Author Topic: So you are hiring a butler for a day?  (Read 13150 times)

JrDoctor

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Re: So you are hiring a butler for a day?
« Reply #50 on: November 10, 2015, 02:48:15 PM »
I think it's pretty easy to tell in this thread who has given birth with a doula and who either used a hospital or doesn't have kids yet.


I suspect I've been involved with more births than days you've spent in hospital.  I've seen dozens, from those coming out cephalic, breach, c-section.  Those with tears, those with episiostomies and all variants.

As one who has served as a doula for my own sister, friends, and as a favor to a professional doula-friend, I can tell you that those mamas view their births as life-changing, soul-stirring, empowering experiences, and hiring a doula as a support, comforter, and knowledgeable voice while in one of the most vulnerable positions a woman will ever find herself was priceless, to them.

Purely from a US based point of view a pregnant mother can be a profit center for them. she’s in no state to object to what a Dr is proposing to do – or just does it anyway and over rides the patients wishes and birth plan.
From a purely financial perspective a Doula can save you way more than the $600 in medical charges. Plus by the time of birth you have met them a few times and built up a rapport with them. They are with you during the birth and advocate on your behalf. Way too often family members will blindly follow what the Docs recommend because that’s what the Doctor said – totally ignoring the wishes of the mother in labor.

3 had 3 kids. One in  hospital (awful experience), one at home in the UK with a couple of midwives (excellent) and one home birth in the USA with a couple of midwives (good – would have been better if they had turned up before the kid was born but she was in a hurry).
A doula would have helped in the first case and the last tow – if they had been hospital births we would have had a doula there.

Not in favor of them – I’m guessing you are either in the medical field and happy making more money from births – or you just don’t have any experience of them.

I really dont think the US obstetricians can be such bastards that they perform unnecessary interventions on mother and child to line their pockets.  And as much as I think the UK offers some of the best healthcare in the world, I do not think our obstetric services can be miles above that of the US.  Miles above villages on the African continent, yes.

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Re: So you are hiring a butler for a day?
« Reply #51 on: November 10, 2015, 03:18:12 PM »
I really dont think the US obstetricians can be such bastards that they perform unnecessary interventions on mother and child to line their pockets.

Sorry to burst your bubble, but yes, that is a very common medical practice in the United States. It's not confined to obstetrics. It's one of the reason the national rate of health care spending is so high, while the results are not proportionate.

Pretty much any time a patient is helpless or very sick, he or she is at risk of being signed up for a whole bunch of extra unnecessary tests, drugs, or procedures. Sometimes you don't even have to be incapacitated: the person who's got the ability to save your life has you over a barrel. You must either submit to the unnecessary tests, drugs, or procedures (generally administered by the hospital or by a business affiliate), or literally die. The corruption isn't universal but it's common enough to be a problem.

Pregnant women in some parts of the USA don't have the right to refuse treatment, to check themselves out of the hospital, or to do anything that differs with what the expert of the day recommends. It's not unheard-of for a woman to be charged with injuring a fetus, child abuse, or even murder for having a late-term miscarriage.

At the other end of the spectrum, patients sometimes can't get their symptoms taken seriously and are denied treatment. This has led to organ failure or even death.

Having an advocate in the room cuts down on all of these potential problems.
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regulator

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Re: So you are hiring a butler for a day?
« Reply #52 on: November 10, 2015, 03:26:15 PM »
Peer reviewed studies are not the be all and end all, particularly not a couple of small studies done on a particular subpopulation.  Ask any researcher or medical professional (which obviously excludes doulas).  But you of course will never concede a point that does not square with your preconceptions, so have at it.
You are correct in that smaller studies and a limited number of publications usually warrant some cautious skepticism, but in medicine it is possible to find meta-analysis studies (considered by some to be the "platinum standard") that review and aggregate many studies together. A fairly quick search of PMC found "Doula support compared with standard care: Meta-analysis of the effects on the rate of medical interventions during labour for low-risk women delivering at term" which had the following to say:

Quote
DISCUSSION

Continuous support during labour has been shown to be beneficial whether provided by a woman’s partner, a family member or close friend, or a dedicated member of the clinical team providing intrapartum care.1 The presence of a trained doula providing continuous support to labouring women and their partners appears to have a significant effect on rates of instrumental vaginal deliveries and cesarean sections.

Quote
Conclusion

The presence of a trained doula reduces the odds of cesarean delivery and instrumental vaginal delivery when compared with women receiving standard maternity care. The presence of a doula does not have an effect on the use of epidural anesthesia or on the use of oxytocin to augment labour. We suggest that doulas have a positive effect on the rate of certain interventions during planned vaginal deliveries of term pregnancies in women of average risk.

In short, having them around can be a good thing and since you are paying for them to be their the entire time you are giving birth, it can help to relax the mother knowing someone is there for them the entire time. Odds are the medical staff is not going to be giving the mother their undivided attention and it can help free up the dad to take care of things that might need to get done while the mother is in labor. As others have noted, historically there were traditionally midwives and (female) relatives involved with giving birth who would be their throughout the process which is very different from how it is done now.

So basically if your husband/baby-daddy is useless and another family member cannot step in, having a doula may be helpful.  Again, sounds a lot like we are selecting for the shitiest possible population and then saying having someone looking out for them is a good thing.  Big difference from upper middle class women getting massages in the delivery room.    Different strokes.  As I have been told, not my money or orifice.

OK, I will throw you a bone.  The meta-study suggests that there may be a small improvement in outcomes from having a birth butler in the room.  The random grab bag of studies they looked at and the small number of them preclude one from saying more than it might be worth some further investigation.  But that is about it.
« Last Edit: November 10, 2015, 03:45:25 PM by regulator »

Syonyk

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Re: So you are hiring a butler for a day?
« Reply #53 on: November 10, 2015, 04:04:16 PM »
So basically if your husband/baby-daddy is useless and another family member cannot step in, having a doula may be helpful.

Wow, fuck you too!

There's a big gap between "first time involved in the child birth process" and "useless."  I was quite happy to have someone who was experienced with the non-medical aspects of keeping my wife as comfortable as possible during labor around.  The midwives are great, but their focus really is on a healthy baby and wife, not the most comfortable labor process.
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Re: So you are hiring a butler for a day?
« Reply #54 on: November 10, 2015, 04:15:07 PM »
Rule of thumb when it comes to L&D: if your dick got the baby in, or your uterus will get it out, you get a vote. Otherwise? You're not registered in this particular precinct.

regulator

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Re: So you are hiring a butler for a day?
« Reply #55 on: November 10, 2015, 04:19:19 PM »

Goldielocks

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Re: So you are hiring a butler for a day?
« Reply #56 on: November 10, 2015, 04:19:37 PM »
The doula is in addition to the team of medical professionals, but has enough medical background to be a useful advocate if something goes wrong.

Female patients find it extremely difficult to get their concerns taken seriously, but when there's a non-patient in the room advocating for the patient, somehow the same statement is taken seriously from the non-patient.

And for some $600 reason my BIL is incapable of doing so?
He wouldn't be the first!

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Re: So you are hiring a butler for a day?
« Reply #57 on: November 10, 2015, 04:34:57 PM »
My second birth.

DH was there. Junior nurse made an error on my pintocin dose in middle of night, GREATLY extending labour, then I birthed vaginally an 11 lb baby who got stuck and had low scores as a result. Hospital birth. NO DOCTOR. He was too busy so the senior nurse took over.

No other relatives.

I could have really used some doula advocacy. DH was so far out of his league to even realize early that things were going sideways.

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Re: So you are hiring a butler for a day?
« Reply #58 on: November 10, 2015, 05:21:47 PM »
regulator, I’ve got some legitimate curiosity over here, that I really hope you’ll answer. Why are you so wrapped around the axle over the existence doula’s? Nominally this thread is about your sister's financial choices, but she got dropped back on page one in favour venting your spleen all over an entire profession. It seems really out of proportion. What the heck?

Syonyk

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Re: So you are hiring a butler for a day?
« Reply #59 on: November 10, 2015, 05:49:50 PM »
DH was so far out of his league to even realize early that things were going sideways.

Yeah.  I do computer stuff for a living.  I don't show up to births.  I've been to one so far.  I'm not an expert on it, by any means.  I was mostly useful as physical labor ("Squeeze here.  Adjust pressure as directed.").
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Avidconsumer

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Re: So you are hiring a butler for a day?
« Reply #60 on: November 11, 2015, 10:53:57 AM »
I think the majority here either advocate for a birth doula or don't have an issue with others having a birth doula, so I think its reasonable for the OP to give their sister some slack over hiring a birth doula. Plus its 600$. If that seems like a painful expense, then you should be understanding why 600$ means so much to you, and what you can do about that.

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Re: So you are hiring a butler for a day?
« Reply #61 on: November 11, 2015, 11:03:50 AM »
how did we ever get to this point as a human race without doulas helping us give birth... holy cow OP this belongs on this wall.  these came about mid 20th century.  its a dumb luxury like everything else that we knock here. 

i mean anyone can sit there and make an arguement for cable TV or having your lawn mowed. 

a DOULA is a LUXURY ...

can't believe the amount of people standing up for such an extravagant expense.
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Re: So you are hiring a butler for a day?
« Reply #62 on: November 11, 2015, 11:21:39 AM »
how did we ever get to this point as a human race without doulas helping us give birth...

Prior to the medicalization of birth, humans gave birth at home with female friends and family assisting, and the males banished. Doulas probably result from the combination of the diaspora modern families accept as normal, the decreasing amount of friendships modern folks have, and the push for doctor and hospital attended birth.

Gin1984

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Re: So you are hiring a butler for a day?
« Reply #63 on: November 11, 2015, 11:45:58 AM »
how did we ever get to this point as a human race without doulas helping us give birth... holy cow OP this belongs on this wall.  these came about mid 20th century.  its a dumb luxury like everything else that we knock here.

i mean anyone can sit there and make an arguement for cable TV or having your lawn mowed. 

a DOULA is a LUXURY ...

can't believe the amount of people standing up for such an extravagant expense.
Do you know why we now allow a "helper" (normally the father) into the room at all?  Prior to the 1960s this was not the case.  This changed partly because of the evidence that having a support person decreased negative medical outcomes.  Do you consider other medical improvements luxuries as well?

Quince

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Re: So you are hiring a butler for a day?
« Reply #64 on: November 11, 2015, 11:55:57 AM »
Of COURSE a doula is a luxury. So is anesthetic. So is the option for surgical intervention. So are sterile surroundings and antibiotics. So are lactation consultants.  Some of these things are replacements for midwives, female relatives, neighbors. Some of these things decrease mortality for mother and child. None of these things are necessary for the continuation of the human race.

Giving birth is stressful, physically and emotionally.  Some countries have higher rates of intervention than they should- some because of the CYA attitude in medicine, some because interventions are faster and more controllable than waiting for nature to take its course.  Having someone familiar with the process and also not as emotionally invested to help advocate can relieve the stress on the family. It is not necessary, but for some people, it is desirable and worth it.

Breast pumps are another luxury- you can hand express milk or formula feed if your child has issues nursing.

There are degrees of luxury. We are not talking about a crib/changing station made out of rare hardwoods, with an interior designer called upon to decorate a separate room for the nursery, and expensive bedding sets that you aren't even supposed to use with newborns because of the risk of SIDS. We are talking about hiring a patient advocate and birth coach to help make a painful, stressful, risky situation go more smoothly.

I have a friend whose husband would be dead weight in the case of childbirth (he faints at the sight of blood or needles), her female relatives are unreliable, and her preferred friends live across the country,  and you can bet she'd get a doula rather than have to be the only one advocating for herself when she's in a great deal of pain and possibly incapacitated for an emergency c-section.

Gin1984

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Re: So you are hiring a butler for a day?
« Reply #65 on: November 11, 2015, 12:03:23 PM »
go find something else to mock your family about.

you don't agree, which is obvious, but its not your vagina, nor your baby. nor in the end, your pocket book

Well then, lets just do away with the entire wall of shame forum .  After all, not our pocketbooks/orifices/houses/debt/lives, right?  Who cares?


oh sorry, in that case:

BHAHAHAHAh!!! they want to spend how much,  making sure the Dr doesnt cut her rectum against her wishes?!

what shills!  $600 to make sure mother and baby have a great delivery experience!   in 20 years that $200 could have been 2,796.57,  if they had invested it in an index fund. one day they will look back and realize they were huge chumps. and you were soooo right

I have read all the arguments and read the links that claim doulas are magically empowered delivery people.  I still see no credible evidence that this isn't just an upper middle class women's fad and an expensive one at that.  You feel different, well, it is your pocketbook/orifice/life/whatever.  Have fun indulging your fancies.  I will indulge my sense of humor at your expense.  You might try it some time.
So peer reviewed data is not credible evidence?  And your bolded comment was not what the data said, perhaps your understanding is the issue, not the data.

You talking about the two linked studies talking about medicaid beneficiaries?  Not credible beyond pointing out the obvious: the mothers who were self selected as the least addled members of the studied population had better outcomes.  Says nothing useful as to whether having a doula is beneficial (or harmful) if you were to remove that massive confounding effect.  I like studies as well as anyone, but one should read all of them with a grain of salt.
Given that both groups were part of "a prenatal health and childbirth education program." how do you determine that those who, of that group, chose to have a doula are as you said "self selected as the least addled members of the studied population".  In fact according to the study "They were similar in age, race/ethnicity, income status, and geographic location. All of the mothers had participated in at least three of the agency’s childbirth classes, and all received case management as part of their participation with the agency."  So where is your statements coming from?

Did we control for drug addiction, general health, presence of husband/baby daddy, etc?  Nope.  So it s hard to generalize or make conclusions from these studies.  No doubt you are aware how many studies have to be done in order to "prove" something sufficiently to make a public policy or medical decision based on said studies.  This ain't it.  But I know that you have an axe to grind, so grind away.
My only "axe" is that peer reviewed studies are pretty much the gold standard for "credible evidence", and to pretend they are not just because you don't like the result and to state that the methodology was flawed without actual basis just bias is something I certainly object to. 
But on the topic of bias, you incorrectly assume mine.  I did not have a doula nor do I plan to.  My object was soley on your statements.

No, your biases are wider than that.

Peer reviewed studies are not the be all and end all, particularly not a couple of small studies done on a particular subpopulation.  Ask any researcher or medical professional (which obviously excludes doulas).  But you of course will never concede a point that does not square with your preconceptions, so have at it.
ROFL, sure I will walk down the hall and ask some colleagues.  When they stop looking at me like I have lost my mind, most will agree with me.  Especially because AGAIN (as shown by the meta-analysis) this is not one study.  And if you think it is, the better way to argue it, is to find conflicting studies, not complain that you don't think their sample size was large enough to compensate for the variability in the population, which btw, you have assumed to be an assume with no data to back you up.
But given that you even complained about a meta-analysis shows your education in this. 

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Re: So you are hiring a butler for a day?
« Reply #66 on: November 11, 2015, 12:11:27 PM »
Prior to the medicalization of birth, humans gave birth at home with female friends and family assisting, and the males banished. Doulas probably result from the combination of the diaspora modern families accept as normal, the decreasing amount of friendships modern folks have, and the push for doctor and hospital attended birth.

^^

Do you know why we now allow a "helper" (normally the father) into the room at all?  Prior to the 1960s this was not the case.  This changed partly because of the evidence that having a support person decreased negative medical outcomes.  Do you consider other medical improvements luxuries as well?

Go back a lot further.  Like, pre-1900.  Birth was not considered a medical emergency at that point.
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regulator

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Re: So you are hiring a butler for a day?
« Reply #67 on: November 11, 2015, 12:17:42 PM »
go find something else to mock your family about.

you don't agree, which is obvious, but its not your vagina, nor your baby. nor in the end, your pocket book

Well then, lets just do away with the entire wall of shame forum .  After all, not our pocketbooks/orifices/houses/debt/lives, right?  Who cares?


oh sorry, in that case:

BHAHAHAHAh!!! they want to spend how much,  making sure the Dr doesnt cut her rectum against her wishes?!

what shills!  $600 to make sure mother and baby have a great delivery experience!   in 20 years that $200 could have been 2,796.57,  if they had invested it in an index fund. one day they will look back and realize they were huge chumps. and you were soooo right

I have read all the arguments and read the links that claim doulas are magically empowered delivery people.  I still see no credible evidence that this isn't just an upper middle class women's fad and an expensive one at that.  You feel different, well, it is your pocketbook/orifice/life/whatever.  Have fun indulging your fancies.  I will indulge my sense of humor at your expense.  You might try it some time.
So peer reviewed data is not credible evidence?  And your bolded comment was not what the data said, perhaps your understanding is the issue, not the data.

You talking about the two linked studies talking about medicaid beneficiaries?  Not credible beyond pointing out the obvious: the mothers who were self selected as the least addled members of the studied population had better outcomes.  Says nothing useful as to whether having a doula is beneficial (or harmful) if you were to remove that massive confounding effect.  I like studies as well as anyone, but one should read all of them with a grain of salt.
Given that both groups were part of "a prenatal health and childbirth education program." how do you determine that those who, of that group, chose to have a doula are as you said "self selected as the least addled members of the studied population".  In fact according to the study "They were similar in age, race/ethnicity, income status, and geographic location. All of the mothers had participated in at least three of the agency’s childbirth classes, and all received case management as part of their participation with the agency."  So where is your statements coming from?

Did we control for drug addiction, general health, presence of husband/baby daddy, etc?  Nope.  So it s hard to generalize or make conclusions from these studies.  No doubt you are aware how many studies have to be done in order to "prove" something sufficiently to make a public policy or medical decision based on said studies.  This ain't it.  But I know that you have an axe to grind, so grind away.
My only "axe" is that peer reviewed studies are pretty much the gold standard for "credible evidence", and to pretend they are not just because you don't like the result and to state that the methodology was flawed without actual basis just bias is something I certainly object to. 
But on the topic of bias, you incorrectly assume mine.  I did not have a doula nor do I plan to.  My object was soley on your statements.

No, your biases are wider than that.

Peer reviewed studies are not the be all and end all, particularly not a couple of small studies done on a particular subpopulation.  Ask any researcher or medical professional (which obviously excludes doulas).  But you of course will never concede a point that does not square with your preconceptions, so have at it.
ROFL, sure I will walk down the hall and ask some colleagues.  When they stop looking at me like I have lost my mind, most will agree with me.  Especially because AGAIN (as shown by the meta-analysis) this is not one study.  And if you think it is, the better way to argue it, is to find conflicting studies, not complain that you don't think their sample size was large enough to compensate for the variability in the population, which btw, you have assumed to be an assume with no data to back you up.
But given that you even complained about a meta-analysis shows your education in this.

OK, then show us some large scale, broad population studies.  All I saw was a meta-analysis of a handful of small studies with disparate/oddball populations.

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Re: So you are hiring a butler for a day?
« Reply #68 on: November 11, 2015, 12:20:04 PM »
Prior to the medicalization of birth, humans gave birth at home with female friends and family assisting, and the males banished. Doulas probably result from the combination of the diaspora modern families accept as normal, the decreasing amount of friendships modern folks have, and the push for doctor and hospital attended birth.

^^

Do you know why we now allow a "helper" (normally the father) into the room at all?  Prior to the 1960s this was not the case.  This changed partly because of the evidence that having a support person decreased negative medical outcomes.  Do you consider other medical improvements luxuries as well?

Go back a lot further.  Like, pre-1900.  Birth was not considered a medical emergency at that point.

It should have been:

Gin1984

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Re: So you are hiring a butler for a day?
« Reply #69 on: November 11, 2015, 12:33:51 PM »
go find something else to mock your family about.

you don't agree, which is obvious, but its not your vagina, nor your baby. nor in the end, your pocket book

Well then, lets just do away with the entire wall of shame forum .  After all, not our pocketbooks/orifices/houses/debt/lives, right?  Who cares?


oh sorry, in that case:

BHAHAHAHAh!!! they want to spend how much,  making sure the Dr doesnt cut her rectum against her wishes?!

what shills!  $600 to make sure mother and baby have a great delivery experience!   in 20 years that $200 could have been 2,796.57,  if they had invested it in an index fund. one day they will look back and realize they were huge chumps. and you were soooo right

I have read all the arguments and read the links that claim doulas are magically empowered delivery people.  I still see no credible evidence that this isn't just an upper middle class women's fad and an expensive one at that.  You feel different, well, it is your pocketbook/orifice/life/whatever.  Have fun indulging your fancies.  I will indulge my sense of humor at your expense.  You might try it some time.
So peer reviewed data is not credible evidence?  And your bolded comment was not what the data said, perhaps your understanding is the issue, not the data.

You talking about the two linked studies talking about medicaid beneficiaries?  Not credible beyond pointing out the obvious: the mothers who were self selected as the least addled members of the studied population had better outcomes.  Says nothing useful as to whether having a doula is beneficial (or harmful) if you were to remove that massive confounding effect.  I like studies as well as anyone, but one should read all of them with a grain of salt.
Given that both groups were part of "a prenatal health and childbirth education program." how do you determine that those who, of that group, chose to have a doula are as you said "self selected as the least addled members of the studied population".  In fact according to the study "They were similar in age, race/ethnicity, income status, and geographic location. All of the mothers had participated in at least three of the agency’s childbirth classes, and all received case management as part of their participation with the agency."  So where is your statements coming from?

Did we control for drug addiction, general health, presence of husband/baby daddy, etc?  Nope.  So it s hard to generalize or make conclusions from these studies.  No doubt you are aware how many studies have to be done in order to "prove" something sufficiently to make a public policy or medical decision based on said studies.  This ain't it.  But I know that you have an axe to grind, so grind away.
My only "axe" is that peer reviewed studies are pretty much the gold standard for "credible evidence", and to pretend they are not just because you don't like the result and to state that the methodology was flawed without actual basis just bias is something I certainly object to. 
But on the topic of bias, you incorrectly assume mine.  I did not have a doula nor do I plan to.  My object was soley on your statements.

No, your biases are wider than that.

Peer reviewed studies are not the be all and end all, particularly not a couple of small studies done on a particular subpopulation.  Ask any researcher or medical professional (which obviously excludes doulas).  But you of course will never concede a point that does not square with your preconceptions, so have at it.
ROFL, sure I will walk down the hall and ask some colleagues.  When they stop looking at me like I have lost my mind, most will agree with me.  Especially because AGAIN (as shown by the meta-analysis) this is not one study.  And if you think it is, the better way to argue it, is to find conflicting studies, not complain that you don't think their sample size was large enough to compensate for the variability in the population, which btw, you have assumed to be an assume with no data to back you up.
But given that you even complained about a meta-analysis shows your education in this.

OK, then show us some large scale, broad population studies.  All I saw was a meta-analysis of a handful of small studies with disparate/oddball populations.
First, a study of over 200 participants is not classified as small.  Second, you don't need a large sample to have the ability to generalize to a whole population.  Third, multiple studies actually have more validity than one large study (avoid bias) which is why the meta-analysis is considered better than one large study. 
So no, I won't show you those because there is no actual need. 

regulator

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Re: So you are hiring a butler for a day?
« Reply #70 on: November 11, 2015, 12:35:18 PM »
go find something else to mock your family about.

you don't agree, which is obvious, but its not your vagina, nor your baby. nor in the end, your pocket book

Well then, lets just do away with the entire wall of shame forum .  After all, not our pocketbooks/orifices/houses/debt/lives, right?  Who cares?


oh sorry, in that case:

BHAHAHAHAh!!! they want to spend how much,  making sure the Dr doesnt cut her rectum against her wishes?!

what shills!  $600 to make sure mother and baby have a great delivery experience!   in 20 years that $200 could have been 2,796.57,  if they had invested it in an index fund. one day they will look back and realize they were huge chumps. and you were soooo right

I have read all the arguments and read the links that claim doulas are magically empowered delivery people.  I still see no credible evidence that this isn't just an upper middle class women's fad and an expensive one at that.  You feel different, well, it is your pocketbook/orifice/life/whatever.  Have fun indulging your fancies.  I will indulge my sense of humor at your expense.  You might try it some time.
So peer reviewed data is not credible evidence?  And your bolded comment was not what the data said, perhaps your understanding is the issue, not the data.

You talking about the two linked studies talking about medicaid beneficiaries?  Not credible beyond pointing out the obvious: the mothers who were self selected as the least addled members of the studied population had better outcomes.  Says nothing useful as to whether having a doula is beneficial (or harmful) if you were to remove that massive confounding effect.  I like studies as well as anyone, but one should read all of them with a grain of salt.
Given that both groups were part of "a prenatal health and childbirth education program." how do you determine that those who, of that group, chose to have a doula are as you said "self selected as the least addled members of the studied population".  In fact according to the study "They were similar in age, race/ethnicity, income status, and geographic location. All of the mothers had participated in at least three of the agency’s childbirth classes, and all received case management as part of their participation with the agency."  So where is your statements coming from?

Did we control for drug addiction, general health, presence of husband/baby daddy, etc?  Nope.  So it s hard to generalize or make conclusions from these studies.  No doubt you are aware how many studies have to be done in order to "prove" something sufficiently to make a public policy or medical decision based on said studies.  This ain't it.  But I know that you have an axe to grind, so grind away.
My only "axe" is that peer reviewed studies are pretty much the gold standard for "credible evidence", and to pretend they are not just because you don't like the result and to state that the methodology was flawed without actual basis just bias is something I certainly object to. 
But on the topic of bias, you incorrectly assume mine.  I did not have a doula nor do I plan to.  My object was soley on your statements.

No, your biases are wider than that.

Peer reviewed studies are not the be all and end all, particularly not a couple of small studies done on a particular subpopulation.  Ask any researcher or medical professional (which obviously excludes doulas).  But you of course will never concede a point that does not square with your preconceptions, so have at it.
ROFL, sure I will walk down the hall and ask some colleagues.  When they stop looking at me like I have lost my mind, most will agree with me.  Especially because AGAIN (as shown by the meta-analysis) this is not one study.  And if you think it is, the better way to argue it, is to find conflicting studies, not complain that you don't think their sample size was large enough to compensate for the variability in the population, which btw, you have assumed to be an assume with no data to back you up.
But given that you even complained about a meta-analysis shows your education in this.

OK, then show us some large scale, broad population studies.  All I saw was a meta-analysis of a handful of small studies with disparate/oddball populations.
First, a study of over 200 participants is not classified as small.  Second, you don't need a large sample to have the ability to generalize to a whole population.  Third, multiple studies actually have more validity than one large study (avoid bias) which is why the meta-analysis is considered better than one large study. 
So no, I won't show you those because there is no actual need.

And presumably because it does not exist.  Thank you for playing.  I think I am done here.  Enjoy your birth butler.

Gin1984

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Re: So you are hiring a butler for a day?
« Reply #71 on: November 11, 2015, 12:42:55 PM »
go find something else to mock your family about.

you don't agree, which is obvious, but its not your vagina, nor your baby. nor in the end, your pocket book

Well then, lets just do away with the entire wall of shame forum .  After all, not our pocketbooks/orifices/houses/debt/lives, right?  Who cares?


oh sorry, in that case:

BHAHAHAHAh!!! they want to spend how much,  making sure the Dr doesnt cut her rectum against her wishes?!

what shills!  $600 to make sure mother and baby have a great delivery experience!   in 20 years that $200 could have been 2,796.57,  if they had invested it in an index fund. one day they will look back and realize they were huge chumps. and you were soooo right

I have read all the arguments and read the links that claim doulas are magically empowered delivery people.  I still see no credible evidence that this isn't just an upper middle class women's fad and an expensive one at that.  You feel different, well, it is your pocketbook/orifice/life/whatever.  Have fun indulging your fancies.  I will indulge my sense of humor at your expense.  You might try it some time.
So peer reviewed data is not credible evidence?  And your bolded comment was not what the data said, perhaps your understanding is the issue, not the data.

You talking about the two linked studies talking about medicaid beneficiaries?  Not credible beyond pointing out the obvious: the mothers who were self selected as the least addled members of the studied population had better outcomes.  Says nothing useful as to whether having a doula is beneficial (or harmful) if you were to remove that massive confounding effect.  I like studies as well as anyone, but one should read all of them with a grain of salt.
Given that both groups were part of "a prenatal health and childbirth education program." how do you determine that those who, of that group, chose to have a doula are as you said "self selected as the least addled members of the studied population".  In fact according to the study "They were similar in age, race/ethnicity, income status, and geographic location. All of the mothers had participated in at least three of the agency’s childbirth classes, and all received case management as part of their participation with the agency."  So where is your statements coming from?

Did we control for drug addiction, general health, presence of husband/baby daddy, etc?  Nope.  So it s hard to generalize or make conclusions from these studies.  No doubt you are aware how many studies have to be done in order to "prove" something sufficiently to make a public policy or medical decision based on said studies.  This ain't it.  But I know that you have an axe to grind, so grind away.
My only "axe" is that peer reviewed studies are pretty much the gold standard for "credible evidence", and to pretend they are not just because you don't like the result and to state that the methodology was flawed without actual basis just bias is something I certainly object to. 
But on the topic of bias, you incorrectly assume mine.  I did not have a doula nor do I plan to.  My object was soley on your statements.

No, your biases are wider than that.

Peer reviewed studies are not the be all and end all, particularly not a couple of small studies done on a particular subpopulation.  Ask any researcher or medical professional (which obviously excludes doulas).  But you of course will never concede a point that does not square with your preconceptions, so have at it.
ROFL, sure I will walk down the hall and ask some colleagues.  When they stop looking at me like I have lost my mind, most will agree with me.  Especially because AGAIN (as shown by the meta-analysis) this is not one study.  And if you think it is, the better way to argue it, is to find conflicting studies, not complain that you don't think their sample size was large enough to compensate for the variability in the population, which btw, you have assumed to be an assume with no data to back you up.
But given that you even complained about a meta-analysis shows your education in this.

OK, then show us some large scale, broad population studies.  All I saw was a meta-analysis of a handful of small studies with disparate/oddball populations.
First, a study of over 200 participants is not classified as small.  Second, you don't need a large sample to have the ability to generalize to a whole population.  Third, multiple studies actually have more validity than one large study (avoid bias) which is why the meta-analysis is considered better than one large study. 
So no, I won't show you those because there is no actual need.

And presumably because it does not exist.  Thank you for playing.  I think I am done here.  Enjoy your birth butler.
They don't exist because there is no reason to do the study, they are no more valid than smaller studies (and in many cases less valid).  Researchers actually do care about wasting government funds, funny thing that.  And again, given my field and my spouse's, I don't need one, that does not mean they are not useful in certain situations. 

Syonyk

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Re: So you are hiring a butler for a day?
« Reply #72 on: November 11, 2015, 12:43:12 PM »
It should have been:

From 1% down to about 0%.  The common case was still a perfectly healthy baby.
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beltim

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Re: So you are hiring a butler for a day?
« Reply #73 on: November 11, 2015, 01:01:00 PM »
It should have been:

From 1% down to about 0%.  The common case was still a perfectly healthy baby.

That's also true of people infected with pertussis, smallpox (variola minor), and a whole bunch of other diseases.  I assume you don't take any precautions or get medical treatment in those cases?

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Re: So you are hiring a butler for a day?
« Reply #74 on: November 11, 2015, 01:02:37 PM »
regulator, I’ve got some legitimate curiosity over here, that I really hope you’ll answer. Why are you so wrapped around the axle over the existence doula’s? Nominally this thread is about your sister's financial choices, but she got dropped back on page one in favour venting your spleen all over an entire profession. It seems really out of proportion. What the heck?

I think I am done here.

But wait! ARGH. You haven't answered my question. Whyyyyyyyyy? Why, of all the optional expenses available to mock in this world are you so offended by doulas? Is it their doula-ness? Is it because the word is kind of silly? Are you offended for your BIL? Why, why! You're driving me to distraction.

I mean, studies aside, if my wife (or even my sister who can be judgemental and difficult in my younger kid opinion), said a doula was necessary to comfort and succour them while they squeeze a living human out their cervix, I'd immediately hire three. Even though I think the word doula really is legitimately silly.

Avidconsumer

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Re: So you are hiring a butler for a day?
« Reply #75 on: November 11, 2015, 01:06:53 PM »
It should have been:

From 1% down to about 0%.  The common case was still a perfectly healthy baby.

10,000+ babies born everyday in the US would result in 80+ dead mothers a day. Doesn't seem negligible to me.
« Last Edit: November 11, 2015, 01:10:52 PM by Avidconsumer »

Dollar Slice

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Re: So you are hiring a butler for a day?
« Reply #76 on: November 11, 2015, 01:09:45 PM »
It should have been:

From 1% down to about 0%.  The common case was still a perfectly healthy baby.

That graph is for maternal mortality rate, it has nothing to do with a "perfectly healthy baby". (Not sure where you got that.)

Infant mortality rates were around 10%. And that counts death only, it has nothing to say about the health or quality of life of the babies who survived - the numbers are much worse if you consider sickly babies who died under 1 year of age.

That sounds like a medical emergency to me...
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beltim

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Re: So you are hiring a butler for a day?
« Reply #77 on: November 11, 2015, 01:23:03 PM »
The equivalent chart for infant mortality:


mm1970

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Re: So you are hiring a butler for a day?
« Reply #78 on: November 11, 2015, 01:37:57 PM »
I think it's one of those things that comes down to having data (from studies and such).

Studies show they improve outcomes.  That's pretty clear.  That means they probably also save money.

It's kind of like education, or free breakfast at schools, or drug intervention, or prison training or...???

You may have an inherent bias about the topic, and the money.
"Parents should feed their own kids"
"I never went to preschool so it's not necessary"
"You made your bed, so lie in it"
etc etc

But in these and many other cases, studies, and statistics, show positive outcomes.

If spending "X" on free breakfast means that you save "Y" because kids pay attention in school, get degrees, and have better outcomes, then it's worth it, especially when Y > X.
If spending $600 on a doula means that you have a vaginal birth instead of a C-section, then you are saving $10k or more.
If paying "A" for preschool for underprivileged kids saves you "B", and B>A, then it's worth it.

Sometimes it's important to take a step back from personal biases about whether something seems necessary, or fair, and instead look at the numbers and actual results.

UnleashHell

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Re: So you are hiring a butler for a day?
« Reply #79 on: November 11, 2015, 02:00:56 PM »
I think it's one of those things that comes down to having data (from studies and such).

Studies show they improve outcomes.  That's pretty clear.  That means they probably also save money.

It's kind of like education, or free breakfast at schools, or drug intervention, or prison training or...???

You may have an inherent bias about the topic, and the money.
"Parents should feed their own kids"
"I never went to preschool so it's not necessary"
"You made your bed, so lie in it"
etc etc

But in these and many other cases, studies, and statistics, show positive outcomes.

If spending "X" on free breakfast means that you save "Y" because kids pay attention in school, get degrees, and have better outcomes, then it's worth it, especially when Y > X.
If spending $600 on a doula means that you have a vaginal birth instead of a C-section, then you are saving $10k or more.
If paying "A" for preschool for underprivileged kids saves you "B", and B>A, then it's worth it.

Sometimes it's important to take a step back from personal biases about whether something seems necessary, or fair, and instead look at the numbers and actual results.

The problem you have is trying to use logic to point out the flaws of an assumption of the OP who , despite having evidence available to them, is not going to change their mind. I've seen the OP's comments elsewhere. he's a troll.
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honeybbq

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Re: So you are hiring a butler for a day?
« Reply #80 on: November 11, 2015, 02:16:49 PM »
If I could rewind the clock, I would have paid $6000 for a doula to have attended my child's birth.

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Re: So you are hiring a butler for a day?
« Reply #81 on: November 11, 2015, 02:20:25 PM »
From 1% down to about 0%.  The common case was still a perfectly healthy baby.

Since 1900, the death rate for the baby went from over 14% (as in, one in seven full-term babies didn't survive) down to less than 1%.

The mortality drop from 8% to near 0% was for the baby producing vessel. But that statistic, is for each birth. Most baby producing vessels in 1900 produced more than one child due to lack of birth control and also the desire to see at least one child survive to adulthood. That's a significant risk of a slow, excruciatingly painful death. At a population replacement rate of 3 children per baby producing vessel, a baby producing vessel in 1900 had at least a 25% chance of dying in the process. That's more than the combined occupational hazard for all fifteen of the most dangerous jobs in modern America. (Deadliest catch? Pshaw...) It's even higher than the 1 in 5 death rate for Civil War soldiers on and off the battlefield.

These days, thanks to modern science, the mortality rate of baby producing vessels in the USA is only about 18 per 100,000 births. This is slightly higher than the annual suicide rate in the active duty US military. Interestingly, nobody suggests getting rid of existing suicide intervention programs, and few are criticizing new publicly funded initiatives to prevent suicide in the military as "luxuries". Why, therefore, are initiatives designed to reduce the equally high maternal death and injury rates being so widely derided?
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honeybbq

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Re: So you are hiring a butler for a day?
« Reply #82 on: November 11, 2015, 02:21:06 PM »
regulator, I’ve got some legitimate curiosity over here, that I really hope you’ll answer. Why are you so wrapped around the axle over the existence doula’s? Nominally this thread is about your sister's financial choices, but she got dropped back on page one in favour venting your spleen all over an entire profession. It seems really out of proportion. What the heck?

I was wondering the same. Now a husband is a useless pile of garbage if you have a doula! Who knew?

honeybbq

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Re: So you are hiring a butler for a day?
« Reply #83 on: November 11, 2015, 02:22:46 PM »
It should have been:

From 1% down to about 0%.  The common case was still a perfectly healthy baby.

Survival rate is not the only valid end point of a study.

LadyMaWhiskers

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Re: So you are hiring a butler for a day?
« Reply #84 on: November 11, 2015, 03:00:57 PM »
how did we ever get to this point as a human race without doulas helping us give birth... holy cow OP this belongs on this wall.  these came about mid 20th century.  its a dumb luxury like everything else that we knock here. 

i mean anyone can sit there and make an arguement for cable TV or having your lawn mowed. 

a DOULA is a LUXURY ...

can't believe the amount of people standing up for such an extravagant expense.

To the contrary. The fact that the doula role is fulfilled by someone that the parents may have just met for this purpose and they are paying her money is the modern element. The idea that a female specialized in attending births stays with and helps a delivering mother for the entire duration of labor/delivery is part of the human birth process. The OP might light up on the lack of empirical validation for the following, but I'll go ahead.

If you polled 100 adults chosen randomly from all of human history/cross-culturally and told them that there is a society where the only person expected to attend the entirety of labor and delivery as a support person for the mother is the father of the baby, at least 99 of them would laugh their asses off, and once they came to would suggest that maybe this society should do the normal thing and have [some version of a doula] attend the birth.

This is not because dads are somehow useless or OB/GYNS are malicious, but rather that labor and delivery is quite an ordeal, and it's beyond reasonable to have someone on hand who has both been at lots of other births and also is not currently on a shift of their hospital job.

Also anecdotally: I had a doula at the birth of my son about a year ago and I would 1) do it again in a heartbeat, 2) recommend it to anyone who asked, 3) happily pay for it for any friend or relative who could not afford it. I had a long labor and feel confident that I would have delivered surgically if not for the doula.

It's like this: you're 8-9 months pregnant (which itself is quite an ordeal) and you learn that any day now, someone will lace your drink and you will be on an acid trip. It may be a good trip or a bad trip, but you'll have to spend it in a hospital room with medical authority figures and bleeping machines in abundance. The medical authorities may try to give you drugs or take you to surgery. Due to this particular strain of acid, you'll also feel like you have food poisoning and kidney stones at the time. You can either a) bring along your husband and expect him to get you through this alive or b) pay $600 to have someone who deals with this sort of thing once a week come with you. What do you chose?

Rezdent

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Re: So you are hiring a butler for a day?
« Reply #85 on: November 11, 2015, 08:23:58 PM »
how did we ever get to this point as a human race without doulas helping us give birth... holy cow OP this belongs on this wall.  these came about mid 20th century.  its a dumb luxury like everything else that we knock here. 

i mean anyone can sit there and make an arguement for cable TV or having your lawn mowed. 

a DOULA is a LUXURY ...

can't believe the amount of people standing up for such an extravagant expense.

To the contrary. The fact that the doula role is fulfilled by someone that the parents may have just met for this purpose and they are paying her money is the modern element. The idea that a female specialized in attending births stays with and helps a delivering mother for the entire duration of labor/delivery is part of the human birth process. The OP might light up on the lack of empirical validation for the following, but I'll go ahead.

If you polled 100 adults chosen randomly from all of human history/cross-culturally and told them that there is a society where the only person expected to attend the entirety of labor and delivery as a support person for the mother is the father of the baby, at least 99 of them would laugh their asses off, and once they came to would suggest that maybe this society should do the normal thing and have [some version of a doula] attend the birth.

This is not because dads are somehow useless or OB/GYNS are malicious, but rather that labor and delivery is quite an ordeal, and it's beyond reasonable to have someone on hand who has both been at lots of other births and also is not currently on a shift of their hospital job.

Also anecdotally: I had a doula at the birth of my son about a year ago and I would 1) do it again in a heartbeat, 2) recommend it to anyone who asked, 3) happily pay for it for any friend or relative who could not afford it. I had a long labor and feel confident that I would have delivered surgically if not for the doula.

It's like this: you're 8-9 months pregnant (which itself is quite an ordeal) and you learn that any day now, someone will lace your drink and you will be on an acid trip. It may be a good trip or a bad trip, but you'll have to spend it in a hospital room with medical authority figures and bleeping machines in abundance. The medical authorities may try to give you drugs or take you to surgery. Due to this particular strain of acid, you'll also feel like you have food poisoning and kidney stones at the time. You can either a) bring along your husband and expect him to get you through this alive or b) pay $600 to have someone who deals with this sort of thing once a week come with you. What do you chose?
+1
The only thing that I could add...
While you are on this particular acid trip with all of its discomfort and pain, your lady parts will be on display, at the moments when you are really undergoing a transformation, and it is immaterial to others whether you are shy,  vulnerable, or insecure.

regulator

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Re: So you are hiring a butler for a day?
« Reply #86 on: November 11, 2015, 09:26:30 PM »
I think it's one of those things that comes down to having data (from studies and such).

Studies show they improve outcomes.  That's pretty clear.  That means they probably also save money.

It's kind of like education, or free breakfast at schools, or drug intervention, or prison training or...???

You may have an inherent bias about the topic, and the money.
"Parents should feed their own kids"
"I never went to preschool so it's not necessary"
"You made your bed, so lie in it"
etc etc

But in these and many other cases, studies, and statistics, show positive outcomes.

If spending "X" on free breakfast means that you save "Y" because kids pay attention in school, get degrees, and have better outcomes, then it's worth it, especially when Y > X.
If spending $600 on a doula means that you have a vaginal birth instead of a C-section, then you are saving $10k or more.
If paying "A" for preschool for underprivileged kids saves you "B", and B>A, then it's worth it.

Sometimes it's important to take a step back from personal biases about whether something seems necessary, or fair, and instead look at the numbers and actual results.

And all I said was that the skinny data presented does not appear to be convincing, at least to me.  Hey, it is your pocket book/orifice/life.  If it is really out of your pocket and not mine (via tax dollars, insurance coverage, etc.), have at it.  I am not convinced of the efficacy of having a birth butler, at least from what has been presented here.  Show me a large population study with good controls and I could change my mind.  Instead I get told "fuck you too,"  labelled a troll, etc.  It does not take a genius to see where the biases of the shrill squealers here lays.

Argyle

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Re: So you are hiring a butler for a day?
« Reply #87 on: November 11, 2015, 11:50:15 PM »
When I saw that the OP labelled people who explained the value of a doula "shill squealers," I actually laughed out loud.  Okay, I get it now.  Troll.

Cressida

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Re: So you are hiring a butler for a day?
« Reply #88 on: November 12, 2015, 12:33:34 AM »
baby producing vessel

It says a lot about the current state of affairs that I did not immediately grok that this was tongue-in-cheek.

Cressida

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Re: So you are hiring a butler for a day?
« Reply #89 on: November 12, 2015, 12:44:38 AM »
Show me a large population study with good controls and I could change my mind. 

aka "a study without any dirty poors because who cares about them"

arebelspy

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Re: So you are hiring a butler for a day?
« Reply #90 on: November 12, 2015, 12:48:58 AM »
MOD NOTE: This thread has run its course.  Trolling being dealt with.  Locking thread. Cheers.
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