All About Doulas

This post isn’t specifically about being pregnant after infertility, but my reasons for wanting a doula are indirectly related to my infertility experience. Since the whole doula thing is relatively new to me, I’m keeping things basic and posting lots of links to some great resources.

A while back, I posted about starting my search for a doula. Since then, I have visited with four recently trained doulas and decided to hire one of them.

What is a doula?

According to DONA.org, a doula is “a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.” Doulas are trained in a variety of techniques to help you labor comfortably and to have the kind of birth experience you desire. A doula probably has her* own labor and birth philosophy, but most will work with you whether your philosophies match up or not. So, even if your doula prefers a medication-free birth, and you plan on an epidural from the start, she will (should) respect your choice. Having a doula can be a positive experience, whether you plan on a vaginal birth or a scheduled c-section.

There are all kinds of benefits to having a doula, including shorter labor, fewer complications, and reduced need for interventions. If you’re the type who likes evidence to back up such claims, I refer you to the DONA International Position Paper on birth doulas, which references several studies that you can look up and read for yourself. I read a couple, but, to be honest, that a doula would improve the birth experience in those ways just made sense to me, so I didn’t need much convincing to know that a doula was right for me.

Doulas are not medical professionals. They do not offer medical advice, or interfere with the medical team treating you. However, one benefit of an experienced doula is that she can help you better understand what the labor and delivery team is doing and saying.

Some doulas offer extras, like photography, help with breastfeeding, birth classes, help with writing a birth plan, and help with writing your birth story (she will be able to help you fill in some of the gaps). Sometimes these are at no extra cost, but you need to ask.

Why hire a doula?

10 Reasons You Should Hire a Doula

8 Reasons People Don’t Hire Doulas

5 Reasons Dads Should Demand a Doula (Sorry for the heteronormativity; it’s still a helpful read)

I decided that I wanted a doula for a couple of reasons. 1) This will be my first time giving birth (assuming all goes well with this pregnancy). I can read and research until my brain melts, but I know that when the time comes, I won’t remember any of it. I want someone who knows labor and birth like the back of her hand, who can coach me and support me in having the birth experience I desire. 2) After everything I’ve gone through during my infertility journey, I believe I deserve to have the very best care and assistance while giving birth the way I want. In a way, it’s wrestling back some of the control I lost during the getting pregnant part. 3) A doula will help relieve some of the pressure on my husband to keep me comfortable and motivated, and even help coach him in techniques that will help me.

I should say a few words about the partner’s role in all of this. Obviously, your partner needs to be on board with having a doula. He or she may initially feel like the doula is meant to replace him or her, but a little education can go a long way in calming that fear. Your partner may or may not want to be part of the decision-making process. My husband basically said, “Your body, your decision.” So, I did all the interviewing myself. We will both meet with the doula a few times before I go into labor, so that we’re all on the same page.

How to find a doula?

Once you decide a doula is right for you – or even if you just want more information before making your decision – it’s time to start interviewing. I found a list of doulas at a local moms group on Facebook. I also emailed DONA International for a list of licensed and trained doulas. (Note: You can search DONA.org for licensed doulas, but you have to email the organization to find the ones who have training but are not yet licensed.) You can also ask your OB, midwife, nurse, or clinic receptionist, as well as friends and family. Of course, there’s always Google.

What questions should you ask?

During the interview process, you will want to ask lots of questions. Again, DONA.org provides a great list to get you started. I also asked about other work/jobs, since the doulas I interviewed were new to the field. I wanted to be sure they could be by my side the moment labor started. In addition, I wanted to know about their experiences (if any) with the hospital where I am planning to deliver, to make sure it’s doula-friendly. Lastly, this was a tough one, but I asked each of them if she would still be my doula if I knew the baby would be stillborn. (This is also something you should consider for your birth plan – how do you want to proceed if you know the baby has already passed?)

What does it cost to hire a doula?

The cost of hiring a doula varies based on the services they offer, level of experience, and geography. The doulas I spoke to range from about $400 to $800, but that’s because they were only recently trained and have very little experience. They need to assist a certain number of births in order to complete their certification and licensing, hence the reduced rate. You’ll have to do some research to find out what the going rate is in your area.

What happens after you hire a doula?

The doula should have you sign a contract that spells out the services she will provide to you and how and when payment is due. The doula will put you on her calendar, reserving the weeks surrounding your due date for you and you alone. If she doesn’t have a regular back up doula, you should let her know which of the other doulas you interviewed you would like to use as a back up, if needed.

In conclusion

I’m obviously a huge supporter of having a doula, but I know it’s not right for everyone. Some women may prefer to have a friend or family member provide support in addition to their partner, while others prefer only their partner. There’s no right or wrong way. I briefly considered asking my mom to be by my side, but her only experience was vastly different from the type of birth experience I want. I know she would provide awesome emotional support, but technical and physical support, not so much. I also like that a professional doula is emotionally detached from me, compared to a friend or family member.

Of course, only time will tell if the doula experience is all I envisioned it would be. I will definitely follow up to let you all know how things go in about 5 months or so.

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* I say her and she because the only doulas I know of are women. I wonder if male doulas exist somewhere?

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12 thoughts on “All About Doulas

  1. I’m very happy for you & hope it works out as planned. The thing about birthing though.. it’s kinda like taking a ski ride down a steep mountain for the very first time. Sure, you can have a plan in place & hold on to it for some semblance of control, but be prepared to relinquish all control and let things unfold. I also have the type of personality that makes me pre-plan & research every step of the way (and I have tons of empathy from wanting to take back some measure of normalcy & best care available during birth after infertility) but after my first kid’s NICU adventure, I realize how little those plans really matter. It sounds like you did your research though:)

    • Oh, I totally get that the birth plan may go out the door entirely depending on circumstances. I don’t have a “plan” in place, so much as a list of preferences. It’s important to me that WE (my husband and I) are the ones to decide, especially in non-emergency situations. Some women may prefer to just walk in and take orders from the medical staff, but that’s not me. I guess it all boils down to my point of view that pregnancy and childbirth aren’t a medical condition that needs to be managed. Things may come up that need to be managed, and if that happens, we will be more than willing to do whatever we need to do to ensure our baby’s safety and health. I just happen to believe that I can have a healthy baby AND the birth I want. It may not turn out that way, but in my book, that’s not a reason not to go into it expecting the best.

  2. Thank you for this, it was super helpful! I’ve been wresting with the decision of hiring a doula, mostly based on cost, so I really need to make some phone calls and see what the going rate in my area is. I’ve also wondered if there are male doulas, I’ve never heard of one!

    • Yes, definitely make some calls! I think most doulas will give you a free consultation, so it doesn’t hurt to meet with a few. Good luck and let me know how it goes for you!

  3. Great read! I know I definitely want a doula too. I don’t have that close friend or family member who I would be comfortable with in the room and who I know would provide me with the necessary support.

  4. I was so 100% set on having one, and then I got lulled into this sense of complacency somewhere along the way. Also, I anticipated hating my new MFM and was viewing having a doula as a way to increase the volume of my voice should I find myself disagreeing with my medical team on the day of delivery, but I’ve been pleasantly surprised with how much I’ve loved each and every doctor, midwife, and nurse I’ve seen at the practice. Granted, I know the nurses will be different in L&D, and I’ll likely end up with the one doctor I never meet on the big day, but I’ve been heartened by the practice’s approach and the compassionate care I’ve received there.

    All this to say, I was 100% on one track,then flopped in the totally opposite direction, and now, after reading this and shaking my head along to your comments, here I sit more confused than ever! I hate that it’s the case, but money is playing a large role in some of this. As much as being OOP for fertility treatments stung, I maximized our opportunities by putting huge balances on our FSA and documenting every penny spent on our taxes… Doulas are not covered under either option in my case (FSA outright excludes them, and her fees can’t be claimed as a medical expense on our taxes). That news, plus the going rate for doulas in these parts, made me cranky and take a step back…

    Anyway, my indecision may have sealed my fate. I suspect my first choice doesn’t have openings any more for June!

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