(I wrote this up to explain to friends why we had hired a doula for our fifth birth. We hired the same doula for our sixth birth, of course!)
Why did I need a doula? In order to be able to best surrender to the experience, I needed to be able to hand off my list (literal and figurative) and know that someone else was going to take over the duties of my logical/analytical self. I needed someone to be my brain, as I told my doula - so that I could just release everything except the focus I needed to best birth my baby.
This was my fifth baby and I had a pretty fine tuned list of what I needed/wanted/didn't want in labor. But as a first time mom, I think a doula is ESSENTIAL. Especially if you are laboring in the hospital and dealing with their protocols and don't want to do things exactly by the book. I think the extra support person is a crucial part of ensuring your labor wishes are accompanied whenever possible. Just for the peace of mind, someone with labor experience that can help explain things and remind you of what you wanted and reassure a partner that is also going through this labor thing for the first time. We've had five babies and Kit said just with this last one he thinks he started to get it right. 🙂 (For the record, he has always been amazing as labor support but it's true - this last time he blew me away with how perfectly he read my needs.)
Kit is beyond incredible as labor support, but he needs to be in that role - my labor support. He's completely focused on me, my body language, reading me, whispering to me, helping me cope. He's my very literal support and encouragement and I need him in that role. I didn't want him to be worried about anything else but focusing on helping me get through each new contraction.
My midwife is also utterly amazing, but she needs to focus on my health and the baby's health. She needs to monitor contractions and heart tones and give all of her mental energy to making sure we are physically okay. She has vitals to look at and equipment to grab and she has a birth assistant to help with all of those things, but I wanted my midwife's attention to be 100% there on the physical needs of me and our little baby. She also provides emotional support but that is not her primary role - I have a midwife to be my midwife, not my spouse and not my doula. I want her to be 100% my midwife.
Our friend there as caregiver to the kids was fabulous, I could hear her explaining things and comforting and answering questions and I needed that. I didn't want Kit to worry at all about the kids and how they were coping with the birth. I knew our friend took Mo out when it was too intense and I needed to know the kids were in very capable hands and so I needed that friend there for support. I could relax knowing my kids were there if comfortable and could leave if unsure and I knew that they were okay. That let me focus on the new baby.
And of course my sister was there taking pictures and I wanted her there for that - she would have been equally great in child care or labor support but I really wanted to utilize her talent as a photographer and she captured the birth for me and that is priceless.
So that leaves me and my big "To Do" list and I needed to be able to focus internally - not externally, I didn't want to be distracted by all the little things. I needed someone to whisper, "Open your eyes!" when the baby was coming out. I needed someone to look at the clock and write down the timeline for me, because I really wanted that - when I was starting to get serious? How long was I pushing? I love having that timeline and I loved knowing someone was taking care of that. All the little things - I wanted a picture of this, I want some alone time with the new baby and Kit, I want to be reminded to stay upright while I'm laboring so don't let me retreat to the bed, I want to be reminded to drink enough and to eat. She walked around the block with me in early labor and kept me company while Kit took care of other things. Kit could have done all of those things, been my reminder, but I didn't want him to be distracted by those things when I so desperately needed all of his attention on helping me cope. And once the baby was born, I didn't want him to have to think about those things because he deserved time to just focus on his new baby, too.
So, it was a pretty big support team but it was perfect. Beyond the help in labor, having a doula throughout the pregnancy was crucial to my sanity! She helped talk me through my fears, my anxieties, what I wanted in labor and what I wanted to avoid. She helped me put these random thoughts into words and down on paper. She provided emotional support, labor comfort tips, suggestions, answers to questions... then postpartum the help keeps coming as she comes to talk me through the labor experience and share her outside perspective, provide nursing support (and I needed it! Even with my fifth baby, I needed that!) And the doula is a sounding board, someone to tell you, "That's normal, you're doing great!" A good friend can also fill that role, but I appreciated having someone that did have all the doula training and techniques because those are great! Plus they have a level of objectivity that a close friend may not have and since they are hired by you to be your doula, I felt more comfortable saying, "I need x, y and z." I don't know if I would have felt as comfortable making those same demands/requests of a friend?
A doula is for many people a luxury, I realize that. I always thought of it as a nice perk, but not crucial and there were also other things I felt like we should spend the money on instead of a doula. But wow - I'm now convinced! Not even touching on the issues of better outcomes with fewer interventions and higher rates of satisfaction with your marriage after birth and all the other benefits of having a doula there... it's worth it! Really, really worth it.
So, that's why I think everyone needs a doula. And if a doula is not financially feasible, then an experienced mom friend could also be a lifesaver. After this birth I just attended for a friend, I smiled to hear the very experienced dad (and a phenomenal labor support to his wife!) say that he really appreciated having the support team there to help his wife AND to help him. Kit said the same thing. I think it makes the father's life infinitely easier to know there are other people there worrying about the details so he can just be focusing on his wife, and they can also provide reminders and support to him along the way. (So, it's important for the dad to be equally comfortable with the doula, I think.) The doula does not take over the father's role, the doula complements the father's role. You do not need a doula, but I don't know anyone that has regretted having one and everyone I've talked with that had a doula has been so glad they did.
Update: If budget is an issue then many doulas work for a discounted rate as they work towards their certification. And of course you can always try to find a friend that has birth experience - either attending others or has children of their own, but I think it's crucial you find someone that's on the same page as you in regards to birth and your approach/philosophy. Not that you and a doula will share the same opinions about all things, but you share the common goal of YOU achieving the birth of YOUR dreams. No one else's opinion matters except yours, your partner, and the care team you trust (if you want their opinion!) You need as labor support someone that's completely supportive of your goals at birth, not someone that is going to hate seeing you in pain and suggest you get the drugs if you are trying for a drug free birth or someone that is very pro-drug free if you know you want to get the epidural. (Another perk of a doula - they are there to support your choices, whether that is water birth or epidural birth or whatever.)