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To Doula Or Not To Doula

Written by James Kicinski-McCoy

Photography by Photographed by Kate Danson

Considering hiring a doula while on this crazy, scary, yet magical ride called pregnancy? Have questions? We got you. We’ve tapped seasoned doula, author, and co-founder of LOOM, Erica Chidi Cohen, to give us the scoop on this, often times, mystifying word and service. Whether you’re just starting out on your quest, are looking for a simple definition, or are searching for ways to budget a doula into your birth plan, take a look at our Q&A below where Cohen gives us the 4-1-1.

First things first, what is a doula? Is there more than one type?
“Traditionally, a doula is a trained person who helps a mother navigate her pregnancy, birth, and postpartum experience. A doula’s primary role is to focus in on a mother’s emotional and educational needs. Birth doulas provide childbirth education, introduce women to comfort measures that might ease or improve their labor experience—such as massage, breath work, and aromatherapy—and sometimes serve as a medical liaison. Postpartum doulas focus on working with new families within the first eight weeks after delivery, nurturing them, helping with newborn care, feeding questions, and advising new mothers on self-care and how to navigate the normal physiological events that occur postpartum. Outside of birth and postpartum, doulas can also offer support around loss, providing emotional support and non-medical advice to women who experience a miscarriage, or choose to terminate their pregnancy.”

How is a doula different than a midwife?
“Doulas are non-medical professionals; they are not focused on the physiological components of the birth experience. They focus on helping the mother and her partner feel safe, and work along side them to implement whatever comfort measures feel in resonance with their birth goals, whether they are at the hospital, at a birth center, or at home. A midwife’s principle responsibility is to mother’s and baby’s physiological health throughout the pregnancy, and during the labor.”

What are some of the benefits associated with having a doula? What role does a doula play during pregnancy, delivery, and beyond?
“I think doulas have the most efficacy in the hospital environment. The hospital is a transient environment, nurses change shifts every seven hours (the average labor is 10-12 hours), and most OBGYNs only arrive to manage the labor in the third stage when the mother is starting to push. This makes a doula critical; not only have you developed a relationship with the doula during your pregnancy, but they are also present throughout the entire labor. They are a constant which can help create much needed continuity and emotional stability for women and their partners during labor.”

Can you provide any insight on the father’s role when utilizing a doula?
“A doula should make a father feel more involved, not less. For fathers, their role is to lean into the doula, bounce their ideas off of him or her, and share concerns if they are feeling at a loss about how to best support their partner during their pregnancy, or at the birth. Ideally, a doula should equip the father to stand in and perform many of the comfort measures the doula themselves would use. My favorite thing to show fathers and partners is how to best navigate the birth space and their partners growing and changing body.”

Are there any myths about doulas that you can dispel? 
“Yes, working with a doula does not mean you’re having an unmedicated birth. Modern doulas support all birth outcomes, even if your choice is to move forward with a planned cesarean. Our job is to provide unconditional, non-judgmental support, and preserve the emotional integrity of the woman and her partner. A doula’s personal beliefs have no place in the birth environment. It’s about tuning into the client and meeting them wherever they are at, even if it’s a place unfamiliar to you.”

How does one decide if a doula is right for them?
“Energetics are key. When you interview a doula, listen to your body. Do you feel tension in your stomach, shoulders, or face while you’re chatting with your potential doula during your interview? Or, do you feel like you can take a deep breath and lay everything out without scrutiny. Feeling relaxed and supported in the doula’s presence is key because you’re about to go on a crazy journey together, and you need to feel at ease. Beyond the intangible, referrals from you doctor, friends, or people in your community can be a great jumping off point. Also, make sure your doula shares and supports the same birth and parenting values you do. If you’re set on getting an epidural, don’t choose a doula that’s going to shame you or have reservations about pain medication management. And, conversely, if your goal is to birth at home, work with a doula who has had lots of home birth experience. Postpartum, your doula should be on the same page about your feeding goals, whether you choose to breastfeed or bottle feed with formula. In any event, your emotional comfort is paramount.”

On average, how much do doula services typically cost? Any advice on working a doula into one’s budget?
“It depends on where you live. In major cites, a birth doula can range from $600 up to $5000. For postpartum doulas, it depends on their experience, and whether they offer daytime or nighttime support. Postpartum fees can range from $20 to $60 per hour. If you’re trying to budget and decide on having a doula, asking friends to pitch into your doula fund for your baby shower can be a great way to go. In addition to that, check in with your insurance provider. Some outlets cover doula services, or provide flex spending dollars, which you can allocate to doula support.”

Any tips or advice on finding the best doula for one’s particular needs? What questions do you consider necessary when interviewing a potential doula?
“The first step is getting clear on your needs, and deciding where you most seek help in your pregnancy or postpartum journey. Are you needing more education, or just another safe and supportive person to call or text questions? Do you only need help during your labor? Postpartum, are you feeling anxious about breastfeeding or baby care, or do you want someone to help make food for you at home? A doula’s skill set can range, and many of them have various areas of expertise. So, getting clear on what’s best can help narrow your focus when you begin to look for who you’d like to work with. As far as questions, here are few to ask that will help clarify if the doula is a fit for you:

Why did you become a doula?
What sort of training have you had?
Do you generally work with home births, birth center births, or hospital births? Which hospitals are you most comfortable with?
How do you feel about epidurals?
Who is your backup if you are sick or have an emergency?
How many clients do you take per month?
What does your fee include?
Do you have experience in high-risk pregnancies?”

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  1. It’s interesting to know that doulas are non-medical professionals focused on helping the mother and her partner feel safe and working alongside them to implement whatever comfort measures resonate with their birth goals. I’ll start my new job soon as a doula, which is why I’m still researching it since I’m still familiarizing myself. I’ll note these tips as it sounds beneficial for my new career. Thanks!

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