Frequently Asked Questions
How can hiring a doula contribute to the outcome of my birth?
The evidence shows that professional labor support can have some of the following effects :
labors with doulas present were shorter with fewer complications
emotional support reduces negative feelings about one’s childbirth experience
reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction
reduces the requests for pain medication and epidurals, as well as the incidence of cesareans
significantly reduces the rates of cesarean births
In over 15 trials, which included over 22,000 women, the results provided impressive statistics, all of which indicated that unconditional labor support positively affected a woman’s birth outcomes.
“Overall, women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth.
What does this mean?
It means that if you have continuous labor support (that is, someone who never leaves your side), you are statistically more likely to have better outcomes and your baby is more likely to have better outcomes! How did doulas compare to the other types of continuous support?
The researchers also looked to see if the type of support made a difference. They wanted to know—does it matter who you choose for your continuous support? Does it matter if you choose a midwife, doula, or partner for your continuous support? They were able to look at this question for 6 outcomes: use of any pain medication, use of Pitocin during labor, spontaneous vaginal birth, C-section, admission to special care nursery after birth, and negative ratings of birth experience.
For most of these outcomes,* the best results occurred when woman had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of the woman’s social network.”
We encourage you to read the complete summary of the evidence, here.
What is the difference between a doula's, nurse's or midwife's support?
Doulas are non-medical support for pregnancy and labor. We provide support in a number of emotional and physical ways and do not leave your side in labor. We do not perform clinical or medical tasks such as take blood pressure, monitor your baby’s heart rate, or perform vaginal exams. Midwives are primary care providers in pregnancy and birth, and oversee the safety and health of you and your baby, they are trained and licensed to attend your birth in either a home or hospital setting, depending on the state. While midwives tend to be incredibly supportive of women during birth, their primary concern and responsibility is the safety and wellbeing of you and your baby. A nurse is present in a birth center or hospital birth and they are not your provider nor can they make final ‘calls’ on your course of ‘treatment’ like the OB can, but they are the person you see the most in a hospital birth. In most hospitals, L&D nurses do not have training to physically support laboring Moms, and many do not encourage or advocate for certain types of birth (such as an unmedicated birth). Their primary job is to make sure that a baby and Mom are safe and that all of her patients have the necessities and that she is meeting the hospital’s policies and protocols as expected of her in her unit.
Does a doula make decisions on my behalf?
A doula does not make decisions for clients or intervene in clinical care. We encourage you to be your own advocate in pregnancy and birth. As doulas, we provides informational and emotional support, while respecting a woman’s decisions. Much of the reasons doulas do the work they do is that they recognize that you are accountable and capable to educate yourself and make the choices necessary that design your birth experience. A doula will offer a breadth of information and evidence based practices to consider. It is ultimately your responsibility to make choices concerning your body and your baby.
How will the doula benefit my partner?
Doulas offer objective support throughout your birthing time to both you and your partner(s). Often those who are closest and/or related to you are strongly influenced by the process of labor and struggle on how best to support you. They are too caught up in their own experience, that they struggle to be both wholly there for you physically and mentally. We allow partners to be more present for you, while we handle the more mediocre things like, fetching water, food, taking care of the ambiance of the room. Doulas allow partners to take breaks, contact family, go to the restroom and occasionally sleep in those longer labors. Doulas often foresee standard processes that might be coming down the line so that you and your partner have time to navigate these choices together without being caught completely off guard. In some of the most basic ways a doula can support partners by showing them the time and experience tested methods of physical & emotional support like how to perform comfort techniques through touch and verbal coaching. Your partner is also experiencing the birth of their child or a new family member. A doula allows for your partner to have their own experience while concurrently supporting yours.
How do I select a doula?
Selecting a doula is a very personal choice. As a collective, we advocate for women and choices and we encourage you to contact at least a couple, if not more doulas, and interview them to better understand who they are and how they can serve you. We believe that there is a doula that is the right fit for every woman and we know the greatest benefit to labor will happen when you’ve found the one for you.
When approaching this search, ask yourself: what am I looking for in a labor support person? While considering training, experience and approach are all very important elements of the decision, the most important factor is how do you feel with the doula? Do you feel heard, safe and understood? Do you experience a level of trust when you engage with her? Choosing a doula has more to do with fit and instinct than specific qualifications. Some women seek mother types to guide them in the birth room, others are seeking peers. For example, many newer professionals may not have a huge resume of experience to offer, but you can see sharing your most intimate details and space with them. That is more the key to finding the perfect doula for you. When you meet her, you will just know she is the one intended to be with you through this experience.
What questions do I ask a doula when interviewing them?
When Interviewing a Birth Doula
1. What is your philosophy to supporting families in birth?
2. What do you think is the most important aspect of your services?
3. What is your background, training and are you certified with any organizations?
4. Why did you choose to become a doula?
5. What does your offer of services include?
6. Do you have one or more backup doulas for times when you are not available?
7. What is your fee, what does it include, and what is your refund policy?
When Interviewing a Postpartum Doula
1. Tell me about your experience as a postpartum doula.
2. What is your philosophy about parenting and supporting women and their families during postpartum?
3. May we meet to discuss our needs and the role you will play?
4. What different types of services do you offer?
5. When do your services begin postpartum?
6. What is your experience in breast-feeding support?
7. Have you had a criminal background check, a recent TB test and/or CPR certification?
How much does a doula cost?
The cost for doula services is dependent on many factors and is individually set by each doula. Price should not be your deciding factor when selecting a doula. Compassionate and competent support through the birthing experience is truly priceless. Most of us live in the real world and we know cost is a factor during most of our decision making processes. If you really have a financial need, let the doula you are interested in know. Some insurance flex plans may reimburse for doula services, there are billing codes that doulas can offer so that diligent people can be reimbursed through their insurance companies, there are doulas-in-training offering lower cost services. Many doulas also offer some form of payment plan, sliding-scale and sometimes bartering options.
Do doulas accept insurance?
At this time insurance carriers do not usually cover doula services, however, some have flex payment plans that will now reimburse you for doula services and occasionally you can find out about billing codes that your insurance company will accept. Contact your insurance company for their specific requirements. Talk to health care professionals and peers about what they've seen work.
Do you support clients who plan to use pain medication?
Doulas support a women's right to choose how THEY wish to birth. This includes supporting a laboring woman who chooses to labor unmedicated or medicated. When you are making choices about interventions during birth, your doula can work with you to facilitate conversations with your provider about the risks, benefits, and alternatives to any test, treatment or procedure.