Hiring a Doula

I am a firm believer that doulas come in all shapes and sizes.  Some of us choose to certify, and some of us don’t.  I know some doulas who are not certified, but hold more birth knowledge and experience in their little finger than many of us do in our entire bodies. I have seen doulas who took an online certification course (with no in-person training or experience required) and tout that they are experts in their field. Believe me, not all doula certifications are created equally, and certification is not the only way to pursue this work. Some doulas prefer to gain their experience through apprenticeship and community involvement rather than going through organizations like DONA.  There is no perfect path to becoming a doula.  What makes us doulas isn’t a title, it is the heart that drives our efforts to support families and bring positive changes to our communities. 

So what do you look for in a doula?  How do you know that you are getting the quality that you expect in your experience?  Research.  Just as a business owner would look at a resume, check references, and have some email correspondence with a new recruit before an interview.  Check out their website, look at their reviews on multiple platforms (Facebook, Google, and Doula Match), look into the organizations they are associated with and ask around your local birth community to see if the doula is well recognized. 

I clicked around on my certifying organization’s website and found a few lists that might be helpful when beginning this process.  Those lists are in bold and the links to more information are cited at the end of this page. 

Wondering what you should look for when hiring a doula? Here are a few key points that parents consider.

  • Training
  • Certification status
  • Experience
  • Availability
  • Services offered
  • Conversational compatibility
  • Fees
  • General instincts about having the doula in your home or private space

Another common theme that comes up during interviews is the list of questions that we see in so many mommy-blog articles.  “10 Questions to Ask Your Doula in an Interview,” and so on… Don’t get me wrong, questions are a great tool to help you narrow down which doulas you want to meet with, but the most important purpose of an interview is connecting.  Most reputable doulas list their training, experience and philosophies on their websites.  If they don’t, or they don’t have a website, this is a great time to connect pre-interview through email.  You would be surprised at how well you can connect with someone before you meet them face-to-face, and I don’t know any doula who isn’t willing to answer questions or offer a list of references ahead of time through email correspondence. BUT, more than anything, don’t forget that the interview is allllll about connection.  It is important that you feel comfortable inviting your doula into your home and into some of the most intimate moments of your life; otherwise, things can be just plain awkward during your birth. So yes, a few prepared questions or talking points are great to bring to an interview, but remember that the interview is about connection… and a long, tedious list can be more distracting than helpful in finding the right doula for you. 

Questions to Consider After a Birth Doula Interview:

It’s a wonderful opportunity to choose a doula to be a part of your birth experience! Sometimes, you just know that a particular doula is the one for you, and sometimes you need several interviews to find just the right person (or people, some doulas work in teams). These questions might be able to be helpful as you choose a doula who is the right fit for your family.

  • How comfortable was I with the doula/s?
  • Did the doula/s communicate well with me and my family?
  • Do I feel confident that the doula/s will be able to work collaboratively with my birth team?
  • What was the doula’s level of knowledge? Did one seem more knowledgeable than another? Did I feel that my questions were answered thoroughly?
  • Do I feel comfortable having this doula (these doulas) in my home?
  • If there are unexpected situations, or if I need support early in labor, do I feel confident that this doula (these doulas) can offer what I’ll need at the time?
  • Who is the right doula to nurture and support my family through this process? Did I feel a connection?
  • What does my overall intuition say?

To recap, when hiring a doula, do your research.  Not all doulas are created equally.  Learn about them and find what drives their work before meeting them.  Understand how they gained their knowledge-base and what organizations they associate with. If you aren’t able to answer the important questions through your own research, begin a dialogue via email or text. Go into your interview looking for connection, take note of how you feel, whether or not the doula will flow well with your vision for your birth, and more than anything listen to your intuition. Because any good doula can agree with me that our goal is for you to have a beautiful birth experience, and connection plays a huge role in how well-supported you feel during your birth.  You’re likely to be in a room with your doula  for a very long time.   Feeling comfortable is key.  And if you don’t feel that magical doula connection you think you should feel, I promise we won’t have our feelings hurt — we probably know another doula who might be the perfect match for you. 

The lists included above were found on the DONA International website:

What to Look For When You Hire a Doula

No is a Complete Sentence.

Let’s talk self-advocacy…

Lately I’ve received a lot of messages, and have seen questions on social media, where a pregnant person is asking for research and data to argue a point (or prepare to argue a point) with their care provider.  This was a huge mistake that I made during my pregnancy and my hope is to address this as simply as possible so that I can help others avoid unnecessary anxiety.

If we trust our care provider and are on the same page about our wishes from the very beginning, the likelihood of disrespect and confrontation is much lower.  This is why building a trusting relationship with our care provider and keeping an open line of communication is so important.  I find that there are two common reasons why many of us find ourselves in this defensive position: 

  1. We never really researched and interviewed care providers to be sure that we were on the same page.  So many of us continue with our OBGYN as usual when we become pregnant without considering whether they hold the same values that we do about birth.
  2. We’ve had a previously traumatic experience and have an underlying distrust of care providers. Unchecked, this can lead to iatrophobia, which is a fear of doctors that can cause anxiety and panic. 

No is a complete sentence.  It’s that simple.

Arguing your opinion is counter-productive and unnecessary. No is a complete sentence. Your care provider is there to answer your questions and provide information and support, NOT to convince you of anything.  But we are all human beings, and sometimes personal bias creeps into the equation, even when we have done everything in our power to create and maintain a healthy relationship.  So how do we prepare for those circumstances without living in fear or anticipation that it will happen or that we will have to fight or argue our point? 

There is a reason why this is such a common concern.  As humans, our immediate response to confrontation is fight or flight.  When perceiving a threat, we always react in one of these two ways, but just as I mentioned in this post about facing our inner tigers, sometimes all we need is to find our inner truth and know how to respond confidently.  Because some tigers feel very real but are only in our heads.  We have the choice to react or respond

So what do we do when we are feeling pressured or unheard by our care providers?  How do we respond without reacting?

  • First, take a deep breath bringing your attention back to the breath helps bring you out of that fight-or-flight reaction and grounds you so that you can respond appropriately.
  • Ask any questions you may have, but if you already know your answer, “Yes” and “No” are both complete sentences.
  • If you don’t feel heard, calmly reiterate that you understand your options, you’ve made a decision and you don’t wish to discuss it further.  This normally gets the point across.
  • If you still don’t feel heard, ask the provider to make a note in your chart.  Whether you are saying “no” or you feel that symptoms aren’t being addressed or taken seriously, a care provider will almost always pay closer attention or take a more serious look if asked to document the encounter. 
  • If you have done all of the above and the provider continues to disrespect your personal choice, calmly dismiss yourself and find a new provider. 

I want to stress that finding a new provider should be your very last resort.  And that brings us back to finding a provider you trust with your choices from the very beginning.  The provider-client relationship is the most important part of your pregnancy.  Just as I advise all of my clients to interview 2-3 doulas before making a final decision, I also suggest they interview multiple providers at the beginning of their pregnancy.  If you’re not sure about how to interview a care provider or what questions to ask, I have a printable PDF that can help you get started.

If you’ve experienced previous trauma and need more thorough communication throughout your experience, consider choosing a smaller practice where you have a better opportunity to get to know your provider during your pregnancy.  Tell your care provider that you have had negative experiences before and that communication and understanding are important to you.  Hypervigilance is a sign of anxiety, and if you find yourself in the position where you trust your provider, but are inclined to prepare for every possible situation where trust could be breached, this is something that needs to be addressed sooner rather than later.  If we don’t unpack our trauma, it will follow us into our births, especially if that trauma is care provider related.  Hire a doula, find a therapist who specializes in pregnancy and postpartum, and face your paper tigers now so that you can better recognize them as they are when you are in labor.