A doula is an experienced professional who provides physical, emotional, and informational support to the birthing person and their family.

A doula is NOT a medical professional.  Though a doula is trained in and has experience with the anatomy and physiology of birth, one does not perform medical tasks, analyze test results, or make medical recommendations.  A doula does not take vitals (such as temperature, blood pressure, or check heart tones for you or baby) or do vaginal exams.  

A doula will be glad to help you understand what is normal, what your options and alternatives are, and assist you with processing information to make medical decisions, but one will not make such decisions or recommendations for you.  If you are unsure a doula will always guide you back to your health care provider for further information.

The research is abundantly clear - "Evidence shows that continuous support can decrease the risk of Cesarean, the use of medications for pain relief, and the risk of a low five minute Apgar score. Labor support also increases satisfaction and the chance of a spontaneous vaginal birth. Continuous support may also shorten labor and decrease the use of Pitocin. Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that with some outcomes, doulas have a stronger effect than other types of support persons." - Rebecca Dekker, PhD, RN, APRN; Evidence Based Birth

For further details, statistics, and links to research articles, please visit Evidence Based Birth - Evidence On: Doulas

There are many theories as to why doulas make such a substantial difference in birth outcomes compared to other types of labor support.

1- Doulas can act as a "buffer" in an environment that isn't necessarily the most ideal for birthing from an evolutionary biology perspective.  Strangers, questions, bright lights, lack of privacy, interruptions, etc...these do make for an ideal birthing environment from a physiological standpoint.  A doula can act as a buffer to these distractions with continuous support and companionship which can also boost the mother's self-esteem.

2- Doulas are a form of pain relief in and of themselves, and the avoidance of medical pain relief is associated with less risk of other interventions such as Pitocin augmentation, continuous fetal monitoring, and Cesarean births.

3- The attachment between a birthing person and their doula can lead to an increased release of oxytocin and endorphins.  Endorphins are our bodies natural "pain-killers." Oxytocin promotes labor contractions and their effectiveness while decreasing stress, fear, and anxiety.

For further details, statistics, and links to research articles, please visit Evidence Based Birth - Evidence On: Doulas

No...a doula does not perform any clinical tasks.  While most midwives take a holistic approach to their birth clients including physical and emotional support, their primary focus will always (and should always) be on the medical health and well-being of the birthing person and their baby.  Whereas the primary focus of a doula is solely on the emotional and mental well-being of the birthing person and their partner.

I have always had wonderful, collaborative relationships with the midwives, nurses, and doctors that I've worked with.  I have no agenda of my own and no desire to have a conflict with any member of your care team (outside of an abuse of your rights, of course), so I've found it very easy to work pleasantly with everyone. Sometimes that means offering to help in some manner, other times it means fading into the background so that they can do what they need for you. 

Of course, people are human and sometimes have their own biases or preconceived notions, so some people are more open to doulas than others.  However, I've never had a "bad" experience with a care provider, even in some of the more unwelcoming situations.  I've even had situations where I changed their viewpoint on doulas!

Absolutely not!  I am on YOUR team for what would give YOU a positive birth experience.  A friend once told me that someone's response to her planning on having an epidural was that she "could do it!"  She said, "I know I can...I don't WANT to!"

Everyone's vision for their birth is different, and I want to support YOUR wishes.  There are still so many ways that a doula can support someone who isn't planning an unmedicated birth.  Emotional and informational support, physical support leading up to the epidural (after all, you don't get an epidural at the first contraction), physical comfort after the epidural, and assistance with pushing positions are all key parts of supporting a birthing person who is not planning a "natural" birth.

Definitely not...how could I possibly begin to replace one of the most important people in your life?  Your partner has been there long before me and will be there long after me.  As we often say, doulas know birth...your partner knows you.  I'm simply there to support you both.  In fact, I'm always striving to do what I can to bring you and partner even closer together during this process...from our prenatal visits and the exercises I give you to the labor and birth itself.  My greatest joy is watching you come together.

A key thing that I've always believed strongly is that this is their birth too.  They might not be the one doing the work of labor and birth, but this is their baby and their "birth" into parenthood with this baby.  I am as much there for them as I am for you.  I'm there to complement their role and help them participate at their comfort level.  I'm there to help them help you, to reassure them of what's normal, to explain things and give support if there are complications, and to give them a chance for a break so that they can be at their best for you when you might need them most.  

Unlike most midwives and hospitals I do not have a "rule of thumb" for when my role should start.  I come whenever YOU want me to come.  For some people they enjoy the solitude of just them and their partner til later in labor, and I totally respect that.  But for a lot of people, they like me to come earlier for any number of reasons - physical comfort, to calm anxieties, help them decide when it's time to go to their birth location or call their midwife to come, etc.  I would much rather come "too early" than for you to have not had support when you needed it.

No, I do not have any time limits or fees for long labors.  There may be times when we mutually agree that it would be good for me to take a bit of time to rest (for example if labor is still early, if you choose to have an epidural after a long labor, if you're in the early stages of an induction, etc.), but this would be something that we mutually agree upon.

Birth is unpredictable...and that's ok!  "False alarms" happen sometimes, and there is no penalty or added fee.  Obviously it's something we try to avoid, but again...I would rather have a false alarm than you be worried about having me come when you really needed me.

A homebirth transfer is often full of emotion, anxiety, and questions...a time when you need support more than ever!  I will go with you and be there every step of the way when possible (if needed, EMS and OR policies may limit the number of support people, but I will be there if possible).  

Yes, there are still so many ways that a doula can support someone who chooses an epidural!  Oftentimes a doula is a large support in helping someone decide if they want to choose an epidural.  Emotional and informational support, physical support leading up to the epidural, physical comfort after the epidural, and assistance with pushing positions are all key parts of supporting a birthing person who chooses an epidural.

This answer varies from hospital to hospital.  I have been in the OR several times.  However, hospitals typically have a policy of 1 support person in the OR.  Some hospitals view a doula as simply another support person and will not allow them into the OR in addition to your partner.  However, some hospitals see a doula as a key part of your birth team and will allow both your partner and your doula to be present in the OR.  The latter is, of course, a much better experience for you.  Typically once the baby is born your partner will leave your side to be with the baby while it is being cared for (hopefully in the OR, to the nursery/NICU if necessary).  This can leave you somewhat alone, even if they are still in the same room, during a vulnerable time while you are being stitched up.  So it's always worth talking to your care provider about beforehand to see if that will be a possibility if that should come up.  

If I am unable to be in the OR with you I can typically (barring any complications) be in your room for both pre-op and recovery where I can help answer questions, calm anxieties, give physical support, and assist with breastfeeding.

Yes!  I always have a backup available for you.  I have a handful of people that I trust, and I would be happy to give you their information and arrange a "meet & greet" if you'd like.  Of course, I do everything I can to avoid this, but I do promise you - if I have to send a backup I am only sending you someone that I would personally want at MY birth if I was in labor.  I promise you will be in good hands if that situation arises.  Excuse me while I go knock on wood 6173958 times!

It's really never too early to hire a doula!  For one, sometimes our calendars can fill quickly, especially with repeat clients booking us as soon as they get a positive test!  Here are several reasons why it's a great idea to hire a doula early in your pregnancy: 

• better connection with you
• better connection with your partner
• more resources earlier in pregnancy
• resources to assist with your older children
• early pregnancy complications
• support with early testing and results (genetic testing, anatomy scan, etc)
• registry assistance
• as I get to know you I get a better feel for your desires during your birth
• assist with care provider questions and concerns
• helping you navigate the decision to switch care providers if you choose to do so
• processing past trauma & anxiety

Health insurance companies do not offer coverage for doula services like they do other coverage.  However, they will sometimes reimburse a portion of the cost or put it toward your deductible.  This is something I am happy to help you navigate!

You can also use your HSA/FSA funds towards doula services!