10 Things to Consider Before Choosing a Doula

You’re pregnant with your first child and aside from being beyond excited. There are many things to consider when hiring a doula, but it doesn’t have to be stressful. After all, a doula’s job is to help reduce your stress, so hiring one can be one of the best decisions you make. But just what does a doula do?

‘Doula’ is an ancient Greek word meaning “a woman who serves” and it has been adopted as the term to describe the certified professionals who provide continuous physical, emotional and information support to a woman before, during and after giving birth. They prepare individualized care to you based on your situation and preferences for childbirth, whether it is at home or in a hospital.

Think of her as a trusted friend and coach who supports you every step of the way. It just so happens you are paying her to be there.

There are so many benefits to having a doula. She can answer all your questions, calm your fears, hold your hand when your partner has passed out from the sights of all the activity “down there”, encourage you when you’re down, provide comfort, explain what’s happening during labor and – most importantly - act as your advocate and liaison with medical staff. In other words, she’s your best bitch.

According to DONA International, the largest Doula association in the world, clinical studies show that women who have a doula present at birth tend to have shorter labors, fewer complications and less stress than women who don’t. Sounds like a great investment, doesn’t it?

So if you’re looking to hire a doula, here are the top 10 things you should consider first.

10 Credentials

Doulas are accredited professionals so it’s important to choose someone with the proper education and training. As with any profession, there is a governing body who oversees the certification and standards of practice of its members.

DONA International is the largest association and its certification is recognized worldwide. The organization boasts a rigorous certification process, a Code of Ethics and Standards of Practice that each qualified doula is expected to meet.

To become certified, a doula needs to complete 12 or more hours of in-class training, extensive reading and hours of hands-on experience in assisting births.

Ask for Referrals

Ask any potential hires where they did their training and if they are certified. They may also belong to their local or state-level doula association, which you can ask about as well. If they are, you can search their names on the association’s website and it will tell you if they are certified and are in good standing.

A little bit of due diligence can go a long way in the beginning and help narrow down your list of candidates. You want to know how experienced they are and if they their credentials match what they tell you.

Even though doulas are trained and certified, they differ greatly from a midwife. A doula’s prime concern is the care and support of the mother in the weeks leading up to birth, during labor and in the weeks that follow. She is there to make you feel as comfortable and nurtured as possible throughout the whole process.

See More Than One Doula

A midwife is a trained healthcare professional who helps deliver the baby, often without the assistance of a doctor. While they do provide care before and after giving birth, their main concern during labor is to help you have a healthy delivery. They are trained to handle routine complications as they come up, but are too busy to hold your hand while it happens.

So can you work with a doula and midwife? Yes, you absolutely can! In fact, they often make a great team. The doula provides you with emotional support while the midwife gets down to the business of delivering your baby.

9 Philosophy

We’re not talking about Socrates or Plato here, although I’m sure their views on childbirth would be rather enlightening.

What you’re looking for here is the doula’s view on childbirth and how she can support you and your partner. It’s as simple as asking, “What are your philosophy on birth, and supporting women and their partners?”

Why is this important? Well, you’re not going to let just anyone into that delivery room with you. You need to know you share the same ideas on just exactly how this bambino is going enter into this world.

Make Sure What They Believe Jives with Your Beliefs

For example:

  • How does she see her role in supporting you and your partner? Is she more cheerleader than advocate? Or is she like a soothing and loving mother who makes you feel valued and supported?
  • What does she do to provide comfort for the mother during birth?
  • Does she support natural childbirth, if that’s what you choose? And if so, what is her role in supporting you in this?
  • Does she support home births?

Nothing Is More Reassuring Than Knowing You're on the Same Page

  • What is her role and experience in a hospital? Is she a good advocate with medical staff?
  • Is she supportive if you elect to have a c-section? What will her role be if you’re in surgery?

There are a number of answers and you’re looking to see if the doula shares your views and will support your choices. It’s also good to find out how she supports you in the time leading up to birth and during the postpartum period. Some doulas specialize in one area or the other, while many do both. But you want to know what her thoughts are in supporting you after the birth.

Trust me, don’t be a hero on this one. You’re going to need all the help you can get in the weeks after your little bundle arrives. Your doula may just be the one who stops you from second-guessing every decision you make or from chronically calling the ER with every little cough and sniffle!

8 Services

So you now know what your doula’s views are, but what sort of services does she offer? It’s not as simple as hiring one and she shows up at your birth. Most will specialize in either birth or postpartum care, and many do both.

Birth Doula

A birth doula’s primary goal is to make sure you have a positive birth experience. We’ll say positive as pleasant may not be the right word! But she’ll certainly aim to:

  • Answer questions leading up to and during the birth
  • Help you write your birth plan
  • Provide emotional and physical support, including lots of reassurance!
  • Assist with comfort measures such as positioning you, and guiding you through breathing and relaxation techniques
  • Ensure you and your partner remain informed on your options as your labor progresses and advocate on your behalf with medical staff

Postpartum Doula

Some birth doulas will visit you once you’re home with your baby. But others specialize in the postpartum process, which means they will:

  • Help you set up a support plan for who can assist you and your partner during those early days and weeks at home
  • Visit with you to ensure you’re getting the help and rest you need
  • Ensure you’re having success with breastfeeding
  • Assist with light duties around the house
  • Check in on your emotional well-being

A new baby in the home is a big adjustment – it’s ok to ask for help! A postpartum doula can help ease you into this new transition and make you feel less like a sleepless idiot who carelessly brought a new life into this world.

7 Time and Availability

So you’ve found a qualified doula and she shares in your views and ideas about childbirth. But is she available when you need her?

There are two things to consider when booking a doula: availability around your due date and her availability to tend to your needs in the lead up to the birth. It may seem a little selfish to demand she be available whenever you need her, but you are essentially looking for your wing woman. So she needs to ready!

Let’s break it down further. Availability around your due date:

  • Is she going to be around when you’re due? This is one of the first things to ask in case she’s already booked a vacation.

Make Sure They're Going to Be There

  • How many other mothers is she working with who are due around the same time as you? Again, not to sound selfish, and nobody can fully predict when they will give birth, but you want to ensure she won’t be over-extended around your due date.
  • Will she be available in the weeks after you give birth? If you’re looking for post-partum care as well it’s essential that her schedule allows for her to visit you even as she may still have other births to attend.

Availability in the lead-up to giving birth:

  • How many visits does she offer in the time before your due date? Is it enough for you to feel your needs are being met?

They Should Be Included in Your Birth Plan

  • Does she provide communication access in between visits? For example, can you email or call her with any questions?
  • Does she provide postpartum visits as part of her initial service, or is it extra? If she does, how soon after birth and how often are the visits?

If her schedule doesn’t suit your needs, feel free to keep looking until you find a doula that provides the level of service that you’re comfortable with. After all, the service is all about providing comfort and care for you. If you you’re at all stressed about the situation then it’s a sign to move on.

6 Back Up

You’ve picked the perfect doula with an open schedule that is sure to suit your needs, but there’s still no accounting for the unexpected.

Perhaps one of the other mothers she’s working with goes into premature labor and you’re suddenly left without the support you need. Or she’s come down with the flu and isn’t allowed in the delivery room. Crap! Don’t panic. This is why you need to ask about back up.

A good doula will have a back-up plan if she suddenly finds herself unavailable. It may be she has another doula on her team, or she has worked out a back-up system with another practitioner.

Make Sure There's Someone Waiting in the Wings

Either way, you should ask about her plan in the event of the unexpected happening. It’s perfectly ok to ask to meet her back-up doula because you want to make sure your personalities also fit. After all, this person could end up being the one holding your hand and shouting words of encouragement to you just when you’re about to feel yourself rip wide open and you start swearing off sex forever.

In other words, you need to feel like you can be yourself in this person’s presence when you’re at your most vulnerable.

Don’t forget to also do the same due diligence as you did on your first choice doula: ask about her credentials, philosophy and availability. In all likelihood, if your first choice doula has chosen her as a back-up she will share in the same beliefs. But still, if you’re calling in the pinch hitter, you want to know she can at least run the bases!

5 Location

This may seem like a no-brainer, but it is important to look at where your doula lives. She may advertize that she serves a general area, for example, the city and surrounding area of where you live. But this can actually be a very large geographical region.

This is something to consider because you need to factor in travel time. Do you know where she resides in relation to where you are? If you live on one end of town and she’s at the other, travel time could become an issue.

Distance may not make a difference if you’re meeting for appointments before the birth. She’d presumably have time to drive through traffic and meet with you. But what if her schedule is full? How do you fit in? Is she able to then meet you at appropriate times?

Where's Your Doula Going to Be When You Go into Labor

And then, of course, there’s when you go into labor. When you start feeling those contractions and your hoo-ha feels like it’s on fire, you want your wing woman with you pronto! You want her to be able to hop in her car and get to you as soon as she can, not be stuck in traffic or battling snow-drifted country roads to get to you. 

So think about distance and travel. Even if you technically fall into her region of service, ask yourself if the time spent panicking while waiting for her arrival is worth it!

4 Fee Structure

Ah, yes. As nice as this service is to have, it doesn’t come free. Although some hospitals may have a doula on staff who is available to assist at the time of delivery. But chances are you’re going to want to meet your doula in advance and build a relationship with her.

According to Babycenter.com, the most basic doula service is going to cost you somewhere between $300 to $500. That usually involves 1 – 2 visits before and after giving birth, as well as being there for the birth. A more experienced doula will cost more.

But many doulas offer varying packages to suit your needs and can go as high as $1200 or more. These packages will likely include many more prenatal visits, email or phone access for questions throughout the pregnancy, and postpartum care. It’s really up to you and how much care you feel you need.

3 References

This is a big one! Of course you want to know how other mothers have enjoyed their experience with your doula. If the doula has a website, she will likely have testimonials posted on it. It’s a good idea to take a read through them.

Of course, these testimonials may not always tell the true story as she will only post the good reviews. You can ask your doula if she has the names and numbers of previous clients who are willing to talk to you and tell you about their experience. Why not give one a call? You can ask all the questions that you really want to ask like how her bedside manner is, or does she blush easily at swearing? Can she handle you crushing her hand for hours on end? You know, important stuff.

2 Motherhood

Ok, this may not seem like the right thing to ask – but you know you’re dying to. Is your doula a mother herself?

There’s no need to discriminate if she’s not – a childless doula is more than capable of providing you with the support and care that you need. After all, she is a certified professional. But there’s something to be said about getting support from someone who’s been there, done that.

No matter how sympathetic and nurturing a coach she may be, sometimes you want to hear words of reassurance from someone who knows what it feels like to push out a mini-football from her vajayjay. She survived and so can you. Or at least that’s what you think when she’s telling you to breathe and push when all you really want to do is punch someone in the face.

1 Personality Fit

This is probably the most important point of all. You can have the most qualified doula who is also the mother of 7 children and knows every OBGYN in town... but if she doesn’t understand your need to joke when you’re scared or how much you hate being cooed at, then there’s nothing she can do for you.

You have to get along and feel comfortable with each other. This is why it’s good to meet a few times well in advance of your delivery date so that you can feel each other out. If it’s not a good fit, there’s no need to make it work. You’re far better off finding someone who gets you.

After all, you’re paying a doula to be there as your key support!

Get What You Paid For

You can still be polite and professional about it. You can simply say that you don’t feel like you’re the best fit together and will continue to look elsewhere. If you’re not feeling it, then she likely isn’t either and will be a gracious professional and let you go.

Remember, a doula is there to help make your delivery as stress and complication-free as possible. When you’re feeling your worst, she is there to lift you up – literally and figuratively! Once you consider all of these tips, you’re good to go ahead with what can be one of the best investments you’ll make for you and your baby.

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