vdoula, doula services

Fequently Asked Questions 

What is a doula?

A labor assistant/birth doula provides continuous care for the laboring woman and her partner, and helps them fully experience their birth by offering physical and emotional support.

An ALACE doula is trained to understand the natural process of birth, respect its spiritual, physical, and emotional aspects, and facilitate the birth experience for parents, baby, and primary care providers.

Why should I use a doula?

Studies show that the presence of a doula results in shorter labor, a reduced need for pain medication, a reduction in Cesarean births, and improved outcomes for both mother and baby.

What exactly will a doula do for me?                                                        

A doula’s role and duties change with each birth.  You can define my role as your doula.  This means that together we will determine, based on your unique needs, what role a doula will play at the birth of your child. If you’re saying to yourself “I want someone to do X, and I may need help with Y, but definitely not Z,” then you’re in need of a doula!

What are the benefits of hiring a doula?

Women who are continuously supported by a birth doula through labor are:

• 41% less likely to give birth with vacuum extraction or forceps
• 26% less likely to give birth by cesarean section
• 28% less likely to use any pain medications (epidural/spinal anesthetic and narcotic analgesia)
• 33% less likely to be dissatisfied with or negatively rate their birth experience

Additionally, women with doula support experience the following after the birth of their child:

• lower rates of infections and fever in the mother
• lower reported rates of postpartum depression and anxiety
• higher rates of breastfeeding
• a higher sensitivity to and awareness of her newborn

Hodnett ED, Gates S, Hofmeyr G J, Sakala C. Continuous support for women during childbirth [PDF]. The Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.

What is the difference between a doula and a midwife?

Midwives are primary caregivers who make clinical decisions and give medical advice. Doulas are not the primary caregivers for their clients; and, unlike midwives or doctors, doulas are neither medically trained nor responsible for the medical wellbeing of mothers or babies.                                                                       

What is the difference between a doula and a nurse?

A nurse’s first priority is to monitor the laboring mother’s physical health while managing multiple laboring mothers at once. Nurses rarely have time to provide sustained comfort measures and support, and they are often pleased to learn that you have hired a doula.

What is the difference between a doula and a labor assistant?

The words are interchangeable; a birth doula and a labor assistant both provide the same services: providing informational, emotional, and physical support to a woman and her partner during labor and birth. There are also postpartum doulas that provide emotional and physical support in the client’s home after the birth; they may help with light housekeeping, cooking, babysitting older siblings, and breastfeeding support. (Victoria is a labor doula.)

What is the difference between ALACE doulas and other doulas?

ALACE doulas are known for their trusting support of the natural birth process. ALACE doulas are trained using a program which incorporates research in psychology, sociology and anthropology – but above all has been developed and guided principally by women. We respect birth as an intimate act and a creative expression of love. We believe that it is possible to help strengthen family bonds through improving the experience of birth.

If I have a midwife or am having my baby at home, why should I need a doula?

There are two reasons why it is a good idea to have a doula even when using a midwife. While a midwife may provide the same support of that of a doula, she may not in fact include that aspect of care in her services. Secondly, a midwife’s primary responsibility is clinical in nature (taking blood pressure, vaginal exams, listening to the baby’s heartbeat, “catching” the baby and the placenta, repairing any tears etc). Even though you may need support during these times, the clinical tasks will take precedence over directly supporting you. Consequently it can help to have a designated person solely focused on your ongoing physical and emotional needs.

If my husband or partner is there with me, why should I use a doula?

While your husband or partner may be the most intimate and important person to you during labor, he/she may not have the knowledge, stamina, and skills needed during labor and birth. It also may be difficult for the partner to watch mom experience the normal pain of childbirth. While the doula can provide all of the support herself if needed, she is also trained to help your partner or family know how to help you. Often the doula and your partner work together to provide the continuous needed support. The doula never takes the place of the partner, but supplements his/her attention and care with her knowledge and experience.

I’m planning to give birth in a hospital; why should I use a doula?

Many of us are intimidated in medical institutions, especially when we are the patient in that institution. In addition to the continuous physical and emotional support provided by your doula, she can also help you understand what the nurses, doctors and midwives are talking about. She can remind and support you in asking questions and stating your concerns or your preferences. Your doula is a knowledgeable lay person who can help you navigate the medical system, as well as stay focused on you and your needs throughout your labor.

I’m planning to have an epidural; why should I use a doula?

A doula’s support is not only focused on managing pain during childbirth. She is your advocate throughout your labor and birth helping you and your family with any questions or concerns that may arise, helping you understand what your care providers are saying, and attending to your comfort and needs. Pain medication and/or anesthesia don’t always arrive at the exact moment you are ready for it. You may benefit from having a doula support you during contractions until you get the relief you are planning on receiving. Once you have received anesthesia, although you may not be feeling the intensity of the contractions, you are still having a baby. Your doula will remain with you throughout the birth, as well as the immediate postpartum period to support you and ensure that your and your family’s needs are being met.

I’m planning to have a C-Section; why should I use a doula?

Having a cesarean section is having a baby. Your doula is your support and advocate throughout the preparation for surgery, and depending on hospital policies, she may be able to support you in the operating room as well. She will be at your side in the recovery room and can help you and your family with any questions or concerns that may arise, helping you understand what your care providers are saying, and attending to your comfort and needs.

Can a doula take care of my older children while I’m in labor?

Yes, a doula can take care of your older children while you are in labor, but she can’t provide her support services to you at the same time. Children can become tired, antsy, bored, curious, hungry or irritable in the normal course of the day. They need designated adults to focus exclusively on them during their mother’s labor so that you are not trying to both have a baby and take care of your other children at the same time. Many women hire doulas for themselves and doulas for their older children as well.

Do you have backup in case you cannot make it to the birth?

Yes, I do have a backup doula in case of emergencies.  It is important to note, however, that the backup doula would only be called in for a true emergency. I have several options for childcare and I carefully arrange my schedule around my clients’ due dates so that I can leave immediately when they call. 

It seems so expensive!

Doula fees may seem high because it is an expense that was not anticipated. Many couples do not consider doula services until they are already pregnant and the birth is looming. Every family needs support and encouragement before, during, and after labor and birth. Doula fees are actually quite reasonable when you break it down. You receive three in-home, completely personalized visits to discuss your needs and wishes for your birth and to help with breastfeeding or other postpartum needs. Your doula is also on-call 24 hours a day, 7 days a week for 4 weeks at the end of your pregnancy. She will stay with you for the duration of your labor (average labor of a 1st time mom is 24 hrs). Not even your doctor will do that! The benefits of having a doula at your birth are truly immeasurable.
 

Will my insurance cover my doula’s fees?

Currently most insurance plans do not cover doula fees. Most doulas will expect to be paid up front by the client and will provide you with a bill to submit to your insurance company. Although your claim may be denied, we encourage consumers to submit a claim and then appeal if the initial claim is denied. Insurance companies are not going to start reimbursing for doula services unless they are aware of the consumers’ demand for the service and the potential that the presence of a doula will save them money. The ALACE office can supply you with supporting information to submit with your appeal.

What questions should I ask a prospective doula?

It's important when choosing a labor doula that you are informed not only about their experience and what services they offer, but also about how their approach to birth complements your own. We suggest the following questions to get you started:

• What childbirth experience do you have?
• Tell me about your training.
• What services will you offer me as a professional labor doula?
• How much time will you spend with me as your client outside of labor and delivery (how many prenatal and postpartum visits are included in your fee)?
• Do you have additional skills which may help me?
• Can you provide me with references?
• Have you worked in a hospital setting? birth center setting? homebirth setting?
• What is your philosophy about childbirth and supporting mothers and their partners during labor?
• How do you feel about natural childbirth? About use of pain medication in labor?
• Can I call you with questions or concerns before or after the birth?
• When will you join me when I'm in labor? If I'm giving birth at a hospital or birth center, will you support me in labor at home first if I choose?
• Do you have back-up doula support for times when you aren't available? May I meet them?
• What is your refund policy?

The bottom line is do you and your partner like her.

Find out more about vdoula.

Please contact me anytime! I look forward to hearing from you.