HELENA — Chelsea Hillman knew she wanted her children to have a natural birth.
When she and her husband Stuart were researching best practices, they kept reading that it often helps to have another woman around who has experienced natural birth.
Without family nearby, Chelsea and Stuart decided to hire a doula — a professional who provides support and information throughout the pregnancy and birth.
The doula proved to be a strong voice of advice and support throughout Hillman’s pregnancy and labor that she said was a great help.
“I just could connect with the fact that she’s done this herself; she’s done this with other women. Her voice just spoke to me and I connected with that,” Hillman said.
Demand for hired help to support mothers from the early stages of pregnancy through birth and beyond has grown nationwide. There are no numbers to show Montana is following suit, but doulas in the state say their services are receiving more attention.
Doulas support pregnant mothers and facilitate conversation between partners and doctors, but say they do not provide any medical expertise.
“Whereas before we (were) seeing just kind of an emerging interest in natural birth and how do I get there, I think people are just kind of getting the idea that they need support ... especially first-time moms,” Sherry Bushnell, president of the Montana Midwifery Association, said.
Bushnell, who works as a midwife, said she’s seen through her practice more mothers hiring doulas, and they often make her job easier. With a doula there to provide support, Bushnell said she can rest until needed and refrain from wearing herself out, making certain the mom is comfortable.
For first-time moms, doulas help provide realistic expectations of birth and comfort through challenges the mom has never experienced. Especially for moms wanting to give birth without drugs, Bushnell said, doulas can be a major factor in the success.
A first-time mom choosing a doula has a difficult choice to make because, similar with all states, Montana does not require doulas to become certified.
DONA International, a widespread doula association, does offer trainings and certifications for doulas in Montana, however.
Abbie Phillip took over as the Montana and Wyoming state representative for DONA in June 2014. Since then, Phillip said she hasn’t had a single request for DONA training in Montana, but she said she knows of other local groups that have hosted local training sessions.
“There is a demand for training and there are more and more people who want to become doulas in Montana,” Phillip said.
She stated that 2013 numbers show six percent of expecting mothers in the United States are reporting hiring a doula. In Montana she assumed it was less, based on the anecdotal evidence that there are 25 DONA registered doulas in the state. Not all may be active, Phillip said, adding that an active doula typically assists in one to four births per month and those are most likely concentrated in Montana’s urban centers.
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“The demand for doula services is less in Montana because of the need to continue to educate people on the benefits of doula services so women understand why,” Phillip said.
She pointed to a 2011 study and said mothers with doulas are 28 percent less likely to need a cesarean section, 31 percent less likely to use synthetic Oxycontin to speed up labor and 34 percent less likely to view the experience as negative.
Phillip said those benefits are magnified in low-income populations, but insurance often does not cover the cost of a doula. She estimated the average doula would charge $500 for the whole support process.
Emily Brand, a doula practicing with Swell in Helena, said the request for doula services in Helena has been steady for the past decade, but more health presentations have made more people aware of what a doula is.
There’s still a common misconception that anyone who hires a doula is determined to have a home birth or one without using pain medication, but most of the mothers who Brand works with give birth in a hospital.
“In reality, choosing a doula is not choosing a certain type of birth, it is choosing to plan for consistent support that allows the birth process to unfold with as much gentleness and care as possible for the whole family,” Brand wrote in an email.
“There is no wrong way to have a baby, and a doula should be by a woman's side making sure she feels strong and confident throughout the process while making space for the medical team to ensure the safety of mom and baby,” she continued.
Natural childbirth educator and doula Amanda Osborne also practices Helena. Osborne said natural childbirth and doula services are gaining momentum, but she agreed the real purpose of doulas remains largely a mystery for most Montanans.
But understanding and use of doulas are growing as mothers who had positive experiences spread the word.
“Childbirth for women is either very empowering, or very disempowering,” Osborne said.
Women with positive birth experiences often felt like they were in control, whereas those who had negative experiences often felt like others were making decisions for them, Osborne said. She added that when a woman comes off an empowering birth, she thinks they feel better prepared to tackle motherhood.
Doulas can help women feel more empowered because they work for the parents, not for the doctors or other parties, Osborne said.
Chelsea Hillman now has two children who are three years old and six months old. Because of her positive experience and success with natural birth, Hillman said she would absolutely recommend a doula to other women.
“I hope that it can grow in Montana, that field and the acceptance of using a doula or going that route of trying to have a more natural childbirth,” she said.