Tuesday, December 1, 2015

Choosing your Doula

Where does one even begin?  It is a profoundly important position to fill and if you rely on a google search or even a more specific resource like doulamatch.com, it can feel very overwhelming.  It feels this way because usually families are trying to find a match for a role they don't: A. completely understand, or B. know what their personal specific needs throughout labor might be.

First, if you haven't honed in on an idea of what you'd like your birth to look and feel like (so long as there are no urgent complications) it's difficult to match yourself to a doula's specific experience/skill-set/style/energy/etc.  I strongly recommend that you get yourself somewhat informed before beginning the interview process.  You can read the entire series on What to Expect, you can sign up for Childbirth Education classes, BUT BEFORE YOU DO THAT, can I just recommend that you grab a copy of my book, Expecting Kindness. 10 easy to read, very informative lessons, available on Amazon.com (with 10 five star reviews) here: http://www.amazon.com/Expecting-Kindness-Kristin-Dibeh. For only $15, you will be prepared to make better decisions regarding what sort of care provider you may prefer, which classes to sign up for, and you will be much better prepared to interview a doula, I even provide a list of questions that I want my potential clients to know the answers to...about me and everyone else they may interview...before making a choice.

Second, avoid Doula's who work FOR the hospital, or are a service provided by the hospital, or a list of doula's who provide support only once you arrive at the hospital.  This is a misrepresentation of the Doula profession.  Our job is not to show up at the time of delivery and be YET ANOTHER stranger in your face telling you to push or hold your leg. The true role of the doula goes much deeper than that.  Even the newly emerging group doula "practice", which is a team of doula's who share call, is less than ideal in my opinion because it dilutes the amount of time you would spend with ONE doula. You would need to meet with each one of the doula's to be certain that you won't have a complete stranger show up at your birth. Each time you make a call to ask a general question, you may hear a different voice on the other end of the phone, and more importantly, receive a variety of feedback. It can be very confusing. The independent, privately contracted doula's job is to create a real trust, a relationship, with you and with your partner (when present).  Our job is to know you enough to understand your wishes, your fears, your perceived strengths and weaknesses.  Our job is to know enough to help hold some challenging space with you, to help hold you accountable to what you believed you wanted...with a clear understanding of YOUR convictions as well as YOUR limits.  Our job is to help meet your physical and emotional needs without overstepping the role of your partner, and to do that we need to know what he or she wants and where you want him or her to be, so we can be and do everything else.  Our job is to be YOUR employee, the one constant that is there for you from prenatal meetings, to phone calls leading up to your birth, to communications in early labor, to your bedside, to your birth center, and/or hospital, and even in to the OR (when allowed) to provide continuous emotional and physical support.  The one constant.  It's a conflict of interest to be beholden to hospital or birth center staff, policy, or protocol and to be your doula.  It would be difficult to perform all my duties if I was concerned about losing referrals if I shush someone while you are having a contraction, offer information to you, affirm your desire to question a procedure, or offer you questions to assist you in obtaining informed consent that may put a proposed intervention into question.

Third, don't place too much emphasis on certification.  Certifications can be a valuable beginning, but many doulas with the highest degree of experience, do not feel the need to carry it.  The certification process for doula's wasn't even a thing when I started attending births. Additionally, there are so many ways one can become "certified", and not all are reputable. There's a weekend course, an intensive workshop, a 9 month course of study, a mail order certification....etc.
There are varying levels of experience at every price point, so don't be afraid to ask how many births a doula has attended and details about their training and certifications, regardless of any price point.  We should want you to be informed about everything regarding your birth, including ourselves.
In my humble opinion, I would recommend you seek a doula who:

  • You genuinely like.  This is a role that has historically been filled by family: mothers/sisters/aunts/grandmothers, so ideally, you should have a strong, positive, maternal/comforting, protected, confident sense around your doula.
  • Your partner genuinely likes (I always say that your birth partner knows more about you, and I (usually) know more about birth. Together, we make a great team to support you during your labor, so we should be able to work well together)
  • Can answer your informed questions professionally and thoroughly.
  • Has considerable experience in a range of birth locations: homes, birth centers, hospitals.  This demonstrates that they can...and have...worked with a broad range of care providers and circumstances and will bring that experience to your birth.
  • Is in your price range.  The range of pay in my area is anywhere from $0-$2000.  That gives you the green light to ask questions, don't be shy about it. We should be comfortable with our price point and confident discussing it. We may be able to work with you on payment plans, or discounts, even barters when asked.  If we cannot meet your needs at your price point, we probably have some trusted referrals to offer.
  • Will meet with you for a bare minimum of 1 interview (free), 2 prenatal appointments and be available for phone calls/texts in the days and weeks leading up to your due date.  
  • Doesn't take on more than 2 or 3 births per month.  We should all have emergency back up, but more than 2-3/mo increases your risk of building a relationship with one doula at prenatals, but having a backup doula (often a doula that you have not met) attend your birth. If your primary doula might be overbooked or has plans to be out of town or otherwise unavailable between weeks 37-42 of your pregnancy it is reasonable to ask about talking to or meeting with the back up for one of your prenatal appointments. 
  • Does not have a particular agenda FOR you.  Once you offer the position, and your doula agrees to support you, your goals, wishes, and ideals, those are the only ones that matter.  You can often read reviews, read blog posts, etc to get an idea if you have compatible ideas. It is our responsibility to offer relevant information, statistics, etc. (even if it might not be exactly what you want to hear) but your doula shouldn't be shoving personal beliefs down your throat. If their birthy dogma differs that much from yours, they should not have accepted the position. 
  • Likes and is comfortable with any animals you may have in the home, since we normally labor at home with you prior to making nay move to a birthing center or hospital.
  • Is kind and compassionate.
  • Is interested in YOU, and asks thoughtful questions.  The right doula is not just interviewing for any old job, there should be a sense of an easy, comfortable partnership.
I hope this helps you in your search for a wonderful Doula, I wish you compassionate, highly competent support during your labor, and an experience that you will look back on and feel like the doula was an invaluable resource  providing guidance which allowed you to really focus on allowing your body to do its work, allowed your partner to be exactly where you needed them to be, and doing exactly what you need them to be doing.  My hope is that we are ultimately remembered as a valuable member of your birth team that held your family together as you welcomed a new, beautiful life.


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