How do you know if a doula or birth companion is right for you? Set up a preliminary interview and ask them some questions. Get a feel for them as a person, their philosophy, and whether you click. You’ll be working hard with this person, who will see you naked and pooping as your body prepares to help you push out your child. You need to be comfortable with them – keep interviewing until you find one that just feels right. Remember, they are interviewing you too, and if they know they aren’t the right fit for you, a good birth companion or doula will refer you to someone they think will click with you.
why did you become a birthworker?
Ask them as a way to understand their philosophy, motivations, and any underlying biases they may have – we all have them, it’s a matter of which ones and how we manage them. It’s also a good way to open up a conversation and hear them talking – I recall several professors I learned from who incessantly repeated the same word as a verbal tic. It was annoying enough to count the ‘okay?’ dozens of time in a lecture, let alone when I’m working very hard!
how many births do you take a month?
If they take many births a month, you may spend time building a relationship during prenatals, only to meet their backup when the show starts! It is normal and healthy to give birth anywhere between 37 and 42 weeks. If they are on call for three people during your expected window of delivery, will they be able to make it to your birth? If they take many clients a month, do they plan for you to meet their backup? Will there be any change in fee if their backup attends your birth?
do you err on arriving too early or just on time for labor?
Check if they prefer to come too early to labor, or leave it later. If you want to labor privately with family members, a just right arrival may suit you perfectly. If, however, you prefer to have an expert with you sooner, you may prefer someone who arrives too early. Keep in mind the birth stories of people who give birth sooner than expected – how will you feel if every road is closed and there’s a parade on the one open road and your birth companion misses your birth? Check, too, their area of service – if they live far from you, this will affect how soon they can arrive to support you.
what specific trainings have you completed?
Each certifying agency will focus on different areas of support. Some, for example, work really well for heterosexual, nuclear families with no history of trauma or addiction. Others focus on the social justice aspects, and will work better with queer, trans*, and people of color, survivors, and people in recovery – or not in recovery. Choose someone who has specific trainings in areas important to you. It doesn’t matter if your labor companion is the best at physiologic, unmedicated birth support if you want a planned cesarean section.
what is your strongest area? what are you working on?
Your labor companion should have the confidence to tell you what they are good at and what they are not, and the transparency and self-awareness to tell you how they’re changing that. If they lack confidence, how well will they advocate for you? Will they be able to empower you to advocate for yourself? (Remember, advocacy is not the same as speaking on your behalf!) If they feel they do not need to change their knowledge, are they keeping current with the latest research?
how will you support me in labor? my partner?
Labor is very difficult, and you deserve the assistance and pain management you need and prefer. If you are particularly interested in a technique, check to see if they are well-versed in it. At the same time you are becoming a parent and delivering your child, your partner is becoming a parent and meeting their child, too. While the birthing parent is the priority, that does not mean the other parent or parents fall to the wayside. Ask what specific ways your partner (or anyone else present as part of your birth team) will be supported.
how will you work with my birth team?
Your birth team is everyone gathered to support you in birth. A non-exhaustive list of possible members includes your partner(s), parent(s) (mother is the popular choice), siblings, dear friends, other children, birth photographers, nurses, midwives, ob/gyns, anesthesiologists, and doulas or birth companions. Everyone works together in different roles and scopes of practice to create the safe, healthy, and happy birth you deserve. Part of a birth companion or doula’s role is to advocate for you, so if they have a history of working poorly with ob/gyns locally, they may not be the best choice for your planned cesarean. If they are staunchly anti-circumcision, they won’t be recommending any mohels for you. While your doula or birth companion’s top priority is you, if they don’t notice your partner is exhausted, your experiences meeting your child may be very different. How will your birth companion support your beloveds as you labor?
On the other hand, are there any other birth professionals they work particularly well with and recommend – acupuncturists, perinatal massage therapists, birth photographers, postpartum doulas? If they have a history of working particularly well with any of these people, you may receive referral discounts or learn of professionals you would not have heard of otherwise.
how long do you stay after the baby arrives?
Each birth companion / doula will stay a different amount of time with each client. It’s the nature of birth. Some families want and are able to establish nursing right away, and are ready within an hour for some quiet bonding time. Others may have medical needs that necessitate a longer companionship and support. Do they plan to stay a particular length of time, or until an event, or do they have a window they plan to stay immediately postpartum?
what is included in your fee?
This is simple good business sense we are often taught is impolite. This is a professional interview, not a social visit, it’s okay and important to ask these questions. Find out up front what their fee includes, what are negotiables, what are add-ons, and how long those last. All doulas and birth companions have a standard amount of pre- and post-natals they offer; some give a bonus prenatal appointment if you hire them early in your pregnancy. What is this person’s standard? If you know you will need to meet with someone more frequently before the labor to get comfortable, or you want someone more versed in information than massage, or someone who is also a gifted drummer to drum your child earthside, see if this birth companion / doula offers that, or is open to adding to their standard packages. Ask ahead of time to make sure the services you are purchasing include all the services you want. You may learn of other services that become something you want and need.
After you’ve asked all these questions, take some time to consider the answers. Most doulas / birth companions have a window of time they will need to hear back from you by in order to secure your spot in their calendar. Take a week or so – or less if you are already certain, and ask yourself the last question:
is this a person whose presence would change my birth for the better?
At the end of the day, this is your birth, and you need to have someone who will support you the way you need. If you like this person as a friend, but know you would clash in labor, they aren’t the right choice. If this is a person whose business or cultural values are not in line with the birth you want to have, they aren’t the right choice.
If this is a person you feel good about, who makes you feel supported, cared for, and safe, they are the right choice. I felt like my doula thought I was funny, and was surprised by how much that mattered to me. I felt like she understood where I was coming from, what my values were, and how I saw the world. I felt good about having her in my home, having her touch me, and listening to the knowledge she had to share.
If this is a person who you know is absolutely the right fit for you, but is outside of your budget, don’t let it deter you from considering them. Many birth companions and doulas have a sliding scale, or take scholarship clients, or offer payment plans and gift certificates. Consider the amount you can pay, and talk to them. Most insurances do not include doula care, so their prices are not inflated for insurance. The prices they charge are in line with the trainings they have completed and local costs of living. They know how much things are in your area, and will either be able to work with you to find a price that works, or refer you to someone with a lower price range who they think will work well with you. You can also ask for doula care gift certificates on your baby registry if you have one. Yes, diapers are expensive and the need seemingly endless, but you get one chance at any birth. Who wants to make another sculpture of diapers shaped like a cake when you could gift your beloved a birth supported by a continuous, personal relationship by someone trained in the art of birth?