FAQ
DOULA SERVICES
FREQUENTLY ASKED QUESTIONS
When do you join me in labor?
In short, I come when you have regular contractions and feel like you need more support. Unless other arrangements are made, I arrive at your home around the beginning or middle of active labor. Prior to that, we are in communication and you receive support by phone. There are some instances where I may join you earlier such as at an induction. We go into more detail about this and possible scenarios in our prenatal meetings. I even provide a handout to help you decide when you need me.
What tools do you bring to the birth?
I have a Mary Poppins bag of goodies and some tricks of the trade but I encourage you to assemble your own comfort items. I bring a lot of mindfulness in the form of calm, reassuring and nurturing presence, verbal guidance, encouragement and suggestions as needed for the laboring person and their partner, as well as hands-on comfort measures such as counter pressure, massage techniques and other soothing relief. Each person is different in labor, so I get to know you and your preferences. When labor comes, I am prepared to adapt to what works in the moment.
What do we do in the prenatal visits?
We get to know each other, become more familiar and build rapport. I learn about your desires, what matters to you, and your style of communication. We develop a birth plan or preferences and supplement your prenatal care with information, practices and perspective. There are definite topics to cover but with flexibility to meet your needs and interests at the time.
How do you support partners?
I am there to support the birthing person, their partner and anyone else they include in the birth. I often describe how I work with partners as a triangle between them, the birthing person and myself. There are times when a birthing person wants direct contact with someone who knows birth very well and sometimes from someone who has birthed. That said, they will more likely want the memory of their partner or others close to them helping and nearby. Partners are supported by: Demonstrating comfort measures, offering encouragement and quiet confidence or gestures to let them know this is normal and everything is okay. Holding all the information so they don’t have to remember it in the moment. Facilitating conversations by knowing the questions to ask. Taking turns for food and bathroom breaks or naps. Being available to listen or bounce ideas with.
What’s your birth philosophy?
It’s your birth. Not mine. Not your careprovider’s, either. So, I am less interested in the dogma and philosophy that can cause us to intellectualize, strategize, compartmentalize or in other ways get caught up in shoulds, judgment and control. I am committed to informed decision making, consent, respect, bodily integrity and an absence of coercion. I approach birth as an embodied, mammalian process with honesty, humility, compassion, loving-kindness and reverence.
What happens if you can’t make it to my birth?
The chances of me not being at a birth which I have committed to being on-call for are very slim and limited to sickness, injury or other urgent situations. In these cases, I provide a qualified replacement doula. If the birth is outside of on-call time, I will do everything in my power to be there or otherwise send a qualified backup doula. If your labor goes so quickly that it is impossible for me to get to you within a reasonable amount of time, you neglect to contact me or there is a natural disaster, it is outside of my responsibility. Of course, if I didn’t meet my responsibilities, you would receive monetary reimbursement or other agreed upon compensation.
How do you work with my care providers?
I am in service of your agency and helping you advocate for yourself. Theoretically, I don’t work directly with or for your medical providers. However, in practice there is generally a positive rapport between doulas and providers, some professional courtesy and camaraderie which can be based on familiarity and previous experience working side by side, and some collaboration/communication about best ways to be supportive of the client. Further, having a doula present can be helpful for the providers–many of whom tend to provide better care when a doula is present. There is less misunderstanding and another layer of safety from the extra set of eyes on the laboring person which takes pressure off of the provider. Less problems are likely to arise and if they do, they are more easily resolved.
What if I decide that I want an epidural?
First, this is nonjudgmental support. Next, whether it was part of your original intention or the result of unknown circumstances, I help you have the best possible experience with an epidural–to be emotionally supported and physically comfortable during hte procedure and afterward. Usually the aim is to get some sleep and I help to create restful conditions. Sometimes an epidural calls for increased doula support and other times, it is important to know when it’s best to give some space.
What if I need a Cesarean birth?
I’ll be there to support you however possible in valuable ways. As many local hospitals move towards what they call family-centered Cesareans, doulas are often not allowed in the OR but partners and babies stay in the room if there isn’t a medical reason to leave. Whether the Cesarean is planned or after hours of laboring, I help to prepare beforehand and assist afterwards in recovery even when not allowed in the room during the procedure, while being available to partners and other family members. I also act as a conduit for communication and emotional stability for everyone involved throughout.
Do you help with birth plans?
Yes. I tend to call them birth preferences and there are a variety of ways that I approach this with clients depending on their desires, values and the culture where they are birthing. The goal is to help clarify what you want and set intentions around it, have what you need to make informed decisions and best communicate this to your providers in a way that makes the birth go smoother and the experience more positive. I also approach this holistically so that it goes beyond just making medical choices. This can include setting intentions around the mood in the room, physical space, any spiritual preferences or rituals to be included, if applicable.
Should I invite my mother/sister/best friend/other relation?
This is a very personal decision. It depends on your relationship with them and whether their presence would be helpful, comforting, calming and enhance your experience. Your decision is not a reflection of how much you love or care for them and it doesn’t have to mean anything about them or your relationship. I’d recommend very honestly considering if their presence would in any way make you more self-conscious, influence your decision-making or if you would feel like you had to take care of them or their feelings. Next, ask yourself if the invitation is more about trying to make them happy and included because there are other ways to do that. Birth hormones really like privacy, safety and to be undisturbed. Setting boundaries and expectations in advance is key. Additionally, you are always allowed to change your mind, though it is usually easier to make boundaries looser than tighter. I can support you through this decision and its implementation. I can also be a liaison or help find ways to include or care for them.
Do you offer postpartum doula services?
While I no longer offer postpartum doula packages, I recognize their importance and have some great referrals. My birth doula services include a follow up home visit after your baby is born and we stay in contact by phone over the first few weeks. For an additional fee, birth clients can add 1-2 additional postpartum shifts to help with recovery measures, breastfeeding support, emotional processing or other matters, schedule permitting. However, a lot of my work is concerned with the postpartum phase of recovery, integration and return and I encourage you to explore my other offerings of coaching and postpartum groups to support you during this time. I would love for you to join Wild Return New Mom and Baby Nature group.
What other add-ons do you have?
So glad you asked. You can peruse my website for my other offerings, such as coaching/mentoring/consultations, classes or groups, maya abdominal therapy and professional development. Those listed below are only available as add-ons to birth doula services.
- Prenatal and Postpartum Discounted Maya Abdominal Therapy Session
- Postpartum Closing the Bones, Bajos/Yoni Steam or Mother Roasting Ritual
- 1-2 Postpartum Shifts “Welcoming Baby Home”
Do you take insurance?
At this time, it is not possible for me to accept insurance for payment but please check in because I am continuously working on this. In the meantime, there are some companies with plans (typically PPOs) that will at least partially reimburse parents for doula services. I can provide billing codes and an invoice for you to submit, but you will have to check with your insurance or human resources department. It is my hope that insurance will one day cover these services in order to make them more available and accessible to all.
Why do you charge that amount?
When my clients hire me, they are reserving:
- my time and availability (including more than a month on-call around their due date during which time I plan my life accordingly)
- access to my expertise (cultivated over a lifetime of learning and almost two decades involved with birthwork during which I have invested countless hours and dollars)
- tools at my disposal (honed over thousands of hours of hands-on experience)
- a vast network of resources and referrals (research and relationships actively maintained)
My fee is commensurate with my training, experience, services and offerings, local costs of living and the market rate for professionals at around the same level. As a professional, I feel an obligation to the entire birth community to charge a fee that keeps this work viable and sustainable. Since, birthwork is often considered women’s work or pink labor which is notoriously undervalued and undercompensated, this is also part of taking a feminist stance.
Do you have a sliding scale? What if I can’t afford your fee?
Unfortunately, I am unable to offer a sliding scale or discounts for doula services (see above). From the beginning, I am transparent about my fee to ensure that there is clear communication and expectations. If it is helpful, I am sometimes able to set up a payment plan and accept multiple methods of payment, including Venmo, Paypal and Stripe. Some folks have had their relatives and friends contribute towards doula services instead of a material shower gift. You might also consider whether one of my other services might be a better way to work together.
Everyone deserves this kind of support and should have access to quality care. Frankly, this is a challenge that I struggle with. At the same time, I have found other ways to be of support and give back to the community more sustainably as we all work to change the system. I am also happy to provide referrals for other doulas who may have less experience and charge less.
Do I need a doula for a homebirth?
While many out-of-hospital birth providers can spend more time with their clients and may prioritize emotional support, the role of a midwife involves medical responsibilities and necessitates the prioritization of related tasks. As your doula, I am solely available for emotional support and physical comfort measures that extend to partners or loved ones, which may include other family members. There can be some overlap with a midwife but the usual result is the sense of a team with differentiated roles that offer a more cohesive, personalized safety net and welcoming environment. The timeline of their presence at the birth and peak of involvement by a midwife is different from a doula, with the latter arriving earlier in many cases. Also, depending on the personality and particular practice, some midwives prefer to have a doula present and clients may find that their midwife and doula complement each other. For example, a doula may be rubbing someone’s back and reassuring their partner while the midwife is occupied with charting. Because of my training in midwifery, I have been able to anticipate how to best supplement support in the birthing environment. In the case of a transfer, I would accompany clients to the hospital.
What if my labor is very long or short?
Unfortunately, there is no accurate way to predict the length or speed of a labor in advance. Birth Doula Services are a package that covers you whether your birth is long or short. In the case of a very long labor, I may need to take breaks to refresh myself and reserve the possibility of calling in a back up for a period of time. But it is more likely that I would take turns with your partner to nap and eat. For a labor that is moving quickly, a birthing person may experience more intensity and need support to stay grounded and cope. I do my best to get to you as soon as possible. Since I am on-call and available, the fee is the same regardless of the length of labor.
What method do you use? Do you follow Lamaze, Hypnobirthing, Bradley…?
I am not wed to any one method, though I have studied many. I use what works and would describe my approach as ecclectic, holistic, practical, mindful and personalized. I am very influenced by Birthing From Within and have studied with Pam England among other birth luminaries. I also apply gleanings from other disciplines that emphasize trauma-sensitivity, harm reduction, somatics, neuroscience, endocrinology, epigenetics, psycho-spiritual teachings and anatomy/bio-mechanics.
Further, the trademarked (brandded) methods with a tendency towards teaching conditioned response and control seem to suggest that pain in childbirth and outcomes can be attributed to mastery of techniques, willpower, positive thinking and influx of information.
While we can be thankful to Lamaze and Bradley (named after male obstetricians) which helped to involve partners and further the natural birth movement in an era of over-medicalization, they have had to evolve over the decades and were partly responsible for creating a false image of what labor should look like and a pass/fail consciousness. Further, they have become known through application in comedy routines and popular entertainment that are very disconnected from actual birth. Hypnosis and hypnotherapy, along with the methods they have inspired, are shown to be effective in supporting relaxation for childbirth and coping with anxiety for some people. However, coping with labor is not one size fits all and depending how these methods are taught and contextualized, they can be presented in a way that is limiting and dogmatic.
If there is any consistent approach or tool that I draw from, it would be mindfulness. To me, this means grounding in present moment, kind or loving awareness, without judgment or resistance as an intention and something to return to again and again. I find that it is the surest way to reduce suffering. Whether or not my client chooses to practice, I strive to embody it myself.
You mentioned virtual doula support. What does this look like?
Virtual doula services developed out of necessity during the Covid pandemic and evolved to be an effective alternative when in person is not available. This makes it possible to work with people who live outside of my area or who need less of the hands-on physical support. The package is similar in that we meet the same number of times but our visits are on Zoom or Facetime. During labor, I provide the same initial phone support but instead of joining in person, I continue to be available via phone and facetime with agreed upon check-in intervals. At times, I may just stay on the line and listen to the room, then provide encouragement or feedback when appropriate, as well as assist in making decisions or discerning best comfort measures.
I resisted offeing this at first as it seemed to contradict some of my values and commitment to full presence, but I found that it could be surprisingly effective, supportive and comforting to clients. This success has convinced me to continue providing virtual support on a case to case basis.
