How to Choose a Doula

You want to be supported, informed, and empowered during your birthing experience. You’ve heard that doulas help you advocate for your needs and desires. A doula sounds like an ideal person to have before and during labor and delivery. But how do you find a doula who’s right for you? Doulas have varying personalities, cultural backgrounds, philosophies on birth, costs, training, and experience.

Deciding on a type of doula

There are a few different types of doulas. Birth doulas are sometimes called labor coaches or birth coaches. Through the prenatal period and through labor and delivery they provide emotional, physical, and informational support. Postpartum doulas generally don’t attend you when you give birth. Instead, they help with the fourth trimester, which starts after the birth. They may cook nourishing meals, clean your home, or take care of your baby for a few hours so you can take a break. Full-spectrum doulas offer support through a pregnancy journey, which could include abortion, miscarriage, adoption, labor, and/or postpartum.
 

Each doula has their own standard practices and some may offer several tiers of support. Some birth doulas may come a few times after your baby is born. Some postpartum doulas will provide you with prenatal education. You can request which services you do and don’t want from a full-spectrum doula. Postpartum doulas may help you for a few months after giving birth, or they may come for a full year. You may even be able to extend the length of time your doula supports you with a la carte services. There really are so many options available.
 

Ask yourself where you think you’ll want the most support: before and during labor, after the baby is born, or the whole time? This step will help you narrow down your search.

Choosing doulas to interview

After you’ve decided what type of doula you’d like, there are a few more things you should take into consideration before reaching out to any. What the doula offers, certification and training, and cost can all be important factors.
 

What do doulas offer?

Each doula will offer a unique experience, but most have core competencies that you can expect from anyone you hire. 
 

From the time you hire them, most birth doulas interact with you throughout pregnancy. This may include counseling you on conversations with your provider, helping to research topics and ensure you understand them in order to make informed decisions. They can hold space for you emotionally and provide community resources. When you go into labor, they offer physical and emotional support for you and any partner(s) and family up until a few hours after you give birth. Birth doulas know labor positions and relaxation techniques, among other things.

Postpartum doula offerings can vary more widely than birth doula’s. Some may offer practical support, such as cooking and cleaning. Others may focus on helping you heal with herbal remedies and perineal care. Many offer family, partner and/or sibling support if desired. Postpartum doulas can help everyone transition to the new arrival(s). Postpartum doulas also offer emotional support and advice on caring for newborns.

Doulas may also have other complementary trainings. Prenatal nutrition, lactation, yoga, herbalism, or other specialties can enhance your doula’s offerings. If a doula does not specialize in these things, they may have contacts they can provide to you. Most doulas know a broad network of birth professionals or specialists who work with pregnant or postpartum people.

How are doulas certified?

Often, doulas will complete a training course through an organization, such as Childbirth International, Birth Advocacy Doula Trainings, and DONA,  for example. After training, a doula may go on to become certified through their organization. There are no national or state specific certifications. A doula’s training and continuing education may or may not be important to you.

How much does a doula cost?

Birth doulas are usually not covered by insurance.  The cost varies by doula. Their fee may be a flat rate, or they may have tiers pricing that offers different levels of support. Some doulas also offer payment on a sliding scale, payment plans, and/or scholarships.
 

If you find a doula you’re interested in but aren’t sure that you can afford their services, you can still contact them to talk. Some are willing to work with you on payment. They may also have another doula in mind that you can talk to. Talking about money can feel like a hard thing to do. Remember that doulas are familiar with talking about money with their potential clients. Feel free to share with them the specific fee you can afford. The doula has the right to say they will or won’t accept that amount. Being transparent about what you are able to afford will only help in the long run.
 

Interviewing doulas

Most doulas offer a free consultation before you commit to see if you match well. Doula interviews are a great way to assess if the doula will provide what you are looking for. Here are some sample questions to ask when interviewing a doula:

• What is your philosophy on birth?
• Are you a certified doula? Please share why or why not. 
• Do you offer prenatal and postpartum visits? If so, how many? What do they include?
• When do you go “on-call” for my birth?
• Do you have a back-up doula in case you can’t come to my birth? Will I be able to meet them?
• How do you help support my partner(s)/family to be involved in the way they want to be?
• How quickly do I need to let you know my hiring decision?
   

You may also choose to ask about their experience supporting someone like you. They may have experience with twin pregnancy, laboring people with epidurals, first time birthing people, vaginal birth after Cesarean (aka VBAC), trans families, surrogacy, or any other situation that applies to you. A doula will be most valuable when you can build a relationship with them.

If you are working with a collective or group doula practice, ask what their “on-call” schedule is like. While an independent doula will always be the same person, group practices vary. Some operate like hospital shifts, where the available doula varies daily or weekly. If you want a specific doula to attend your birth, ask beforehand if this is possible.
 

If you have the time to interview multiple doulas, doing so can be beneficial. Doulas who you don’t end up hiring may inspire you. They may offer things you hadn’t thought about or provide options that you can ask whoever you do hire to do for you.
 

If the list of questions overwhelms you, stick with this simple piece of advice: do you connect well? The relationship you have with your doula, regardless of their experience and certifications, can make all the difference.

Hiring a doula

Making a decision is a purely personal choice. After each interview, take some time to reflect. Jot down a few notes immediately after. The next day, feel free to do the same writing exercise. Your feelings about this person may change from the day before. Do you need additional information to make the hiring decision? If you have more questions for this person, reach out and ask them!

Finding a great doula is just one of the many ways to improve your birth experience. The more comfortable you are sharing what you need with your doula, the more they will be able to help you and provide support.

At Quilted Health, we believe in the benefits of having a doula by your side. We fully fund and help find a doula for each of our clients who wants one.