View Full Version : UPDATE: Doula Hired! What Do You Wish you had Asked Your Doula for in advance?
So, I did end up with the relatively more expensive doula (1k) but thanks to everyone's insight I interviewed a few people by phone in the $400-600 range as well. Unfortunately, I couldn't find anyone with vbac experience or that has the same "style" as me with respect to returning phone calls, setting interviews, etc. in that price range - - I am sure because I was looking relatively late.
Anyway, in case this is helpful to anyone looking what we realized from the process is that individual doulas have their own professional norms and some have very significant family responsibilities and don't have regular childcare help or partner support. For us, we really needed someone who was very reliable, prompt, organized, etc.and we didn't really want an informal or overly personal relationship (many people want the opposite from their doula though, this is just us). And, to avoid conflict between DH and doula, someone with a strong medical background. So, we ended up with the experienced midwife who can't practice in our state and is kind of the total package in terms of also being an experienced childbirth instructor and lactation consultant so we are getting those services as well. Also, for us it was very appealing that this doula works through a highly regarded agency which deals with billing, offers a 75% refund if you end up with a planned c-section and doula does not attend, guarantees back-up, offers a huge host of other services a few of which are free to clients, and has a 24-hour answering service/will attempt to get you doula services for basically any pre or post partum need or emergency, including emergency childcare.
Last, I learned that something to consider is total cost comparison. Since our doula is through this agency they actually medically code our services and I should be able to run almost all of the costs through our flexible benefit plan, which reduces the cost to about $650-700 for us. Also, because she is doing a private childbirth/pain management class in our home for $75 (which btw is also covered by flexible benefit plans) that is a savings of about $100 compared to weekend childbirth classes in our area.
So, probably still paying through the nose! But, I think you need to start very early in my areas to find cheaper doulas with the same level of skills/experience/professional support. Thanks for the advice and for guiding me in finding a doula!
So, we are interviewing doulas! I am BLOWN away by the services that are available in my city for such a comparatively reasonable price for 2 prenatal visits, delivery, and then one post-partum visit. In the 1000-1200 price range I am interviewing people at the very experienced senior-level, all with glowing word of mouth recs, who are former midwives, certified massage therapists, profesionally certified natural childbirth instructors, special lactation consultant training, and most often a combination of the above! I am wondering if doulas are being affected by the bad economy this is so affordable!!!???
Anyway, I want your suggestions about what things to ask/ask for. So far on my list:
1. Birth positioning: per snugglebuggles excellent advice in previous threads, I am concentrating on doulas with alot of positioning experience either as midwives or as part of their interest in massage/pilates etc or just due to tons of birth experience/additional coursework.
2. Massage - - I want massage!
3. Will teach husband a few simple massage techniques.
4. Will meet in our home, at additional compensation, for individualized relaxation and natural pain management classes (so far both of the certified teachers possibilities were fine with this)
5. Is available for additional post-partum support if needed (at additional compensation)
6. Will come to our home if we want and support us during labor at home
7. Will create a plan in advance with us for what they will offer in support services if we end up with a c-section
8. Is fully supportive of whatever our ultimate decision may be with respect to pain meds - - we are taking a wait and see approach and delaying epidural but we aren't dogmatic about skipping it.
What else do you mamas think we should ask/request during interviews???
06-15-2010, 03:20 PM
I paid $350. :) I know that fees vary *wildly* though across the US though. When ds1 was born it was probably before doulas really caught on, 2002. Ds1 was born in NC.
I would want someone familiar with your practice and where you are going to be giving birth. My doula came recommended by my CNM (and others) so that was nice. It was handy that the nurse at the hospital chose to be assigned to me b/c she liked my doula. It was cool that my doula knew her way around the hospital too and could get me food!
Honestly? I would not rule out a less experienced doula. Sometimes new is ok. They all have to go through a lot of training. Some older doulas can be set in their ways and just have strong opinions. Of course a new one can too. That leads me to...
Personality. I attended an intro how to be a doula seminar and man almighty the woman running it would have made me want to go w/o a doula. She was loud, annoying, had weird ideas and just would have gotten on my nerves. But, she was also extremely well reviewed in our community by satisfied parents. If you can't stand someone when not in labor you probably won't like them in labor. :)
All doulas should know about positioning options. You don't need anyone special for this- yoga and pilates are irrelevant. Heck, if you just showed up with a copy of "The Birth Partner" by Penny Simkin you could just flip through the pages and find one that you like. It doesn't take any additional work. This is a standard part of the training. Experience could be handy though.
You want a massage during labor or before?
I loved the my doula brought lullabies to play during pushing. She took great pictures. I wish my doula had written up my birth story from her perspective for me. My friend's doula did that.
Review the DONA stuff here for a list of other good questions to ask:
In line with what I said about knowing your careprovider and facility, it wouldn't hurt to ask your Dr. etc about their thoughts on the doula. If they really don't have a good relationship you might want to consider someone else. Negative tension wouldn't be ideal.
Thanks Beth! I can't even imagine $350. With our pre-interview current top-choice person I am in shock that she is willing to attend our delivery and 3-4 additional in-home visits for 1k, especially given that she is a former midwife (can't practice in our state), childbirth instructor, and lactation specialist (I think not a certified consultant but also teaches in this area). How are these doulas making a living?! I think the rock-bottom price for someone good in my area is 600-700 and that is hard to find and often you are dealing with a team, an apprentice doula, someone without as much word of mouth recs, etc.
I am printing out all of your suggestions. No doulas are familar with my OB's practice because my OB runs a tiny, solo-practice that is almost structured like a boutique and serves alot of medical professionals - - though my OB takes normal insurance. My doctor loves doulas so that won't be an issue though I am going to check to make sure her OB back up is similarly inclined - - her suggestion to me though was to find someone who would do birth positioning and massage and that the few times my OB had had negative experiences it was when the doula literally ignored the couple or when the doula just kind of flittered around but didn't physically engage with the labor process. The doula my OB suggested seemed to have moved, did not have a working phone number.
I think the hospital is OK with doulas - - its harder for me to figure that out, the doula who is top choice is delivering another baby there in July and I know other doulas I spoke with had delivered at our hospital and they didn't mention anything negative. My DH works at the hospital I am delivering at and he is extremely familiar with the logistics, food, etc. so I am less worried about that.
Thank you again!
06-15-2010, 04:20 PM
I paid $400 in 2007 for a doula with 6-10 years experience.
Are you guys in metro areas? I am in a top five metro area which I think drives up pricing considerably.
The cost is not the major issue for me - - I would much rather spend $300-400 more and have someone who is a great fit and has the specialized experience we want (which includes being a childbirth instructor and willingness to come to our home and teach a private class to dh and I as one pre-natal session and for us to pay additional for a one or two more if needed). And I would much rather compensate someone at a level that enables them to do the job I need in our very expensive city (that is they are not overbooking, running out of gas, or generally stressed). Even at 1000-1200 I am worried that this is not the case and I am just assuming almost everyone who does this in my area has a ft woh partner/spouse . . .
06-15-2010, 06:54 PM
An expensive house in my area is over $200K. Does that answer your question?
I also discovered that I personally do better without a doula. I just teach my dh. I teach childbirth ed & I worked in L & D. I found myself irritated (and clashing) with my doula. I tried doing hypnobabies too. I got so annoyed at the 'bubble of peace' concept. I love labor & delivery. I'm at home there. I must be one of very few who say that though.
Uh, swissair, can I move to where you live? :)
For our first birth, I didn't really want a doula - - my solo-practice OB is very holistic and hands-on and I didn't see a huge need. But, my OB has become very ill and I can't rely on her being there for the delivery anymore (it may be her backup, which is her former mentor and I am sure great but just not the same for me). So, we thought for this birth the doula would provide some continuity and extra support. Plus, we have very little time so we ideally need people to come to our house for everything -- private childbirth classes in home, lactation consultant in home, prenatal massage in-home. I know it sounds crazy but by the time we are done paying for sitters it is often cheaper to get someone to come to our house.
06-15-2010, 08:38 PM
I would even come to you if it wasn't too out of the way. Unfortunately for you, I am due 9/4. So on to Plan B.
06-15-2010, 08:39 PM
No help, but thanks for the thread. I'll come back to it for #2.
06-15-2010, 10:03 PM
Btw, no worries on the price point! I have heard that doulas can cost even more that that. I think it varies tremendously simply by location not by qualifications. Cheaper ones could be just as good but are pricing themselves lower because they don't need the money and just like the work. Some want to be sure that doula services are attainable to anyone interested w/o cost being a factor. But, there is no need to defend your choice. I loved having my doula with ds1 and would have paid that much. Just happy to have been in Raleigh and not have to pay that much. ;)
06-17-2010, 11:30 AM
I live in the burbs of your metro area, and paid $600 for a doula with 10+ years of experience in 2006. Her services were comparable to what you describe, but she was not a former midwife, etc. I'm glad that you are happy with what you are finding, but I also think that you are paying top dollar for it - so should end up with the best!
06-17-2010, 11:48 AM
I've only used a doula one time (first birth) and paid $400 (IIRC) 6 years ago in suburbs of Philly.
She did photography as a semi-professional as well and got some great photos of me while in labor (which I wanted). I didn't end up needing her for 95% of my labor, but in that 5% (transition) she was well, well worth the $$. She was very experienced.
Any doula not familiar with positioning would be crazy IMO. That should be a given.
Personality is critical...that you mesh with her. Our doula did a fantastic job of advocating for me when I was in labor. She got the nursing staff to hook me up to the intermittent EFM so I could be on all 4s on the bed, or sitting on the ball. Being hooked up in bed was the only time I was having discomfort (in retrospect I should have declined EFM for my particular scenario, and I didn't have anything other than intermittent doppler checks w/ the other two births). It was nice in that she used a sweet, kind approach but made sure the nurse knew it was important for me to be hooked up with the option to move. The nurse wasn't happy, but it was totally doable with a little more work on her end. THe doula handled it very diplomatically.
Hmmm . . . maybe I am overpaying? I live in the city itself and my frame of reference is medical billing - - *not* that we see the money but DH's 20-minute long procedures are billed out at way more than even the high-end doula compensation I am talking about. I just don't see how I could fairly pay someone much less given that DH and I are I think nice but demanding people to work with.
Since I am an August due date I think I waited too late for the people in the $700-900 range - - they are long booked. I really haven't found any highly rec'd doula, with many, many births under her belt, vbac experience, childbirth instructor with natural pain management training, lactation training with yearly continuing education in lactation, etc for less than $900. And no one period for less than $700 unless they are an apprentice. But if anyone in the chicago area has please pm me!
Also, are you all quoting prices that include: 2 prenatal visits, labor & delivery, first BFing, unlimited phone support, and one post-partum visit?
Last, if there is anything else I should ask the doulas I am interviewing let me know!
06-17-2010, 03:37 PM
Also, are you all quoting prices that include: 2 prenatal visits, labor & delivery, first BFing, unlimited phone support, and one post-partum visit?
yes. First BFing was immediately after the birth so she was there anyway. She didn't do childbirth ed for us but provided books, offered a birth ball to use in my last tri (I had my own), wrote a birth story, and took photos.
I don't know if you are overpaying, just sharing what our doula handled.
06-17-2010, 04:44 PM
My price included all of that.
06-17-2010, 04:55 PM
Mine included that. I do think that you might be overthinking qualifications. Have you reviewed the DONA requirements? They all have training in the things you want even if they don't "specialize" in it (natural pain management, lactation training...). Some have no desire to officially become childbirth instructors b/c it does cost money and time but they might be extremely knowledgeable. Think of the bf'ing boards here too; plenty of knowledgeable moms about nursing b/c they have a passion for it and have read and kept current wll without having the letters after their names. Look over what doulas need to do to be certified. Also, check ICAN message boards for a good VBAC doula too, maybe there is someone else out there to interview.
06-17-2010, 04:59 PM
I hired a doula and although she was helpful, she was not as great as I had hoped for. I actually ended up with an emergency c-section because DD had not descended low enough (I was 10 cm and pushing) and her heartrate was getting faster with each contraction etc.
Looking back, I wonder if the doula could have done something to bring DD down...My SIL had a great doula who put SIL in specific positions during labor to make the baby descend, and it worked!
The only other thing you might want to ask is if she is willing to come in the car with you to the hospital...I would have really appreciated that!
No doubt overthinking. I spend my life overthinking!
I guess my concern is that I don't have any ties to the birthing/doula community to get inside info on the rising stars or hidden gem type doulas. I am confident there are equally competent people without the formal qualifications but I wouldn't know who they are. Whereas the qualification, while is imperfect, is at least somewhat of a proxy for knowing about x or y. At least that was my thinking.
I did contact an additional doula off my rec'd short list (sent to me by a top doula in the area who has been hired by other doulas for their births . . . but who herself is booked). This doula is less experienced at 3 years, less formal certification but some very good reviews and seemed very personable. And is $650. So, I will interview one less expensive person, I promise!
I think I have reached the point in this pregnancy where I am willing to basically say, "Here is my wallet, can someone please just provide me with morale support!"
06-20-2010, 05:18 PM
We're looking into a few right now recommended by DONA. The average is $250-275 and includes unlimited phone and email support, one in-home visit prior to birth, unlimited support during the birth (although I'm sure it varies when they'll show up--like when contractions are X minutes apart, start at your home vs only meet you at the hospital), and breastfeeding support following birth. Postnatal doula visits can be negotiated at extra expense (usually $30-40/hr). I feel blessed that it's so low, but parsing out qualificiations can be tricky, as years of experience or births attended don't necessary equate to the type of skills you desire.
Good luck w/ the doula for $650. I sometimes like the younger/newer ones b/c they have an attitude that is learning as much as teaching.
update and thank you in first post!
07-23-2010, 01:35 PM
Glad you've hired someone! I thought I'd just mention that I paid my doula $1K as well. She is also a midwife and I hired her as a doula/monitrice meaning that she could monitor my vital signs, check babies heartbeat, and check my dilation in order to keep me from getting to the hospital earlier than I'd like.
I've had my baby now, and I will say that she was worth four times that cost. I can't believe how much she gives for such a reasonable cost. I truly believe she saved me from a C section. It was the BEST decision I made.
07-23-2010, 03:09 PM
Hurray for doulas!
I probably paid my doula more than anyone else here - $1700 - and that was after requesting a reduced rate from her regular $2000 charges. (She was a rural midwife for a decade and has been a doula 17 years.) But she was worth her weight in gold (not literally speaking since we don't have that kind of money! ;)) She even provided post-partum support although that was not in her contract, and she still checks in on us to make sure all is OK. A real gem.
You are lucky to be able to do this thru FSA - no such luck here! No regrets though. Hope everything goes as smoothly as possible. :thumbsup:
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