What to expect when hiring a doula
What is a doula, what do they do?
I find a lot of time expecting families are searching for a midwife and they think a doula is unnecessary if they have a midwife, but that is not entirely true. A doula is someone who is there in the room with you from the moment you request them to a few hours after you birth your baby. A midwife is essentially an OB, but their outlook on birth is more physiological than medical. If you are seeking to have an unmedicated birth free of unnecessary interventions then a midwife is a great choice for your birth team. A midwife will not be in the room with you continuously, chances are they have other families in labor they have to attend to. A doula is there for you and your partner, applying hot and cold compresses, counter-pressure, suggesting changes in position, bringing your focus to your breath, sending encouragement your way from start to finish, and even is there to let your partner catch some z’s if needed. A doula does not replace a midwife, doulas are there to provide mental, physical, and emotional support they do not do anything medical i.e. no cervix checks or monitoring your baby.
How do I find a doula?
There are a lot of ways to find a doula, but my favorite sites are dona.org and doulamatch.net. At dona.org you will find only DONA certified doulas. Certified means they have attended at least 3 births and provided a minimum of 15 hours of labor support (it is usually way more than that). A certified doula is also required to submit 45 area resources, an essay on the importance of labor support, a reference from a perinatal professional, a reference from a client, complete a DONA training workshop, complete a reading list, and submit paperwork for each birth they attended for certification. On doulamatch.net you can find doulas who may or may not be certified, how many births they are attended are required to be on the site (if that is important to you), prices etc.
If you want to birth your baby at a stand alone brith center like the Minnesota Birth Center, Roots, or Health Foundations they often have doula interns for little to no cost. Woodwinds in Woodbury has a doula on call program; however, you do not get to meet the doula before you arrive to the hospital, you simply get whoever is on call.
Some insurance options reimburse a certain amount for a doula. Medicaid and HSAs often help cover the entire cost or partial cost of a doula. BUT not all doulas are covered with Medicaid. Be sure to check your insurance before hiring a doula!
What do I ask a doula?
The reality is, there are hundreds of lists you can Google to find questions to ask a doula, but I think one of the most important things to know is that a doula comes at a price, and don’t interview a doula who has their prices clearly labeled if you are not willing to pay them that. With that being said, there is a wide range of prices when it comes to having a doula in the Twin Cities, $800-$1200 is pretty standard. The payment is usually broken up in half, half at the time the contract is signed and the other half by 36 weeks gestation. (below, in bold are the rest of the questions you should be asking during a meeting).
I don’t get this question often, but some families will ask how many births I have attended. I don’t dislike this question, but I don’t think a determination should be made off of this number. Why? A brand new trained doula has a lot of knowledge they are ready to use. They are unbiased to any techniques and willing to try anything. They have new energy and are unlikely to be spreading themselves too thin. You may also find a doula working towards their certification will offer an extremely discounted rate. This question can also be very important to families, maybe they had a difficult first birth and want a doula with a lot of experience to be able to combat the nuances of birth during their second birth experience.
Always ask a doula what their package offers. The standard package usually includes:
1-2 prenatal meetings (2 hours/meeting)
on call from 37-42 weeks
present for your birth up to 2 hours after you have birthed your baby
1 postpartum visits (1-2 hours)
Ok, so what is a prenatal meeting? During this time your doula will likely get to know you by asking some questions like your fears about labor and delivery as well as the postpartum period. Prenatal meetings are also a good time to cover any educational aspects of childbirth and to test out some natural pain management techniques.
What does being being on call mean for a doula? Being on call means that from 37-42 weeks your doula has their phone on and next to them 24 hours a day. If we are at a wedding or other event, and it’s not too far away, we will leave to come be with you if you are in labor. In the event we are on a vacation or attending an event we don’t want to miss, the dates should be known before you sign the contract. For example, I plan to go out of town for the 4th of July so I would tell my clients that I will be out of town from 3-7 July and during that timeframe I would have a backup doula available for them.
When does a doula arrive to provide support? Doulas often arrive at your home when you request them to help you manage your labor pain and drive separately to the hospital or birth center and remain with you until after your baby has been born for up to 2 hours. A good rule of thumb is if you are unable to distract yourself during contractions it’s probably a good time to call the doula! BUT always let them know as soon as you think they are in labor, so they can make childcare arrangements if needed.
What happens at the postpartum visit? The postpartum visit is usually scheduled by the family 4-7 days after baby has arrived (or later if requested). At this visit the doula will go over your birth story with you and fill in the gaps. This is usually a time to chat about all things baby, but doulas will often be able to grab groceries for you (reimbursed of course), fold laundry for you, or watch baby while you grab a quick shower.
What other services do you offer? What I listed above is the standard, the basics. Doulas may also offer other services that have additional costs, or may not. For example, some offer photography, a postpartum package with lactation goodies or meal prep help, some doulas double as lactation consultants or carseat technicians, placenta encapsulation, and/or postpartum doula work, homeopathic work, and the list goes on.
Finally, always interview the doula(s) you are interested in, in person or over the phone. You have to make sure you get along with them. I recommend interviewing a few doulas, but sometimes you vibe with someone right away and don’t want to continue on the search, and that’s fine too.