Modern Doula Care

As doulas, we go on a significant amount of interviews. The interviews can take place at a coffee shop, the clients home, our office or even a mall or park. The location may be diverse, but the questions seem to inevitably be the same.  As experienced doulas, we try to give an overview of our services and experience and cover the questions that we know are running though a potential client’s mind. We hope, by the end of our conversation, the client’s neatly typed up questions or ones printed from the internet have been answered in a much more casual and comforting way.

But, what should you be asking that maybe the internet doesn’t even know about? Sure, certification is a good place to start. Number of births attended, although this one is subjective in many ways and doesn’t necessarily indicate whether a doula is skilled or even ‘good’, and finally, the fees.  There are other important, almost deal breaker items that don’t seem to be listed on the pregnancy forums.

The hard questions which should be asked are not about quantity of births, certifications, birthplace experience or even what ‘tools’ are in their birth bag. It can be business practices alone which can be the most important to an expectant couple.

“So, what happens if I labor for a really long time? Over 24 hours? Does your fee change? Do you leave? Do you share shifts like the nurses? is there continuity in care?” 

For many DONA certified doulas, continuous labor support means just that…continuous. Your present for active labor.  As a business owner, we have to manage the long labors and the short labors in our own business plan, but the continuity of care should not be broken because of the need for business profit. We are running a business, but let’s face it, the woman whose labor just hit the 24 hour mark isn’t exactly excited about being the woman who is making you work overtime and, quite frankly, may be the woman who needs doula support more than others.

Some doulas do have clauses to switch out or charge extra after a certain amount of time. Ask this question. Think about the answer. Mull it over. You may be comfortable with the risk and feel like overtime pay is appropriate. You may not. It’s a question that needs to be asked to avoid last minute feelings of resentment.  Let the doulas, who run their own small businesses, handle the details of their profit margin. As the expectant family, be comfortable with your choice of support and budget in any situation that may arise. In our practice, we don’t feel that a woman should be charged for a long labor simply because we need to cover our expenses for being at work longer than expected.  We don’t  believe we handle this issue the only right’ way, but we are comfortable with our business practice.

When do you come to me in labor?

Labor is unique. I have yet to attend two births that are exactly the same in the way labor begins, how a woman reacts, or even how quickly it progresses. As experienced doulas, we can typically tell from the ‘birth song’ of a woman through contractions or the partner’s voice on the phone and description of the laboring mother where they are in the stages of labor. If a doula’s business practice is that they arrive during early labor and stay throughout the birth and after or whether they come to you during active labor (4-5min apart contractions), is an important question to ask and feel comfortable with the answer.  You need to feel supported during your labor. Doulas are, by definition, servants to laboring women. Feel comfortable with the answer.

Can I meet your backup? Do you have backup? What are you plans for my birth window as of now?

Many women ask the question, “how many clients do you take a month?”. While this is an important question to gauge how busy a doula may potentially be, it doesn’t gauge what will happen if, by chance, those 2 or 3 clients go on the same day. Collisions happen. Not often, and in doula collectives or partnerships, they are handled much easier. Whether you take 6 clients a month solo or 2, mother nature sometimes just throws a doula a curveball.  So, as a client, you need to know the game plan. What if it happens? Will I know the doula who walks through the door? Will they have the same pieces of experience or philosophy that you have that I feel comfortable with? Meet the backups. Talk to the backups. Even if a doula has never used a backup, there is always a first time.  And most importantly, ask about your birth window. Even through we try not to, we tend to look at a first time mom and think, well, she will probably go a little overdue since that is extremely common. Do we plan vacations on your due date? Of course not! But, ask a potential doula anyway. They may not have the same business practices.

What Else?

There are many more questions that can be asked. Philosophy, connection, the all important feelings of ‘clicking’, but business practices and the details of the contract you sign will definitely matter when the first contraction strikes. Make sure you understand the way your doula handles her business and the protocol for a laboring woman.  We all do things differently, and that’s the great part of being a doula business owner. Connecting and supporting women with clear cut expectations of our roles in their birth village is an amazing job.  What better way to spend the day than to welcome a new baby earthside……