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