Some of you might remember reading about one of my couples that accidentally gave birth at home last year. The plan was to have their doula - who was at the birth - have a doula-in-training shadow her at this upcoming hospital birth. Frank, the father-to-be, referred to the student doula as "the dude-la" -- she was to be his doula! His "dude-la" was actually at another birth when Nancy gave birth at home, much to Frank's dismay. I wish I could take credit for coining this term, but I have to give credit where credit is due. It makes me laugh every time I think of it.
I always have a couple of doulas that I refer my students to, usually for a bargain price, as my students are usually very prepared for labor and birth. A bit less work for her -- certainly less educating on her part. I am very picky about who those doulas are. Like lactation consultants, doulas are not all created equal. I knew of a doula in Albuquerque that had a 90% epidural rate! Certainly not the doula I wanted for my students!
The first question I always ask is why she wants to be or why she became a doula. I am amazed at how many women become doulas because of a personal traumatic birth experience. They want to help other women not go through what they went through. That is totally respectable, but not necessarily who I want at my couple's births. She will often be defensive and looking for things to go wrong. Her "bad" birth experience led her down this road and she is, in my opinion, trying to right a wrong.
I have been writing about the birth team a lot lately -- doulas, midwives, and OBs. I've decided that it is 50% of the "requirement" to having a happy birth experience. Education is great, an absolute must, but if you are surrounded by people who do not believe in your ability to birth your baby without medication or intervention, you likely will not be doing so, no matter how prepared you and your partner are.
If I were looking for a doula, these are things I would want to know:
Has your doula given birth? (It is hard for someone who has not gone through labor and birth to understand the thoughts that go through a woman's head during labor.)
Where did she give birth and why did she choose that location? (If you are planning a homebirth and you are hiring a doula who has only given birth in a hospital, you might ask her why she chose to not birth at home. She may, deep down, be fearful of birth. Or maybe it was an issue with insurance. Or maybe her husband was too fearful. Find out why she birthed where she did.)
Did she have medication or intervention? (When the going got tough, how did she handle contractions? What seems to be her general attitude about medications and interventions in labor? Does she really believe that these things are usually not needed? On the flip side, is she willing to use intervention if required? Does she recognize that sometimes a woman may need intervention or medication?)
Has she ever been "overdue" and how did she deal with that? (A woman will naturally doubt her body's ability to start labor on its own towards the end of pregnancy. Having an encouraging doula by her side, reminding her that her baby and body knows just when the time is right, is crucial. The "overdue" woman is bombarded with questions of when she is going to finally induce, and her doula will be her rock in refusing induction.)
How long were her labors? (There is an emotional tug-of-war here. Most women hope for a short labor, but that is often much harder, physically, than a longer one. A long labor is not only physically challenging, but very mentally difficult. It's just interesting to hear her perspective on length of labor.)
What is her c-section rate? Epidural rate? (Some things are obviously out of her control, but if her rates are higher than you think they should be, she may not know how to really help a laboring woman - which may be a physical or mental issue. If she doesn't know her rate, ask her to figure it out. You'll be doing her a favor, trust me. She should know this information if she's never figured it out. If her rates are high, she can evaluate what she can/should do differently, and if they are low, it will help her in talking to potential clients.)
Where is her favorite place to doula? Hospital, home, or birth center? (Listen to her answer on this one. This tells you who is the most supportive of doulas at a birth. It's usually the places where she feels like she has the freedom to work with a couple and her opinions and experience is valued. These are usually good places to birth. If a doctor or hospital is not at the top of her list, it's usually because they have policies and procedures in place that make it hard for her to really help you. They are usually resentful of her presence and feel that she is interfering with their work.)
Does she have backup with similar rates and philosophies? (I don't want certain doulas at my student's births, so I want my doulas-of-choice to have doulas backing them up with similar styles and philosophies. Things come up in life, and your doula could have the flu the day you start labor. Ask about her backups. You will all be more comfortable if you know these things in advance.)
Does she have "time limits" of being away from home (nursing baby, child care, husband's job, etc.)? This is one reason I don't doula. I have lots of kids, all attending different schools. I don't let them ride the bus, so I spend half my day in the car. I don't live near family to depend on either. Oh yeah, and I have a husband with a demanding job. Lastly, I don't have the patience necessary to be good doula! If she does have "time limits" she may be very distracted. Know what the issues are and how she deals with them. For example, she may need to pump breastmilk every 4 hours during your labor. If you are fine with that, great. If that will drive you crazy, she's not the doula for you.)
Lastly, ask her what she literally brings to a birth? (One of "my" doulas is a massage therapist so she doesn't bring a lot of physical items to a birth. She brings her hands, ready to work. She knows acupressure points that stimulate labor and actively uses them throughout labor. Other doulas have a bag that they bring, full of "birth toys" to help throughout labor.)
It's nice to know what your doula brings to a birth, both literally and figuratively.
I hope this list helps you in your search for a doula. They are such an important part of the birth team. I see more epidurals and c-sections at births without a doula than those than have a doula. And if your husband is resistant and wants the job all to himself, start calling the doula a "dude-la" and remind him that she is there as much for him as she is for you!
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