How to get the most out of having a doula

Inspired by support 
It was having doula support myself that inspired me to become a doula.  At that time I wasn't well versed in how doulas worked, I just knew I wanted the reassurance of a familiar and experienced person during the unknown.  Someone who was there for me, on my team. 

Quiet magic 
And both times, in different cities, with different doulas, the quiet magic of my doulas' belief in both birth and me had a transformative effect on the birth process. Fear melted away and focus stayed. 

What is the value of 'being'?  
I wasn't a savvy doula shopper - I was a lucky mama to find two authentic birth keepers.  But my two doulas worked in quite different ways and I was taking things as they came with no formalised agreements. Looking back one gave more antenatal support and one gave more postnatal support. Both were fantastic during labour. One charged three times the fee of the other. The bottom line is that doulas are hired for their 'being' not their 'doing'. The influence of deep calm and confidence sitting quietly can have a priceless effect on your hormones during labour - something I have found out from personal experience. But as a new mother you can be very sensitive and it is helpful to know what to expect from this new person who can quickly become close to you. 

Unwrapping the package
Now that I am working as a doula myself and have seen the role from the other side, I know that every doula has their 'birth package'. Some have several flexible packages to choose from, some stick to a single formula that fits into their life. Most doulas have some other professional hats, often within the pregnancy and birth field, but sometimes outside it. Having been both client and doula, I have some tips for those considering hiring a doula to help make sure that you have a valuable experience of doula support. 

Here goes...

1. Don't restrict yourself to doulas who live in your neighbourhood.  Take a sensible look at your doula's journey time to your house, but especially within urban areas you needn't be looking only in your postcode. I would put a limit at around a 45 min journey in case of a swift labour and to make meeting up for antenatal sessions easy. 
2. Which helps with the next tip...interview several doulas. In person if possible or at least via video.  You should allow around 45 minutes for an interview so you get a chance to get a good sense of how comfortable you feel and to cover your questions. 
3. Before you interview doulas, even if this is several months before your due date, think about what is important to you for this birth. Make sure that the doula you choose feels as if they will contribute to helping you achieve or protect these priorities. Do you get the sense that their ethos around birth is in alignment with your hopes and wishes? It's never to early to be exploring your wishes for your birth. 
4. Prepare some key questions so that you don't forget them - often interviews turn into lovely conversations that take you away from the practicalities of the doula's offering. You could ask for a detailed sample contract or letter of agreement, a write-up of their packages, find out how flexible the package is, what they do alongside doulaing, and their level of experience. The personal 'fit' is more important than the list of extra study days they have attended, but there may be indicators such as having attended a home birth or induction before if you know you are planning or needing one. 
5. Consider the benefits of shared care. Doulas in the UK are increasingly working in pairs and small teams. This is because it makes providing doula services viable in the face of weddings, travelling partners, children's birthdays and the occasional visit from the norovirus. Doulas go on call for weeks at a time and if working alone there can be months when you know that there are a few days you just can't do. If you are a pair who both get to know your clients well during antenatal sessions, you know that they have a great guarantee that they will have one of 'their' doulas and that they can rely on double the knowledge, instinct and experience of a solo doula. If labour is long, your doulas can swap so that you always have someone with you who is energised and able to support the room. 
6. Involve your partner if they are going to be your primary birth partner - or whoever is. Sometimes a doula is the sole birth partner and that can work beautifully. But if there is going to be a team, let it be one from the start. Doulas give lots of support, reassurance and encouragement to partners during the antenatal sessions, labour and the immediate postpartum period, and when they attend antenatal sessions, partners have the chance to build a comfortable, trusting relationship with the doula and value the investment in her support. 
7. Do understand what a doula is and isn't. What doulas do varies quite widely as some are trained in alternative therapies, some do birth and postnatal work, some are breastfeeding counselors or lactation consultants... so styles and exact activities will vary, but ultimately the doula bit is about their essence, their belief in you and their support for your wishes and choices. A doula isn't a maternity nurse, a housekeeper, a babysitter, and definitely isn't a midwife. There are wonderful doulas who used to be midwives, but the doula role is not clinical and does not involve medical advice. We're mother-catchers not baby-catchers. 
8. There will be at least one postnatal visit in your agreement with your birth doula - some offer several more. Take up your postnatal visits! Discussing your birth experience with your doula is a really valuable part of completing the birth journey. She will have time to listen and to listen again and may have insights or memories you want to hear. She isn't a regular visitor that you have to make any effort for. She can make you a cup of tea and either won't notice the piles of baby laundry or will offer to put it into the machine for you. The early weeks can be a shifting emotional landscape as you get used to feeding, soothing and caring for your baby - having the continuity of your doula over a few visits is a reassuring thread. 
9. Doulas offer continuous labour and birth support but you will get the best out of your doula if you have a toolkit for early labour. It is a great idea to let your doula know as soon as labour seems to be beginning - most will ask you to keep them well informed - but early labour unfolds best with privacy, and even your doula can be an extra unnecessary pair of eyes. If your doula is your only birth partner you may want her earlier than if she is your second pair of supportive hands. Unless labour is very quick, it is ideal to try to rest, or walk, or bake, or eat, or shop, or bath, or sway, or cuddle, or nest, or listen to hypnobirthing tracks, or roll around on a birth ball while your surges are manageable. When you feel that the things you are trying are wearing thin, your doula will be a really welcome relief and will doubtless have new suggestions to up your comfort and calm. 
10. Think about whether you want a birth doula, a postnatal doula or both! Some birth doulas will also provide postnatal packages, but others do their postnatal visits and bid their clients a very fond farewell (until the next baby). Don't be shy of keeping in touch! We love seeing photos of your babies grow. If you want regular support from a postnatal doula, you can book this before you give birth and just as for a birth doula, you can interview several postnatal doulas to find your ideal match. Postnatal doulas are heaven - I can say that as I'm not one! In a nutshell they look after you so well that you can concentrate on growing in confidence as you care for your baby. They make delicious food, support you in the practical aspects of baby care, let you get a longed-for nap and prevent the isolation that can happen with a newborn once your partner has returned to work. They support you to enjoy the crazy/amazing early days of being a parent. 
11. Look for the gold standard. Doulas are not regulated, but can choose to join the UK's organisation for birth and postnatal doulas - Doula UK. Doula UK is a gold standard for doulas because it provides: an approved education pathway for aspiring doulas; a mentoring scheme as doulas gain experience, and a directory to help you find doulas who work in your area.  Doula UK has a code of conduct, a feedback department and an identified leadership team and work constantly to build ties between doulas and the wider maternity services. 
12. Recommendations and references... If you have a friend or acquaintance who had a doula they were really happy with, ask for their contact details. If a doula you love the sound of on the phone isn't available, ask them to recommend you to one of their close colleagues. If you are thinking of hiring a doula after meeting them, or deciding whether to meet them in person, feel free to ask for a reference. You may get a glowing report that influences your choice. If you feel an affinity with a doula but are unsure about her being less experienced, you can also get a reference from her mentor, who will give you honest and reliable feedback based on their work together. 

I wish you much joy in your journey with the doula for you! 

If you have any further questions about choosing and hiring a doula you can ask them in the comments below! 

If you are interested in working with me as your birth doula, you can contact me to arrange a free phone consultation.