UPDATE: Doula Hired! What Do You Wish you had Asked Your Doula for in advance?

[sste]

UPDATE:
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!
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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???

[SnuggleBuggles]

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:
http://www.dona.org/mothers/how_to_hire_a_doula.php

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.

GL!!!

Beth

[sste]

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!

[swissair81]

I paid $400 in 2007 for a doula with 6-10 years experience.

[sste]

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 . . .

[swissair81]

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.

[sste]

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.

[swissair81]

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.

[Sweetum]

No help, but thanks for the thread. I'll come back to it for #2.

[SnuggleBuggles]

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.

Beth