Birth doulas are becoming more common, and you may have heard your friend talk about their experience with their doula. Or maybe a pregnancy book or blog told you that everyone should hire a doula. However you learned about doulas, you may have some questions about hiring and working with a birth doula. I hope that this FAQ can help demystify the birth doula and help you decide if this is an option that you want to explore.
What is a Birth Doula?
A birth doula provides informational, physical, and emotional support during your pregnancy and birth. Many doulas also provide some advocacy, especially during hospital births. Doulas are not medical professionals and do not perform any medical care. Unlike doctors, midwives and nurses that answer to their licensing bodies and also usually the hospital or birth center that employs them, doulas work directly for the family.
Can a Doula Deliver a Baby?
No, doulas do not deliver babies or provide any medical care. Doctors or Midwives are the licensed professionals that deliver or watch over the birth of babies.
A few rare doulas do feel comfortable attending births without a doctor or midwife present, but the family is responsible for their own birth. This is referred to as a free birth.
What is the Difference Between a Midwife and a Doula?
A midwife is a licensed medical professional that is trained in normal healthy pregnancy. Some midwives attend home births or work at birth centers, while some are nurse midwives and deliver babies at a hospitals. In addition to attending births, they can provide well woman, prenatal, and postpartum care; often this is in place of the care of a doctor. They are experts in normal, healthy pregnancy and in recognizing if something is happening that requires medical attention from a doctor.
Being a doula does not legally require any training or licensure. There are many different doula trainings out there and many of us have trained with multiple organizations. Doulas do not deliver babies or provide any medical care. We provide information so that you can navigate the system. We provide emotional and physical comfort and support during your pregnancy and labor. And many doulas also provide some advocacy, especially for clients delivering at a hospital.
So midwives are medical professionals that do things like take your blood pressure and listen to baby’s heartbeat. Doulas do not provide any medical care. Both can provide support to you during your pregnancy and labor, and both can be an important part of your care team!
Why Should I Hire a Birth Doula?
Doulas improve birth outcomes and increase the level of satisfaction that people feel about their births. But most of all, you should hire a doula if you want to have that support prenatally and at your birth; only you can decide if working with a doula is right for you.
Doulas can help you identify your values, write a birth plan, navigate the system, find providers that are more aligned with your value system, choose a birthing location and so much more. I believe doulas are an invaluable part of your care team!
Doulas reduce cesarean rates, reduce epidural rates and reduce assisted deliveries. They help people feel more positive about their birth experience. If you want to know more about the evidence on the benefits of working with a doula, check out Evidence Based Birth:
When Should I Hire a Birth Doula?
I think it is a great idea to hire a doula sometime before you are about 20 weeks pregnant. This gives you time to interview different doulas and find one that you feel alighned with. You also have plenty of time to establish a relationship with your doula and will have a companion to journey with you through pregnancy. A lot of the most important work that I do with my clients is during pregnancy.
But don’t worry if you are further in your pregnancy than 20 weeks. Plenty of my clients have come to me much later than this and some doulas will even take clients that are past their estimated due date if they have the availability in their calendar. So yes, it is ideal to hire a doula sooner, but it is never too late to hire a doula (or change care providers for that matter). This is your birth, and you get to decide what kind of support you want.
Which Certification is the Best?
There are dozens, if not hundreds, of doula trainings out there. Some trainings are a year long while others are three day intensives. Many of the doula training organizations offer the option to certify after meeting certain requirements . There is no overseeing body that dictates the criteria to become a certified doula. Some trainings merely require that you attend the training while others involve things like writing papers, reading books, attending a certain number of births and continuing education to maintain certification.
Some doulas hold multiple certifications as well as other related trainings and other doulas may have only taken one training to certify. I do believe that continuing education is so important but I think we should also not undervalue the practical experience from journeying with people through pregnancy and attending births. While certification may be important to some parents, it may not be important to others, that depends on their value system. The way that you feel while spending time with a doula may be more important to you than which certification the doula holds.
Please note, if you are being reimbursed for your doula expenses by certain companies, for example Carrot, it is a good idea to make sure that the doula you are thinking about hiring holds a certification that is accepted by the benefit company.
How Much Does a Birth Doula Cost?
The cost of a birth doula varies greatly depending on several factors such as location, doula’s experience & training, and the type of package offered. I live in the SF Bay Area and the cost of a birth doula ranges from about $1,500-$4,000 and sometimes even more. There are some place in the US where the average price of a doula is closer to $1,000-$2,000.
Remember that the service offered can be quite different between doulas. For example, some offer one prenatal visit while others may offer four or more prenatals. Some doulas include other services with their birth packages such as Child Birth Education, body work, or lactation education. So it’s a good idea to compare what is actually being offered when looking at the price of a specific doula.
Want to see what is offered in my Birth Package:
To find out the cost of a doula in your specific area you can simply use your search engine to look up “Birth Doula near me” and check out the websites of doulas local to you.
Will My Insurance Cover the Cost of a Birth Doula?
Typically, insurance does not cover doula care but there are some exceptions to this. In some states Medicaid will cover at least some of the doula fee, FSAs or HSAs can often be used to cover doula services, and some private companies offer their employees additional benefits that may cover doulas.
Want to know more? Check out my blog on doulas and insurance:
Mairi Wood is a Birth & Postpartum Doula serving San Mateo & Santa Clara Counties along the San Francisco Peninsula, CA. Her focus is on building relationships with parents to be, providing information and elevating their autonomy during their pregnancy, birth and beyond. She is the owner of Autonomous Birth LLC. She lives with her husband, stepdaughter, three kitties and bearded dragon in the SF Bay Area.
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