Stuff You Should Know - Selects: The Deal With Doulas

Episode Date: March 29, 2025

The word doula in Ancient Greek might mean "female servant" but it's really not a great description of the 21st century job. Doulas are birth coaches who help women get through the process of childbirth as efficiently and painlessly as possible. They aren't midwives or nurses, but they can provide an invaluable service as advocates. Learn about the deal with doulas right now in this classic episode!See omnystudio.com/listener for privacy information.

Hey everybody, Chuck and Josh here and I was recently a guest once again on one of my favorite podcasts. It's called The Puzzler with old pal and friend of the show AJ Jacobs. AJ gives really fun and funny word puzzles to guests like me, like Ken Jennings, like Dax Shepard and hopefully like Josh because he would be so great on this show. Yeah, it's definitely on my to-do list. Oh, you got to be on it. It's a lot of fun.

It's sort of like Wordle or Connections, but for your ears. And I think we should play everyone just a little clip. It's a puzzle that I have to convert movie titles from the metric system back to their actual title. Oh, wow. From my second appearance on the Puzzler right now. Nice. All right, so I'm gonna give you a title of a movie

and you have to reconvert it to the Imperial system. All right. This is going to be great. Here we go. The green 1.6 kilometer is... I would say it's the green mile. Exactly. The green mile.

Yeah, yeah. So subscribe to The Puzzler with AJ Jacobs to tease your mind and tickle your funny bone. I am Bob Pipman, Chairman and CEO of iHeart Media. I'm excited to introduce a brand new season of my podcast, Math and Magic, Stories from the Frontiers of Marketing. I'm having conversations with some folks across a wide range of industries to hear how they reach the top of their fields and the lessons they learned along the way that everyone can use. I'll be joined by innovative leaders like Chairman and CEO of Elf Beauty, Tarang Amin.

Legendary singer-songwriter and philanthropist, Jewel. Being a rock star is very fun, but helping people is way more fun. And Damian Maldonado, CEO of American Financing. I figured out the formula, I just have to work hard, then that's magic. Join me as we uncover innovations in data and analytics, the math, and the ever important creative spark, the formula is you have to work hard, then that's magic. Join me as we uncover innovations in data and analytics, the math, and the ever important creative spark, the magic.

Listen to Math and Magic on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. So what's the deal with doulas, everybody? That's my question to you on this wonderful Saturday morning. This one goes back to December 12th, 2017. Dulas do great work. They're wonderful people and they bring babies into the world.

So I hope you enjoy The Deal with Dulas. Welcome to Stuff You Should Know, a production of iHeart Radio. A production of iHeartRadio. Hey, and welcome to the podcast. I'm Josh Clark, and there's Charles W. Chuck Bryant, and there's Jerry over there. And this is Stuff You Should Know, the podcast. Childbirth edition. Yeah, we are traipsing into more territory.

What does that mean? I don't know. I mean, we've done two on into more territory. What does that mean? I don't know. I mean, we've done two on, you know, feeding babies. Yeah. Done female puberty. Yeah. Uh, this will, this will get into childbirth a little bit. So yeah, I, we're not afraid.

I don't care. Yeah. I guess is what I'm trying to say. You can be a male doula. You can, although I, this is the only article I ran across that in. Did you find anything about that anywhere else? No, I mean, it happens.

It's just super rare. It happens. Because, I mean, we'll go ahead and spoil it. Generally, doulas are, well, let's just get into this. Generally, doulas are women who have already had a baby Yes, not even just women but women who have had a baby so they can really know how to help another lady Have a baby. Yeah. Yeah, and this is actually so this this is an ancient thing That's kind of come back around full circle and even the name doula is a Greek term

used way back in the classical Greek days When a woman giving birth would have female servants attending to her during birth helping her with it Probably feeding her some grapes waving palm fronds on her that kind of thing so doula means female servant or female slave depending on who you're talking about. And after ancient Greece fell, a little Rome and the Roman Empire fell, and all of civilization took this weird course. Throughout it all, women were helped by other women while they were giving birth, basically up until about the first third, first half of the 20th century in the West, where hospitals entered. And all of a sudden, it was just the mom giving birth surrounded by a bunch of nurses and doctors.

Is that true? Yeah. Because I could see scenarios where there were women in the birth room helping along. I think once you started to get into hospitals and the physicians in the hospital starting asserting their authority more and more, especially through drugs, like I saw that when hospitals kind of took over the birthing process or took responsibility for it from the family and from midwives and moved it into the hospital,

they used to administer a lot of sedatives as part of the birthing process, as part of labor. You could understand why they would, but then there were all sorts of complications from it, problems from it. So they stopped giving sedatives as much. And about that time, women who were giving birth started to like kind of come out of it and look around and say, Whoa, it's just me and you guys in here.

I need some family members in here. Right. And at the time, like if you were a dad, you were not in there. You were not in the delivery And at the time, like if you were a dad, you were not in there. You were not in the delivery room at all. You were out in what was called the Stork Club, handing out cigars, maybe pacing. And the reason why was because to the doctors involved, it was just another medical procedure, right? So you're not going to have randos who have nothing to do with the actual procedure in the room during a procedure.

They treated childbirth the same way. But women started to say, no, I need more than just you people who I've never met before, really, attending to the birth of my child. And so dads started to come in and then more family members. And then now doulas have definitely kind of come back like they were originally. That's my understanding of the whole thing. Yeah, so doulas, we haven't even said what that is yet, and that would probably help clear it up if you don't know.

Doulas are people, like we said, generally women, but not always, who are childbirth coaches. They coach you through the process. They will, depending on the service they offer, will come on before, obviously, you give birth and kind of prep you for what's going to happen. And this, I mean, it kind of depends on when your doula will come aboard in the process. But at the very least, they will help you in the delivery room and they are your advocate

to kind of coach you through this whole thing. And that term actually started in an article in 1969 by a woman named Dana Raphael and then later on in a book in 1973 called The Tender Gift Breastfeeding. And that's when she brought this term back and said, you know, we're going to start calling these women doulas and it's going to be a real job. Right. And, and I think at first what was the name of the woman who brought it back? Dana Raphael. So she had like a pretty good idea that was actually ahead of its time when doulas really

started to come into use and come into their own as a profession was in the 80s. And the reason why they came into wider use was because hospitals were going to C-sections a lot. C-sections went up from 1970, 4.2% of live births in the U.S. involved C-sections. 16 years later in 1986, a quarter of live births in the U.S. involved C-sections. And there were a lot of complications with C-sections. And so you could have your husband in there, you could have your mom in there, you could have friends, but they're just there for you. One of the first services that doulas started offering was to say, whoa, whoa, whoa, does she really need that c-section? Are you sure about that? Or are you just doing it because you can charge more

money? I think that was overstating exactly the interaction they had, but that was the role they had, was to basically provide a barrier between a doctor who wanted to just give a C-section because he wanted to go home and the mom who really didn't want a C-section. Yeah, and it's not just C-sections. They're your advocate. They're your birth advocate to make sure, or at least as best they can, to try to ensure that the birth plan that you feel best about is the one that you end up with. Things always change, of course, and a doula would never put you in danger by insisting on something. In fact, they can't. But they are there to speak for you on your behalf because as a mother in labor

You're going through a lot on your own. So it's nice to have someone that is just there to do that job Yeah, and and is coming from a place of empathy and sympathy and most importantly experience Like you said most doulas have had children of their own But they've also after a while attended other births too. So they know what they're talking about. They know what to expect and they can tell you what to expect, which can make the whole process easier, I would imagine, for any mother giving birth. Yeah, it's definitely gained popularity in the 2000s. I think I tried to find more recent statistics than 2012 but I couldn't but in 2012 there

were 6% and this is in the United States. It's a, it's very much, I know it does happen all over the world some but it's sort of an American thing. Six percent of people in 2012 used a doula versus 3% in 2006. And in that same survey, 27% of people said they would like to use a doula. So, you know, at least they're wishing or hopeful that they can. Yeah, that was question eight.

Would you like to use a doula? Yeah. Yeah. 27% said. And so if you get the impression that like a doctor would not really prefer a doula to be in the labor and delivery room, you've kind of read between the lines there, especially at first, the medical community saw doulas as they were starting to really kind of come into use in the 80s as basically meddling busybodies who could potentially put their patient's life in jeopardy, right?

But then in 1992, the DULAs of North America was founded, DONA, it's like the first DULA licensing body, certification and training and licensing body. And they were founded, it was founded by medical professionals, which kind of created a bridge. It bridged the gap or kind of got smoothed over the rough feelings between the medical community and the doula community. And it also added a real air of legitimacy to the profession of being a doula.

Yeah. And the impression I get now is that if you have a good doula who is good with people, which is ideally what your doula is, if your doula is not a people person, it's probably not going to be a good thing. But the idea I get is that doctors and nurses like having doulas there now because they can just concentrate on, they don't have to be the ones providing emotional empathetic support, although they can still do that if want they can Just concentrate on the medical aspects of it and they know that they have a trained Hopefully licensed doula and we'll get into that later

On hand to sort of say you know what I don't have to deal with that part of things You're in good hands with this doula and I can just concentrate on the medical parts. Yeah. Now all love doula. That's right. One of the other reasons or functions that doulas provide you kind of hit on is that they provide a service that hospitals used to provide through nurses, right? Where if you had a nurse in a labor and delivery room,

they wouldn't spend as much time or give you as much attention as say like your mom would or a friend or your husband even, but they gave you a lot more early on than they did as surveillance of patients moved to electronics, right? To where somebody could just kind of sit at the nurse's station and check on everybody

and they didn't have to go into the rooms. And now you nurses were charged with watching even more people at once, right? So the personal attention dropped dramatically as electronic surveillance of patients increased and the doulas kind of came in to fill that role as well. You know, like they're sitting in the room with you and hanging out. They don't get called in like 20 minutes before you give birth.

They're with you, you know, sometimes days and weeks beforehand coaching you on what to expect and how you're gonna go about this and what your plan is. And then on the day, like even if dad is in there and the husband is in there providing support, that's great. But the doula is just that extra step and that extra measure of support that is super knowledgeable about what it's going to be like where the husband might not exactly be

able to lend the most insightful ear there. You know what I mean? Yeah. So you want to take a break? Yeah, let's take a break and then we'll come back and talk about what to expect when you're expecting to work with a doula. Imagine you're scrolling through TikTok, you come across a video of a teenage girl, and then a photo of the person suspected of killing her. And I was like, what?

Like it was him? I was like, oh my god. It was shocking. It was very shocking. I'm Jen Swan. I'm a journalist in Los Angeles, and I've spent the past few years investigating the story behind the viral posts and the extraordinary events that followed. I started investing my time to get her justice.

They put out something on social media so I'd get calls in the middle of the night all the time. It's like how do you think you're going to get away with something like this? Like you killed somebody. It's the story of how and why a group of teenagers turn to social media to help track down their friend's killer. This is their story. This is my friend Daisy. Listen to My Friend Daisy on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. Have you ever wondered if your pet is lying to you? Why is my cat not here? And I go in and she's eating my lunch. your podcasts. have answers for you in the new iHeart original podcast, Science Stuff. Join me, Jorge Cham, as we tackle questions you've always wanted to know the answer to about animals, space, our brains, and our bodies. Questions like, can you survive being cryogenically frozen? This is experimental.

This may never work for you. What's a quantum computer? It's not just a faster computer. It performs in a fundamentally different way. Do you really have to wait 30 minutes after eating before you can go swimming? It's not really a safety issue. It's more of a comfort issue. We'll talk to experts, break it down, and give you easy to understand explanations to fascinating scientific questions. So give yourself permission to be a science geek and listen to science stuff on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Prohibition.

It's no secret that banning alcohol didn't stop people from living it up in the 1920s. When we're five years into prohibition, the government is starting to go, OK, this isn't working. In fact, you might even say it backfired spectacularly. I'm Ed Helms. And on season three of my podcast, Snafu, we're taking you back to the 1920s and the tale of formula six because what you probably don't know about prohibition is that American citizens were dying in massive numbers due to poisoned liquor and all along an unlikely duo was trying desperately to stop the corruption behind it. They were like superhero crusaders turning the page on a system that didn't work,

wasn't fair, and was corrupt. So how did prohibition's war on alcohol go so off the rails that the government wound up poisoning its own people? To find out, listen and subscribe to Snafu on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. All right, so here's a misconception. Some people get Some people think that doulas are are authorized or trained to give birth That is not true. They don't deliver babies

They don't perform any sort of medical procedures. They don't put an IV in your arm. They don't work the heart rate monitor Most times they don't even work for the hospital you have hired them independently and again And again, they're just there to coach you. They're not even midwives. Midwives can deliver a baby. Right, yeah, they're not allowed anywhere near the medical stuff. But they need to know what the medical stuff is so that they can say, well, this is what they're about to do, or this is what they're suggesting right now,

and here are your options. And then also, when they're administering the medical stuff, which can be pretty uncomfortable pretty frequently, I would imagine the doula is there to kind of tell the mom what to expect and to comfort her in all sorts of ways. Yeah, and maybe not even offer advice. Like I think the idea is that a doula will lay it all out there so you can make an informed decision Right and not necessarily say well if I were you this is what I would do well Yeah, that's it

That's a slippery slope right there because then all of a sudden if things go wrong you can say well the doula told me To do that and the doula is like I'm toast Doulas have to be great listeners We already talked about the the empathy piece have to be great listeners. We already talked about the empathy piece. They have to be very empathetic. And they will, like I said, start meeting before birth to answer any kind of questions, come up with that birth plan, and really listen a lot to the wife and the husband. So, everybody is on the same page. And like I said, on the day, things

can change. but going in you generally want to have a pretty good idea of everything from medications you might want to use, if any, to where you want to have the baby. The doula can come on board and kind of explain if they're knowledgeable, which hopefully they are, about the the hospitals around you and maybe even help you pick out where you're going to give birth. Yeah. And, I mean, if you already have an idea of what you want, the doula can, you know, kind

of tell you how to make that happen. Or if you have no idea what you want, the doula can also tell you some other alternatives that you might not have thought of. And I saw a Parents Magazine article about doulas. They laid out what, basically what you can expect from the average doula for the doula's fees. One to two in-person prenatal visits, and then access to the doula for follow-up questions through email or phone calls.

Their full attention and presence during your labor, and then sometimes frequently I get the idea, a follow-up visit in your house after the baby comes home. That typically if you hire a doula, this is about the average you can expect to him. There's definitely a lot of differences. Some will give you a little more, some will give you a little less. Some will charge more, some will do it for free. It's just all over the place as far as what you're actually going to shell out and what you're going to get from a doula.

But for the most part, the doula is going to have met you before you give birth and then the doula will be there throughout the whole labor and delivery process. Yeah, and it says in this article that there are specialist doulas like antipartum doulas and postpartum doulas and labor doulas that if you want an antipartum doula to be, if you want more than those two meetings, you might want to hire someone who will be with you for several weeks beforehand. Or if you want someone postpartum to be with you to coach you through breastfeeding or you know, changing diapers or just any of that kind of coaching, you can hire someone

to do that. But I get the sense that doulas generally will sort of work with you on whatever kind of plan you want. Right. sort of work with you on whatever kind of plan you want. Right. It may cost a little extra, but I get the sense that a doula wouldn't say like, nope, you get two meetings and that's it.

They might be like, no, I'll come in for a third and fourth meeting. It'll be an extra of this much money. And I can hang with you for a week or two afterward here and there. I found, I think it was through a Buzzfeed article, I stumbled upon a, there's a huge rift in the doula community actually

between the typical traditional approach to being a doula, which is I'll work with you on a sliding scale for how much you can afford, or this is my fee, but I'll throw in an extra visit just to make you feel like you you feel like you're getting your money's worth or I'll do it for free. Yeah, I just want to help you because Dona's mission is that a doula for every, every mother who wants one, like every mother should have a doula basically, right? And then there's this other group called Pro douDula, and they can't stand Dulas who charge less than like a decent amount for their services, or do it for free. They actually call

Dulas who do this for free oxytocin vampires. Like they're just there to to bask in the reflective glow of this amazing experience that the mother just went through, the parents just went through. And they're really kind of kicking other doulas around and they're kind of bullies in a really weird way. But there's like this big debate over whether doulas are undervalued or underselling themselves. But I mean, I definitely get the idea

that every woman who wants to have a doula should be able to have a doula regardless of her income. That makes sense to me. Pro bono for people that don't have as much money. Yeah, on the other hand, I also get that if you are a doula and you're doing your job really well that yeah, you should expect to be paid I think there's a happy medium. I don't think it has to be like nope This is the price and anybody who goes underneath it should be ostracized from the doula community Yeah, the other thing about doula is another misconception

a lot of people think is that it's just some hippie-dippy thing that if you don't want to, if you only want to have like a natural childbirth, then you get the doula in there and they're not there for anything other than that. And that's not the case. They are there to support you in whatever kind of birth you want to have, whether it's a home birth or water birth or whether or not you want to get an epidural or be loaded up on every pharmaceutical they offer mothers in labor. They're there just to have knowledge of all that stuff so you know what you're getting into.

Yep. And then so during labor, this is where the doodle shines, right? They're there to help with alternatives to pain treatment, right? So again, they can't administer any kind of drugs or anything. I would guess that they could even get in trouble for giving you an Advil. Um, but they can do other things like they can, um, massage you in ways that you had not ever heard of before that helps with labor pain. I came across this one technique where they pull on a couple of toes, specific toes, and it helps actually move the labor along if you have a slow labor.

There's kneading techniques, there's stroking techniques, pressure on the bottom of your feet. There's all sorts of stuff they can do at various times throughout the labor and delivery process that can help alleviate the pain that you're going through. And that's one of the big roles that they play during labor. Yeah. When my kid was born, it was, I was shocked at how many people were in the room, first

of all. How many? Oh, man. Baker's dozen? I mean. 20? Emily and I? Birth mom. Mm-hmm. Obviously. I mean, Emily and I, birth mom, obviously.

Our adoption counselor, who was a licensed doula, so she really served that function for the birth mom, which was really a great, great plus. The doctor, I guess the, I'm not even sure what the roles are, what their technical titles are, but the doctor came in when it was go time and basically just checked things out and said, well, I think it's go time. And then he stepped out of the way and these two nurses came in there and 90 seconds later, there was a baby. Wow.

So it was, and those were, so it was two nurses. That was probably like, there was probably at least 12 people in that room. Wow. So it was, and those were, so it was two nurses, there was probably like, there was probably at least 12 people in that room. Wow. That's a lot of people. It was crowded and fast and surreal and weird and amazing. Even weirder they brought in Carrot Top to cut the cord, right? No, Emily cut the cord. Okay, cool.

Emily actually helped sort of deliver in a way, because they like to bring in, I guess, in a regular biological birth, it would be the husband probably in there saying, hey, do you wanna help hold the legs or do whatever? In this case, it was Emily. And I just took a respectful position by the birth mom's head, sort of looking down that way.

I was like, you know, she was like, you can go wherever you want to go, but I was like, you know, I'll just hang right here. Right, and Emily's like, that's right. Yeah, I wanted to be there, and I was helping support her as well. Holding her hand and patting her on the head and all that nice stuff.

That's cool, man. Yeah, it was amazing. Did I ever tell you the story of when my niece Mila was born and my sister-in-law was giving birth and she let everybody in the labor room? I was surprised you can have a party in there. Yeah, and when she really was going into, she was delivering, I stood back behind this curtain, right? And the doctor comes in and walks past me and kind of gives me a nod and I hear him go to the crowd. He's like, you know, there's like some guy standing behind that curtain, right?

Like, yeah, he's supposed to be there. That was pretty funny. He's the, he's the ward creeper. Right. Exactly. I'm like, okay, I've heard enough here. I'm going to the next room All right. Well, let's take another break Now that we've shared our stories. Mm-hmm. We'll come back and talk a little bit about how you become a doula right for this

Imagine you're scrolling through TikTok, you come across a video of a teenage girl, and then a photo of the person suspected of killing her. And I was like, what? Like it was him? I was like, oh my god. It was shocking. It was very shocking. I'm Jen Swan. I'm a journalist in Los Angeles,

and I've spent the past few years investigating the story behind the viral posts and the extraordinary events that followed. I started investing my time to get her justice. They put out something on social media, so I'd get called in the middle of the night all the time. It's like, how do you think you're gonna get away with something like this?

Like, you killed somebody. It's the story of the night all the time. It's like, how do you think you're going to get away with something like this? Like you killed somebody. It's the story of how and why a group of teenagers turn to social media to help track down their friend's killer. This is their story. This is my friend Daisy. Listen to My Friend Daisy on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts.

on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. Have you ever wondered if your pet is lying to you? Why is my cat not here? And I go in and she's eating my lunch. Or if hypnotism is real? You will use this suggestion in order to enhance your cognitive control. But what's inside a black hole? Black holes could be a consequence of the way that we understand the universe. Well, we have answers for you in the new iHeart original podcast, Science Stuff. Join me, Jorge Cham, as we tackle questions you've always wanted to know the answer to

about animals, space, our brains, and our bodies. Questions like, can you survive being cryogenically frozen? This is experimental. This means never work for you. What's a quantum computer? It's not just a faster computer. It performs in a fundamentally different way. Do you really have to wait 30 minutes after eating before you can go swimming? It's not really a safety issue. It's more of a comfort issue.

We'll talk to experts, break it down, and give you easy to understand explanations to fascinating scientific questions. So give yourself permission to be a science geek and listen to science stuff on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Prohibition. It's no secret that banning alcohol didn't stop people from living it up in the 1920s. When we're five years into Prohibition, the government is starting to go, okay, this isn't working.

In fact, you might even say it backfired spectacularly. I'm Ed Helms, and on season three of my podcast, Snafu, we're taking you back to the 1920s and the tale of Formula 6. Because what you probably don't know about Prohibition is that American citizens were dying in massive numbers due to poisoned liquor, and all along an unlikely duo was trying desperately to stop the corruption behind it. They were like superhero crusaders turning the page on a system that didn't work, wasn't fair, and was corrupt. So how did Prohibition's war on alcohol go so off the rails that the government wound up poisoning its own people?

To find out, listen and subscribe to Snafu on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. All right, Chuck. So if you wanted to become a doula, basically you start in training at age three, you're sent off to Europe to apprentice at the one doula school in the world, and they make you eat a lot of magic cake. And then when you're 60, you get to actually start out on your own. That's exactly right. Okay.

Well, before you decide to become a doula, you need to get a lot of thought on what you're going to be getting into. The hours are long at birth, childbirth is very stressful, and especially if there are complications, it can be super stressful in a matter of life or death. So you've got to be able to deal with that stuff in the moment and hang in there and be the birth coach that mom needs, you know, in the most stressful of situations. But then on the plus side, you get to see little babies coming out on the reg. And what's better than that, you know?

I can't think of too many things. Talk about an oxytocin hit. Maybe magic cake. Magic Cake? You do not have to have a college degree, you don't have to have a high school degree. However... You don't even have to be certified. It's not law that you have to be certified.

Yeah, you don't, but there are more and more programs now and more certification and licensing programs out there. So if you want to be a doula, my advice is to go that route. You probably just get more work that way. Right. So when you're starting out, you would go to, if you wanted to get certified, you would go to one of the certifying bodies like Dona or what are the other two that are mentioned in here? There's one called CAPPA. CAPPA.

CAPPA? Sure. And then the American Pregnancy Association, all three of those certify and train doulas. From what I could tell, is the oldest obviously, it was the first one. And it seems to be the most respected, but I would guess if you get your training from any of those three, you're probably doing pretty good. They'll offer online classes, in-person classes, self-paced study, and you typically need to go take a birthing class, a breastfeeding class, because again, you need to know, like,

you need to be current on all the stuff that's going on with labor and delivery, right? If you took these classes 10 years ago and then did it again today, you would probably find some real differences in new stuff that's been discovered in the last 10 years. So you would need to be pretty current, even if you've had kids of your own before. And then you also need to attend at least one. I have the impression that multiple births under the apprenticeship of another doula who's already certified or trained or experienced before you really go off on your own to become certified.

And that's just, I would say how many births have you been a part of already before I hired a doula? That's a pretty big question if you ask me. So they would want to say, well, I've assisted in like three or five or however many, but you're going to be my first solo. Your first solo flight? Yep. It depends on where you live, on how much you're going to pay. If you live in a big fancy city like New York City, you're going to be paying top dollar

for your doula. If you live in Los Angeles, you're going to be paying top dollar for your doula. I saw like $3,500 at least for each of those cities. Yeah, but that scale can go all the way down to zero. Well, sure, all the way to 0, but if you're paying a doula, that number can go all the way down to $600 to $800, $1000 in the flyover states. Right. But again, I mean, if this is the doula's first time on their own, you're probably not

going to be paying top dollar. And if you say, look, I really, really, really want to have a doula at my at my child's birth, but I really genuinely don't have this money. I actually got a lift once from a doula. And she was talking about having to deal with this family who clearly was very well off, but was pleading poverty. And she was like, I'm the one who's a doula and driving a Lyft here, and these guys are trying to shortchange me. So she told them no. She said she tried to work with them,

but they wouldn't budge about whatever they thought her services were worth, so she had to just walk on. Why would a family that's well off not pay $800? I don't know. I don't know because I remember thinking like, wow, that's all it costs for a doula. She might have even been quoting them less than $800. Geez. Yeah.

So there is definitely like, there seems to be a tension between the desire to have a doula and the sense of non-obligation to pay a doula a decent wage which I think is where that pro-doula group pulls their hair out. Right. Yeah. Well, you may get it covered by insurance. There are more and more cases in insurance companies that will let something like this be covered. But it never hurts to ask.

This article points out you can always ask, you can always file a claim, and just see if you'll get a little assistance there. Yeah, if you live in Oregon and Minnesota though, Medicaid will reimburse your full doula expenses for a certified doula, which is pretty awesome. Like that's huge and groundbreaking that those two states have that. For sure. The reason why they would pay anything for a doula

rather than just being like, just burn some sage or something and spend five bucks is because there has been studies about doulas and they have come out quite positive in some pretty good peer-reviewed studies and peer-reviewed journals, right? Have you seen any of this? Well, yeah, I saw the one, 15,000 people, that's a pretty decent study size.

And they said in this study size, there were some women who had doulas and some women who did not have doulas or any kind of support like that And then outcomes for women with continuous support were better than those without meaning their labors were shorter by about 40 minutes on average their babies had higher apgar scores which Apgar these tests they give your baby like the first thing your kid has to do is take a test No seconds later. They're thing your kid has to do is take a test. I know. Seconds later, they're giving your kid their first test. Yeah, activity, pulse, grimace, appearance,

and respiration. That's right. Yep. And so, higher APGAR scores, fewer negative feelings about childbirth, like this is the emotional component, they required less pain medication, fewer uses of forceps or vacuum assisted interventions,

C-sections. Across the board, doulas helped. What was really interesting was there was basically nothing that could point at that said having a doula was a negative in any way. Yeah, and even when they looked just at doulas rather than just all types of continuous support, just at doulas, the doulas, they held up to there was less use of pitocin, less C-section, more spontaneous vaginal deliveries, less of a risk of being admitted to a special care nursery, four times less likely in one study to have a low birth weight child, two times

less likely to have complications, and they were significantly more likely to initiate breastfeeding when cared for by a doula, right? So there's all these like demonstrably positive outcomes. And then you hit upon the other thing too that they make the harsh hospital environment, there's something called harsh environment theory, where the bright lights and the people you don't know coming in and out and treating you like a piece of meat that they need to get this thing out of,

they can actually produce a traumatic experience. I suspect in more women than you would think, having birth or giving birth in a hospital is kind of traumatic. And for some women from what I read, it's like deeply traumatic. And that's been a huge reason that doulas have really come into use lately

is because they mellow everything out for you a lot more. And there's actually, I read there's a group of renegade doulas who are acting as midwives out in the pot growing country of Northern California. Oh yeah? What's the relationship there to the pot growing? I would guess they probably do both.

They grow the pot and deliver the babies. I think it's kind of like a whole back to the earth to hell with the the man's establishment hospitals Apparently it's illegal to give birth like this without like a certified Someone from the medical community being there to assist in the delivery Yeah, they're saying nuts to that which I would guess is pretty dangerous, but also illegal and If there's anything that screams Northern California more than dangerous and illegal, I don't know.

Yeah. If you want to use a doula and I'm officially endorsing this, I say don't say don'ta, say doula. Sorry, I couldn't resist on that one. You just get online, you know, the doulas are easy to find in your area. Do a little Google search in, get a reference, a personal reference if you can would be great. Get online, find a friend who has used a doula they can recommend. I mean, that's really the best way.

I don't know if I'd go on Yelp or anything like that or Angie's List. Although, maybe, who knows? Yelp or anything like that or Angie's List. Although maybe, who knows. But it's better if a good friend says, hey, I use this doula and she's great. I think also the certifying bodies have directories of certified doulas in areas too. Yeah, I mean you want it to be a good personality match too. So you should talk to your doula on the phone at the very least, but ideally have a little

in-person meeting to make sure like, is this someone I want to jump into the foxhole with because they're going to be around a lot, you know? And you have to have a good personality match there. Well, yeah, and your husband or co-parent needs to like them too. You don't want weird tension between those two in the delivery room.

True. They need to fit into in the delivery room. True. They need to fit into your jam pretty well. Yeah. Or else it's just going to be, especially if you're one of those people who can't stand conflict, that would be awful to have a doula who your husband or co-parent or wife or whoever doesn't like and butts heads with in the delivery room. That would just be bad. And then you have to pay them afterward.

That would just be terrible. So, yeah, you want to vet them pretty well ahead of time. Yeah. And while a doula is there to support you, so while they may have their own opinions on what they might do in a given situation, their childbirth philosophy is, your childbirth philosophy as a mom is what matters. You know, so a good doula will get on board with that. Or if they aren't on board with that, then they probably shouldn't be working with you.

And yeah, I could see them being like, look, I can recommend a couple of other people who are more in line with what you're looking for than me. You know? Yeah. Instead of wrong, wrong, wrong. This is all wrong. This is how we're going to do it. That's right. Uh, you got anything else on doulas? Uh, just this little bit on death doulas. We may have covered this in our, geez, in our dying episode. Yeah, that's what I was thinking. I feel like we've talked about it,

but it is a job. Um, if you want to help a family or a person or both through end of life care, there are people you can hire just to do that. And it's not the same as, they can work in concert with hospice care, but it's not like a hospice nurse. It's someone just like a birth doula who is there to really just emotionally kind of coach you through through the dying Process with a family member and also to do very concretely hold your hand make sure you're comfortable Yeah, move you around a little bit listen to you talk tell you stories whatever you're looking for to make the whole thing better

That's right. Pretty pretty neat Up with doulas.. Yeah, Up with Doolas, agreed. If you want to know more about Up with Doolas, this new organization that Chuck and I just now founded, you can, I'll just wait a little while. We need to get to work on the website. And in the meantime, let's listen to some listener mail. All right, I'm going to call this flu shot clarification because that's what the subject line says. Okay.

Hey guys, Avid listener wanted to comment on the flu episode. I'm a graduate student and a few months away from completing my degree to becoming a physician's assistant. Well, never mind then buddy, I don't want to hear it. No, I'm just kidding. I spend a lot of time seeing patients, answering questions about things like flu shots and who should receive them. The CDC now recommends that everyone over the age of six months receives a flu shot.

Even those who are perfectly healthy, even those who are allergic to eggs. They're cuckoo for flu shots. The new flu shots are now being designed to be egg-free. So they're egg-free, gluten-free. What else? Dairy-free. They contain 10% quinoa. And there's no evidence to suggest flu shots in recent years could cause a reaction in those allergic to eggs. Alright, that's interesting. Did not know that.

He said the benefits of the flu shots far outweighed the risk in his opinion. This guy's opinion? Yeah, and it sounds like it's an informed opinion at the very least. Sure. So that is from Devin from Philadelphia. Go Eagles. He thinks so really? Yeah, I mean, why not? They're doing great. Okay. Well, thanks a lot, Devin. I appreciate writing in. That was nice of you. And if you out there want to be like Devin, you can hang out with us on email at stuffpodcast.howstuffworks.com. And as always, join us at our home on the web, stuffyoushouldknow.com.

Stuff You Should Know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, Apple podcasts, or wherever Hey everybody, Chuck and Josh here and I was recently a guest once again on one of my favorite podcasts called The Puzzler with old pal and friend of the show AJ Jacobs. Hey everybody, Chuck and Josh here, and I was recently a guest once again on one of my favorite podcasts. It's called The Puzzler with old pal and friend of the show AJ Jacobs. AJ gives really fun and funny word puzzles to guests like me, like Ken Jennings, like Dax Shepard, and hopefully like Josh

because he would be so great on this show. Yeah, it's definitely on my to-do list. Oh, you gotta be on it. It's a lot of fun. It's sort of like Wordle or Connections, but for your ears. And I think we should play everyone just a little clip. It's a puzzle that fun. It's sort of like Wordle or Connections, but for your ears. And I think we should play everyone just a little clip. It's a puzzle that I have to convert movie titles

from the metric system back to their actual title. Oh, wow. From my second appearance on the puzzler right now. Nice. All right, so I'm gonna give you a title of a movie and you have to reconvert it to the Imperial system. All right, this is gonna be great. Here we go.

The green 1.6 kilometer is... I would say it's the green mile. Exactly. The green mile. Yeah, yeah. So subscribe to The Puzzler with AJ Jacobs to tease your mind and tickle your funny bone. Hi, I'm Bob Pippman, Chairman and CEO of iHeart Media. I'm excited to introduce a brand new season of my podcast, Math and Magic, Stories from

the Frontiers of Marketing. I'm having conversations with some folks across a wide range of industries to hear how they reach the top of their fields and the lessons they learned along the way that everyone can use. I'll be joined by innovative leaders like Chairman and CEO of Elf Beauty, Tarang Amin, legendary singer-songwriter and philanthropist, Jewel. Being a rock star is very fun but helping people is way more fun. And Damian Maldonado, CEO of American Financing. I figured out the formula, I just have to work hard then that's magic. Join me as we uncover

innovations in data and analytics, the math, and the ever-important creative spark, the magic. Listen to math and magic on the in data and analytics, the math, and the ever important creative spark, the magic. Listen to Math and Magic on the iHeartRadio app, Apple Podcasts, or wherever you get your podcast. This is Mel Reed, LPGA Tour winner and six-time Lady Juvian Tour winner. And Kira K. Dixon, NBC Sports reporter and host. And we've got a new podcast, Quiet Please, with Mel. And Kira, we are bringing you spicy takes on sports and pop culture, some interviews with incredible

people who have figured out how to make golf their superpower. An I Heart Women's Sports production in partnership with Deep Blue Sports and Entertainment. You can find us on I Heart Radio app or wherever you get your podcasts. Presented by Elf Beauty, founding partner of I Heart Women's Sports.