When I became a professional birth doula in 2007, very few people knew what the profession was. “Is that like a midwife?!”, they’d often ask. My long-winded reply went something like this; “unlike midwives, doulas are not care-providers, they’re professionals hired by the birthing family to support them throughout pregnancy, childbirth and early parenting”. Such a mouthful, I know – and still people would seem confused.
Fast forward to 2020 – a lot has changed in recent years, and now when I speak about doulas I’m often met with a knowing head nod and an “oh cool, we had a doula for Ruby’s birth” and/or “my brother and his wife had a doula and loved her!”. Essentially, “doula” is becoming a common household term for parents everywhere. Even celebrities are touting the benefits of doulas – last year Meghan Markle and Amy Schumer both famously hired doulas for their respective births and had overwhelmingly positive things to say about them afterward.
As the doula profession rises in popularity, pregnant families often wonder what they should ask potential doulas in order to find their ideal fit. So, to help the doula seeking families of the world, I’ve crafted a simple list of essential questions to help them find their ideal doula.
1.What is your birth philosophy?
Doulas can be as different as, well, any other human. Knowing what they stand for is crucial in finding your ideal doula. A good doula (and this often comes with experience) will be supportive of their client’s optimal birth goals; whether that’s unmedicated, medicated, cesarean, “we’ll see how it goes” or “I’m not even sure yet”. Partner involvement is important here too, as partners should be involved as much as they and the birthing mother would like them to be.
Desired Answer: I am comfortable and eager to support my clients in whatever their optimal birth and parenthood goals may be. I will work to facilitate partner involvement that meets the comfortability and desires of my clients.
2. How much experience do you have and in what settings?
Some doulas work mostly (or completely) in hospital settings, some in birth centers and some prefer the home birth setting. Because any birth can take place in any of these locations, finding a doula that has experience in all three settings (or, if a newer doula, at least comfortable in all three settings), is ideal.
Desired Answer: I have experience and am comfortable in all three birth settings. (Bonus points if they’ve worked at your chosen birth location.)
3. How many clients do you take a month?/ What is your on-call availability and how does it work with your back-up(s)?
Like how I put three questions in one here? Most people don’t know that the majority of a doula’s fee goes towards being on-call for their clients 24 hours/day, starting at 37-38 weeks. It is HARD for doulas to drop everything in their lives to leave and attend a birth at a moment’s notice, especially if they have children and/or other life commitments. And, because births are unpredictable, they can sometimes overlap – and doulas will need to sleep after overnight and/or long births. Knowing how many clients your doula(s) is on-call for in your due month will give you a good idea of a) the likelihood that they will attend your birth and b) what happens in the off chance they cannot. To feel comfortable knowing that your chosen doula(s) will attend your birth (and be rested to do so), you want the monthly total of client births to not exceed five times how many on-call doulas there are. (For example, if there are three on-call doulas in the practice, the ideal number of births they take per month would be no more than 15.)
Desired Answer: (If they’re in solo practice:) I take one-five clients a month and have reliable back-up(s) that have a similar level of doula experience. Bonus points if you can meet their back up, even if just for a quick phone call.
(If they’re in a doula practice and/or agency) My practice/agency takes no more than five clients per month per on-call doula, and we have reliable back-up(s) for the rare circumstance that one of us cannot attend your birth.
4. How will you work with my care provider(s) and the rest of my birth team?
Providing maternal care is out of a doula’s scope of practice, so it’s essential to know how they plan to interact with your care team. Professionalism should ALWAYS be number one (because, #obvi). And secondly, you, the birthing family, will be able to feel the collective energy of your entire birth team throughout your labor, birth and postpartum – and you want those vibes to feel positive, encouraging, and collaborative.
Desired Answer: I always professionally collaborate with all members of the care team to collectively support my clients in a positive environment. Bonus points if they have worked with and/or have a professional relationship with your OB, Midwife or staff at your chosen birth setting.
5. What exactly does your doula package include?
Doulas are either in business for themselves, a doula practice, or a doula agency. Given this, their package structures and business offerings can (and will) differ. It’s important to know upfront what their included services are in order to set clear, healthy boundaries for the professional relationship.
Desired Answer: I/we provide (at least) one-two meeting(s) prenatally to get to know you and your optimal birth goals. I/we are on-call for your birth 24/7 starting at 37-38 weeks gestation. I/we will meet you in active labor to provide in-person support throughout your entire birth, and will stay with you until 1-2 hours postpartum. I/we provide at least one postpartum visit within the first week after birth. Outside of labor support, I/we are also available for text, email and/or phone support (within office hours) after contract signing and lasting through two weeks postpartum. I/we also provide referrals to outside professionals as needed. (Childbirth education, lactation consultant, postpartum doula, chiropractor, etc..)
After you ask potential doulas the questions above, ask yourself (and your birth partner, if applicable) what your intuition says about the doula you interviewed. If hired, they will be a key player in one of the most intimate and important moments of your life. When you visualize your optimal birth, can you see this doula present?
Having a doula is a transformational and overwhelmingly positive experience and the driving force in the rise of their popularity. Doulas are trusted, knowledgeable professionals that foster empowerment throughout your birth and parenthood journey. Finding the ideal doula allows you, the birthing family, to rest easy knowing she will support your curated goals and desires at every baby step. (Pun intended.) 🙂
Tara Campbell Lussier is a mother of four and a former doula that supported over 300 families throughout birth and parenthood in the Washington DC area. Her most recent “baby” was founding Arrow Birth, a support and education platform for modern parents. For more information, or to schedule a consulting session with her, please visit arrowbirth.com.