth having (all both of them). Oh, and my mom, too. But mainly the doula-friends.
I ended up with two the second time, one hired, one was my midwife (who swaps to doula role if you're transferred to the hospital, where she had no treating privs).
With the twins, I had only one (same as second time). Yeah, funny, one baby two doulas, two babies one doula... But I was pretty set up that time, and didn't feel a need for a second.
They salvaged the first birth entirely (okay, ep was a big player, too, but they did all sorts of stuff to keep everyone functioning). The second go, the hired doula (who is also a friend) made a major difference at various points, also - like helping me cope with the OB trying to scare me into a c-section - I handled the 'no-thanks' on my own, but then got scared that my baby really was too big for me (even though labor was rocketing along just fine with zero signs of any problems). So, godsend, there. And third go, maybe not absolutely necessary, other than deepening my hypnotic prompt during the no-meds breech second twin extraction (which hurt like stepping on a lego barefoot - ouch, but just ouch, even though my cervix tore).
Never had a 'real' PP doula, so no experience there.
Posted by: hedra | February 16, 2009 at 03:14 PM
We had a birth doula - definitely worth it. I actually wanted her more for my DH as he has a habit of falling asleep during stressful situations (and I would have been so unimpressed if he had fallen asleep in any of the big action parts of the labour). My labour was fast & intense, and there wasn't much she (& DH) could do except hold my hands during my contractions, but it was reassuring to have her (and DH of course) there and I would definitely do it again.
I totally agree with @Ivy's description of a sleep doula. :) I would like one of those. Yes, thank you.
Posted by: the milliner | February 16, 2009 at 03:15 PM
Find a different doula who doesn't believe that pacifiers are the gateway drug to heroin. Doulas can offer great advice and support, but like anybody offering a service, it's good to check out what makes most sense for you and your family.
Posted by: Meg | February 16, 2009 at 03:17 PM
I had a birth doula, or at least had "planned" for a birth doula til she ended up being double booked and missed the entire delivery!
Since we have no family nearby, we hired a ppdoula to help out for a bit. For the most part she was great - another pair of hands to provide me with 'eatable with one hand' snacks and drinks while I breastfed.
I have not used a sleep doula but there is one here in Toronto who is has a good reputation. Like anything, trust your gut and make sure that your sleep doula's values match your own. This one locally will do the gamut from CIO to much much more softer approaches - she follows the parent's lead.
There's "science" and there is "personal opinion/values" and often practitioners (whether pediatricians or doulas or midwives) blur the two.
Finally, on the pacifier - I laughed reading Moxie's paragraph on what to REALLY worry about! So true - wish I knew that when the girl was a baby.
Posted by: Sandra | February 16, 2009 at 03:31 PM
Love Moxie's advice re: soother. I spent too much time worrying over that one.
I am one of those rare people who didn't find a birth doula helpful and will not do it again. I look back at it as insurance I didn't really need after all. My husband travels for work so I was worried he wouldn't be there. He was home when my water broke and I had a very fast labour. So the doula was only there for about 2 hours. I had a really helpful nurse and husband. In fact, there was a little power struggle between the nurse and the doula that stressed me out in the delivery room.
The only positive thing I have to say is that the doula was there for me post-labour when I was bleeding too much and my husband was rightfully holding and caring for the baby.
Also, I live in Canada where the medical system is (possibly?) more baby and mother friendly than in the US. I felt respected and consulted the whole time. Or maybe that was just my hospital's attitude.
But how can you know it will turn out that way? I could just have easily had a 48 hour labour. So that's why I think it's like an insurance.
Posted by: canagirl | February 16, 2009 at 03:36 PM
@Helen, @Hedra- I'm suddenly remembering that really weird trend where the teen girls would wear these pacifiers when they went out clubbing.... that has GOT to be the source of this doula's idea that pacifiers and drug use are at all linked. But really, I'd say it is clubbing and drug use that is correlated and the pacifiers were just an accessory that could alert a parent to the fact that their teen was out clubbing.
I was a thumb sucker until first grade, and have no tendencies toward substance abuse whatsoever. My (22 month old) daughter still uses a pacifier. She wants it more when she's hurt or not feeling well now, and I don't see any reason to mess with that yet.
Posted by: Cloud | February 16, 2009 at 03:47 PM
@Ivy, just wanted to throw in that some people who want more than a birth doula can hire a monitrice. Monitrices offer the support that doulas do, but also provide services beyond what doulas do such as monitoring of fetal heart tones while waiting at home for labor to get going. As I understand it, they usually have some amount of medical/clinical training, are expected to supplement any other prenatal care, are there during labor (not replace a doc), and follow through with breastfeeding help and other postnatal things. I didn't have either a doula or monitrice, since I had a homebirth with ridiculously *awesome* midwives, but my midwife does hire out as a monitrice. If I had planned a hospital birth, I have not doubt it would have been well worth it to have hired her as a monitrice.
Posted by: cakesmama | February 16, 2009 at 03:49 PM
You know what is funny? The first time I ever heard of a "sleep doula" was about a week ago.
I the context I heard it, I think it is a hired-gun sleep trainer, who comes to your house for a week or so and lets your kid cry it out. The one I heard of was definitely toddler-oriented and the gist was if you wanted to sleep train, but didn't have the backbone to actually go through with it. Not a bad idea in the appropriate circumstance but I have no idea how a person would know if the "sleep doula" was worth it or full of it.
Posted by: Carla Hinkle | February 16, 2009 at 04:18 PM
Regarding the pacifiers/teens/drugs connection:
From http://www.gdcada.org/statistics/ecstasy.htm :
"A common side effect of ecstasy is involuntary clenching of the jaw. Pacifiers are often used to prevent teeth grinding."
So there you have it -- drug use (in teens/adults) leads to pacifier use (in teens/adults).
This clearly has no bearing on pacifier use in babies! But I suppose it's possible that the sleep doula in the original post was somehow getting mixed up about this?
Posted by: Alice in Wonderland | February 16, 2009 at 04:27 PM
We hired a post partum doula for my second child...I wish we had hired one for the first, but we weren't aware of the service. At any rate, my husband wasn't able to take off much work at all for my second child's birth, so the doula was a wonderful thing. She helped with the things already listed: cleaning, cooking, breastfeeding support. But for me it was really helpful to have someone tell me to nap (I'm a horrible napper -- too much to be done!), and to run interference between my mom and me. With both births, my mother had no inclination to help, other than taking care of the newborn. Which is really not the help you need, right? I mean, I had a c-section, so I was more concerned with carrying laundry down the stairs (which I couldn't do) than with making sure someone was holding the baby. Anyway, the doula was able to (1) do the things that my mom wouldn't do, and (2) to support me emotionally around the issue.
And as far as the question about toddler care...I guess it might differ for different doulas, but the one we worked with took care of our 2.5 year old, engaged her in conversation, changed her diaper and helped with potty training, and kept an eye on her while I was showering or sleeping. Toddler care was not her main focus, but her goal was to make sure that I was well fed, well rested, and mentally well, and she did what needed to be done to make sure she met her goal.
Having a doula is a luxury, but I would suggest that any new mom who is interested in the service step up and let family and friends know that instead of buying that adorable little dress (that will be worn maybe twice), put the cash in the doula fund. Babies don't need fancy clothes, or many of the baby-related items that are sold to us hormonal new moms (and dads!), but babies definitely appreciate a relaxed, well-rested and happy mom. Just my two cents...
Posted by: charis | February 16, 2009 at 04:44 PM
Regarding pacifier use and early weaning, my 15 month old uses one to sleep, and to get back to sleep and is still BF. He did use it between feeds when an infant, but never lost desire to BF; I just had to have a break, as I was exhausted from being a human pacifier.
I did keep going to LC though if there was ever an issue with reduced feeding which when it happened was more often distraction round 3-4 months. I think; and this is contentious with the LaLL, but I think babies know the difference between a pacifier and a boob full of milk. Well in my case he did.
As my BF says, whatever gets you through the night.
Posted by: lucy | February 16, 2009 at 06:15 PM
Okay. I don't have any info regarding Doulas, at all, but I'm sure both my mom and boyfriend's mom would be wonderful advocates for me, both having been nurses in the 70's and 80's, and both being regular patients now.
However. I do have some insight regarding the pacifier thing.
In another lifetime, when I was far more fond of partying all night than I am now, it was very, very, very common to see kids at raves, possibly tripping on ecstasy and using pacifiers at the same time, in order to keep from grinding teeth. I can easily see how someone might see two separate situations and infer some kind of causation without actually doing any kind of research whatsoever. The main news articles, which includes such information are a few years old, but the information does seem to come around whenever there's a major bust. I am VERY hesitant to link to these sites, as I find most of them have a serious hidden agenda - many kids at the time simply acquired a pacifier to fit in and therefore not be coerced into using a drug, and more than one friend had serious trouble due to overzealous and unbelieving parents - but one example can be found here - http://www.addictionca.com/signs-of-ecstasy-use.htm
Posted by: Anaximander | February 16, 2009 at 06:25 PM
The sleep doula's I've heard of are kind of like night nurses. Several of my more professional track former colleagues used them for the first few weeks or months.
They'd nurse when needed and then hand off the baby back to the sleep doula and get rest/sleep until the next feeding time. The doula would rock the baby to sleep, change diapers, keep that ear out, etc.
Before I was a parent, I thought it decadent and that it would interfere with bonding. And perhaps it might on some level. But if you can afford it for a little while, I think it could help you be a better parent. Because really, not everyone has the support of friends and family close (or if we do, it's not helpful) and what new mama can't use more sleep?
Posted by: Michele | February 16, 2009 at 06:29 PM
@sudra - that sounds like a not fun experience with the doula gossiping. I had a similar 'eek' feeling about one of the midwives where I had V...I overheard her doing some eye-rolling about how someone was insisting they were ready to push, even though they'd been saying that for hours. It made me wonder what she'd be saying about me while I was in labor. Luckily, I got the other MW for V's birth, who I was much more in tune with any how.
@hush - Thanks. I think I just need some people around who will tell me that instead of pooh-poohing my want for one.
@charis - Thanks for the info. That was exactly what I meant...helping w/ potty, talking to her, and watching her while I sleep. I'm a terrible napper too; with V, I would try to sleep on the couch if I could get her in the swing, but then my eyes were always popping open to check on her. With V as a toddler, I'm sure that I won't even be able to manage that amount of 'half-sleep' with a newborn.
Posted by: Cecily T | February 16, 2009 at 06:35 PM
Oh, and I forgot to say about the pacifier use/early weaning thing- my pacifier addicted child is still breastfeeding at 22 months. So no, I don't think the pacifier made her wean! She got her first pacifier when she was about 2 weeks old.
Posted by: Cloud | February 16, 2009 at 07:10 PM
I'm a doula. I provide birth, postpartum and childbirth ed services, amongst a few other things.
A PP pointed that there are MANY certifying orgs out there, DONA is just one of them. I'm trained by DONA, a member of DONA and am in the process of certifying with them (tho I practiced for a few years before deciding that I actually do want the letter salad after my name - it has never impacted my client hire rate).
Tho I do way less postpartum work than birth work, I either be with a mum for 4 to 8 hours, depending on her preferences and needs or overnight for 8 to 12 hours. I'd do some light housework, a little food prep, sibling care, early parenting support like talking about getting more rest, soothing fussy babies and strategies for living a normal life with a very small child, as well as companionship and birth and early parenting processing.
My real passion is in birth support, tho. Every birth is so different and yet so similar in the basics. I love watching and supporting families as they become something more than they once were. And, that is my focus: helping establish strong families. I try hard to make sure families are prepared for what will be happening to them not only in the birth space (about half of my births are at home) but in the first weeks and months of being parents.
I feel pretty lucky that I get along great with med staff in hospitals. I've noticed the med care being more evidenced based in the last 6 months or so, too, as well as welcoming to complimentary care practitioners like myself. The families I work with seem to gush about my support, so I guess I'm doing good by them.
I had a doula at my last birth (didn't know about the profession the first time around) and couldn't have done without her - she got me through transition and made me feel taken care of (and that's with three midwives to take care of my clinical care at home).
I think it's worth pointing out, too, that doulas are usually flexible about fees where there is a genuine financial need. I, personally, have a variety of payment options (discounts for full upfront payments, any pattern of installment plans, bartering...). I want to make it as easy as possible to afford a doula because I think a good doula is invaluable (and I think I'm a good one! haha!)
I think I know the same sleep doula that Sandra does and she's got a decent reputation tho I don't really know anything about her services. To my knowledge there is no training process at all anywhere for "sleep doula"s.
Posted by: Hamilton Doula | February 16, 2009 at 08:05 PM
I had a birth and post-partum doula, and she was invaluable in both roles. I credit her with keeping me from a C-section -- giving me the support I needed to continue working through a very long, very difficult labor in which the epidural wore off (but the pitocin did not!). I also credit her with showing me how to breastfeed in a way that actually worked. Those two things are *huge*, but beyond that, really, in this day when so many of us live so far from family and support, doulas are practically a necessity.
Posted by: Schwa de Vivre | February 16, 2009 at 11:11 PM
i am just so glad so many of you put 2+2 together and linked the pacifier use with teenaged drug use...as TEENAGERS. geez.
i also wanted to add that the pnut is still using her pacifier for a nap and at night (at least to get off to sleep) and she's three. and we're fine with it. i mean really. it soothes her. it certainly did not encourage her to wean early, or get her off me or my boob more, and she certainly would not take it when she was actually hungry. the damn thing was a lifesaver.
*and* the bean, who rejected the paci as a newborn, now will take one since he started teething at about 4 months (oooh, hedra, a link to a change? good one...) thank the good lord. so there's hope for some of you who have a baby who is rejecting the binky.
i also wanted to let y'all know that they have changed the recommended use for pacifiers now- when pnut was a baby, it was recommended not to try a binky til 6-8 weeks since she was breastfed. when we had the bean, the hospital (and the NICU) had all teh babies using soothies as it has been shown to reduce SIDS deaths.
i have no experience with doulas, but around nyc i know lots of folks have a 'nurse' or 'night nurse' to provide support during the first few weeks/months that maybe in the past family members would have supplied. in retrospect, that would have been lovely, especially just to give me a break when i mistakenly assumed i could just keep on living my life with a newborn who needed my boob to live.
i also think the sleep doula is full of bs and marketing herself to a perceived need in a tight economy- and taking advantage of the deepest insecurities of parents is deplorable. if she were truly interested in helping women it would be one thing, but i really understand this as one of those situations around here where someone is carving out a niche for themselves to make a pile of money off of unsuspecting or naive parents. these 'meetings' can be found all over nyc with a variety of topics. blegh. thanks, moxie, for always being you.
Posted by: pnuts mama | February 16, 2009 at 11:56 PM
I remember being pregnant with my first child and laughing at the idea of making a birth plan. I really felt like I had no idea whether I wanted the lights dimmed or music playing. I'd never had a baby before! I have a theory that nurses on the maternity ward entertain themselves on long night shifts by reading ridiculous birth plans. "Hey get this - she wants a string quartet and the smell of cinnamon!" Where am I going with this? oh yes, I think the down side to doulas, is that yes, they advocate for you, but if you're having your first baby, you don't really KNOW what it is going to be like.
I have a friend who planned for a natural birth. She ended up with a long, long, painful labour. There were no complications and she had a vaginal birth, but it was really long and slow. Although she wanted to avoid drugs, there reached a point where she wasn't handing it as well as she hoped. The doula continued to advocate for her avoidance of drugs until her husband just about lost his mind from watching her in so much pain. She eventually got an epidural and felt like a huge failure.
I think it's more important to have a doctor or midwife who you really trust, and have an open mind as to what might happen in your labour. That way you're not beating yourself up if it all goes sideways.
Personally, my husband and the nurses and my trusted doctor were wonderful. I was the one who wanted an epidural, but instead had three fast, intense, here comes the baby births.
Posted by: regiemino | February 17, 2009 at 12:05 AM
I didn't hire my doula until a week before my due date, but I was very glad I did. Hospital birth, unscheduled c-section. I was in labor at the hospital long enough to have three different nurses due to shift changes, and the doctor on call that weekend was not my ob, but another guy from the practice that I'd never met. So at the very least, the doula gave me some continuity, but mostly somebody who was there to help me, and who did help a lot. My doula was also a lactation consultant so at her postpartum visit, she helped with nursing advice, which was a lot easier for me than finding a lactation consultant.
Our doula was either experienced and wise enough, or just mellow enough in general, that she did not push anything on us, just discussed the options for her role and what we wanted. We already had a birth plan.
I didn't have a postpartum doula, bc my mother came after the birth for two weeks and my husband is at home full time.
Posted by: luolin | February 17, 2009 at 01:22 AM