What Is A Labor Support Doula?

Doula is a Greek word for “woman’s servant.”

A birth doula (aka Labor Support Doula) is a supportive companion professionally trained to provide physical and emotional support during labor and birth.

A doula provides continuous support, beginning during early or active labor, through birth, and for approximately 2 hours following the birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement, positioning, and massage. She also assists families with gathering information about the course of labor and their options. Her most critical role is providing continuous emotional reassurance and comfort.

Doulas work with all types of women, whether they are planning on pain medication or unmedicated birth, planning home birth or hospital birth, being cared for by a doctor or a midwife. Doulas may be the only support person for the mother, or may be part of a labor support team including mom’s partner, friend(s), and/or family members. Her role is not to replace mom’s partner or friends, but to work together to support the laboring mom, each in their own unique way.

Doulas specialize in non-medical skills, and do not perform clinical tasks, or diagnose medical conditions. Doulas do not make decisions for their clients. Their goal is to provide the support and information needed to help the birthing mother have a safe and satisfying birth as the mother defines it.

Proven Benefits of Doula Care

Decreased medical intervention in labor*:
Reduces need for cesarean by 26%
Reduces the need for forceps or vacuum extractor by 41%
Reduces use of pain medication by 28%
Reduces dissatisfaction with birth by 33%
Reduces length of labor
6 weeks after birth, mothers who had doulas were:
Less anxious and depressed
Had more confidence with baby
More satisfied w/ partner
More likely to be breastfeeding
For more about the research and these statistics, see http://www.dona.org/publications/position_paper_birth.phpand Hodnett E, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews 2003. Issue 3, Art. No. CD003766. DOI: 10.1002/14651858.CD003766.

How much will doula services cost?

Typically, a doula charges a flat fee which includes: one or two prenatal visits to meet each other and discuss the birth plan, attendance at the birth, from whenever the family requests her presence until two hours after the birth (whether you have a four hour labor or a forty hour labor!), and one postpartum visit.

How much a doula charges for her services depends on these four factors: how much training/education she has (as a doula, or related training, such as nursing, massage, or social work), how much experience she has, what other doulas are charging in her area, and what her income needs are. (For some women, doula work is a labor of love, for some it is supplemental income, for some women it’s their sole source of income.)

In the Seattle area, a new doula may charge $250 – 300. Experienced doulas are charging $300 – 750. A few doulas are charging $750 – 1200. Some doulas offer a sliding scale fee, where lower income women can request a lower fee.

Unfortunately, insurance does not cover doula services.

How do you find and hire a doula?

Step #1: Find a list of available birth doulas in your area. Here are some good resources for that:
Ask your childbirth educator, midwife, or doctor for referrals.

For Seattle area doulas, call PALS at (206)325-1419 or visit their website for a list of Seattle resources: http://www.transitiontoparenthood.com/ttp/resources/Seattle.htm#doula

Doulas of North America (DONA). (888)788-DONA. www.dona.org DONA is the major North American doula organization, and on their website, you can get referrals to certified doulas in many cities.

There are a number of doulas who have personal websites. Try a google search, and see what you come up with.
Step #2: Once you have a list of options, pick 3 – 5 doulas to contact.

Step #3: Call the doulas you’ve chosen and do a brief phone interview with them. Find out if they are available for your due date. If not, ask who they would recommend.

If they are available, tell them you’re doing an initial phone interview of 3 – 5 doulas, to get a sense of who might be a good match for you and your needs.

Then, find out a little more about their experience, the skills they have, the attitudes they bring to a birth, and what their services typically include. Find out about fees and other practical details. Most importantly, in this phone call, you’re checking out “the vibes”. Is this someone you think you could be comfortable with? If so, set up an in-person interview.

Step #4: Meet with one or more doulas in person.

Find out more about them, tell them more about you and your birth plan.

See if you have compatible philosophies, and if you think the style of support they offer would be helpful to you.

If the interaction doesn’t feel right to you, then let them know that, and try interviewing other doulas! Although training and experience and fee structure are all important factors in the selection, the most important factor is: do you and your partner feel comfortable with this person? Would you feel comfortable having her at your birth, and do you think she would be a good support for you? All of us have different personalities and styles, and sometimes the chemistry just doesn’t feel right. Trust this instinct and move on.

Step #5: Hire a doula and start working together on the details of your birth plan.

Once you have found “the right doula”, start making arrangements with her for your birth, and set up another prenatal meeting to discuss your birth plan in detail.

If you need a few days to decide, tell her this, but do make your decision soon, otherwise your doula may have to pass up prospective clients while waiting for your decision.

Most doulas will ask for a deposit before going on-call. This is because when we commit to a birth, it’s a major commitment: it means not taking other clients for that time period, it means not going out of town, or making social plans that can’t be re-scheduled, and taking a cell phone everywhere we go. We have chosen the job knowing the level of this commitment, but it is also important to us that our clients honor that: if at some point you decide not to use a doula as planned, it is very important to call and let them know that so they can make other commitments.

Postpartum Doulas

There are also postpartum doulas who provide support after the baby is born. They have knowledge about postpartum recovery, breastfeeding, and newborn care. Their services vary depending on your needs, and might involve anything from a one-time visit for information and advice, to providing overnight care every night for a month.

To find out more about postpartum doulas, go to: Northwest Association of Postpartum Support www.naps-doulas.org or DONA International at www.dona.org