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Why did you decide to become a doula?
I loved the time in my life when I was carrying our babies and anticipating each labor and birth. I had very positive birth experiences with a great support team, so it was very natural for me to want to continue to be involved in the world of pregnancy and birth. It was after the arrival of my third baby that I was introduced to the term “doula,” and I knew that is what I wanted to be.
What training did you have to become a certified birth doula?
After much research into the many programs available, I became a member of DONA International and followed the guidelines to becoming a certified birth doula (http://www.dona.org/develop/birth_cert.php).
How long have you been working as a doula?
I began my journey as a birth doula in 2003 and have enjoyed providing support to well over 100 women (and their partners) since that time. It has been my privilege to be the birth doula for some women on more than one occasion. More recently I added postpartum doula care to my support package although I have cared for new families in their homes for many years on a personal level.
What role do you play before, during and after labor and delivery?
During our visits we talk about the pregnancy and discuss previous prenatal visits, possible complications and the mother’s feelings and needs as it pertains to this pregnancy. I also ask her how she envisions her birth and what would make it a positive experience from her point of view. That sets the tone for how we will work together to achieve her goals. I explain the natural stages of labor and what one could experience during the course of labor, i.e. possible interventions, medications and natural remedies for pain relief, positions and options along the way. I also offer assistance in creating a birth plan to express her preferences and desires.
Besides our face-to-face visits, I offer telephone and email support both during the pregnancy and in the postpartum period. At the time labor begins, I join her at whatever point she requests, whether at her home or the hospital. At that point I remain with her in labor until the baby has been born, providing continuous emotional support, reassurance and comfort. I also am available to assist with baby’s first feeding.
About a week after the birth of the baby, I make a home visit to talk about the birth experience and to answer any questions she may have, whether it pertains to the emotional or physical well-being of the new mother or baby. This is a perfect opportunity for me to provide a nurturing environment.
Just as my own mother did for me, I offer postpartum support in the home for the weeks after the birth. It is a time of encouraging confidence in the parent(s), nurturing the family through rest and nutrition, and sharing information about a variety of topics.
What is the cost of your services and what do they include?
My labor support services include prenatal visits, assistance with birth plans and birth options, telephone and email contact during pregnancy and after birth and a home visit after the birth. I charge a flat fee of $500 which can be paid in full or divided up over a period of time agreed upon between the client and myself. Full payment is due by your 36th week. I charge a separate fee of $125 for placenta encapsulation. I do placenta encapsulation for doula clients as well as non-doula clients. In addition to birth doula support, I also provide postpartum care in the home for $20 per hour in increments of 4 to 12 hours.
How do you schedule your clients and do you have a back-up if you are not available?
It is my goal to provide undivided attention to each of my clients in labor. To that end, I accept clients according to their due dates and with careful attention to the number of clients due in a given month. I do have a back-up doula available in the event that I am unable to attend a birth, and I will gladly provide each of my clients her name and pertinent information at the time of our prenatal visits. She is someone I have chosen very carefully and would personally welcome into my own birth environment. You will be notified in the event that my back-up doula is taking my place. For postpartum doula care, I am flexible and will work with each family to determine their needs. Perhaps, it is only one scheduled visit at a time, an afternoon to help catch up with sleep or household chores. Maybe it is several weeks in a row for either daytime support or overnight care. If I get called away for a birth, I will let you know as soon as I can, and I will make up the time scheduled.
What does research say about the presence of a doula in labor and delivery and in the postpartum period?
Numerous clinical studies have found that a doula’s presence at birth tends to result in shorter labors with fewer complications, reduces negative feelings about one’s childbirth experience, reduces the need for Pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans and reduces the mother’s request for pain medication and/or epidurals. Research shows parents who receive support can feel more secure and cared for, are more successful in adapting to new family dynamics, have greater success with breastfeeding, have greater self-confidence, have less postpartum depression and have lower incidence of abuse. More information regarding clinical studies and research regarding a doula’s presence can be found at http://dona.org/resources/research.php.