“I couldn’t have done it without you.”
I hear it all the time, and, although I know that each and every woman I serve would have given birth to their babies without my support, I also understand the value of a trained support person during birth. A doula provides continuous emotional, informational and physical support to women and their families. In the past 7 years I have been honored to see over 100 women become mothers, sometimes for the 3rd and 4th time, and it never ceases to amaze me. I still get teary-eyed when women speak to their babies for the first time, gaze into their eyes and count those precious fingers and toes. What makes these women feel that they couldn’t have given birth without my support? As a doula I never leave a woman’s side unless asked to do so. I wipe her brow with a wet cloth, know position changes that are helpful and constantly affirm her ability to become a mother. I help her understand informed consent so she can adequately determine for herself which path she will take if complications arise. I facilitate communication, never speaking on her behalf and allowing her to have open communication with her chosen care provider. I tell her what a good job she is doing with her birth and support her fully in whatever choices she makes, as well as give guidance and assurance to her birth partner if one is present. Doulas give confidence, and confidence is invaluable!
“When continuous labor support was provided by a doula, women experienced a: 31% decrease in the use of Pitocin, 28% decrease in the risk of C-section, 12% increase in the likelihood of a spontaneous vaginal birth, 9% decrease in the use of any medications for pain relief, 14% decrease in the risk of newborns being admitted to a special care nursery, 34% decrease in the risk of being dissatisfied with the birth experience.” Rebecca Dekkar, Evidence Based Birth (www.evidencebasedbirth.com)
Keeping those statistics in mind, who wouldn’t want to have a doula? Doulas can be found by asking care providers who they’ve worked with, searching doula databases, checking with local birth resources or asking friends and families who they have hired in the past. When you have narrowed your choices, you will want to set up in-person interviews to determine who will be the right person for your birth. Here are some suggestions of questions to ask during the interview process:
- What is her level of training and is she certified or working toward certification? There are many reputable organizations including, but not limited to DONA and CAPPA who train and equip doulas to serve women while abiding by ethical standards. Finding out what the doula abides by is essential in knowing how she will respond within the birth environment you have chosen.
- What is her level of experience? Every doula has to start somewhere and newer doulas are very excited and full of zeal for their new profession. If cost is a factor a newer doula is generally less expensive than a doula with up-to-date certifications and multiple birth experiences to draw from. The benefits of established doulas are that they have been exposed to the birth culture within the community, they have previous experiences from which to draw and they have good relationships already established with the providers in the area.
- How does she view her role? A doula’s role is defined by you as the parent while maintaining ethical standards of conduct and respecting the care team you have established. She may do a lot of behind-the-scenes work or be more hands-on and actively encouraging to you. She may be there as a support to the birth partner as well so that he/she can be more actively supporting you as well. Doulas are not medical care providers and do not offer vaginal exams, checks of the fetal heart tones or blood pressure readings.
- Does she have references? Are her own previous clients willing to vouch for her work and have your chosen birth care team worked well with her in the past? Speaking with a few previous clients can help determine if she will be the right doula for you. You can ask them what the doula did that most helped them or if there was anything they wished she had done differently or better.
- How many births does she take per month and has she missed any and why? It is inevitable that full-time doulas will eventually miss a birth due to sickness or clients having babies on the same day, but this should be the exception and not the rule! When interviewing doulas ask who they provide back up for and how often.
- How long would it take for her to reach you? If she has children does she have care arranged? A doula should be able to reach you fairly quickly, especially with adequate notice. Most will have a range of 1-2 hours depending on how far away they live. If childcare isn’t established then finding someone last-minute can prove difficult for most doulas. Ensure that she can attend to you fairly quickly and everything has been planned ahead for your birth. You should be a priority in her life!
- How would she feel if you were to opt for medical intervention even if it weren’t indicated by research? A doula should respect all decisions made by you in all instances. She can help you communicate with your care providers to be sure you understand your options, but not speak on your behalf. A doula will help walk you through any questions you have, present alternatives that may have been looked over and allow you to make the final decision without pushing her own philosophy above yours.
- What are your fees and policies? A doula should have everything outlined in a contractual agreement. This allows everyone to understand what happens in every birth situation. What happens if she misses the birth? What are her fees? What is the refund policy? Who is her back up? What is included? All of these questions are important and provide instant clarity of expectations.
Choosing a doula is something very personal and should be a smooth and fun experience for you. Call around, set up interviews and ask your important questions. Once you have taken some time to discuss and decide on the best doula for you, send in the deposit and relax, knowing you have made a wonderful decision regarding your pregnancy and birth. A healthy baby and healthy mom are important, but a positive birth experience is as well!
Enjoy your beautiful birth!
Julie Six is a local doula certified with DONA and CBI. She has attended over 100 births in the last 8 years and enjoys teaching Hypnobabies and helping women have easier more comfortable births. She is the owner and founder of the up and coming doula group, Birth Kentucky, LLC. For more information on finding a doula or childbirth classes in the Lexington, KY area please contact Baby Moon at 859-335-5949 or email firstname.lastname@example.org