With the popularity of Doulas dramatically increasing in recent years, many expectant parents are finding it a bit harder to navigate all the choices available. At Childbirth Concierge, our tag line is “Delivering Peace of Mind”. With that in mind, we provide guidance for families to find the right support for unique situations and dreams for your pregnancy and birth. Our desire is that you experience Peace of Mind in this process. This document has been created to help you navigate all the basic nuts & bolts of hiring a doula who will support your pregnancy, birth and postpartum period.
This guide will offer thought-provoking questions that you may not have yet considered. There is great value in spending time with your loved ones discussing what really is important and how you envision yourself giving birth. The more clear you are regarding your hopes and dreams for your baby’s birth, the easier it is to express what is key for you. This clarity helps the doula to determine how to meet those needs and support you more fully.
Your Birth Goals
I always love to ask the question “how do you see yourself giving birth”? Do you see yourself in a hospital or out of hospital setting? You have most likely played many different scenarios through your head. Do you want to labor without pain relief medications or do you want an epidural? There is no right or wrong, but even taking the time to identify what resonates with you helps begin to paint a picture of important items for your experience. I encourage parents-to-be to list out ten things that are important to you for your baby’s birth. Once you have your 10, then narrow it down to your top 5.
When you identify those 5 items, begin to envision how a doula would help you work towards that. In other words, think about, “What do I want for my birth experience and who is going to help me to get that?” A skilled doula will help you navigate options and help you determine if your expectations are realistic or unrealistic based on where and with whom you are planning to give birth. Questions to ask yourself and your partner are “What am I hoping a doula will do for us? How will hiring a doula impact my birth experience?”.
The mere fact you are reading this shows that you have some working knowledge about doulas, but let’s go a little deeper. There are birth doulas and there are postpartum doulas. Birth doulas focus on preparation for and during birth and immediately after birth. Most doulas offer package rates for the Birth service. Postpartum Doulas traditionally care for the family day or night and focus on mother, newborn care, and home life for an extended period of time following the birth on an hourly rate.
It is safe to say that in the US, the cultural norm is that a doula is a non-medical support person who provides emotional and physical support and education. Their primary role is to support the families they serve. Here is a quick read https://www.vogue.com/article/what-does-a-doula-do-top-experts-pregnancy-birth . Another way to think of a doula is like a wedding coordinator, golf caddy or even a travel agent. They are professionals in their field, giving guidance and feedback based on their years of experience. You should never feel shamed or judged for your birth plans and parenting choices when working with a doula.
Doulas do not provide clinical skills or assessment like blood pressures, vaginal exams, measuring fundal height or fetal heart tones. Those skills are provided by your medical care giver whether a doctor or midwife. Some doulas may be cross trained as birth assistants or nurses who have a medical skill set, but when working as a doula, they should stay within the doula scope of practice and on the non-medical side of care and support. They should also never tell you what you need to do, instead help you navigate options. Ultimately, decisions rest with the pregnant person and it is their responsibility for their medical care.
How are Doulas Trained
It may come as a surprise, but there are no State or Federal guidelines on universal training or competencies for doulas. So that means a doula can choose to attend a training or not, promote herself and accept clients. Some bigger organizations like DONA.org and CAPPA.org set their own Ethics and Standards and police their own memberships. Some trainings require a certain number of births and experience before certifying the student, while others don’t require any experience to become certified. Therefore, this leaves the process in the hands of families hiring a doula. Just because someone is certified doesn’t make them the right doula for you and vise versa. You must trust your gut when interviewing. It is also a helpful starting point if you are being referred to a doula.
Where to find doulas
A good old Google search of “doulas near me” should get you a list to navigate through. You can also ask your care providers who they have worked with and can recommend. Doulamatch.net is a national data base where a lot doulas lists their services. You can also call local birth centers to see who they work with and recommend, as well as friends and colleagues. Word of mouth is still the best way! Always, always look at the Google or social media reviews, as this can be very telling about the doula, their services and their professionalism. If a doula doesn’t own a formal company on Google and has website, be sure to ask to speak to previous clients to get feedback. Nowadays anyone can quickly set up a beautiful website, but it doesn’t always equate to excellence of service. Do your homework!
When to hire
The sooner the better, if you can. The earlier you connect with a doula the more time in your pregnancy you have to reach out when guidance is needed. Also depending what area you are in, there can be waiting lists as the demand maybe larger than the number of skilled doulas in your area. Starting the process in the 1st trimester allows you to take your time and interview. This will reduce your stress of needing to secure someone later in pregnancy.
Most insurance companies do not yet cover doula services although the profession is seeing a positive movement in this area. Check with your insurance company and employer benefits. Doulamatch.net will give you a bird’s eye view of the average rates in your area. Also, if you have a Health Savings Account you may be able to use this for doula services. One can expect to find those gaining experience (students) to be no cost, all the way up to 3k and more depending on what area you are in. I encourage you to have a price point in mind as you begin looking for services. Some doulas will offer payments plans, and most take credit cards.
Things to ask and consider when interviewing doulas:
- Are they available for your due date?
- What do they offer and what are their price points? Most offer packages that offer a variety of services and some a La Cart Options like childbirth education, breastfeeding support, placenta encapsulation, belly binding.
- What is their or the company’s philosophy of birth? This is really important as you want a doula who is respectful and comfortable with your birth desires, providers and location of birth.
- What motivated them to get into this field? Was there an experience that was a turning point for them, and if so, was this a positive or negative experience? Both are motivating forces but I encourage you to look for a doula who has worked through her traumas and is not projecting those traumas into your birth experience.
- What is their style of advocating for clients? How do they empower those they work with?
- How long have they been practicing as a doula? When you hire a doula you are hiring their years of experience, and their ability to correctly articulate that in your birth experience. Experience in this field is important, however there are doulas who may not have a lot of experience (as in number of births), but carry themselves professionally, and are able to articulate well, and offer you skilled support.
- Are they a solo practitioner or do they work as a team with another doula? This will determine a lot how things get handled if the doula has an illness or family emergency when you go into labor. Who is their back up and will you need to pay additionally for that back-up? Also, will you get to meet them beforehand if even virtually? Another thing to ask is how often have they needed back up?
- What is their specialty, if any? Many doulas specialize in the following areas; Birth, Postpartum, High Risk, Multiples, VBAC, bereavement, hypnodoula, full spectrum, trauma informed, abortion, queer, BIPOC, breastfeeding, hospital birth, out of hospital birth. Be sure to ask what they consider their areas of speciality.
What should I look for in a contract?
Part of choosing a doula is the financial piece and it is very important to look at the contract, as this is a binding agreement. I have had clients tell me they have interviewed doulas who said they didn’t use contracts. I highly advise against that as you would have no legal recourse if needed. When items are clearly spelled out it is clear for both parties, and reduces chances of misunderstandings.
A basic bare minimum contract should include both parties’ names (who is the contract between), beginning and end dates, scope of work, what they do and some include what they do not do, or the provisions if back-up is needed, the cost of the service, and how to terminate the contract if needed.
Making a final decision
After evaluating all the options and things to think about, we really do encourage you to go with your gut feeling. So often we dismiss what our true self is communicating to us. We get all up in our head around so many things. It has been medically proven with over 400 studies that the heart sends more messages to the brain than the brain does to the heart.
I encourage you to take a look at this 3 min quick video about the Science of Heart Focused Breathing. https://www.youtube.com/watch?v=JxNjw3bcfVo . Practicing this simple quick coherence breathing can help calm you and listen to what your heart is telling you.
Check out my guest appearances on The Birth Ease Podcast.
How to Hire a Doula
Doula Services and Labor Support
Spanning a 33-year career in the maternal health field, Kathy is an industry pioneer and the visionary behind Childbirth Concierge. She honors all journeys to parenthood and feeding, and is committed to ensuring that parents feel seen, heard and valued while in her care. As a mother of five herself, Kathy has considerable experience in preparing for the birth and care of newborns, and helps to empower parents by delivering peace of mind during what can at times be a challenging situation. A born educator, she is in her element teaching new parents and health professionals. She worked 14 years in Maternal Health at Winnie Palmer Hospital in Orlando and is a self-proclaimed “Birth JUNKIE”.