How To Choose A Doula

3 years ago

I think some doulas would say, for their own sake, that every mother should have a doula - that every family needs one. I will be the first to say that I don't believe this to be true. And there are a few other things I'd want to hear from a doula if I were pregnant and looking for one. So I'll say some things - some things I say when I'm talking to other doula ladies and you can listen in...



Back to the first part - do you need a doula?

My answer: Maybe. Doulas are certainly nice to have. But there are doulas who can get in your way. You may have a great friend who can be supportive and help you through labor. Your mom may be the awesome birth partner you need. I'm naming female replacements because husbands are not doulas. Husbands can't be doulas. Husbands can be awesome but they can't be doulas. The role of a doula includes taking care of the laboring woman's partner and doing both jobs is too hard for any one person.


Where you give birth and who you choose as your care provider will effect your birth outcome more than whether or not or which doula you choose. People always site these statistics about all the things simply having a doula present at your birth will change but I am telling you - no doula (who is working within her scope of practice) will prevent you from having an episiotomy at a hospital with a 99% episiotomy rate. A doctor who does 75% cesareans and 25% vaginal births will be far more likely to do a cesarean - doula or not.


Choosing a Doula should be about how much you like them, not how many births they've been to, how old they are, whether they have children. What it all comes down to is that you are going to spend a fair amount of time with them, all at once, and you'll probably be naked. And maybe vomiting. On them. So you need to like and trust them and beyond that, not much else matters.


However, look out for crazies. There are plenty of crazy doulas around. It is quite easy to become a "doula" (a weekend class and just 3 practice births) but there are professionals who work all the time and stay current on research and are active in the community and there are wackos who no one hires and may be very inexpensive but also more of a liability than an asset.


There are plenty of web sites that will offer generic questions to ask a doula (I know because lots of potential clients print them out and then ask them all in a row like robots even though all of the answers can be found on my web site and very few of them matter very much.) There are better questions - ones that might actually help you decide which doula is best for you. BEFORE YOU MEET, you should research your potential doulas and know ahead of time:

- how long they have been practicing

- how many births they have attended

- how much they cost

- if they are available

If those pieces of information are not available online or through a conversation over the phone, don't bother meeting with them. If you do find the answers and get together with the doula, please, for the love of God, don't ask them again.


When you get face to face, here are good questions to ask:


How many of the births that you take on have you missed?

What they say to this question is just as important as how they answer it. Doulas who have missed lots of births but have a smooth explanation are very practiced at both missing births and explaining why. If they miss a lot of births (5-10 in several years of full time, busy practice is a lot), then birth work simply isn't their priority. Doulas who also teach yoga or childbirth education classes, travel a lot or have other commitments that can't be rescheduled will be less available. This may be fine with you but trust. You want to know that about them before you go into labor.

What is your relationship with hospital/home birth/birth center staff life?

With this question as well, pay as much attention to the way they answer as to what they say. You want a perfect balance between a professional who understand the bounds of her scope of practice and won't cross the line (think: making decisions for you, talking to doctors or midwives on your behalf or, worse, fighting with doctors of midwives) but not someone who's so in the doctor's pocket that they will blindly go along with anything and forget they are really working for you.


By far, the majority of unsuitable doulas will fall in the former category - crusading for vaginal/unmedicated/insert crusade here_____ birth beyond what you actually need. Your doula should be there to support and empower YOU, not beat her own drum so loudly that no one else can hear.

What else do you have going on in your life?

Find out how big of a role doula-ing plays for each person you meet with. Is it a hobby? Job? Profession? Calling? This will help clarify and put the first question in a greater context and will also give you a chance to hear more about what got them into birth work and why they stayed.

Describe your relationship with your backup doula/s.

A doula and her backup should be tight. They should be one living, breathing organism with mental telepathy and a similar way of working. You want to know that not only will your doula's backup doula take you and your birth just as seriously as your doula will but also that you would like to have the around in the event that your doula couldn't make it.


Spartacus weighs in:


You and your partner should BOTH like and want to work with the person you pick. Your doula will be involved with your partner as much if not more than they work with you - strange as that may sound since you're the one having the baby. Partners aren't all high on birth hormones. They are sitting in a room, sober, with your doula and looking to her for information/suggestions/when to leave for the hospital/a timeline based on how things are going.


Husbands and wives of pregnant women - don't check out of interviews. They're time consuming and can be annoying but are so worth it when you're on hour 65 with the same lady you picked a few months ago and you're so glad she's here rather than wishing she'd shut up and leave. She's the "guide taking you into the wilderness of birth". You better like and trust her.


Beware of free doulas. You get what you pay for. From a father's standpoint - you're about the spend a fortune on raising a child to adulthood, if you don't want to spend whatever a serious doula in your area costs, maybe you should rethink the whole thing. You don't have a layperson do your taxes. You don't go see a part time dentist to remove all your wisdom teeth. This is no different. Hire a professional. You won't regret it.


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