How do I choose the Doula that’s right for us?
Ok…You got your due date, the Hubs has the nursery painted and is now fumbling over the crib assembly. The baby shower is on Saturday and your Mother-in-law just announced she wants to come for the full six weeks of your convalescence, instead of two. With all that on your mind how in the world will you be mentally available to choose the Doula that’s right for you and the birth space?
The word Doula, Greek for “woman of Service” or “maidservant”, was first used (officially) by Dana Raphel in her 1973 book, “Tender Gift: Breastfeeding”. The role of this Gestational Servant is to tend to the very delicate needs of the Mother. As the Doctor speaks for the unborn I n birth, the Doula gives Moms the empowerment and the support she needs during pregnancy, labor and during the postpartum rest period.
The regulation of hiring a Doula is well defined and easy to understand. Contracts are simple and fees vary based on type and length of time of services. Likewise, as of June 1, 2010, some insurance companies will offer compensation of Doula work depending on the state and the Insurances that participate.
Training of Doulas can be a weekend long course to the full ten week session with intern/externships and apprenticing positions. The schools vary from state to state yet, at current, there is no national organization linking all the schools and/or the certification requirements. So it is best that you check your local state courses for the schools and the referral lists in your area.
There are several types of Doulas and the list varies from state to state. They all are great resources to turn to and can be a dynamic resource of information from freebies for mom and baby to referrals to Medical Professionals in your area. The can be prior medical professionals or a lay person with (or without)children. They are required to have training to charge a fee but depending on your area there may be free services offered from those apprenticing or newly graduated. A few of the Doulas to look for are:
Prenatal Doulas educate and support. They take the time needed to inform and advise the client; paying close attention to the rapport established; respecting the boundaries of the Mother’s choice, her birth plan and the medical options afforded the Mom. They range from $50-100 per 1-2 hour session and normally have a requirement of a once-a-month meeting; normally after the monthly/weekly Doctor or Midwife’s visit. (You can expect higher fees with Antepartum (High Risk) clients and clients that are younger when pregnant). Prenatal Doulas can come into the birth space during labor but additional fees can apply.
Labor/Birth Doulas come in during the pregnancy but they primarily show their talent in the birth space. They are ready with natural and holistic pain options and meditation/Hypnobirthing practices as well as equipment for labor postures of comfort and support. They range hourly and can vary from $10- $12 an hour, per labor time, for services. For marathon labors (labors lasting more than 12 hours) Labor/Birth Doulas will have back-up Doulas that will take over and relieve the primary Doula, for a few hours, for rest or personal hygiene purposes.
Postpartum Doulas begin as Prenatal Doulas change to Labor/Birth Doulas but specialize in the “bringing home baby” portion of the birth experience. They can be cross trained as a Lactation Doula (see Lactation Doula below) and offer Life Coaching and Empowerment services to combat postpartum blues. They range from $75-$100 per session (or have a set fee for a number of sessions, as needed) and normally come 48 hours after birth to either the hospital or the homebirth space to make sure Mom, Dad and baby are all adjusting well to the transition. She will offer housework help and time management skills as a part of her duties to the family.
Parental Doula is the educational resource and parenting class educator for Moms and Dads. Formerly labeled Lamaze, the Parental Doula takes the art of parenting and empowers the Mom and Dad with options and management of their parenting styles. They work with the courts, adoption agencies and foster agencies as well. They carry specialties in multiple-birth time management as well as the how-to’s of special needs babies; they become the foreman in the transitioning of the home to accommodate medical equipment and special-need renovations. They are a per-session service and come out as needed and required by the court, the hospital or Social Services. They can be cross trained as a Social Worker, Grief or Group Counselor, but that is not a requirement to fulfill her duties.
Teen Doulas take on the role of both Prenatal Doula and Labor/Birth Doula. This is where the additional fees come in. They act as more of a maternal guidance counselor and in some instances double as their Social Worker or case manager for local welfare offices. These Doulas get very personal with their clients; sometimes visiting group homes, their schools during class time, holding support groups and chat sessions as well as going to the local juvenile detention centers for those that have pending cases. They range differently from case to case. They normally have a set fee and can charge by the hour for marathon labors or extenuating circumstances like postpartum (hospital care) after a C-section or stillbirth.
Daddy Doulas, new to the Doula world, are the Doulas to the Dads. Many Dads have questions about pregnancy labor and Birth but tend to not know when or who to ask. The Dads may feel intimidated by the OB/GYN yet may not have other male friends that have asked the questions he may have, to get the answers needed. Daddy Doulas step in and level the playing field. They have meetings at the local gym, rec center, during a friendly game of Poker or at the Sports Bar; whenever or wherever the Dad feels comfortable. They chat in in a non-conventional style that is neutral and for the Dad and Daddy Doula to open up. The Dad may have several personal questions; questions from his wife’s hormonal changes to what his role is in the birth space to how to help her be her best during the baby blues. The Daddy Doula, operating as a Prenatal Doula only, advises and informs the Dad and explains the Mother’s birth plan, prior to birth and is on the ready, by email, text and phone or in the waiting room, during the actual birth. His prices or flexible and range fromper $75-$100 per session (as needed) and can charge on-call fees, during labor, if applicable.
Some of the other Doulas to mention, service specific specialties and have higher ranges of pricing per consult (Please check your local area for specifics as to what they will and will not offer in their services). These Doulas are required to be certified as a Doula first then take additional classes for the desired specialty.
Adoption Doulas help the expectant parents feel as close to birthing a child as they can get. These Doulas are normally cross-trained in legal terms and have great relationships with law firms and court officers. They take you by the hand and make certain you are comfortable with bringing home baby. They work as a Prenatal Doula and can be in attendance in the birth space with the birth mother if warranted. They open the discussion of bladder feeding (explained in Lactation Doula), natural and chemical Lactation and time management if adopting multiples. Adoption Doulas can range from $150-$200 per session and/or have set labor charges that can range from $15-$20 per hour for natural births and $25-$30 per hour for C-section and postpartum care.
Lactation Doulas come to your home after you are released from the hospital or have cleared the birth space if in cultural or religious Homebirths. They specialize in Lactation, Breastfeeding, proper latching and troubleshooting for inverted nipples, breast that are slow to fill and reduced lactation after success. They are a specialty service and range from $75-$150 per visit but typically stay for as long as the mother needs the help. She is not required to do house work but most will offer the help if needed.
Bereavement Doulashelp the family during the most difficult time of pregnancy; the death of that child. They will be the support and the connection to behavioral health professionals if the need is warranted. They hold the hand of the grieving parents surviving a stillborn birth or can come into the home to offer support and resources after a declared SIDS death. Alike, they offer counseling and referral services, crisis interventions and home visits as needed. They are equipped to deal with the stressors of a Miscarriage, a planned abortion (termination after rape/incest) or even the grief factors of a failed adoption. They range,considerably, per session and can make arrangements for the family if declared a medical spokesperson.
Doulas are a great resource you can turn to as you need them. They take great pride in giving the best of services in the most personal of spaces. They work for the Mom and Dad and are a wealth of resources for the couple and the new family. For more information and questions on Doulas you can email GRRACEE(Georgia Reproductive Referral Alliance Center on Education and Empowerment) at firstname.lastname@example.org
Dr. Ameena Ali, PhD, CD-B/P, VLM
Founder, A Mothers Peace
Birth and Postpartum Doula Support
and Midwifery Services and Orgasmic Birthing Education
770-385-5284 direct line
GRRACEEmail@gmail.com (Reproductive Rights Organization)
www.amotherspeace.wordpress.com (belly testimony blog)
www.associatedcontent.com/amotherspeace (writing log)
www.blogtalkradio.com/amotherspeace (on-line audio classes, tutoring and seminars)