Most mothers in the US chose to use a Obstetritian or Midwife in a hospital setting, especially mothers who are attempting a Vaginal Birth After Cesarean (VBAC). While the choice between OB or midwife is important, it is also important to consider if you would like additional support by a doula or a monitrice. Here, I will talk about both doula and monitrice options and compare the benefits of both.
What is a Doula?
According to the DONA International, an international non-profit organization that certifies Doulas, a Doula is “a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.” Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily. Doulas assist women in preparing for and carrying out her plans for birth, which includes staying with the woman throughout the labor, facilitating communication between the laboring woman, her partner and her clinical care providers. Perhaps the most important aspect is helping the woman get the information she needs to make informed decisions during labor.
Doula services can be sought through individuals, but there are also Doula groups in many cities. The cost of a doula varies based on location, according to costhelper.com, prices can range from $250 in low price areas to as high as $1500. The national average is $600-700.
What is a Monitrice?
According to CHOICE, the Center for Humane Options in Childbirth Experiences, a Monitrice is a woman trained to provide support not only during childbirth but also throughout the course of your pregnancy. A monitrice is similar to a doula, but there are some added benefits. A monitrice does clinical skills for you at home before going to the hospital. She is able to listen to fetal heart tones, check your dilation, and take your blood pressure.
There are no national averages of cost available online, but because of the increased level of care associated with a Monitrice, I assume the cost would be more than a Doula.
How do I know what is right for me?
Both a Doula and a Monitrice provide supportive, mother centered care during labor and delivery. However, if you are a first time mom planning a hospital birth or pursuing a Vaginal Birth After Cesarean (VBAC), you may want to consider a Monitrice, as their additional skills will give you peace of mind to stay at home to labor for as long as possible before going to the hospital.
How do I find a Doula or Monitrice?
To find a Doula, you can go to websites like Doula Match or DONA to find a list of providers near you. It can be a bit more challenging to find a Monitrice. There is no overall certification process for Monitrice services, and many of them are either Midwives who sometimes offer those services, or apprentice Midwives who have already learned some clinical skills. Home birth midwives in your area would be the best place to start in finding a Monitrice.
What should I ask?
Once you have found a list of providers in your area, read their biographies and see if you think they might be a good fit. Narrow your list down to three or four providers if you can. Then, meet with them to talk about your expectations, what kind of birth you would like to have, and ask them questions about their experience. It is important to ask them for referrals, not only from clients that they know had a good birth experience, but also from clients that had things that went unexpectedly. Other questions to ask include:
What training have you had? (If a doula is certified, you might consider checking with the organization.)
Do you have one or more backup doulas for times when you are not available? May we meet her/them?
What is your fee, what does it include and what are your refund policies?
What experience do you have as a Doula/Monitrice?
What is your philosophy about birth and supporting women and their partners through labor?
May we meet to discuss our birth plans and the role you will play in supporting me through birth?
May we call you with questions or concerns before and after the birth?
When do you try to join women in labor? Do you come to our home or meet us at the place of birth?
Do you meet with us after the birth to review the labor and answer questions?
It’s YOUR birth.
Remember that you have the power to plan for the birth that you envision for yourself. Although that doesn’t always mean that it will all go according to that plan, having the right support present can make a significant difference.