Choosing a Birth Doula

Second Trimester

Feb 13

[If you are actually looking for info on postpartum/night doulas, click here.]

A birth doula provides physical, emotional and educational support during the final months of pregnancy and at birth.

While not a medical professional, she ideally has lots of experience navigating the medical system and can be your advocate at a hospital (or birth center). This is especially helpful if it’s your first birth because there will be so much that is new and potentially overwhelming.

Benefits of a birth doula

Prenatally:

She can educate you on the possible scenarios and options. You’ll discuss what could happen from hospital triage to admission to labor and after birth. You’ll review your choices around pain management and other procedures. This might include crafting a birth plan/preferences together. Even just being familiar with all the medical terms will make the experience less scary.
She can help you prepare emotionally and physically for birth. This looks different for each person, but could include creating a mantra or visualization, breathing techniques, perineal stretching, or practicing different labor positions. You can read more about these techniques here.
She can help your partner help you. She can coach your partner in how to provide you with physical support such as counter-pressure, how to count your contractions, etc. During labor, she can give your partner guidance and a break (labor can be very long and demanding for a partner too!)

During labor:

She can help determine when to leave for the hospital. A doula might join you at home during early labor or be in communication with you via the phone. Without a doula, many first-time pregnant women go to the hospital too early and spend an unnecessarily long time there (or get sent home). This can sometimes lead to impatience on the part of the mom or hospital staff, which might increase likelihood of undergoing interventions to speed up labor.
She can interact with the hospital staff so you can focus on labor. This means answering questions, ensuring that new nurses after a changeover are aware of your birth preferences, etc. There may be some tension between doulas and the hospital staff - but ultimately this is a healthy tension that you’ll benefit from!
She can help you decide if and when to undergo a medical intervention. Evidence suggests that having a doula leads to lower use of epidurals and forceps, and also reduces the risk of C-section. But they may also recommend a given intervention depending on your unique scenario (mine did, ask me about it!)

Note: some doulas also offer placenta encapsulation services; while it’s totally up to you if you’re interested in this, know that there is little research to support the benefits and it does carry some risk since it could be infected.

Hiring a birth doula

It’s never too late or too early to hire a doula, but the second trimester is ideal
They typically cost between $1,000 - $3,000 depending on location, experience level and/or your income
Almost all offer a free consultation/interview - below are suggested questions to ask:
- Are you available during my due date window? Do you take on multiple clients during a window and if so, do you work with a backup doula?
- How many births have you supported? Have you supported births at my hospital (or other birth location), and what has your experience there been?
- How many prenatal meetings do you provide and what will we cover? What about postpartum?
- What situations do you believe call for induction/epidural/C-section and how would you help me make that decision? (look for someone who is not dogmatic and will be respectful of your choices)
- What role do you see my partner playing and how will you support them?

Make you choice based on these answers, how well you vibe, and any Yelp reviews or other testimonials.