7 Important Things to Consider Before Hiring a Doula

What is a doula, you ask? According to AmericanPregnancy.org, a doula is a professional trained in childbirth who provides emotional, physical, and educational support to a mother who is expecting, is experiencing labor, or has recently given birth. The doula's purpose is to help women have a safe, memorable, and empowering birthing experience.

I had never heard the word "doula" before my nephew was born, but two short years later, newly pregnant myself for the first time, I was convinced I needed a doula at the birth. My friends thought I was crazy. "That's what the nurses are for," they said when I explained that a doula is a person who supports you while you're in labor and giving birth. "My husband doesn't want someone taking his job," was another comment I heard a lot, and, of course, the "That sounds like a lot of extra money to spend" comment.

What people thought was even crazier was, when having my second child four years later, my husband and I AGAIN hired a doula — the same one, in fact — to support us during labor. "But now you know how it works," one friend said in disbelief. "Why do you need some random stranger there, since you've been through it all before?"

Well, I see the points in all these comments — I get where my friends were coming from. But I also loved having a doula at both births for different reasons. Here are some of the things I loved about having a doula, which are also things you should consider if you're thinking about hiring one yourself.

First of all, I'm not talking about any old doula. We did our research, and you should, too. We actually found our doula through my OB. More importantly, we only considered doulas certified by DONA International, a respected, trusted institution. We checked references, talked to other couples who had worked with each person we considered, and chose a doula who had, at that time, attended over 300 births.

By the time we had our second baby, that number had almost tripled! So, no, a doula isn't random or a stranger. Like any other professional, you should chose someone who has training and a certification you're comfortable with. Like anyone who is going to be intimately involved in your life, you'll want to check references. And, most importantly, make sure your healthcare provider is cool with having a doula in the room. You want to make sure everyone gets along and is on the same team.

In fact, a great doula helps your partner feel even more included and helpful. The doula is there to assist BOTH of you through the amazing process of your baby being born. Whether you're the partner giving birth or the partner supporting the process, you're both becoming parents, and it's a huge moment. Plus, sometimes during labor and delivery, there's more going on than just one person can take care of. Our doula kept me company while my husband signed all the paperwork. She stayed with me after the birth while the doctor cleaned me up, when my husband followed the baby to be weighed and measured. Later, the doula went out to grab us both sandwiches so that my husband didn't have to be away from the baby and me.

Also, unless your partner happens to be a massage therapist, aromatherapist, or herbalist, a doula can bring something to the table that your partner cannot. I'm not saying all doulas are those things, but many doulas have expertise in areas that can help bring the laboring woman much comfort and calm during labor and delivery, whether it's massage or yoga instruction or reflexology. When choosing a doula, consider what extra skill you might want that person to add to the mix. Selecting a doula who can also help when your back muscles are spasming during labor is priceless! Which brings us to the price issue.

Some are. Some doulas charge a few thousand dollars for their consultations, meetings, advice, and attendance at your birth — and rightly so. A doula who has attended 800 births is going to charge more for her time than one who has only attended five. But don't let price keep you from hiring a doula if you think it's something that would enrich your birth experience. Doulas-in-training often offer low- or no-cost options to get their certification. A number of doula groups provide services to women in need or particular populations. Don't hesitate to ask your healthcare provider or birthing center/hospital if they know of or offer doula services. If you think it's something you need, you can probably find a way to make it happen.

I know it seems like a doula might be great for first-timers but a little superfluous after that. As it happens, I think our doula was equally helpful both times. The first time, we called our doula with all sorts of questions about logistics and expectations. She helped us with what to pack for the hospital and how to prepare. She explained things that were only briefly touched upon in our childbirth education classes, and calmed our fears in ways our doctor couldn't. It's like having a coach who is also your fiercest ally.

When I gave birth the second time, I was far more concerned about how it was all going to affect my almost-4-year-old than anything else. Having a third adult in the mix was amazing peace of mind. I knew that if my husband needed to be with our toddler, or if he needed to be with me and we needed someone else to hang with her for a bit in a pinch, our trusted doula could fill in where needed. Plus, by the second time, our doula was a friend who knew us pretty well — nothing bonds people like going through childbirth together! — so both my husband and I appreciated her insights, advice, and company in a whole new way.

Unless your OB is a solo practitioner, there's no guarantee that he or she will definitely be at your birth. And even if she is a solo practitioner, as mine was the first time around, she might be on vacation if you're two weeks late delivering, as I was. Bottom line, it's awesome to know that there is someone in the room who is there, guaranteed, just for you. Plus, the doula doesn't work for the hospital or birthing center. She's there for YOU.

We can't control everything, and we definitely can't plan exactly how a birth will go, but it's important to do a lot of research and at least decide on the factors over which you do have some control. For instance, if you or your baby is in distress and you need an emergency C-section, having a doula there isn't going to change that. But a good doula can help you ride out pain if you decide you don't want to have an epidural.

A doula is not a medical professional and definitely cannot offer medical advice or evaluations, but she can remind you what some of the jargon means (Episiotomy? Placenta previa? Eclampsia? Abruption? There are so many words!) and she can coach you and encourage you and your partner to advocate for the kind of birth you want, when there are choices to be made. According to studies, a woman who is well-supported during labor and delivery is likely to use less pain medication, have less unnecessary interventions, and have overall better outcomes than one who isn't continuously supported through the process.

Once the real delivery gets going, the doula doesn't necessarily have a hands-on job, so ours took incredible pictures both times. Of course, if you don't like graphic, bloody, detailed photos of childbirth in its most intense stages, this one might not be for you. But we LOVE having the record of our children's first moments in the world.

A doula isn't a magician, and she certainly can't make everything easy and painless, but having her by your side during what is arguably one of the most intense experiences of your life can't hurt!