Modern Doulas don't use doula bags...and here's why.

​I took my first doula training in 2001 with DONA. It's been a long time and about 400 births since that training and I don't specifically remember learning about doula bags there, however, it was always known that doulas carried big bags. This is my take on it.

Kind of like the mysterious bottomless bag toted by Mary Poppins. We had a plethora of tricks that could be pulled out and used as comfort measures.

I'm going to break this into 3 categories.  Common Items, The Problems With Them, and Alternatives to the Stuff in the Bag.
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Keep scrolling for the good, the bad, and the ugly on doula bags. I'll share my experience with these items and the last straw for why I stopped using them.

1. Common Items doulas think they should have...

• The infamous birth ball! Giant exercise balls and peanut balls
• Hot packs or rice socks
• Massage tools, maybe a tennis ball
• Massage oil
• Rebozo or birth scarf
• Bluetooth speaker
• Handheld fan
• Essential oils
• Honey sticks and other snacks
• Battery operated candles
• A lot of things I never used

2. WHat's the problem???

​These things sound fab right??? So why wouldn't you want to carry them to births?

NUMBER ONE CONSIDERATION - Blood, vomit, amniotic fluid, urine and stool are all common contaminants at pretty much EVERY birth.

• Birth Balls - obviously they are huge and bulky and awkward to carry everywhere. They are permanent residents in your home and car and have to be rolled around in a bathtub full of bleach water between every client.
  • Doulas with children can probably attest to them being played with like toys at home.
    • The last straw for me was my balls rolling around in the back yard (kids did it) and trying to carry them to the hospital for each client was a circus every time.
• ​Hot packs or rice socks - cannot be sanitized between clients - you cannot put a rice pack/sock into the washing machine because it's full of rice. You cannot simply wipe it or spray it with anything because it's fabric.
  • ALSO - taking anything off a person's body and using a microwave that is used to heat food is pretty darn gross. The nurse's do not appreciate this use of their staff microwave. Rice is also heavy, it adds up in that bag!
    • The last straw for bringing rice packs for me was having vomit splash on my favorite one at a birth. It suddenly became VERY obvious that this was a practice that had to end.
• Tennis balls and massage tools - Tennis balls and some massage tools must be disposed of as there is no way to sanitize them between births and I hardly ever used either.
  • ALSO - I felt like using an object to touch my clients, made me feel out of touch. 
• Massage oil or lotion - Massage oil  is messy. In Texas, we have very hot summers, it's common for temps to reach 105 degrees  and above. Even when capped and bagged, massage oil would often leak in my bag and get everywhere. 
  • ALSO - I hardly ever used it and oil sitting for long periods of time can go rancid. It can be slippery and cause an extra fall risk.
• Rebozo or birth scarf - I have a beautiful woven piece of fabric given to me by my dear friend who brought it back from Africa. It's a Tanzanian baby carrier.
  • Obviously, I didn't want to expose this lovely thing to repeated washings and ruin it. :(
• Bluetooth speaker - I can't think of any reason not to bring this
• Handheld fan - also a great tool
• Essential oils - Same issues as massage oils plus some. They are messy, leaving them in a hot car will compromise their integrity. Clients are very particular about brands and types of oils.
  • ALSO - Many people are forming sensitivities AND allergies to EOs. A couple of doula trainers I worked with have severe allergies to lavender... and I risk causing an allergic reaction if I every use my own EOs on clients. That's a risk I'm not willing to take.
    • The last straw - Having a charge nurse walk into the room, smell lavender and BOLT out. She too is allergic.
• Honey sticks and other client snacks - Honey sticks floating around in a birth bag are likely to get bent or break, making a huge mess... also going bad because of exposure to elements.
• Battery operated candles - can be useful but if they fall into a birth tub (has happened) they'll need to be tossed. Mine were sill made of wax and couldn't be sanitized.
  • The last straw - they melted together in my bag and were deformed. They are expensive to replace.
• A lot of things I never used - there's no point. Just adds to the bulk of the bag you don't need anyway.

3. Alternatives to these items...

• Birth Balls - Most hospitals and certainly birth centers have birth balls. Even the less progressive ones are getting in on this awesome tool.
  • Clients often buy them to keep at home anyway, have them put the ball in the car and in case the hospital doesn't have one, they can use their own. They are cheap and readily available from major retailers
    • Also - utilize the tools you do have! Learn how to work the hospital bed. Move it up, down, make it into a chair. The beds do AMAZING things for positions. Try having her sit on the toilet backwards. Use pillows instead of a peanut ball if there isn't one. They totally work just as well, you just need more of them.
• Hot Packs - The hospital will have disposable hot packs, just ask the nurses. They get tossed when we are done with them. They'll appreciate you not using their microwaves for dirty rice socks.
  • Also - you can make your own! You turn on the hot water, take a towel and soak it pretty good - wrap it in a chux pad so it doesn't get water everywhere and place it on mom's back or legs or where ever it feels good. These work better than you think they are going to and you get to teach the nurse a new trick!
• Massage tools - I found my best massage tools were my hands. I really prefer to touch my client directly. I can feel her energy better, her response to my touch better and was more connected to her than if I used an object.
  • ​Also - have your clients bring their own tools if they want. They may already have something, or a tennis ball, and they get to take it back home afterwards.
• Massage oil - Your clients probably already have a lotion they like to use at home. There is no reason for you to cart around oil when they can toss their own in their bag. No mess, no risk of allergy or sensitivity. 
  • Also - hospitals have lotion they can bring you if you need some.
• Rebozo or birth scarf - There is nothing that a special scarf does that a sheet cannot do. Take advantage of the tools that are already there. A sheet can be folded to the correct width and length for belly sifting, belly lifts, squatting or playing tug of war for pushing. It gets washed and sanitized by the hospital and you are not spending money on an unnecessary item.
  • Also - ask your client if she would like to purchase her own special scarf to keep after she delivers. It will have more meaning for her that way. She can also bring what she already has at home. 
• Bluetooth speaker - Most clients have these already and are happy to bring them if you simply put it on a list of items to bring to the hospital. If they don't, many simply play music directly from their phone. I do have a spotify subscription to avoid the crazy loud commercials during client labors. To me, that is more valuable than a speaker.
  • Also - bring a small one if you want! This shouldn't come into direct contact with your client and pose minimal risk for cross contamination... place it way out of the splash zone and be prepared to toss if it does get juicy.
• Handheld fan - This is also a tool that clients can pack and bring themselves. In a pinch we've used papers, clipboards, and wet washcoths to fan laboring clients with. She will usually only need this for a short period of time, commonly when pushing but an icy cold washcloth on the forehead and sips of icewater are usually great for this.
• Essential oils - This has become non-negotiable for me. If a client wants them, they need to do the research and bring their own carefully selected oils. EOs are potent and can cause burns if used incorrectly. (please never put undiluted oils on a client and never never in a labor/birth tub)
• Honey sticks/snacks - Clients are perfectly capable of bringing snacks for themselves. 
  • Also - Most hospitals have adopted the use of clear liquids during labor and happy to bring popsicles, jello, juices, and broth if mom wants it. 
• Battery operated candles - I don't have an alternative to this. But you can adjust the lights as desired in the room. Take inventory of what switch controls what while she takes a bathroom break so you aren't flicking lights on and off while she is relaxing. 
• All the other what nots... Just use your hands, heart and head and you REALLY won't need all the STUFF. 

In conclusion!

I used a doula bag for years!! It was bulky and heavy and full of stuff that I didn't really need. A few years ago, I remember RUNNING in the hospital with a 25 pound bag ... My client nearly delivered in the elevator. She barely made it. That bag was slowing me down, it was a false sense of security that I found I didn't need. I was elated when I finally summoned the courage to let it go. I had more confidence in myself after the decision was made. I don't miss the feeling that I needed to run home and get it before meeting a client for her birth. Letting it go was LITERALLY a weight off my shoulders.

That being said

• I always have a phone charger for myself
• A change of clothes in your car is a great idea
• I do use TENS units in my practice. I bring the unit to the client at our 37 week prenatal meeting and leave it with her. She is to put it on in very early labor (according to guidelines and best practice) and keep it in HER bag until after delivery when I use the hospital antimicrobial wipes to clean it and throw away the electrodes before taking it back
• I also keep a toothbrush and toothpaste with me or in my car (I've even asked the nurses for one because I felt yuck and needed to brush, so that's not even a total necessity)
• I like to have snacks if I think it will be a long birth but I'm familiar with which hospitals have what in their cafeterias and where the vending machines are (AND COFFEE)
  
• I like to have a refillable water bottle but also no biggie if I don't. Hospitals have endless water and ice.

i hope you enjoy your freedom from the bag!!
- happy birthing -
​Abbey