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How to Choose a Birth Doula

doula holding baby

Soon after I passed the 12-week mark of pregnancy with our first baby, my husband and I went on the hunt for a doula. We planned to deliver in a hospital with a midwife, but I wanted another trained support person on our team--someone who knew us well, would be by our sides for the duration of the labor, and could offer perspective on our situation from their own experience of attending births. So, for about a month, we "dated" doulas, meeting candidates around town for lunch and coffee. We eventually hired Katie, a doula who was an incredible source of support during the birth of our daughter. Whether you plan to deliver with an OB or a midwife, here's how to hire the right doula for you.

Think about your support team.
When considering whom to have at your birth, your list might not go beyond your partner, your mother, and perhaps a good friend. But you may want to consider hiring another set of hands to help you through the experience. "Women have always nurtured other women during birth, and pregnant women are often drawn to this type of support," explains Jessica English, a DONA-certified birth doula and director of public relations for DONA International, the leading association of doulas. Unlike most doctors or hospital-based midwives, your birth doula, or trained labor coach, will spend hours getting to know you, help you write a birth plan, and be by your side from the moment in labor you decide you need her until a few hours after the baby is born. She'll offer natural methods of pain relief and may help you get into new positions to help move your labor along. She'll work to keep you comfortable and calm, and serve as your cheerleader, giving you emotional support. If your partner needs a break, she'll be ready to step in so you won't be alone. She may also update your family as you progress, help you work through difficult decisions, snap the first postbirth photos, and be there to help you breastfeed.

"There's also impressive research that shows that women who use a doula have a 26 percent reduction in cesarean births, 41 percent fewer vacuum extractions and forceps deliveries, and a 28 percent reduction in the use of pain medication, which appeals to many families," English says.

Even before you get to the delivery room, your doula will support you throughout your pregnancy. She'll have information about prenatal nutrition; she may have articles or books to share from a personal lending library; and she'll be able to help with issues such as relieving lower back pain, managing insomnia, and preparing emotionally for motherhood.

Many birth doulas include a postpartum visit in their service. In such cases, a doula will come to your home soon after you give birth to help you process your feelings about your delivery, answer questions about caring for your baby, help with breastfeeding if needed, and discuss postpartum depression. (You can hire a postpartum doula if you decide you need extra support after you bring baby home, regardless of whether you had one during your birth.)

Get recommendations.
Start by asking your care provider if she can recommend any labor support professionals she enjoys working with. If your OB hasn't worked with a doula before, talking about why you want to hire one can help start a discussion of the type of birth you hope to have. Many care providers welcome the extra support a doula can provide. "Doulas help me give patients their best chance of having an unmedicated birth or a vaginal birth after a cesarean," says Jaqueline Worth, M.D., of Village Obstetrics in New York City, where more than half of all patients use a doula. "Like a personal trainer who pushes you to do a second set, a doula is an expert who helps push you just slightly past where you think you can go," Dr. Worth explains.

You can also search online for doulas in your area, using the "Find a Doula" search function at dona.org. Or check with local birthing class teachers, new mom friends, and even local birthing centers or midwives (even if you aren't using them for your delivery) for their recommendations. Dr. Worth notes that "[Birth can be] hard and you need someone who has been there before to help you push past the pain and keep going. My job [as a doctor] is to keep her safe--the doula's job is to keep her going."

Interview candidates.
The most important step in hiring a doula is the interview. You can invite a potential candidate to your house or meet her in a public space, but consider it your opportunity to learn as much as you can about her. Ask how many births she's attended and where she received her certification. (DONA International, Childbirth International, and BirthArts International are the common certifying organizations.) Ask her why she became a doula, how many pre- and postnatal home visits are included in the service (two or three visits is standard), and about the fee. (Less experienced doulas may charge around $400; more experienced ones can charge $1,000 or more.) Discuss medications during delivery, breastfeeding, and the type of care provider you plan to use for your birth. Most important, you should make sure that you feel comfortable with your doula, as you'll be with her through one of the most stressful--and amazing--times in your life. "I would look for a doula who is comfortable in her own skin, but not pushy with her opinions," says Cynthia Gabriel, Ph.D, author of Natural Hospital Birth and a doula who has attended 125 births. "If she is a warm person with whom you can connect, she gives you confidence that you can have a great birth, and she speaks mostly in positive ways--not strident anti-doctor ways--that is a great start."

Make the hire.
Once you and your partner agree on which doula to hire, let her know as soon as possible to secure your spot. Then schedule your prenatal visits and start enjoying the extra support that a birth doula can offer.

Copyright © 2013 Meredith Corporation.