Recently a woman called me to inquire about my services, her first questions was, “How much is a doula?” It’s hard to put a realistic price on that type of support. I have been at births for as little as four hours all the way up to twenty-four hours or more. So I told her I’d like her to consider how important it is for a woman to have someone who will be at the birth supporting her, encouraging her, and offering important information to ease her mind. A labor doula can help the partner experience this magical time with confidence and give him/her more time to spend with the laboring woman. A doula can run around doing things a partner usually does, or answer questions that may come up at the hospital or even during a home labor. A doula can show the partner how to help mom change positions, how to massage her. She can give the partner a much needed break during a long labor. Research has shown that with the help of a birth doula there is a much lower risk of: cesarean births, medical interventions, and the use of pain medications, and that a birth doula’s knowledgeable help during delivery produces greater bonding with the newborn.  More research shows that with the help of a postpartum doula the risk of postpartum depression is much lower.
At home, a post partum doula can help the partner spend more quality time with mom and baby, cooking a meal, allowing them to take a nap, and helping mom with the sometimes challenging task of breastfeeding. She is a loving mentor who can show you ways to appease you baby, bathe him, burp him, swaddle her, and even play with her. A doula is like the “village” support system revisited.
Today most women are isolated from the tribe; many have never seen a birth or seen a woman care for a newborn. Moms make the best doulas when and if they feel up to it, are around, and have the expertise to navigate hospitals. Unfortunately, up until recently most women have given birth in hospitals heavily sedated, and they were discouraged from breastfeeding. Other’s were misguided by “experts” who told them to let the baby cry and to feed only on schedule. Their ideas about birth and baby care might differ a great deal from what you want for yourself. Staying with our commitment to respect other people’s right to act, we must make sure that who we ask, if not a professional, feels like helping not from a sense of guilt but from a place of confidence. Furthermore, some of us have a lot of “emotional baggage” with our mothers and a neutral third party might be just the ticket for our labor, delivery, and postnatal help. Even back in the days were we all lived in the “village,” it was often a neighbor or a cousin who helped women through this life-changing event.
Doulas work hard and for the most part this job is a vocation that comes directly from the heart. Doulas lose night so that you can rest, massage your back for hours while you are managing contractions, spoon feed you, wash you, whisper words of encouragement in your ears, help you remember your innate ability to give birth naturally and care for your child cry with you and bring you good cheer.
Ok, maybe I was preaching a bit, but I wanted her to understand the depth of the profession. Responding to the original question I asked her, “Think of how much you have spent on your wedding dress, honeymoon or the wedding reception. The investment was well worth the importance of the day. Now it’s time to invest in another important time of your life: your labor, birth, and the first weeks of your baby’s life. You’ve had your honeymoon, now have your baby moon. A doula brings the village back to where it belongs.”
She told me she had never quite looked at it that way.
If finances are a real challenge, help is available at a reasonable cost, birth and postpartum doulas who are going through their certification process charge little or nothing. They might not have a lot of experience but research has shown that just the presence of a compassionate woman is enough to change your birthing experience. Visit http://www.dona.org/ to get a list of doulas in your area. For postpartum lactation help contact your local La Leche League organization http://www.llli.org//: their counselors often work on a sliding scale.
Your baby is worth it and your investment will prove to have been money well spent.
The U.S. Family and Medical Leave Act provides for twelve weeks of job-protected leave, but this only covers those who work for large companies.
Across the Atlantic, in Sweden, mothers can expect up to sixteen months of parental leave at 80 percent pay. Moreover, women in Europe not only don’t need as many cesareans or epidurals as Americans do, they have been empowered to stay home with their children and given the financial stability to be able to do so.
There have been several attempts at introducing paid maternity leave in the United States; the most recent was shot down by the Bush administration.
Five states—California, Hawaii, New Jersey, New York and Rhode Island—and Puerto Rico require employers to have temporary disability programs that pay benefits if the pregnancy is defined as a disability by a doctor. A few others have infant care programs that pay subsidies to low-income families for up to two years. Again, we have to be labeled “disabled,” that is, un-able to be who we were meant to be, in order to obtain financial support from the government after a pregnancy.
The benefits available to you will depend very much on the state you live in. In 2002, California led the way in enacting paid family leave, and states such as Massachusetts and New Jersey are considering following suit. Not all states allow women to take short-term disability leave to cover pregnancy, birth, and postpartum recovery.
Short-term disability (STD) is meant to cover your salary—or a portion of it—during the time that you’re unable to do your job due to illness, injury, or childbirth. Many large employers and unions offer this type of disability, as do several states. (It’s generally provided automatically to all employees or residents, not as an optional benefit that you must sign up for.) As a self-employed individual, you are eligible for State Disability Insurance (SDI) if you’ve elected to pay for the coverage and have done so for some period of time. You can address questions about whether you’re covered to your state’s EDD (the State Employment Development Department, that administers SDI).
If your state provides STD, you may pay a small amount out of each paycheck to cover your share. If your employer or union provides STD, the cost may be covered for you. If none of them provides STD, or if the coverage is insufficient, you can purchase your own policy or additional coverage through an insurance provider for a monthly premium.
Private STD insurance through your employer or a provider will generally pay between 50 and 100 percent of your salary for a certain number of weeks, depending on how many years you’ve worked for the company. (The maximum amount you can receive is usually capped.)
Six weeks is the standard amount of time covered for a pregnancy. Some plans allow more time if you’ve had complications or a cesarean delivery, and many also cover bedrest before birth.
State STD benefits typically cover half to two thirds of your salary, and coverage for pregnancy usually lasts from four to six weeks, though it can last up to twelve weeks. If both your state and your company offer STD, you may be required to use the full state benefit and have your employer’s coverage make up the rest. You’ll still end up with the same amount of pay as if you were getting your employer’s full benefit, but you’ll get it in two checks, one from the state and one from your company’s provider. Make sure, one way or another, that you take some time off.
Your baby will be this little person who needs your full attention for such a short while! Even if he only seems to be eating, sleeping and pooping, in reality the nature of the welcome into the world that he experiences at this critical time will be the foundation upon which his character is built. I often take care of newborn babies and spend hours having long conversations with them. Moms comment that it is the very first time they noticed their baby opening their eyes and staying alert for so long. If you don’t talk to your baby he will go to sleep, but you will be amazed when you engage him by looking him in the eye and talking directly to him, how curious and attentive he can be. Do you give more attention to the foundations of a house or to its decoration? Think about it!
To find out what kind of disability or unemployment insurance and other family leave provisions are currently available or will be coming soon to your state, check with your state’s Department of Labor. You can also search the Internet for your state’s disability insurance policies.
For a directory of companies that offer private short-term disability coverage for individuals, contact the Health Insurance Association of America.