How To Choose a Birth Doula

Choosing the right birth team can greatly impact your birth. Those who surround you during this miraculous time must support your desires and provide encouragement. No matter how you choose to give birth, whether using pain medications or not, an important person on your birth team should be a professional birth assistant called a doula.

A birth doula is usually a woman (there are a few male doulas) who supports pregnant women and their families throughout the final months of pregnancy. She provides continuous support throughout labor and birth and offers physical, emotional and informational support to the mother and her birth team. A birth doula does not provide medical support. Birth doulas are not trained in medicine and cannot perform vaginal checks, assess fetal heart tones, or take the mother’s temperature and/or blood pressure. A birth doula is there for physical, emotional, and informational support only.

1. The benefits of a birth doula. The use of birth doulas has been widely studied with the majority of studies showing that the presence of a doula decreases the risk of cesarean section, epidural and pain medication requests, and may shorten the length of labor. Other benefits include higher success in breastfeeding, greater satisfaction with birth, and a decrease in postpartum depression. These benefits are present no matter how you choose to give birth.
2. Common misconceptions. One of the most common misconceptions about birth doulas is that they are only needed for women who are choosing natural childbirth (labor and birth without the use of pain medications). This is not the case, as birth doulas should be utilized for all types of birth, whether the birth is medicated, unmedicated, cesarean section, induction, and/or high risk. The more risk of interventions with your birth, the more reason to hire a birth doula. Interventions are associated with a higher risk of dissatisfaction with your birth. A birth doula will help you understand the risks and benefits of routine as well as unexpected interventions and will help you process these risks so that you feel educated and comfortable making a decision. The birth doula’s goal is to provide a safe and satisfying birth experience for the mother. Now that you understand what a birth doula is and what they can provide, how do you find one and choose a birth doula?
3. Contact the major certifying organizations. There are many certifying organizations; the major organizations are DONA International, the Childbirth and Postpartum Professionals Association, and/or the Association of Labor Assistants and Childbirth Educators. At each website, there will be a section for you to search for birth doulas in your area.
4. Search the Internet. Many birth doulas have websites. Birth doulas are rarely found in the Yellow Pages. But with the Internet, who needs the Yellow Pages, right?
5. Contact your local La Leche League Chapter. Many women present at La Leche League meetings will know or will have had a birth doula. It’s not only a great place to find a birth doula, it’s a great place to learn about breastfeeding and also locate a wider range of pregnancy resources.
6. Ask your care provider. Whether you use a midwife, a family practice doctor, or an obstetrician, your care provider can be a great help in locating a birth doula. They might work with a specific birth doula or group. If your care provider believes there is no benefit to having a birth doula and tells you not to hire one, it’s best to find another care provider. Who you want in the room with you when you give birth is your choice, not that of your care providers. This is a sign they will not be very accommodating to your needs. Once you find birth doulas in your area, contact at least three birth doulas and schedule an interview with them.
7. At the interview, ask lots of questions. There are many questions you can ask a birth doula such as:
   • How long have you been a doula?
   • What is your birth philosophy?
   • How many women have you served?
   • Are you certified?
   • What hospitals will you go to?
   • How long does it take for you to reach me when I am in labor?
   • Where will you meet with me when I am in labor (home or hospital)?
   • How much does your service cost?
   • When are you on call for my birth?
   • Do you have a backup birth doula in case you aren’t available?
   • What is your refund policy?
8. Focus on her personality. The main reason for choosing your birth doula though, should be the personality fit. Do you like her? Can you see her in the room with you naked? Does she rub you the wrong way? Does her philosophy fit your needs and desires? Don’t pick a birth doula you are not comfortable with just because her fees are lower. This could be a huge mistake and you could walk away from your birth very dissatisfied despite hiring a birth doula.
9. Watch her philosophy and biases. There are many qualified birth doulas out there, however, not all of them will fit your needs and desires. For instance, some birth doulas will only work with women who choose no medication for their birth or women who are choosing to breastfeed. This is why I encourage you to interview with several birth doulas to ensure their philosophy matches your desires and wishes.

Once you choose your birth doula, you are well on your way to having a safe and satisfying birth experience. You will remember your birth for the rest of your life. Having a birth doula present will enhance your experience and help to ensure an experience worth remembering. Congratulations on your pregnancy and good luck with your upcoming birth!