Let’s start things off right, because not everyone truly understands what a doula is and what they do, even though it’s become a rather trendy thing to talk about these days in the birth circuit.
What Is A Doula?
Many expectant mothers enter into their first pregnancy and don’t even know what a doula is. They poke around in a support group or two and suddenly find themselves completely immersed in a beautiful world of birth culture that they never knew existed, and a few key words keep showing up—one of them being “doula.”
So what is a doula anyway? Glad you asked. A doula is the best friend you never knew you needed during labor. Most are female but there are male doulas, as well. Stemming from the Greek meaning of “a woman who serves.” Technically, it could take on many meanings from that point of view, but the developed intention of the profession primarily resides around all things motherhood. The most common kind of doula is a birth doula. She (or he) accompanies you during your birth and acts as a support role.
How Do They Help With Home Birth?
So you’ve decided to become a part of the 1.28 percent of American women who birth at home, and your partner will be there with you. (Source) You might even have your mom there, your mother-in-law (if she’s lucky) or your sister(s). Why on Earth would you need any more support? Well, why wouldn’t you need the support of a professional who has attended far more births than your family members ever have?
A doula doesn’t just sit idly by waiting for your baby to be born. They aren’t as emotionally invested in the process either. While they have a deep desire to help women achieve their birth goals, they aren’t waiting on their newest little grandbaby, niece or nephew to arrive. Rather, they’re on deck for anything you may need as you bring your child into the world.
This isn’t limited to just your needs either. Dad may need a break for a nap, a bathroom break, tending to other kids in the home, or just grabbing a quick snack. The doula can serve as a substitute for him in those moments. That being said, a doula does not inherently replace the father’s role during a birth. She aids it. But she may also step in to be a second set of pain-relieving hands.
When you’re in the throes of labor, he might not remember every detail of what those few hours in birthing classes taught him. He may panic or feel distressed that you are in so much pain. Enter, your doula. Hubby might even worry that things aren’t going as planned if events arise that no one told him could happen beforehand. Again, enter, your doula. She calms fears; she makes sure you are both fully informed; she advocates for your choices.
Why Would Anyone Want A Doula?
There are many reasons someone may want to have a doula at their birth, and women are encouraged to share those reasons. Some of them include:
- A prior birth trauma that left them feeling violated and in need of extra reinforcement to make sure their rights aren’t violated again
- Help getting educated on decisions which need to be made on the spot that the mother and father aren’t fully informed on
- A doula can help mom find her voice when she wants to say no to a provider’s recommendation but doesn’t feel very sure of herself
- A doula can help guide Dad in what to do to help support mom and assist with pain management during labor
Who May Not Want A Doula?
I’ll be the first to admit: I’ve never wanted a doula. I can’t say what they may have added to my births, but I’ve also never had a birth I wasn’t happy with. I’m fortunate, yes, and I know it.
Not all women have had the same outcome that I have. Further, I acknowledge that working in this field gives me an educational advantage in some respects. If I weren’t as informed or felt I only had nine months to prepare myself, a doula might be exactly what I was looking for. But it wasn’t.
Even though I acknowledge a doula wouldn’t replace my partner, I did feel having another person present may distract from the intimacy I was seeking during my births. In having a home birth, I was already on board for having as few people present as possible. I did not invite the whole fam.
My father was here to tend to our toddler and our teenage son; our teenage daughter stayed present for the whole birth. Her dad was right there by my side and my midwife and her student were present. That was it. I even decided against the birth photography I really wanted because I truly didn’t want someone in the room clicking and snapping with lights flashing.
So, no, doulas aren’t for everyone. To claim they were when I’ve never desired to have one wouldn’t be right. But they are highly beneficial for many women. I still strongly recommend if I get any sense that a friend or client isn’t as prepared and informed as she may need to be, and generally that is still through no fault of her own. It’s not at all a burden to bear, such as to say a woman needs a doula because she’s not enough on her own. You are enough. But how wonderful to have the option of extra support!
Questions To Ask When Interviewing A Doula
There are lots of questions that might spring to your mind when preparing to interview a doula. Sometimes we don’t know what we need to ask though. We might need further guidance. There are questions that someone who has never hired a doula before may not know to ask, such as:
1. What is your philosophy on natural birth?
Going into natural birth, you’re going to want to make sure you are interviewing doulas who are fans of it. That doesn’t mean they need to have a track record of only attending home births. In fact, that may limit them even more to having attended fewer total births. Natural births happen in hospitals all the time. I’ve done it myself.
In addition, consider whether you’d really want a doula with no hospital birth experience. What would happen if you had to transfer to the hospital during your home birth? Wouldn’t you want a doula who knew how to assist you in achieving a natural birth in a hospital?
Many women think that a nurse can act as the doula during childbirth, but many of them are not at all trained to accommodate women during natural childbirth. In addition, research shows that women expect their nurses to spend roughly 53 percent of their time with them during their labors, but as it turned out, the nurses only spent around 6 to 10 percent of their time on the clock with them. (Source) Don’t forget that nurses are busy and their time is divided between patients. When you have a doula, you are her only client.
It would only be beneficial to you if your doula also had experience working in the very hospital you would transfer to or with the providers who work there. Of course, this is tentative because no one here is planning to go to the hospital to have a baby. But it is a good safeguard to have in mind.
2. How do you feel about home birth?
Expanding upon that, while a doula may be a fan of natural birth, she may not have any experience with home births. If she doesn’t, ask why. Gauge her responses. How do they make you feel? Do you get the impression home birth makes her feel uncomfortable or as though she would be putting herself at more risk? If so, you may want to move on to the next qualified doula on your list.
3. How many births have you attended?
You’ll also want to inquire about how long she had been a doula and how many births she has attended. Some women do make a business out of being a doula on the side. Understand that they will never have the birth statistics of a full-time birth worker, midwife or obstetrician when they’ve only been in business for a few years or working part-time.
4. How many of those were home births?
This is pretty self-explanatory. When you’re planning a home birth, you may want to be sure your doula has experience with such. However, some women are just fine with a doula that hasn’t attended a home birth. Hey, someone has to be the first right? That’s okay, too.
5. What kind of training did you go through to become a doula?
Be up front about you concerns. While the doula isn’t your midwife, you are investing a healthy sum of money into her experience and you have every right to know what that experience consists of. In other words, what are you buying from her?
If she has gone through specific training, how long ago did she complete it? What did it consist of? Has she engaged in any kind of continuing education since completion of it? Questions like this will weed out the more seasoned doulas from those who just opted for calling themselves such without any work being put in first on their part to make sure they do the job well.
6. Are you certified by any formal organizations?
Taking things one step further, inquire as to whether your potential doula is certified or otherwise approved by any kind of formally recognized organization.
7. Are you available for my estimated due date?
A lot of providers are available during your due date. They’ll be around all month, as far as they know at the time you book them. But six months later, they might decide to book a trip the week before you’re due. With a packed schedule, what’s a doula to do when she needs a vacation?
Hey, it happens. If you’re particularly concerned about this, inquire further. Ask about holidays and potential family gatherings or other events that could take them out of town.
8. What happens if I go into labor before or after that four-week span of time?
Your doula will likely be on call for two to three weeks before your due date and two weeks after. That being said, some women will go into labor outside of that four- or five-week range. However, most women who go into labor before 37 weeks will be directed to a hospital for birthing. But those who go into labor after 42 weeks 0 days may still birth at home. If this happens to you, will your doula still be available to you? This is important to know given that 10 percent of women go beyond 42 weeks. (Source)
9. How many clients do you take on at once?
So the good news is she’s going to be around for your estimated due date. But don’t stop there. You should also inquire as to how many clients your doula takes on at one time.
While some doulas do only work on the side as a supplement to their career or motherhood, others will make doula-ing their full-time gig. In either case, they could be overloaded with too many clients in one four-week span. Make sure this isn’t the case for you. The more clients a doula has around your baby’s estimated birth date, the more likely they could end up with multiple clients in labor at the same time—potentially leaving you in the lurch.
10. What happens if you don’t make it to my birth in time?
Now then, rest assured that your doula will do all she can to make it to your birth. You’ve secured her word that she won’t be leaving town short of any emergency that carries her away. But what if your birth happens so fast that she doesn’t make it in time?
Some doulas won’t refund any portion of the money you paid them if this happens, as it was out of their control. Others will refund some of it, but do take into account that what you were paying for wasn’t just their accompaniment during labor but the weeks of time they blocked off for you to have them on-call.
11. Who is your back-up doula?
Sometimes a doula will be tied up at another birth, or she may be sick or otherwise unavailable. Life does happen. Doulas are women; that is, they are human beings.
Be upfront about this and ask during the interview process who her back-up doula is. If it’s important to you to know every possible person that may be around you during your birth, you may want to schedule an interview with the doula’s back-up, too.
You might also want to ask why she chose the back-up doula that she did. Was that the only doula willing to do it or otherwise available? Or were there specific features and characteristics she likes about her back-up that let her know she was “the one?”
12. Do you know my midwife?
Now then, doulas are not the only birth workers in town, momma. You may also want to ask whether your doula knows your midwife. How does she speak of her? You can also ask your midwife about your doula if they do know one another. Getting an idea of how they interact and their opinions of one another ahead of time can make or break your idea of which doula you choose.
13. How many of your clients who aim to go natural end up doing so?
Don’t fault her if she doesn’t have actual statistics at the ready. Not everyone who is looking to employ a doula during their birth is even planning to go natural. Births, in general, are usually the target audience for a doula’s services—not just natural births and not just home births. Keep in mind that research shows women who have continuous support during labor show a 10 percent decrease in the use of medicated pain relief. (Source)
Still, you can get a rough idea of how helpful a specific doula may be in this bracket by engaging in conversation with her about births she has attended where the mom planned to go natural but ultimately didn’t. Make note of how many moms she references and what “went wrong” during those births. Were the “wrong points” things the doula could have potentially intervened upon?
14. How often do we see each other during my pregnancy?
You’ll want to know how often you can expect to see your doula during your pregnancy. You’ll also want to ask how long each meeting will be. These sessions will serve as the foundation of your relationship with this woman who is slated to share in one of the most important moments of your life. You need adequate time to get to know her. It shouldn’t feel like a nine-month-long interview, but rather, a budding friendship.
15. At what point during my labor do you show up?
While I’m not a big fan of putting too much intention into planning for alternatives to a home birth out of concern that said energy can manifest into more, you should be well aware of the roles your birth team will play if your birth plan suddenly changes.
What happens to your doula if your home birth plans are poxed? If you suddenly need to be transferred to the hospital during the birth, or you know in advance you’ll have to be induced, will the doula still attend your birth? This can be one disadvantage of choosing a doula who only works with home birth clients.
16. How long do you stay after I’ve had my baby?
Believe it or not, you will love every minute of that postpartum bliss with your newborn. However, home birth is a new experience for many moms who’ve only birthed in hospitals before. Those moms may be taken aback a bit that their birth team seems to pack up and leave in one fell swoop. Within just a few hours of your baby arriving, the midwife, doula and anyone else who was there for the blessed moment may be on their way out the door.
Be prepared for that moment, knowing that—as silly as it sounds—it can bring some feelings of loneliness. Even though we’re thrilled our baby is in our arms, the penultimate moment of birth we’d been looking forward to for nearly a year is now over. It’s normal to have those bittersweet feelings and not want life to move on so fast. Ask how long the doula will stay after birth—even if it’s just part of preparing yourself emotionally.
17. Do you stay the whole time no matter how long I labor for?
Labor is an intensive process. Some women might labor for a few hours but others—especially first-time moms—could be in labor for days. (Source) You’ll want to know just how much of your labor you can rely on your doula’s support for. If you’re laboring for days, will she come and go? Will she stay overnight? Will she ride this thing with you till the wheels fall off?
18. How will I be able to reach you?
What forms of communication does your doula rely on? Is she available often? Are there certain hours you need to contact her within when it’s not emergent? Get all of this info up front. While most of us have no trouble understanding the doula needs a day off and a good night’s sleep, too, we still want to know they have ground rules in place. It just makes everything more kosher and there’s no worry or hesitation on your part about texting her at 9PM then.
19. What are your favorite coping techniques?
You’ll likely want help getting through labor; that’s probably why hiring a doula is on your to-do list. The pain is generally like nothing else you’ve ever experienced. It’s hard for many women to explain or quantify, and not knowing what to expect if you’re a first-time mother can feeling daunting.
Ask your doula what her go-to coping techniques are. What will she do for back labor? Which positions does she recommend for pain in certain places on your body? What if labor is stalling? These things will come in handy more in the process of birth and you may not even remember her answers after she tells you, but they will give you insight into how prepared she is for your big day. Studies show that having a support person like a doula in place during your labor will keep pain and anxiety levels at a minimum. (Source)
20. Do you have any personal experience with home and/or natural birth?
While it’s great to have a doula who has experience supporting other home birth moms, you may also find additional connection with your doula if she has birthed at home herself.
Perhaps she didn’t birth at home but has had natural hospital births. That counts for something, too. Her knowledge and personal experience can be imparted on you. She really will “get it.”
21. Did you use a doula yourself?
Speaking of your doula’s own birth experiences, if she’s had children, did she have a doula? Why or why not? If she didn’t, what changes would she make now if she could go back and have one? If she did, in what ways did her doula help her?
22. How much do you charge and what does your fee include?
Payment is a big topic, and it may be the first one on your partner’s list. Men and their provider instincts! Seriously though, you do need to weigh what your doula offers alongside what you’re paying for those offerings.
Ask for a thorough description of what services are included in her fee, when it is due, and what methods of payment she accepts. Good news: some doulas love to barter!
23. Do you meet with us after the birth to review how things went?
Some women are fans of this and some feel too busy after birth and are far more immersed in moving on with life. Whether you want this service is up to you.
It can be particularly important if you are planning to have more children. Some women want to make use of the same doula over the years with every birth. In these cases, you might want to meet with your doula after a birth to review what helped you and what didn’t, or things you feel you would do differently next time. Other moms just like a review session to help them process their birth. There really is no wrong way to do this.
24. Do you have references I can speak with?
References are crucial. Don’t be afraid to reach out and call someone in this day and age of a text-dominant society. Whether a woman has had a good or a bad experience, she typically won’t shy away from being front and center and discussing her birth story. Come on, you know we love it!
25. What is your role compared to my partner’s?
Again, a doula doesn’t serve to replace the partner. Any doula worth their salt should make sure potential clients fully understand this. Dad still has the most important role next to mom. The doula is there to support them both.
26. Do you offer any other services?
Often, you can save money by doubling up on who your service providers are. Many doulas offer other services and if you’re using them for your birth support, you may get discounts on them. For instance, a lot of birth doulas also encapsulate placentas, perform birth photography, and act as a postpartum doula, too. The latter can be a great addition to new motherhood as 41 percent of moms don’t attend any postpartum visits. (Source)
27. Can you help with breastfeeding?
This may be one reason you want the doula to stick around for a bit after birth. Sometimes they might pitch in and help taking down the birth pool or cleaning up other supplies. They may help you get settled in with baby, too. Part of that includes helping you to get on the path to establishing breastfeeding.
We can never predict what issues we may happen upon with breastfeeding, even if we’ve done it a few times before. Having someone available to us immediately after birth that has a little experience helping women perfect that latch can go a long way in setting us up in the right place from the start.
28. Why do you doula?
Last but not least, ask your doula why she’s here. Why did she become a doula? Was it her own birth or someone else’s that motivated her? What does she get from it? What part of this career choice really feeds her soul? The answer to this question might really speak to you as a woman. Listen closely.
Now Ask Yourself: How Am I Feeling?
Did you feel heard? Was she really listening to you? Or are you just another in the long line of interviews she’s done with the same questions over and over again?
Did you click? Do you feel like this is someone who could be a part of your sisterhood and your story? Would you look back on your pregnancy and birth and be happy that she was a part of it? Did she inspire you to be your best you?
Take important note of how you feel immediately after your interview with each doula. Go with your gut. Those momma instincts won’t steer you wrong.
How Can You Find The Right Doula?
There are many websites and birth networks that can refer you to doulas in your area. This is the starting point for many women. Sometimes you can also find recommendations from other mothers in local support groups—both on- and offline.
Another option is to ask your midwife who she recommends that she has worked with; she may have extra insight since she’s gotten to know you a bit and may have an idea of what kind of doula personality might suit you best.
There are lots of doulas out there. There has to be. A 2012 study noted 6 percent of women report using a doula during birth and it appears those statistics are only on the rise. (Source) Don’t hesitate to interview as many as you need to until you find the doula that is perfect for you.
Can I Still Have A Natural Birth Without A Doula?
Of course, not everyone can afford to have a doula present at their birth. Short of asking for help from family or making cutbacks to make it happen, if you can’t swing it, don’t fret. You can still have an amazing natural home birth without a doula. All you need to do is prepare ahead of time and educate yourself on the in’s and out’s of home birth.
Pin this article to reference later after you have decided to hire a doula so you know what questions to ask during your interview.
