10 Questions To Ask Before You Hire a Doula

You’re pregnant, and you want to hire a doula. You know they can provide great support to pregnant moms during prenatal care, labor, birth, and even postpartum. But… perhaps you’ve heard of the great doula debate: some doulas will advocate for you while you’re in labor, and some, well, not so much. That might be at the forefront or you mind, or, maybe this is your first time hiring a doula and you just need a place to start. Either way, this resource will help you prepare for your birth journey. Here are ten questions that could make a big difference in your labor and birth experience.

  1. What can I expect from you during my labor and birth as far as communication about what is going on during my birth? Some doulas will tell you, for instance, that a provider is about to do a vaginal exam that you can’t see. Some doulas won’t tell you. If they seem anxious about communication with the provider, know that they will be even more anxious in the birth room and that this could largely affect your birth (as in, you might have an unconsented intervention because no one told you it was happening).
  2. How comfortable are you with advocating for me during labor? From hospital birth to homebirth, there will be times when you physically can’t talk while you’re in labor. Seriously, at a certain point in your labor, it will be hard for you to talk and think strategically. Particularly when you’re pushing. There is just no room for thoughts while all of your energy is being spent on pain endurance. This means even remembering the acronym BRAIN – whether or not it’s posted on your wall or written on your hand – is going to be far, far away from your consciousness. Is your doula comfortable relaying your birth plan to your provider during these moments? Is she comfortable asking you questions or initiating conversation with you? Some doulas even bristle at the mention of the word “advocacy.” This could be a huge red flag that this person will not say anything if abuse or an unconsented intervention is happening.
  3. What are some examples of how you would advocate for me during labor? You want her to be really specific. For instance, she might say, “Provider, my client did not give consent to an episiotomy.” Does she feel comfortable addressing the provider? Or will she only tell you what is going on? For instance, perhaps she will only say, “I see the provider picking up the scissors” and expect you to advocate for yourself or tell the provider you don’t want an episiotomy, as you are breathing through a contraction. How does she feel about speaking up about what you consented to and what you didn’t when you are physically unable to? Or how does she feel about telling the provider to wait a few seconds so you can speak?
  4. Do you have any reason that you wouldn’t feel comfortable speaking up at my birth? Do you have a conflict of interest? Sometimes, doulas have conflicts of interest. Sometimes a doula hasn’t worked at the hospital you’re birthing at before, and they want to make a “good impression” by not making waves. This could result in them not speaking up for you when a physician isn’t getting your informed consent. Or, a doula could regularly work with one to two midwives, where she regularly receives client/business referrals. She is likely not going to go speak up for you in the presence of this midwife, or she would lose work or this relationship. Or, a doula might just be starting out entirely, and want to seem easy to work with to providers.
  5. Tell me about a time when a provider did not follow a woman’s birth plan or get her informed consent. How did you react? How did you advocate? This will tell you a lot about her philosophy on birth plans and her views about what is “controllable” in birth.
  6. What organization did you certify with/train with? Look them up and read into their philosophy. Different schools have very different philosophies.
  7. Are you more experienced in homebirth or hospital birth and how many births have you attended of each? Which are you most comfortable with or experienced with?
  8. Of the homebirths, how many ended in transfers? How many ended with unwanted or emergency c-sections? Did any end with unnecessary c-sections? How did you communicate with, inform, or educate women during these births?
  9. Have any of your clients ever been really dissatisfied with your doula relationship? Can you tell me about your relationship and communication during these?
  10. Walk me through what I can expect from your services from now through postpartum. This should be a one sheet – a scope of work outline, or a bullet-point list at the very least. Included in average contracts are at least two visits with you and yoru partner during your pregnancy, a visit with you and your provider, and when she will arrive after you call her in labor, how long she will stay, and what she will do if she needs backup (becomes sick, etc.) Nowadays it should also include COVID-19 protocols and precautions. It should also tell you if she makes any postpartum visits and post-birth processing. (This might seem like the least important part, but it can actually be life-saving.)

Published by sectionmama

I write about American maternity care, sexism, pregnancy, birth, and motherhood.

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