Wednesday, August 26, 2009

A Doula Interview for Wellness Wednesday

I had the pleasure of interviewing one of the best doulas around, Julie Byers, just a few weeks before she gave birth to her second baby. Her birth story is amazing and you can read it here and here. She took the time to answer all my questions and I found out a lot of stuff I didn't know! I hope you find this informative!!

Me: What is a doula?

Julie: The literal translation of the word is "female slave" in Greek. And, frankly, I find that description to fit what most doulas do. We do whatever the birthing woman needs us to do--and that looks very different to each family. The professional term has evolved to mean a woman who assists during childbirth. She provides emotional and physical support to laboring families. She also helps the couple to know what to expect from their care providers and birth environment, reminds them of questions to ask, and often communicates birth wishes to the medical team. At a time when birth has become more procedure oriented and medicalized, the doula can assist a couple in creating a unique and celebratory experience. We guard their space. Some couples want more from their birth than to simply show up and be delivered of a baby. They want to be active and informed participants.

Me: Why do I need a doula?

Julie: In my opinion, for a first time couple planning a hospital birth, a doula is an absolute essential part of the plan. Regardless of your birth choices (natural, medicated, induced, elective c-section), a doula is the only part of your birth team who is only answering to you. She isn't answering to the hospital administration or a malpractice insurance policy. She knows the routines, the pitfalls, and the perks. Sometimes, just the fact that a couple hires a doula sends a message to the medical team that they have given thought to their birth and that they take informed consent seriously. For out-of-hospital births and experienced couples, a doula is still a powerful addition to the team.

Me: What certifications, experience, expertise should I look for when interviewing a doula?

Julie: I think the most important thing to look for in a doula is how she meshes with your personality and needs. Her ability to tune into your needs will be her best skill and sometimes people just don't mesh. So, don't choose a doula with more experience or better certification that you didn't feel comfortable with. There are several certifying organizations (DONA, CAPPA, Hypnobabies, Birthing From Within, etc). Some doulas choose to certify and some don't. Some receive their training from apprenticing with other doulas/midwives and some attend workshops or complete distance learning courses. I love when couples ask me for references from OBs/midwives or couples I've worked with.

Me: How much can I expect to pay a doula?

Julie: The range I've noticed in our area is between $500-800. You can often find a student doula for less or for free. Some doulas will barter. And usually, a Flexible Spending Account (FSA) will cover doula services. I tell couples: remember what you paid for your wedding! This event is important! Besides, a doula is much less than an epidural or c-section.

Me: Are there rules about paying more if a labor goes longer, or less if it is shorter? Are tips standard?

Julie: I have heard of doulas charging more if a labor goes longer but that is not typical. We usually charge a flat fee regardless of length of labor. Each doula will have a contract with specific provisions for things like precipitous births or planned cesareans. Some couples tip and some don't--I never expect it.

Me: How many times should I meet with my doula?

Julie: It varies. Most offer a free birth consultation or interview. Then, if hired, meet with the couple two times before the birth. The doula is available by phone or email from the time they are hired until the couple is settled postpartum.

Me: What red flags should I look for when interviewing a doula?

Julie: Agendas. Some doulas only want to support unmedicated births or seem to have a plan of their own about how birth should go. You want a doula who takes time to understand your needs and wishes, the culture of your family, and what is most important to you.

Me: Do I need to have my doula approved by my doctors/hospital?

Julie: No, you can bring whomever you choose to your birth. However, it is a good idea to mention to your OB/midwife that you have hired a doula. Or invite your doula to a prenatal appointment even.

Me: Should my doula attend my childbirth education classes with me?

Julie: If it is ok with your instructor and your doula is not familiar with your particular childbirth education choice, this might be beneficial. If you are a single mother, having your doula attend your class with you would be excellent!

Me: I would like to give a gift to my doula. What are some appropriate gift ideas?

Julie: Something simple would be a picture of the doula with your new baby. I love getting those! Other ideas might be birth jewelry or art. has a section of lovely doula gifts.

Me: Where should I go to find qualified doulas in my area?

Julie: Ask. I get all of my clients through word of mouth. Post to a message board like Upstate Moms, ask midwives or childbirth educators, talk to a playgroup. Or google.

Me: I'm afraid that the doula I like is too expensive. Are there grants available? Could we barter? Are there options?

Julie: Most doulas will work with you on this one. Payment plans are almost always an option. I have had couples pay me months after a birth when they received their tax refund! And I've bartered. I mentioned using a flex spending account. And check with your insurance company--you never know!

Me: How many births have you attended?

Julie: I hate this question because I haven't taken the time to add them up! I honestly don't know. I didn't mean to become a doula so many of my early births went undocumented--one day I'll gather together all the records. I will say that I attend 2-3 births per month now and I average 12 hours of continuous labor support (not including prenatal and postpartum care) with each couple.

*A big thanks to Julie for answering each question so thoughtfully and completely... She's the best!! :)


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