What is a birth doula?

Margaret_DoulaingA birth doula is a professional trained in labor support.  Birth doulas provide informational, emotional, and physical support for a pregnant and laboring (and newly postpartum) family.

Prenatally birth doulas form a relationship with their clients, providing information and resources in their prenatal meetings.

When families are in labor, birth doulas provide continuous physical, emotional, and informational support from active labor (and sometimes even in early labor) until the baby is born and remain with the family for the first couple of hours after the birth.

In the days and weeks following the birth, a birth doula checks in with a family 2-3 times to process the birth and see how the family is doing.

What are the benefits to having a birth doula?

IMG_5591There has been ever-increasing amounts of research being done on the benefits to mom and baby when doulas are involved.  Women who receive continuous labor support by a professional doula are more likely to give birth without assistance (vacuum/forceps or cesarean) or pain medications.  Women who have given birth with the assistance of a doula were more likely to report high satisfaction levels, and have shorter labors.  Babies with doula assisted births have higher APGAR scores.  No adverse effects have been identified.

Cochrane Review including 22 studies, in 16 countries, involving more than 15,000 women.

Yes, but what does a doula actually DO during labor?

Hannah_workingBottom line – we do what families need us to do within our scope as doulas.  Things we might do during labor:

– assist families with laboring at home before it’s time to head to the chosen place of birth
– suggest and assist with position changes
– tell mom she’s doing a great job
– work with partners to give mom continuous support and to give partners time for eating and resting
– reassure partners that mom really is doing a great job (and that they are doing great too)
– massage, touch, and/or provide pressure
– be an “encyclopedia” for moms and partners about the process, and about various interventions
– remind families that the intense process of labor is normal
– nod at partners that though mom may seem to not be herself, that she’s doing exactly what she needs to be doing
– tell mom her body is working perfectly, and all she needs to do is breathe in between the intensity of her contractions
– acupressure
– brainstorm options
– rub a partner’s back a bit (labor support is hard work!)
– remind mom that this work is going to birth her babe (moms often get so deep into the work of labor that they forget there’s a baby at the end of it)
– use lights, smells, and music to make the room the sort of space mom wants/needs
– shut the doors if the staff hasn’t been diligent about it
– act as a “gofer”, so that moms and partners have food, water, ice, etc
– tell mom again that she’s doing amazing

What sorts of things will doulas not do?

– Speak for a family
– Make decisions for a family
– Judge families for their decisions
– Alienate partners/family members
– Interact antagonistically with staff
– Expect you to worry about them
– Be offended by anything a laboring mom says or does
– Cervical checks
– Listen to heartrates
– Perform other medical procedures

How do birth doulas work with partners?

LWP_8728-(1)Doulas aren’t in love with their clients.  Don’t get us wrong – we love what we do.  But we didn’t choose to have a baby with mom, we didn’t work to create the baby (whatever that creation process looked like), and we are not in love with mom.  There is no way we can replace a partner in the ways in which partners are often the best support to a laboring mom.  Birth is hormonal – it takes lots of oxytocin; doulas can help oxytocin levels through reassurance and by helping to keep the laboring space quiet and mellow, but we are not going to snuggle and nuzzle and caress mom in the same way her partner might, and we don’t love mom the way her partner does.

What we are able to do is help partners to be the best labor support they can be.  We can make (often very subtle) suggestions and redirections about physical labor support and position changes to help move labor along.

Doulas won’t make decisions for a family, but we are able to provide information, brainstorm questions to ask, and talk through decision-making – relieving partner of the sole responsibility involved with being the one who has to remember everything ever read or learned in childbirth class.

We can help keep the environment around a laboring couple quiet, mellow, and low-stress so that partners can remain calmly by mom’s side.

We make sure partners are physically supported themselves so that they are able to give mom good support – being hungry (or “hangry”), exhausted, and/or thirsty only increases partners’ stress levels, and a stressed out partner isn’t good for mom.

We can double-up with partners if mom needs lots of hands-on support, and we can ensure mom is never left alone (there’s no way to get through the average length labor without peeing, and at least eating a snack).

Often it is the partner who becomes the doula’s biggest cheerleader after the birth – it’s hormonally appropriate for mom to “checkout” into labor land during childbirth, and it’s often partners and doulas who bond as a team in giving mom good support.

How much time does a birth doula spend with us prenatally, at the birth, and afterwards?

www.littlepeoplephotostudio.com--4The doulas of MDC meet with clients for a no-obligations coffee/tea date (generally 30-45m).  Once you’ve chosen your doula, she will set up 2 prenatals where you will meet directly with her for ~2hrs each.  If you come to the monthly group prenatals each month (check the calendar for dates), there are 1.5-10 more hours of client-doulas facetime as well.

Once labor gets some momentum and you are needing support, your doula is there until – well, until babe comes.  We may take some power naps, and step away for a breath and some food if things are going long but our aim is to be continuous support for a family from active labor until babe arrives.  If things truly are getting exhausting, we may consult with a family about having one of the other MDC doulas come for a couple of hours so we can get a solid nap out in the waiting room.

Your birth doula will stay 1-2 hours, or until things are calm and it feels like a good time to go.  If things are hectic (for any reason) we will generally hang out until we can see you tucked in and things are chill.

In the postpartum period your birth doula will visit you 1-2 more times, spending another 2-4 hours with you, reviewing birth timelines, answering questions, and directing families to any resources they might need.  And if a family is needing additional support, your birth doula will talk with you about postpartum doula options.

What's the difference between what a birth doula does as compared to a l&d nurse, or a midwife?

LWP_8802-(1)Your care providers and nurses are charged with mom’s and baby’s medical well-being.  You have hired them to make sure that you and your baby are physically and medically healthy and safe.  They may love to do labor support (and let’s face it, they may not – and particularly when giving birth in a hospital, there’s no way to know ahead of time whether you will get someone who likes labor support or not), but their first charge is to monitor mom and baby’s medical wellbeing, and to chart what they find.

Though doulas they may take notes about when certain things have occurred (so that families have a timeline to use in creating their birth story), they do not need to chart as one of their primary tasks during your birth and so they are able to focus first on being very present for a family.

Hospital staff work in shifts – midwives and nurses alike – which means they are entitled to (and deserve to!) take breaks, take a lunch, and leave at the end of their shift.  Doulas are there continuously – perhaps even for hours at home before it’s time to head into the hospital if you are giving birth in the hospital.

Your doula has worked prenatally to form a relationship with you, and to learn about what it is you want and need in order to have the birth that you want.  And though this is our work, we take at most 4-5 clients per month, which means though this *is* a day of work for us – we know you and we have worked to learn what is important to you, and you are one of only a few families we know in this way.  This is very different than a hospital-based midwifery practice or an l&d nurse.

When working with a midwife (at home or in the hospital), though your emotional wellbeing is a piece of the puzzle of the midwifery model of care, you have hired your midwife first to care for your medical wellbeing.  It isn’t good strategy for them to exhaust themselves giving continuous physical support to a mom, when their first priority needs to be keeping watch on medical wellbeing, and making decisions about medical care.  Many midwives (and l&d nurses as well) report that they enjoy working alongside professional doulas, knowing that the emotional and physical support doulas provide help make for a complete team surrounding a family.

My mother/BFF/sister wants to be there. Can't she doula me?

www.littlepeoplephotostudio.com-Including extended family at a birth can be an amazing experience if a laboring mom feels in her gut that she wants them there.  Birth is a vulnerable time.  It is hormonal and it is instinctual.  We encourage moms to invite people into their laboring space who make them feel safe, strong, powerful, and amazing – and people who understand that birth can be long, and that it takes determination.  We also encourage families to make a thoughtful decision about who they allow to invite themselves to a birth – the presence of extended family and friends at a birth should be a decision a mom makes, for it is her hormonal vulnerable state that can be affected.

Family and friends who are invited by mom will be able to work with partners to help give mom the hormonal, physical, and emotional support – but they have an emotional tie to mom that means that the work of labor support will likely be more tiring than it would be for a doula.

Often it is the informational support a doula provides that help families to navigate the physical environment of the hospital, and the research knowledge regarding birth, procedures, positions, and interventions that makes the support of a doula priceless to families.  And very few family members and friends will have such a skillset.

We are happy to work with extended family and friends to provide labor support, and we are happy to give them information and a reassuring hug too.

I'm not sure if I want to use pain meds during labor, is a doula going to be okay with that?

www.littlepeoplephotostudio.com-(1-of-6)It is a misconception that doulas only support or like non-medicated births.  All of the doulas of MDC would say that their first priority is a supported birth.

A “good birth” is not measured by choices a family has made around pain relief, but around how families feel about their birth.  An empowered birth is a “good birth”; and empowerment looks different for different families.  It is not our job to make judgement calls – it is our job to help families connect to information, provide continuous support, and be a noncritical source of emotional comfort.

We're having the babe at home, or thinking of it - do we still need a birth doula?

IMG_5225When planning a homebirth, the midwife you’ve been working with through your pregnancy will be your main care provider, which means you do often have a closer relationship to your care provider than you would birthing in a hospital (particularly since each prenatal is ~1hr) but this does not mean that the care of a doula can’t/won’t be appreciated.

Just as in the hospital, you have hired your care provider so that their first priority is mom and baby’s medical well-being.  This doesn’t mean they are going to ignore your emotional well-being, but they are going to be first and foremost assessing the data they are collecting and working through medical decision making processes.  And they are then responsible for charting the data.

Doulas are able to do continuous labor support, often starting before the midwife and her assistant have arrived (sometimes the midwife’s assistant or a midwifery student will be able to provide active physical labor support, but you have likely not formed the same relationship with them as you would have formed with your midwife or a doula) and our main priority as doulas is to give physical and emotional support.  Should a hospital transfer need to happen (a high percentage of homebirth transfers occur not because of emergencies, but because of maternal exhaustion) your doula will make that move into the hospital with you (oftentimes along with your midwife), and use the knowledge they have of working within the hospital to continue to support you.

Hannah Bernard Donals, one of the founders of MDC and now a practicing homebirth midwife, appreciates doula care for her practice so much that she helps her families with the fee if you hire an MDC doula.

When do I hire a birth doula?

www.littlepeoplephotostudio.com (1 of 1)There is no wrong time.  The earlier you hire your doula, the sooner you have access to the support she gives prenatally – her lending library, resources, the MDC group prenatals, and email/phone support.

We’ve been hired as late as “we’re in labor and realized we want support!” and as early as “we just saw our positive pregnancy test”.  Many of us do book up for several months before a given month however – so earlier is better if you want maximum choice in who you hire.

Let us know if you’d like to come and meet is at our next Meet YOUR Doula Meet & Greet.

What does the process of hiring a doula look like?

You have a couple of options:

MDC holds a Meet YOUR Doulas Meet & Greet each month, and it is a great space to meet all of the doulas at one time, ask questions, and get a sense (in person) of what a doula does, how the collective works, and address any concerns you might have.  Please reserve your spot for our next Meet YOUR Doulas Meet & Greet.

You can also contact the doulas you are interested in directly to schedule a coffee/tea “date”.  These are generally 30-60m, and allow doulas and potential clients to get a sense of one another, and determine if it is a good fit.  These meetings can be as laidback or as interview-like as a family would like to make them – it’s not necessary to prep for the meeting, at the same time, if it’s more your style, feel free to bring questions.  And also feel free to schedule these one-on-one times even after meeting the doulas at a Meet & Greet – we’re happy to have a more in-depth individual discussion.

From there, once you have made your decision as to who you want to work with, a contract will be signed, a deposit will be paid, and prenatals put on the calendar.  Easy peasy.

What is a postpartum doula?

Postpartum_ServicesIn the first 12(ish) weeks following a birth, a postpartum doula provides physical, informational, and emotional support to a family.

Postpartum doulas offer practical assistance and reassurance in breastfeeding and/or feeding; basic newborn care (diapering, bathing, etc); creating effective home management systems; cooking, cleaning, and laundry; integration of new family roles; and developing safe sleep practices.

Postpartum doulas are also there to “normalize” the postpartum experience and validate the many emotions that come with parenting a newborn.   Often families say the most important thing that the doula did for them was to tell “you’re amazing”.

What are the benefits of having a postpartum doula?

NoahPostpartum doulas offer a calm and reassuring voice in the so-called “fourth trimester”.

We have specialized training and experience to assist the new family to make many transitions and feel empowered and capable at the same time.

Postpartum doulas believe in the strength and intuition of parents to make the best choices for their individual family.

We are also very connected within the community and can easily refer to tried and trusted services that meet your family’s specific needs.

How do postpartum doulas and partners work together?

www.littlepeoplephotostudio.com-(2-of-6)Postpartum doulas are there to support the entire family.

Again, similar to a birth doula, we are there to create a safe and comfortable newborn parenting environment in which both partners can participate and enjoy the experience.

Postpartum doulas also have specialized training to offer effective communication tools for both partners to use as the family roles transition in caring for a new baby.

I have family and friends in the area - why would I need a postpartum doula?

www.littlepeoplephotostudio.com-2Postpartum doulas offer non-biased and nonjudgmental education to empower you as the parents to make your own decisions, and we have zero emotional investment in how you parent.

We expect to get middle of the night phone calls and are happy to sort through the many and diverse emotions that are normal in newborn parenting.

We are up-to-date on current literature and research about newborn parenting.

Our relationship to you is that of a caring professional – we do not have intricate or deep emotional ties to you.  Nor do we want to create our own relationship with your baby.

When do I hire a postpartum doula?

Postpartum doulas are hired at all stages of the game. It’s never too early or too late to hire. We’ve had folks sign a contract at 8 weeks pregnant and at 8 weeks postpartum.

How do I go about hiring a postpartum doula?

Depending on how quickly you need support, we can meet in person or have a phone conversation to learn a little more about each other and ensure we’re a good match.

We have contracts that outline expectations and a potential schedule. Feel free to email or call any of the postpartum doulas with questions.

What benefits are there to working with Madison Doula Collective?

MDCHere are some direct benefits for clients working with a doula from MDC:

– our collective lending library: all of the doulas have placed their respective lending libraries into one, and it’s a pretty kickbutt collection; you’re able to peruse, checkout, and return books during our group prenatals each month (your doula will also be happy to bring books back and forth for you during your individual prenatals)

a quarterly social at our offices: once per quarter, come and meet all 7 of us so in the rare situation you need backup coverage your doula won’t be stranger, and be in the company of other expectant families who have chosen doula care

– we aim to make the process of meeting and hiring a doulas as stress-free as possible and believe clear communication of availability is important to potential clients; all of the doulas who work with us are actively practicing birthworkers; at MDC as collective members move on in their lives to other things (places and further schooling), they bow out of the collective (or their status is clearly listed as is the case when folks take time off to have their own babes)

Benefits for your doula, that help her to help you:

– a collective brain: there are 7 (actually there are 12, as we sometimes call on the expertise of past MDC doulas) of us, with different backgrounds, varying doula experiences, different skill sets, and many research interests

– support: we come together regularly to help one another to be better doulas, people, mothers, and friends; this sort of work environment is amazing and is one of the best tools we have as doulas

– education: as a group we often ask area professionals (docs, midwives, nurses, chiros, acupuncturists, etc) to come and speak with us as a group to help us better support our clients

How can I meet all of the doulas?

If you haven’t yet hired a doula, please come to our Meet the Doula Happy Hour.  Reserve your spot now.

Once you’ve hired your doula, please put our quarterly socials on your calendar!

What happens at the Meet the Doulas Happy Hour?

Happy Hour happens on the 3rd Sunday of each month and we get started a little after 430.  This events is for prospective clients looking to learn more about doulas, and about the doulas of MDC.  We begin with a documentary on doulas, and then move on to introductions, beginning with the doulas, and also asking families to share a bit about themselves as well.  We discuss what doulas do and do not do, how doulas and partners work together, and discuss any other questions families bring to the meeting.  We end by 530, though the doulas will stick around for a bit of one-on-one.

How do MDC members work together?

We work together well!

Heh.  Guessing you were looking for more than that?

We are all independent business women, who have chosen to work together for the good of ourselves professionally, and for the good of our clients.  We trust one another, and enjoy one another.  We work as professional colleagues.

MDC doulas meet at least three times each month: our Meet the Doula Happy Hour and twice “in-house” to learn from one another and support each other.  We also do a good amount of email, phone, text, and online communication as well.

How does backup work?

Backup.  It’s important that any doula you work with has backup.  Illness, emergencies, and family funerals are the most common reasons backup is used.  Even if a doula only took one birth every 6-8w (the only possible way to try to “guarantee” a family a “spot”) the reality is, as cliche as it sounds, life happens.  At MDC, if your doula is unable to be at your birth, for any reason, another doula will be there in her stead.

When you come to the quarterly socials (and if you’ve have interviewed more than one of us), you get a sense of the other doulas in the collective.  Should your doula be unavailable, you are more than welcome to nominate a first or second pick – there are no guarantees, but your doula will do her best to first reach out to your preferences.

Should, for any reason, you not be able to get in touch with your doula (it’s very very rare, but technology sometimes sucks), you will call the general MDC line (608.516.8606) and the doulas will work together to make sure someone is there with you until your doula is able to be.

You will not have to worry about or deal with a change in payment or fee if a backup is used – we take care of that amongst the doulas.

If a backup were at your birth, you will work with your original doula and the backup doula to determine the best postpartum followup plan – there are several options for who and how your pp visits will go, and everyone will work together.

What if I want to interview several doulas from MDC, is it uncomfortable when I choose one over the others?

A resounding NO!  Truly.  Hiring a doula is personal.  Just as it isn’t our job to judge your choices around your labor and birth, it is not our instinct to judge your choice of doula.  Most people report it’s a “gut” choice – who you want seeing you at your most vulnerable.  We all enjoy talking about pregnancy, birth, and babes, it is what we are passionate about.  We don’t meet potential clients for coffee/tea to “close the sale”, so we don’t see it as a waste of time if you hire another doula.

Can I use different doulas for different services?

Definitely!  The doulas of MDC have different services they provide in addition to being birth doulas.  We are always super excited to work together to support a family.  We have one (now repeat) family who joked that they used one of the services of every doula in the collective with their first kiddo.

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