"Giving birth is priestess work; it requires a woman to pass through a painful and dangerous initiation in which she journeys to the threshold between worlds and risks her own life to help another soul cross over.”
- Jalaja Bonhein
BIRTH DOULA SERVICES
With me by your side prenatally and in labor, you can expect to feel cared for, informed, confident in yourself and emotionally prepared -- for whatever the universe presents to you as the path to your baby.
I will be a dependable, adaptable presence during labor: fading into the background when you are laboring comfortably or need space, reassuring you as your body and baby intensify their dance, offering suggestions, encouragement and physical assistance with movements to promote fetal rotation and flexion, and supporting your partner in supporting you.
I will laugh with you, cry with you, and breathe with you. I will cheer you on when you approach the birth you have worked so hard for, and comfort you if factors beyond your control conspire to send you down a harder path.
I will honor your strength, beauty and sacrifice, no matter what.
MY ROLE AS YOUR DOULA:
PREGNANCY: My services include two appointments to get to know you and your desires for your birth. We will discuss your pregnancy, your relationship with your provider, planning for labor, birth and the postpartum period, strategies for maximizing chances of your desired outcomes, any challenges you are facing, and any questions or concerns. Between meetings, I am available over phone, text and email to provide support as needed.
BIRTH: After week 37 of your pregnancy, I am on-call for you 24/7 if you are waiting for labor to begin spontaneously. When labor is well established, I will join you to provide physical comfort measures, reassurance and suggestions, and to support you in understanding and making decisions about any suggested interventions. I will also work to keep you hydrated and nourished, and support others attending your birth in being helpful to you. In the event of an unplanned cesarean or other difficult outcome, I provide extra emotional support and resources for you and your partner.
POSTPARTUM: Following delivery, I will stay with you for a few hours to help facilitate nursing and bonding with your new baby. I will return for a follow-up postpartum visit, which may take place in the hospital or at your home depending on your needs, to provide additional breastfeeding assistance, review your birth experience with you, see how you are settling in, and offer further resources.
This package is ideal for first-time parents, or parents with a history of birth trauma or other unique needs in this upcoming birth. It is designed to offer comprehensive support, including multiple prenatal appointments and postpartum follow-up care, in addition to birth support. Components include:
- free initial consult
- two 60-90-minute appointments in your home between 28 and 36 weeks
- email/phone/text support from time of hire through 2 weeks postpartum, including access to referrals and other resources as needed
- 24/7 on-call availability for your birth
- attendance at your labor and delivery and 2-3 hours of assistance post-birth
- one 90-minute postpartum visit in your home
- option to add on additional appointments and services as needed
Ideal for second-time (or higher order) parents who are comfortable with birth, experienced with newborns and just looking for labor support. This more streamlined package includes:
- free initial consult
- one prenatal appointment in your home
- 24/7 on-call availability for your birth
- attendance at your labor and delivery
- 2-3 hours of assistance post-birth
- email/phone/text support from time of hire through 2 weeks postpartum
Full package: $1100
Basic package: $750
Full package: $1400
Basic package: $1100
A LA CARTE ADD-ONS TO DOULA CARE:
FREQUENTLY ASKED QUESTIONS
While both midwives and doulas are statistically associated with improved outcomes, they have very different roles. A midwife is a healthcare professional trained to deliver babies, make recommendations and perform clinical tasks to evaluate the well-being of mother and child, including assessing fetal heartrate and maternal vital signs (like blood pressure) prenatally and during labor, controlling hemorrhage, suturing lacerations, etc. In contrast, a doula is a non-medical support person only. We are focused on the social and emotional aspects of childbirth, such as helping our clients feel prepared for and capable of coping with hospitalization, birth and postpartum. Instead of clinical assessments, our prenatal appointments focus on planning, addressing fears, and developing a trusting relationship. Similarly, our care during labor involves offering physical comfort measures and reassurance, as opposed to medical surveillance. Because midwives and doulas have complimentary roles, it is common that families planning to deliver with a midwife will still hire a doula (see the next FAQ for more information!).
If your birth will be attended be a midwife, it is important to understand that most midwives do not provide continuous support during labor. This is because midwives have other clinical and administrative responsibilities to attend to that leave little room for providing physical and emotional comfort, the most important of which is ensuring your safety. For example, if you are delivering with a hospital-based midwife, other demands on her time will include charting, assessing fetal heart tracings, checking on other patients, interacting with other providers such as nurses and obstetricians, attending cesarean sections, and admitting new patients. If you are delivering with a homebirth midwife, she may also be organizing her equipment, charting, supervising a student midwife, rescheduling a prenatal appointment she had that day with another client, or discussing matters with her partner while you are laboring. Additionally, many homebirth midwives like to give clients space to labor with their partner undisturbed, which means that they may only come into your immediate space when its time to assess fetal heart tones, take your blood pressure or make some other clinical observation. Finally, it is important to note that need for pain relief is the number one reason women transfer to the hospital from planned home births -- so having a doula can really help combat this risk, especially if you are a first time mom. As a result, women delivering with midwives, whether hospital or homebirth, can still benefit immensely from doula support, and will often hire a doula to fill that gap.
Unlike lay persons, doulas are professionals who are specially trained to provide physical comfort measures, emotional support and accurate information before, during and after birth. They are able to enhance your existing support system by serving as a disinterested third party dedicated only to you. By contrast, family members are understandably emotionally invested and often see your birth through the lens of their own biases and experiences, which can make it difficult to identify and be confident in your own instincts, preferences and needs. A doula’s role is to hold space for you and your partner to claim your own power as parents and to shepherd your baby into this world on your terms.
Yes and yes. Although doulas are typically associated with women and families expecting vaginal deliveries, in particular natural or unmedicated births, I also attend and provide the same prenatal, delivery and postpartum support to women and families welcoming their baby by planned cesarean section or with an epidural. Women planning for medical pain relief or having a scheduled surgical delivery can benefit immensely from the information and support a doula can offer, as many aspects of these deliveries are amenable to planning and strategies to improve outcomes for mom and baby. My fee remains unchanged for a variety of reasons, including that I still spend the same amount of time with you prenatally, in the hospital, and postpartum, and because women planning medicated or cesarean births often require as much if not more support than women planning for deliveries with less intervention. I help you understand your options and how to advocate for the most positive experience for yourself and your baby.
Absolutely. I doula for home births attended by credentialed midwives (certified professional midwives or certified nurse midwives). Additionally, I do prenatal and even preconception consultations with folks who are looking to plan a home birth and want more information about finding a homebirth midwife, the risks and benefits of homebirth, and similar questions. Please see the "General Consulting" tab above for more info!
I doula at all hospitals in my service area, which encompasses the Twin Cities Metro Area, St. Croix & Polk Counties, and the Chippewa Valley.
Doula care is proven to reduce the incidence of costly and negative birth outcomes. You would think the preventive aspects would make the case for insurance coverage obvious, however, private insurance currently does not cover non-medical social support such as doulas. Some families have access to an FSA (Flexible Spending Account) or HSA (Health Savings Account), in which pre-tax money previously saved can be used to pay for eligible expenses; in some cases, doula care qualifies. If this is the case for you, please let me know. Following conclusion of our care together, I can provide a receipt for my services that you can use to obtain reimbursement. I cannot, however, invoice insurance companies directly, or provide an NPI number or billing code. Check with your benefits administrator to find out whether birth or postpartum doula care is an eligible expense.
Not unless you have separately hire me for that purpose. My patient advocacy service is a legal offering distinct from my doula service, which is non-legal in nature. As your doula, I will advise you privately on your legal rights during labor, and indirectly facilitate communication with your care provider by encouraging you to advocate for yourself, but I will not advocate on your behalf directly toward care providers unless you have previously retained me to do so in my capacity as a lawyer. This is because direct-to-provider advocacy is outside the doula scope and inappropriately usurps the birthing person's voice. Additionally, as an attorney, ethical rules prohibit me from acting in a way that suggests I represent someone when that person has not actually hired me to represent them.
As a result, if you want or need me to speak directly to providers on your behalf during labor, that goes above and beyond what I am capable of providing as a doula and instead calls for a higher level of service involving legal representation. To access my legal support during labor you will need to hire and contract with me separately through my legal practice prior to delivery, which means that you will pay a retainer on top of my doula fee. Please note that you also have the right to seek another attorney to represent you during your time in the hospital, although to my knowledge, no other attorney provides this service.
My current policy is to only take on clients for legal advocacy during labor if they hire me in advance. This is related to ethical rules governing attorney interactions with prospective clients. As a result, if you have any concerns about potentially needing my legal support during labor, you will need to book that service simultaneously with doula care.
As your birth doula, I will not:
- drive you anywhere, including to the hospital or appointments
- act as a dedicated caregiver to your other child(ren) or family members during delivery
- provide or contradict medical advice or interfere with your medical care
- speak on your behalf to your care provider (unless you have separately hired me to advocate for you in a legal capacity)
- deliver your baby under any circumstances
Why hire a doula? Research on benefits of birth doula care
What is a doula? A doula is a person trained to provide physical, emotional and informational support to expecting women and families prenatally, during labor and delivery and in the immediate postpartum period.
Research shows that women who have the assistance of a doula during birth have healthier outcomes and report more positive birth experiences than those who do not. In particular, doulas are associated with a 39% reduction in the risk of cesarean section, a lower likelihood of other invasive interventions, shorter labors, less use of pain medication and improved outcomes for the baby. For these reasons, the American Congress of Obstetricians & Gynecologists and the Society for Maternal-Fetal Medicine have recognized doulas as "one of the most effective tools to improve labor and delivery outcomes." (1) More recently, state Medicaid programs, such as New York, have begun covering doulas in an effort to reduce maternal mortality. The compassionate, individualized care doulas provide their clients thus serves as an important harm reduction tool, despite being non-medical in nature.
(1) "Safe Prevention of the Primary Cesarean Delivery," American Congress of Obstetricians & Gynecologists & Society for Maternal-Fetal Medicine Obstetric Care Consensus (2014, reaffirmed 2016), available here.