What you should know before interviewing a doula.

Finding the perfect support for you and your family is a must during pregnancy, birth and postpartum. When seeking out birth services, including care providers and assistants, you should be confident in those person’s abilities and comfortable with the standards they portray. You don't have to settle for a doctor you don't like, nor do you have to hire the first assistant you interview with. These people can become like a member of your family and you want them to be worthy of that honor.

Q

What are the costs for doula services?

A

No one is ever turned away! Competitive fees with payment plan options. Pregnancy, Labor & Birth Support Local $350.00 Distance $500.00 plus expenses Informational, Emotional, Physical and Advocacy Support. Birth preference plan, on-call 24/7 from 38 weeks to birth of baby, continuous labor support from time needed to recovery, postpartum meeting and birth story. Labor and birth photography optional. Postpartum support Local $15.00 an hour with a 10 hour minimum and a 6 week maximum. Distance Minimum cost $200.00 plus expenses for first 5 days of support, then $50.00 a day there after for a maximum of 14 days. Services include: Breastfeeding and baby care support, unlimited phone access, unlimited postpartum visits, light housekeeping and errands for at risk moms. This service benefits moms who need extra support because of birth or family circumstances. Childbirth Education Local $55.00 Distance $100.00 plus expenses 8 hours of Chilbirth Education taught in your home on your schedule. CBE handouts and assistance with birth preferance plan included. Fee applied to doula services if hired for doula support.

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Q

My husband doesn't see a need for another person in the room, won't the nurses be enough?

A

Your husband is right, it is possible for many people to come and go from your hospital room, however those working for the hospital have their own jobs to perform. The doula is the only person who is a constant presence during your labor and birth, she has no shift change, no paperwork and no other clients to care for. Your doula is the only person aside from your family that is there solely for your benefit. The nurses will have other patients to tend to, paperwork to do and will only be able to spend 20-50% of your labor in your room. Sadly with the other responsibilities such as charting and medical care, your nurse will not have time for comfort measures. This responsibility is left solely to the support people you choose to bring to your birth. The task of support and comfort can mean long hours of hard work and commitment. Whether you choose professional support or family support, the work of labor is not meant to be handled alone. Plan to bring your mother, a sister or best friend to assist you and your partner in your birth.

Q

How will my doula support me?

A

Doulas offer informational, emotional, physical and advocacy support. In pregnancy, I am available by phone and in person when you need me. I have research and information available to me for education and choices. I offer massage for physical comfort, help with sleeping positions, show you exercises to decrease pain and muscle aggravation and help to align your baby for an easier birth(Optimal Feotal positioning). A doula provides emotional support through pregnancy, over-date births,issues with anxiety and stress, and many, many more options. During labor and birth I am a constant presence once called upon, giving emotional support, physical support through massage, movement and positioning and encouragement to you and your family. For your postpartum visits, I will supply you with a story of your birth, offer breastfeeding help, help with managing a fussy baby and emotional support for those first few weeks with your new baby.

Q

If I choose an epidural how would a doula help me?

A

As part of your support team, I want you to make the decisions that are best for you and your baby. Once you have the information you need to make informed choices for your care then it is my job to fully support those decisions. The facts are, you cannot just walk into the hospital and get an epidural. Once you present in labor, your status will be checked, the nurse will check your dilation and effacement, the strength and timing of your contractions and your emotional state. If you are in very early labor, your cervix is dilated to less then 4 cm, the baby is still very high or your labor pattern is erratic you may have to wait for changes to receive an epidural. Epidurals are most effective when given between 4-8 cms. If you present after 8 cm your doctor will assume your progressing quickly and may want you to avoid an epidural because it can slow progress. Keeping all of this in mind, it is best if you labor comfortably at home until you are sure of your labor pattern, meaning contractions are 3-5 minutes apart and lasting for 60 seconds, your feel pressure in your back or bottom or your water breaks. Once at the hospital it takes 45 minutes or more for an epidural to be administered and pain relief to take effect. If there are others in need of an epidural or C-sections taking place you may have to wait longer. Once the epidural is in place the work is not over, you must be turned from side to side every half hour or so, you may have windows of pain, itching, chills, sweats or side effects that are more serious. When pushing starts it can take 1-2 hours longer with an epidural requiring more effort from mom and her support team. Because your doula is a constant support presence, whether at home, or the hospital, you will have other options at hand for pain management. You and your family will have emotional support and advocacy available to you. Having an epidural for birth doesn't take the hard work, emotional needs or physical comfort needs away. It does however mean you no longer have the means to manage these on your own and you have to look to outside support.

Q

I'm being attended by a midwife, won't she doula me?

A

It depends on where you are birthing. If at home, ask your midwife if she brings assistants with her. Some homebirth midwives bring assistants to help with support. A minimum of 4 people to support you would be appropriate, your partner, the midwife for your care, an assistant for the babies care and an assistant for your support. At home there is also the need for food preparation and cleaning. This needs to be done during the birth and after. If your midwife does not employ assistants, it would be worth your time to look into doula assistance. If your birthing at a birth center the a doula would be an important part of your birthing team. Some birth centers employ doulas so check into what your center offers. Even a midwife at a birth center cannot focus on comfort measures. She is responsible for your clinical management and may have to split her time between you and another client. For a hospital birth, a doula is quite necessary for support. You may have hired a midwife for your delivery but your birthing in the hospital. Hospitals are clinical places with rules and procedures. Your midwife will have other clients to tend to and will be working under an obstetrician. It would be beneficial for you to labor at home as long as possible if you want a low intervention birth and are planning on birthing in a hospital.

Q

My provider said a doula would cause tension and would prefer me not to have one, what should I do?

A

It is good to remember that you are the consumer. Your wishes should be honored, and if you wish to have extra support then you should have extra support. Doulas do not work against your care provider, they do not interfere with medical care and they do not ask you to go against your providers care. Doulas offer you solid evidence based information so that you can make informed decisions and informed refusal if that is the case. A patient who has questions requires more time and a busy provider may see that at a bother. A patient who wants lower interventions takes more time and energy and the provider may be too busy to comply. If you are uncomfortable or unhappy with the care your provider is showing you, you have the choice at anytime in your pregnancy to change to another provider. A good provider will welcome the chance to work with an educated patient and enjoy the presence of a doula during birth.

Birth As a Choice

Q

When should I hire an Assistant?

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Any time in pregnancy you feel, you need extra support, education, information or advocacy. It is generally a good idea to meet with your Assistant a couple times before your birth. This way you can build a relationship, talk about needs and wishes and work out a system that best supports you. I like to meet with my clients starting at 32-34 weeks and then have weekly contact, whether by phone or in person until birth. However, if you are high risk or have concerns you can contract doula support at any point in your pregnancy, even during fertility treatments.

Q

My partner is concerned about being pushed aside. Will a doula replace my partner or be overbearing?

A

On the contrary, all of the research has shown having a woman knowledgeable with birth actually helps both client and partner feel calm, relaxed and safe. A doula should compliment the relationship that exists between the partner and client. The doulas job is to ensure the partner participates as much or as little as they want. The doula should never interfere with Partner support. I have enjoyed helping several couples in birth and my greatest joy is witnessing the bond that creates itself in such intimate moments. Women are more satisfied with their partners and partners are more comfortable supporting when doula support is available to them.

Doula: The Real Risks and Benefits They Offer

Q

Can I tell my provider No or refuse interventions and procedures?

A

You are the consumer and the one in charge. While you have hired your provider for his/her medical opinion, it is just that an opinion and not a rule or law. You are the one who must decide what choices are right for you and your baby, and the only one who can allow or consent to interventions and procedures. If your provider disagrees, he/she has the option to transfer your care to another provider who is more willing to support your needs and wishes. This is also true for you, as the consumer, you have the right and ability at any time during your care to transfer to a provider who will support you in your choices. You may say No…..regardless of outcome the decision is solely yours. Birth Preferance Plan