What exactly is a doula?
The simple definition of a doula is that we provide emotional, physical and educational support for the birthing woman and her support team during pregnancy and birth.
A more formal definition: A labor doula or birth doula is someone (often trained, though this is not required) who provides non-medical and non-midwifery support (physical and emotional) to a woman leading up to and during her labor and delivery. A labor doula may attend a woman having a home birth or a woman laboring at home before transporting to a hospital or a birth center, where she will continue her support.
They do not perform clinical duties such as heart rate checks or vaginal exams, or give medical advice. Labor doulas rely on techniques like massage and position changes to help women through labor. Many offer phone and email support as well as prenatal and postpartum visits to ensure the mother is informed and supported. The terms of a labor/birth doula's responsibilities are decided between the doula and the family.
Doulas serve as advocates of their client's wishes and may communicate with medical staff to help the client make informed decisions. The doula is also an ally for the father or partner, who may have little experience with the labor process. Many fathers and partners experience birth as an emotional journey and find it hard to be objective. A responsible doula supports and encourages the father or partner in their support style rather than replacing them. (Wikipedia.com)
Where did the name "doula" come from?
Doula is a word that has most closely become associated with a woman who provides non-medical support during labour and birth, and also the postpartum period. Doula comes from Ancient Greek δουλοσ (meaning "female slave.") "Anthropologist Dana Raphael used the term for experienced mothers assisting new mothers in breastfeeding and newborn care in Tender Gift: Breastfeeding (1973). Marshall Klaus and John Kennell who conducted clinical trials on the medical outcomes of doula-attended births, adopted the term to refer to labor support. (Wikipedia.com)
How do doulas work with dads or other support persons? My husband/partner/friend thinks they can do it all themselves.
You may feel like one of my clients did. Here's what she had to say, "I thought my husband would be my everything in Labor and Delivery, and while he was wonderful and irreplaceable, another piece that was irreplaceable was the knowledge and understanding of a woman. (Especially a woman who has spent some time with women having babies!)"
My role as a doula does not take the place of the support people you have, including family and friends, but rather complements it.
Aren't doulas the same as midwives? If I have a midwife, I don't really need a doula, too, do I?
Simply said, No.
Many people have misconceptions about a midwife's role. Here's the thing, even though midwives and doulas share the same philosophy about birth being normal and healthy, we have different responsibilities.
My role is the help the woman get through the labor, being by her side continuously to help with positions, comfort, understanding what's going on - and therefore, by the time the baby is born, my energies should be exhausted.
The midwife, on the other hand, is responsible for the health and well-being of mom and baby, monitoring their vitals throughout the labor; but her most important time is when the baby is being born, so she needs to be at her best when that moment comes.
While many midwives are indeed very supportive and hands-on with their clients, if the midwife is there "holding the woman's hand" during the length of the labor, she will not be mentally at her prime when she needs to be most ready - the birth itself. And she can't hold your hand if she's also trying to catch your baby, can she?
(The closest you would come to someone doing a combination of both is the role of a monitrice - essentially a nurse who works as a doula and uses clinical skills such as vaginal exams and assessing baby's vitals, etc. in addition to traditional doula support techniques. But they would do this only at home and would discontinue the clinical side upon arrival at a hospital. They do not handle the birth and newborn care, as a midwife would.)
Truth or Myth?: All doulas wear patchouli and long skirts and they only like natural birth.
This one's easy to debunk, since I'm living proof. Patchouli gives me a headache, and I can't remember the last time I wore a skirt. Some doulas are crunchy, some look a lot like your grandma or your banker, and some of us are more of the soccer-mom set.
As for going natural, you can find doulas who had medicated births or cesarean births themselves. Many doulas feel comfortable supporting any couple, no matter what kind of birth they're hoping for.
Others, and I include myself in this group, have a true love for natural birth, but also a strong sense of compassion for women faced with challenging situations or true medical complications. We're not in your body, and we can't completely know what the labor experience is like for you. Medications and interventions, while vastly overused, certainly have their place. The core of a doula's role is support - support for your decision-making process and your innate wisdom about the best path for your birth. I've witnessed some truly beautiful births that included Pitocin, narcotics, epidurals, and even c-sections.
A good doula nurtures and supports you on your birth journey, wherever it leads you. One of my clients told me after her VBAC that during her birth she felt surrounded in love. That's much more important to me than whether someone experiences my idealized version of a "perfect birth." If every family I work with feels surrounded in love, I've done my job.
I'm having a Cesarean Section (c-section), so I don't need a doula, right?
Wrong. Although the type of support I provide looks different during a surgical birth, it is no less beneficial. I've helped many moms through c-sections; some planned, some unexpected. One point I emphasize is that once the baby is born (which is within a few minutes of the surgery beginning), he or she will shortly be whisked away to the nursery. It is preferable for the father to go along with the baby, to be present for all that is happening and to record those early moments on camera, but this ends up leaving mom alone for the duration of the surgery and recovery period. Not good! I recommend that we both join mom for the surgery, if possible. If only one of us can be in the room, I suggest that dad wait just outside and let me stay with mom for the procedure. I explain what is happening, express any needs she communicates, etc.
What training have you had?
I completed my original birth doula training and certification with DONA International back in 2000-2001. I recertified with them a few years later, but chose not to recertify most recently for a variety of reasons. (I'm happy to elaborate on those reasons during a free consultation.)
During the same period of 2000-2002, I also completed training and certification with the International Childbirth Education Association (ICEA) as both a Childbirth Educator and Perinatal Fitness Education. This training provides a depth of knowledge that I am able to draw from in my doula work which I would not have if I had completed doula training alone.
I've been helping other doulas get established in their careers for a few years. Many doulas seek me out for ongoing mentorship as they grow in their profession. It's a pleasure for me to participate in training and mentoring doulas in both formal and casual environments.
Ongoing education is a passion of mine and I am always learning new things about birth, whether by attending workshops and webinars, reviewing current research, sharing experiences with peers or reading books.
How many births have you attended?
As of January 2015, I've attended at least 185 births. (I've lost count of some client files along the way in the process of various moves.)
I've been working as a doula for over 10 years now, so I've seen quite a variety of births - in hospitals, homes and birth centers, from water births to cesarean births and everything in between!
Do you have one or more backup doulas for times when you are not available? May we meet her/them?
Yes, I do have backup to cover for me. There are a few doulas I prefer to work with and I can arrange for you to meet them if you would like, based upon who has availability for your due date.
Backup is typically necessary in the event that two of my clients go into labor at the same time. Though this doesn't happen often, it does sometimes occur. Other circumstances would be if I were ill (rarely) or if I had a planned time to be out of town - which you would be well aware of and wouldn't occur close to your due date.
What is your fee, what does it include, and what are your refund policies?
Please visit my Doula Services page to read details of my fees. I believe every woman should have a doula, so if you cannot afford my services, we can discuss other options including, but not limited to, working with a doula-in-training.
My refund policies are detailed in my contract, which I will provide to you upon request.
Do you offer a payment plan?
I require the Deposit portion of my fee when we sign the contract. This secures your date on my calendar and my on-call availability during your birth month (4 weeks).
The Balance of the fee can be paid in whatever portions you choose, as long as the total is paid by the time you reach 36 weeks gestation.
Payment can be made by cash, money order, check or Paypal (which allows for the use of credit cards).
There are limited options for discounts and bartering for goods & services. Inquire about availability.
Tell me/us about your philosophy about childbirth and supporting women and their partners through labor.
Like most doulas, I believe that pregnancy, labor & birth are normal, healthy processes that are best cared for from a "hands-off" approach with few exceptions. At the same time, I believe there *is* an appropriate time and place for medical intervention and when used correctly, those can be tremendously helpful and even life-saving.
What does that mean for my clients? As labor progresses, I will encourage and support you using the least invasive options first. It is only after those options have been exhausted/eliminated that I would advocate progress towards more invasive techniques.
For example, while I wouldn't encourage a mom to get an epidural as her first choice for managing pain - without having first tried comfort measures as massage, hot/cold compresses, hydrotherapy, etc. - there are times when an epidural is the best choice based on her particular situation and place in labor. I do my best to educate my clients on what their options are, the benefits and risks of each, put that in context of their labor and support whatever choice they make.
May we meet to discuss our birth plans and the role you will play in supporting me/us through childbirth?
Yes! I provide a free consultation to anyone who would like to consider using my services and we will discuss these topics briefly at that time.
Should you choose to hire me as your doula, we will cover your birth plan and my support techniques in depth during our prenatal meetings. I offer help with developing a good birth plan and explaining how to communicate about these topics with your caregiver. In addition to our discussions, there are many print resources that will help you to learn what your tools for labor and birth are.
May we call you with questions or concerns before and after the birth?
Yes! Part of the service I provide is unlimited phone consultations during your pregnancy and postpartum period. In addition to the information I can supply, I will also direct you to local and national resources for specific areas as needed, such as breastfeeding help or care for postpartum depression.
When do you try to join women in labor? Do you come to our home or meet us at the place of birth?
I join women in labor when they are ready for additional help. Most often this request comes as Active Labor begins, when contractions build to 3-4 minutes apart or less and mom is most likely dilated to 4 or 5 cm (although I do not assess dilation myself).
I will support initially by phone during the early parts of labor, before my presence is needed, then join you at either home or hospital, whichever you prefer. In my experience, I find that many women who are planning a hospital birth are able to manage early labor at home without me and ask me to meet them at the hospital. But I have also labored with women at home before relocating (and am available for midwife-attended homebirths as well).
Do you meet with me/us after the birth to review the labor and answer questions?
Yes! This is a very important component of my support. Part of what motivated me to become an educator and doula what that I heard women tell birth stories that I knew could not be accurate, but there was no way to correct them since I wasn't at their birth. (For example, they would say a drug was given for a purpose that it is not used for or that something happened with their body that simply is not how the body works.)
I make a point of keeping notes as best as I can during labor and explaining things as labor progresses so that my clients really do understand what is going on. I want my clients to know the facts of their birth story and understand truly what happened so that when they repeat it to their friends and family, it is TRUE!