Tips & Tools: Labor Support

How can I select a labor support specialist, or doula?

• organize your thoughts and concerns
• ensure that you get all of your questions answered
• show respect for the doula's time by being organized and efficient
• compare the responses of different doulas.

What should I ask myself about the experience of meeting with a doula?

• Does she seem knowledgeable?
• Is she a good listener?
• Does she respect my vision for my maternity care and birth?
• Is her personality a good match for me, and for my partner?

What questions should I ask when interviewing a doula?

What if I want to work with a doula, and cost is an issue?

• Check with your insurance carrier to see if doula services are covered. If there is no policy, you may be able to show them evidence about benefits of doula care (see resources) and influence coverage for you or for other women in the future. If the initial response is "no," further inquiry or a formal letter directed to someone with more responsibility may turn up a favorable reply.
• Doula trainees often attend births at no cost in order to gain experience.
• Some experienced doulas offer some services at no or reduced costs.
• Experienced doulas may be willing to barter for their services or to set up a schedule for payments at a rate that you can afford.
• You can ask your friends and relatives to give the services of a doula as a baby shower gift.
• Hospitals are beginning to set up doula services. You can check the hospitals in your community to see if any have a doula program.
• Consider whether you have a friend or relative who could commit to providing labor support for you.

How can I learn more about and select childbirth education classes?

• independent educator: An employee of a hospital, clinic, or private practice may focus on her employer's preferred policies and practices. An independent educator may feel freer to present all of your options and discuss disadvantages of standard practices. Chances are good that classes located in a community center or an educator's home, or offered through a childbirth education organization, are taught by an independent educator.
• certified educator: Certification by a national organization (see below) ensures that the educator has met some standard for skill and knowledge.
• enough time per class and number of classes: It takes time to learn new skills and information, get questions answered, and explore issues. Classes with at least 6 to 8 sessions may be more helpful to you than those with fewer sessions.
• small classes: Class size should allow for good discussion, individual attention and help, and comfort with intimate or sensitive topics.

What are some considerations when choosing a family member or friend to provide labor support?

• Are her thoughts and feelings about birth similar to mine?
• Can I be myself around this person without worrying what she may think? Would I feel comfortable having her present during the intimate time of labor and birth? Does my partner feel the same way?
• Is she able to commit to making herself available whenever I go into labor, and staying with me until I give birth?
• Is she interested in learning more about ways to support women in labor?

What labor support considerations are involved with my choice of maternity caregiver and place of birth?

• your maternity caregiver:Would the caregiver be able to stay with you through labor and provide supportive care? What are the caregiver's experiences with and attitudes toward working with doulas?
• nursing resources during labor:How many laboring women does each nurse care for (nurse-to-patient ratio)? Will a nurse stay with you throughout labor? Do the nurses have any special training, skills, or commitment to providing supportive care to laboring women?
• institutional policies:Are there any institutional policies about who or how many people may be with you? What are the staff's experience with and attitudes toward doulas? Are there any circumstances in which your doula would not be permitted to be present? Does the facility have its own program for making doulas available?
• institutional resources:Apart from pain medications, what is available to provide comfort during labor? What about tubs, showers, birth balls, hot and cold packs, rocking chairs, options for moving about? Are there enough (tubs, for example) to go around?