Q & A

Are your services only for mothers who wish to labor naturally?

My primary purpose is to help you decide what kind of birth you want, and to support that happening.   If you desire pain relief during your birth, I can still help you have the healthiest and and most satisfying birth experience possible.  I can:

  • Help you assess the risks and benefits of the different pain relief methods, and so that you can decide which one is best for you and your baby.
  • Provide information about common medical interventions that follow from a given pain relief method, and their risks and benefits–to help you choose the one you are most comfortable with.
  • Recommend positions in labor which may help your birth proceed without complications (mothers using pain relief are still able to benefit from positioning).
  • Support you in your discussion with your care provider about which interventions may be genuinely indicated during your birth.

It is important to remember, that doulas specialize in promoting evidence-based maternity care.  Even when you need pain relief, you can still benefit from evidence-based care.

What does the research say about having a doula?

Some of the proven benefits of birth doulas include:

  • Reduction in the overall cesarean rate by 50%
  • Reduction in the length of labor by 25%
  • Reduced oxytocin use by 40%
  • Reduction in the use of pain medication by 30%
  • Reduction of forceps deliveries by 40%
  • Reduction of requests for epidurals by 60%

For more information, a reference of evidence based studies, scientific reviews and a diagram of how doulas can help reduce the use of interventions in birth, please click the following link for a downloadable pdf.  Improving Birth Doula Fact Sheet.docx.  This PDF can also be found at the terrific website Evidence Based Birth  The Evidence for Doulas .

 

What does a doula do?

A doula’s service begins with providing prenatal education in evidence-based care.  Their biggest and most energetic role, however, is in the birthing room.  Doulas provide continuous support for women and their partners during labor.  Shifts change, nurses have other patients to care for, fathers need time to eat or catch a moment’s sleep; A doula stays with you and does whatever she can to give you a feeling of security and to make you more comfortable.  Sometimes that means just talking with you about whatever you’re thinking about; sometimes, rubbing your back or shoulders to help you get through a contraction; sometimes, helping you assess the risks and benefits of an intervention your doctor or midwife suggests, as they fit your particular situation.  And sometimes a doula supports you just by saying what you need to hear to keep up your strength, confidence, and determination.

Why you would hire someone you hardly know to be present at your birth?

A spouse, friends, parents, and siblings can all provide a level of support and comfort during labor.   For some mothers, this is all they need.  The main questions to ask yourself when considering each of these options is,  does this person know what’s normal and what’s not during labor and birth?  How will they respond to seeing me working with my contractions?  If we are in a situation of low sleep, high stress and unexpected events, how will that affect the support they can give me?  Will there be positive or negative effects on my relationship with them afterwards?

Unfortunately, in the United States today most people have not been present at any birth except for their own.  They have neither experience nor particular knowledge about the challenges that labor presents, or how to address those challenges when they arise.  As evidence-based care studies show, the medical solutions that doctors and nurses often leap to are not always the safest or most effective long-term.  Doulas are educated in exactly these issues.  Moreover, as someone outside your social circle (but with whom you feel comfortable from the first–this is very important in choosing your doula!), our ongoing relationship with you is not going to be affected by anything that happens during your birth.  Our only concern for the entire duration of our relationship with you is that you have the safest and most satisfying birth possible.

 

Will you be replacing my partner as birth coach?

I will never be a replacement for your partner, nor will I seek to be.  I want to support the two of you as a couple.  I can remain “invisable” but accessible, appearing with extra hands and knowledge when you most need it.  Situations where you may suddenly need me include medical procedures on which your opinions suddenly don’t fit, or simple needing to know when and how to help you change positions.

Part of my art is finding ways a partner can easily support and enhance the work your body is doing during labor.  I like to keep things low stress and to honor where a partner is at in his level of confidence and interest.  Birth can be an overwhelming experience for partners; not only are they becoming parents themselves, but they are also witness to the most astounding transformation in their beloved–and for many partners, none of this is something they have seen before.   The pressure of being the laboring mother’s sole continuous provider of physical support, encouragement, and knowledge about medical procedures, can truly feel overwhelming to a partner experiencing birth for the first time.  Taking the pressure off is one of the biggest parts of the doula’s role.

Can I labor at home?

Yes!  One of the advantages of my midwifery training, is that I am both comfortable and well trained to support mothers who wish to labor in the privacy of their own home.  Although I do not perform dilation checks, I have a well honed ability to gauge where a mother is at in her progress and whether active labor has started or is likely to soon.  I can let parents know when laboring at home no longer seems appropriate, or when there seems to be a reason to contact their midwife or doctor.  I can provide information about the use of hydrotherapy for relaxation, as well as the use of more active poses and other techniques for helping labor move along.  I strive to visit all parents at their home before labor begins, so that I can have a familiarity of the home environment and what may work well in labor ahead of time.

 

Will you meet my physician, homebirth or nurse midwife?

Absolutely.  I would be happy to join you for one of your prenatal appointments with your medical care provider.  I see a meeting with your care provider a helpful way to create some familiarity and understanding of my role as the doula ahead of time.

How long are you oncall?

I am oncall for your family from 38 weeks until 42 weeks/you birth your baby.  When I am oncall, I remain within an hour or two of my clients, keep my cell phone on and nearby at all times.  I keep a full tank of gas and my birth bags packed.  I arrange backup childcare, and ensure that I have a back up Doula if at all possible in case illness prevents me from attending your birth (safety first!).  I also do my best stay well rested so that I have extra energy reserves for those night time labors 🙂

What happens if my baby comes before 38 weeks/your oncall period?

This is a very good question.  The 38-42 week period is by far the most likely time for you to go into labor.  During this period, I always have my cell phone nearbye and am prepared each day and night to join you if your labor begins.  Sometimes, babies decide to surprise us by coming early.  I will do my best to come to your birth if humanely possible if you go into labor before 38 weeks.  I have acted as a doula for mothers birthing as early as 35 weeks, and was happy to do so.  The difference when calling me during an offcall period, is that I may be out of town, though tend to limit trips to just a few hours drive at the most.  I may need some extra time making childcare arrangements before coming to your side.  Basically, I do my best to be completely available through your whole pregnancy.  No matter how soon or late your baby decides to come, However, it is only from 38 weeks to 42 weeks that I can promise to be available 24/7 to answer all phone calls and to drop plans suddenly.

**If you have a history of early labors or preterm birth, or are birthing twins, I am happy to make special arrangements with you at no extra fee.

What if you don’t make it to the birth?

If I am notified once you start labor and am updated throughout early labor as specified in my handouts, and I do not make it due to my error or fault, I will reimburse you 80% of my fee.  However, if you do not notify me that your labor has started and do not call until it is too late for me to arrive in time to assist you at your birth, the doula fee is non-refundable. I will still come as soon as possible and support your family in those first moments after baby has arrived and stay for an extended postpartum period.  I would also be willing to provide a complimentary 6 hours of postpartum care at your leisure, in this situation.  Please see the section under Reimbursement in the Birth Doula Contract for more specifics.

How long will you stay at the birth?

I usually stay with you from the time you call me to your side, until approximately 1 hour after you birth your baby.  If a client calls me in really early labor, or possible false labor, it may feel appropriate to both the client and myself, for me to help the client with comfort measures and then to go home to await further progress.  During truly long labors (more than 24 hours), I may briefly step away for food and fresh air.  If complications arise in the labor or postpartum, I do my utmost to stay until baby is back with mama, mama is doing well and the family feels they are in a good place to continue on their own.  I have supported mothers who labored just a couple hours, and I have supported mothers who labored 48 hours-this is all part of my work, and I do not consider it “extra” to support a mother through a longer birth process.

What if I have a Cesarean?

If you require or request a c-section, I will go into the OR with permission from your care provider and will continue to act as your doula. If I am not allowed in the OR, I will do my best to ensure your partner or other loved one, can support you there.  I will attempt to communicate your wishes to your surgeon (skin-to-skin contact after, delayed cord claming, etc).  As soon as you and your baby are ready, I will rejoin you.  I give clients who have Cesareans extra care in the postpartum, as the recovery can pose certain challenges.

How far do you travel?

Depending on my client load, I will travel up to 2 hours away.  I try to limit my practice to two clients a month, which reduces my chance of overlap and allows me to serve clients in a larger geographic area.

Who are your backup doulas?

There are several doulas in the area who I can call as back up in the case of unforeseen events or illness on my part.  I like to use doulas who have finished their training, are certified and are experienced assisting women in the hospital setting.