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Ten things to consider when choosing a birth doula

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I often get questions from friends or readers who are looking for a doula, and unsure of how to go about finding and choosing one. So here are a few things to consider.

1) What kind of support are you looking for? You may not know exactly, but it is important to envision your ideal pregnancy and birth experience, and think about what role you see a doula playing. While there are certain things that doulas cannot do (anything medically-related to the pregnancy, for example) there is a lot of flexibility when it comes to the doula’s role, and what you might want to look for when it comes to choosing the doula. For example, if you’re really interested in massage as a technique for relieving contractions, you’d want to look for a doula who has experience with those techniques. Or maybe you have a really engaged partner, and you want a doula who is experienced at working with partners to help them be involved in the birth process. Do your best to envision what kind of support you might want, and then ask questions of the doulas you meet that are specific to those things. You’ll likely change your mind along the course of the pregnancy, or during the birth itself, but it’s a good starting point and helps evaluate the skills of the doula you choose.

2) I think the most important thing, above all the details about a particular doula, is chemistry. Do you feel comfortable with this person? Do you feel at ease? Do you have any connection with them, do you get along? Do you feel comfortable communicating openly and honestly with them? These characteristics are less tangible than other factors you might consider, but I think it’s the most important, and why I recommend meeting potential doulas in person (you might consider a phone call first with a few potential doulas, and then meeting in person with the top one or two). Some doula collaboratives have regular meet and greets where you can talk to a number of potential doulas at once–another good option that is also less time-consuming than one on one outreach.

3) Ask for referrals from friends. There are lots of places to find potential doulas, but I think referrals are the best place to start. If you know people who’ve worked with doulas before, ask them for recommendations. It’s likely you may even have doulas in your social or professional network. I wouldn’t pick someone solely because of another’s positive recommendation because what one person needs in terms of birth support is really different than another, but it’s a great place to start, and then you can explore more in depth with others.

4) Check out local birth and baby expos or fairs. Another place you can meet a number of potential doulas at once, which can be a great way to explore options. Bonus: you might meet prenatal massage therapists or birth photographers as well!

5) What’s your budget? The vast majority of doulas are paid for by the clients, out of pocket. A few insurance companies are starting to reimburse, but it’s rare. The doula you work with may be able to give you more information about potential insurance reimbursement, but it’s a good idea to be prepared to pay out of pocket. What can you afford? Doula services range widely in terms of cost–anywhere from free or barter if a doula is in training, or has a sliding scale for low-income clients–to up to $3000 for a really experienced doula in an expensive metropolitan area like NYC. The fees also depend on what services the doula offers. Consider your budget and what you’re able to afford when exploring potential doulas.

6) How important is it to you to have a doula whose identity or experiences mirror your own? While diversity in the doula community is still a struggle, there’s a growing number of doulas from diverse backgrounds. Does it feel really important to work with a queer doula, a doula whose race or ethnic background matches yours, a doula of color, a doula who is an immigrant, who speaks a language other than English? There are two things to consider here: whether it’s important that they come from the same community as you, or that they simply have experience working with people from that community. You may find that having a straight doula is fine even if you are queer, as long as they have experience working with other queer clients.

7) Do you have any specific pregnancy or birth experiences you want the doula to have experience or expertise in? For example, if you’re pregnant with multiples, it might be important to find a doula who has worked with other clients with twins before. Or if you’re having a second birth, and your first was a c-section, maybe you want a doula who has worked with a VBAC client before (vaginal birth after cesarean). If you’re considering an epidural, you may want a doula who has worked with epidurals before. Or if you’re giving birth at a birth center, or at home, you may want to ask potential doulas if they have worked with people in those settings.

8) Is political alignment important? Do you want a doula whose political perspectives or values match your own? If you’re a solidly pro-choice atheist, for example, would you be okay working with a doula who was very religious and pro-life? Many doulas wouldn’t let their personal beliefs interfere with their doula work, but it’s worth considering how you feel, and assessing this when you meet with potential doulas.

9) Ask for references. Just like when considering hiring anyone, you might want to ask for references of other people who’ve worked with that doula. It can give you a sense of what they are like in practice, and give you an opportunity to ask questions of someone who worked with them.

10) A few other places to look for doulas: I have many radical doula profiles you can browse here (with the caveat that these are not endorsements, simply a series for anyone who self-identifies as a radical doula), and you can also look at any number of doula training organizations for doula listings in your area (DONA for example has a directory of doulas by location). You can also use google to browse doulas with their own websites, or find doula collaboratives. Also consider asking your provider (OB, midwife, primary care provider, massage therapist, etc) for recommendations.

Other doulas or people who’ve worked with doulas, are there things you would add to this list? Add them in the comments.

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Radical Doula Profiles: Nikki

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This is a series highlighting folks who identify as Radical Doulas. Are you interested in being part of the series? Go here to provide your responses to the profile questions and I’ll include you!

Nikki smiling with long hair

About Nikki: My name is Nikki and I’m brand new to the doula game! I’m training as a birth doula and serve Warren (PA), Erie (PA), and Chautauqua (NY) counties. I became a doula for a plethora of reasons. I’ve always been an activist for women’s rights. I’ve known too many women walk into the hospital planning to breastfeed, to have a natural birth, to avoid a cesarean, only to walk out with a bottle fed baby that, while beautiful and magnificent, was not given the chance at the birth both mom and baby deserved. No one should fear birth. We’ve been doing it for eons. I want to welcome babies into the world. I want to see them take their first breath and have their mother, alert and overjoyed, gaze into that babies eyes and know that this is her world now. I don’t want anyone to suffer the misery of not getting the experience they deserve.

Out of all of this, I was inspired to search for a way to help. I created Birth Essentials Doula Services as a way to spread the love the mothers and babies. Helping women who may otherwise not be able to afford a doula or even know what a doula is! You can find Birth Essentials at facebook.com/pabirthessentials, on twitter @BE_Doula, or our website.

What inspired you to become a doula?

Years ago, I became enamored with the birth process, I considered the life of a doula, but that it was far-fetched and impossible. Fast forward to more recent times. I suffered a devastating miscarriage of my first pregnancy, at first I wanted only to wallow in my sadness, but, for the sake of my lost child, I knew I had to do something better. I discovered Intuitive Childbirth, the program through which I am certifying. I knew that this was something I had to do. I needed to ensure that, although my family did not expand the way we expected, other women were not stripped of their choices and their autonomy. I never want anyone to feel so helpless, whether in the midst of a loss or on what should be the most joyous occasion they will ever experience. Every birth, every mother, and every baby is precious, unique, and deserves the best.

Why do you identify with the term radical doula?

To be a radical doula, to me, means to never stop pushing (no pun intended). No matter where we’re practicing, who we’re working with, or what kind of obstacles might get in our way, a good doula takes care of her clients. She supports her community and educates women who need her. She doesn’t turn away a client because of a lack of funds, she stays up all day and night, sacrificing her own time to ensure that every woman that needs her can have her at their side.

I believe that I am destined to be a radical doula.

What is your doula philosophy and how does it fit into your broader political beliefs?

Trust.

Trust your body, trust your instincts, trust yourself.

Nobody knows what’s better for you than you do. You may need some assistance along the way. Sometimes it may feel like you’re never going to make it out alive. That’s where people like myself come in. That’s why there are midwives and OBs and doula’s to help you through every part of this experience. More than anything, you need encouragement. Nobody should ever make you feel inadequate. Ina May has said it and I believe it is true. Your body is NOT a lemon.

My whole philosophy on life, in all venues, is about trusting yourself. Doing what’s best for you without stepping on too many toes. Do You.

What is your favorite thing about being a doula?

I love being an advocate. I love empowering women. I love that I can be a source of support in what can be a beautiful, yet very difficult time. Being a doula is about support and love. That’s all I want from this.

If you could change one thing about the experience of pregnancy and birth, what would it be?

Obstetricians are for complicated pregnancy! Midwives are for the majority of women who are perfectly capable of giving birth on their own terms!

The United States has this so backwards! Birth is not scary or inherently dangerous. Why is it okay to show an inaccurate, TERRIFYING scene of a cesarean birth on tv, but not a natural, loving, peaceful birth? Women need exposure to the truth. They need more women like us Radical Doulas to show them the way.

We are not broken, pregnancy is not an illness. We can’t afford to believe these falsehoods anymore.

Florida Senate unanimously passes anti-shackling bill

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Via The National Advocates for Pregnant Women, news that a bill which would institute universal standards for Florida prisons, jails and detention facilities in regards to shackling of pregnant incarcerated women has passed the Florida Senate.

Writing for the Florida Independent, Ashley Lopez reports:

A bill that would create uniform and humane rules for the shackling of incarcerated pregnant women passed the state Senate unanimously today.

State Rep. Betty Reed, D-Tampa, and Sen. Arthenia Joyner, D-Tampa, introduced the bill this session to creates rules in county and city jails to protect the health of pregnant women who are incarcerated. Advocates for women’s health have said the law would fill a present gap in jail policies in Florida.

Joyner echoed the feeling expressed by advocates and said today that the bill would “address a deficit in Florida law” by adding rules that require “equal and uniform treatment” of women who are incarcerated.

Lopez told me via twitter that the next step is passage in the House. Great news for Florida, let’s hope it makes it all the way to law.

Update: The bill moved forward in the House today, through its first committee step.

Update: Subway Ticket Incident

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A month ago I posted a story about how I was given a ticket on the NYC subway. It was allegedly for taking up more than one seat (even though it was 2am on a Thursday). The whole incident was ridiculous, including what I would consider harrassment on the part of the officer involved.

Well yesterday I had the great fortune of going to the Transit Adjudication Board to contest the ticket. After two hours of waiting, I spoke to a very sympathetic woman who dismissed the ticket. Also, a colleague of mine who happens to be on NYC Transit Riders Council was outraged enough to bring the story to the chief of the council, who is talking to the Chief of Police about the incident. I’m just happy it’s all over.

Did this actually happen?

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(I apologize that this is not directly related to the topics I usually cover here. I just had to write about this.)

True story: I am riding a particular downtown subway home, late on a Thursday evening (around 2:30am), all the way from one far-away borough to my home in another. Due to exhaustion and a long subway ride, I fall asleep. Because the subway is almost empty (there are maybe 5 other passengers in the car), I stretch my legs out across the seats next to me.

About five stops from my destination, I am awoken by a tall male cop telling me that “I can’t do that.” In my sleepy state of confusion, I quickly sit up, not knowing what is going on. The police officer then asks me to stand up and step off the train (this is not my final destination). I say with confusion, “Can’t I just go home? I’m only a few stops away.” He repeats, “Please step off the train.”

As I leave the train car and enter the station, I hear a series of gasps behind me, presumably other passengers who are as astonished as I am. The police officer then proceeds to interrogate me, without really explaining the reason I have been removed from the train. As the doors close and the train moves on, I sigh, knowing that this altercation has just added at least 30 minutes to my already long trip home. But my situation only gets worse, as I sit down on a bench and continue to answer the police officers questions: “Where are you going? Where do you live? Do you have identification?”

He begins to talk over his radio, and I still have no idea what is really going on. Three more uniformed police officers come over, and at this point I am surrounded. Now, let me just clarify that I was neither intoxicated nor doing anything more threatening than sleeping on the subway, apparently taking up too much space. Apparently this was enough to warrant the involvement of FOUR police officers.

The cop proceeded with what turned out to be a background check, to see if I had any warrants for my arrest or outstanding tickets. Since when does sleeping on the subway correlate with criminal behavior? I felt completely belittled and distrusted, being treated as a criminal for doing something that I was not even aware was a violation. I finally ask for clarification about what my crime was, and one of the other three cops standing around me shows me his violation book with a paragraph highlighted about taking up more than one subway seat. Never before had I seen anything of the sort listed.

After what felt like a ridiculously long amount of time (and reassurance that in fact, there were no outstanding warrants for my arrest), the cop gave me what he called a “summons,” which amounted to a $50 ticket or an appearance in court. For taking up more than one seat on a mostly empty train at 3am on a weekday. I asked if there was any type of warning for this, since it was my first offense. The cop gruffly responded, this is the warning, it’s either this or arrest. Apparently my offense was agregious enough to merit handcuffs and a lock up.

An hour later, I finally arrive at my apartment, frazzled and full of questions.

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