Hiring a Birth Doula
*scroll to the bottom for a list of questions to ask*
There are just a few things to consider when you find out you're pregnant. Ya know, like, is the baby healthy, all the testing, bloodwork, "morning" sickness, nutrition during pregnancy, what I can and can't eat, gestational diabetes, pushing a baby out of there, how my life is going to change, am I going to be a good parent, is my partner going to be excited and supportive, what are my parents going to say, do I feel supported by my provider, what hospital am I going to be delivering at, do I want to find out the sex of the baby, what are my birth preferences, allllll the health insurance things... just to name a few! No wonder most women I talk to are scared when they find out they're pregnant. The last thing on your mind is hiring a doula.
What do we really have as real world examples of what pregnancy, labor and delivery looks like? The movies?! That's not real. They show you craving pickles and ice cream and waddling around. The woman pushes three times and the baby is out. Even June in The Handmaid's Tale made it look so easy free birthing her baby in an abandoned house in front of the fire. That's not reality. In my case, I craved nothing, puked every day from 11 weeks until 35 weeks and pushed for 35 minutes.
If you're like me, your OBGYN brought you in for a pregnancy test to confirm what you already peed on at home. They send you for bloodwork to confirm that your HCG levels are rising as they do in a healthy pregnancy. They schedule a sonogram to figure out how far along you are and if your HCG levels are where they should be in relation to the sonogram, and they send you on your way until another one at 12 weeks. That's up to 7 weeks before you talk to anyone about your pregnancy again!
Then, you go in at 12 weeks and they check your blood pressure, baby's heartbeat, and do another sonogram and send you on your way. I came in with a long list of questions because I had a lot of birth preferences. You're going to hear "birth preferences" a lot, because nothing can be 100% planned in pregnancy, labor and delivery. I started asking my obstetrician questions that she assured me we would "get to later in pregnancy." However, by my 12 week appointment I had already toured The Birthing Center of Buffalo because I wanted an out of hospital birth. We'll get to those reasons another day. I had already met an obstetrician at The Birthing Center who had answered all of these questions and I was happy with her responses. So I told my provider my wishes, concerns, and that I was willing to shop around to find a provider that aligned with my views. She answered my questions but I wasn't 100% convinced that she would honor my preferences when it came time for labor and delivery.
At this point you can probably already tell that I've had an idea in my head for a really long time about how I wanted to birth my baby well before I was ever even pregnant. I am not like most people, but I think more people are becoming this way with health care, or lack of, in our country and more people learning about holistic medicine.
After this 12 week appointment, I went back to Google to research all my options. I searched for providers and hospitals who had midwives because they have more experience with natural childbirth and I ended back up on The Birthing Center's website. In order to receive care there, you must hire a doula. I thought that was interesting. I spoke with a friend who has birthed most of her babies at home and she got me in touch with her doula. We spoke on the phone but unfortunately she was not available around the time of my due date.
Back to The Birthing Center's website. There was a decent amount of approved doulas that they work with. I read each of their bios and they all seemed great, all from different backgrounds, different ages and I looked at their pictures. I decided the first person I would reach out to was Malissa. Her photo was nice, she seemed about my age, owned a yoga studio, and felt like someone I would hang out with. She actually answered the phone! I told her who I was and where I got her number, and if this was an okay time to chat, and her response was why I knew she was my doula before I even met her in person. "Honestly, I'm walking my dog and I'm not in the right head space right now, so I'd much rather talk about birth." We scheduled a time for me and my partner to grab coffee with her.
That was my start of hiring a doula. I could've interviewed a few others, but she just felt right. During my doula training I learned that a woman's gut and intuition during and right after pregnancy is heightened and not to be messed with. Women have to trust their guts, and I'm glad I did.
Remember when I told you I wasn't 100% convinced my provider would honor my birth preferences when it came time to labor and delivery? This should be your first red flag that this provider is not right for you. If you and your partner are not steadfast and rock solid on your care and what you want, this is going to be an issue when it comes time to getting what you want. Do I have to remind you that this is your care? The doctors work for you, just so you know. They get paid by providing care to you. You are allowed to question everything and advocate for yourself.
That's not to say that doctors and medicine don't have our best interest in mind. Their main concern is a healthy mom and healthy baby... no matter how that has to happen. I personally don't like that. My opinion is that there's something in the mind-body-spirit connection side of health. If you don't think and feel healthy, are you actually healthy? There are so many things we will never understand about the power of the brain.
Doula enters stage right. You don't have to want an unmedicated birth. A doula is there to support you, unbiased, however you wish to birth your baby. If things change throughout pregnancy and you go from low risk to high risk (this could be from gestational diabetes, blood pressure, etc) they can support you even more. With the length of time between appointments, and in my case an office with 6 doctors and 4 midwives, it was beneficial to have someone that I knew would support me throughout the entire process of becoming a mother. Someone that I knew would help me advocate for my birth preferences and who would actually be there for the birth and not just on call like my provider.
I'm going to say it. My boyfriend hates when I say this. Your doctor only comes in to catch their paycheck. As much as you want your chosen obstetrician to be there for your birth, if you are at a practice like mine, you might get whichever doctor is on call at that time. And if you do get your doctor, they only come in for the last 3 pushes. Seriously. The nurse and your partner are the only ones in the room with you towards the end, but for continuous support that is where a doula with birth experience comes in. Nurses and hospital staff change very 12 hours, and your partner will probably be tired and confused at times. A doula can provide assurance when you are going through the transition stage and provide evidence based information when hospital staff offer interventions.
Make sure when hiring a doula, you "click" with them. Is this someone you want to be apart of the most incredible experience of your life? Becoming a mother is surreal. Could you hang out with them for a full day? This is likely the case for first time labors.
I can speak for DONA International certified doulas that they should be unbiased, inclusive, should strive to become and remain proficient through continuing education, should be respectful of client's privacy, other doulas and the doula profession. The doula is encouraged to promote the DONA International vision of “A doula for every person who wants one,” by providing birth doula services, or making appropriate referrals, as available.
Here are some questions you might find helpful to ask when interviewing a doula:
-Are you available around the time of my due date?
-Do you have any other births around the same time?
-Do you have a backup doula if you cannot make it to my birth? Can I meet them?
-What are your fees for birth doula services?
-What comes with your doula support?
-Do I receive prenatal and/or postpartum visits?
-Do you accept insurance?
-How many births have you attended?
-What training did you receive? Are you certified?
-Do you have a birth philosophy?
-Why did you become a doula?
-Have you had any children? Did you have a doula for your birth?
-Do you have experience with home births? Hospitals?
-How do you support the laboring person?
-How do you work with the nurse/midwife/hospital staff?
-Do you have experience with breastfeeding?
-Do you offer any additional services? Photography? Placenta encapsulation?
-Do you have any reviews or references?
And as always, I strive to provide you with resources :)