There are many types of doulas! Fertility, Labor and Postpartum are just a few examples. As the benefits of having a labor doula are flooding the internet, creating panel discussions and influencing policy changes some parents still are not sure when to actually hire the doula. This blog serves to speak about LABOR or BIRTH doulas only, those whose primary function is to attend the birth itself.
So when is the right time to hire your labor doula?

The quick answer? As soon as possible!

Hiring a Private Practice Doula:
To gain the full benefits of having a doula, time should be spent getting to know each other. Of course, this is assuming you have completed an interview process with local doulas and chosen your favorite. One who aligns with your values, birth philosophy, target experience and budget. I am not going to get into all that here. But should you like more information on how to begin finding a doula here's a good link. 

https://www.parents.com/pregnancy/how-to-choose-a-birth-doula/

Once you have selected your doula, hiring is the next step.
Ideally, you should be about 5 months pregnant or less. This may sound early, but your doula is also trained to assist you during your pregnancy. Comfort measures to alleviate headaches, nausea, back pain and all other pregnancy induced minor annoyances can be handled with a simple text to your doula. Your doula could also be a childbirth educator; so you may need more time to either attend classes or have detailed prenatal visits with education as the focus.

Navigating the “lay of the land”, your experienced doula has first-hand knowledge working with local providers and can give you some background based on your preferred options. Sometimes this may mean changing providers to obtain your desired birth outcomes. So hire your doula the earlier the better to ensure getting this information in a timely manner. For example; you are currently with a practice that does not support homebirths, water-births, birth center access, or VBAC (Vaginal Birth After Cesarean) and you want your best chance to obtain one or more of these birth choices. Your doula also has a vast resource list, from doctors/midwives to pediatricians to chiropractors.

Sounds great, right? However, a great doula is usually booked well in advance, so do not miss your chance to hire them and GET ON THEIR CALENDAR!

​I'm a private practice doula who insists on childbirth education classes with me before hiring me as your doula. That's just my philosophy. It builds our relationship while you attend classes, creates trust and an overall sense of empowerment. My clients actually prefer it that way. Most say "you don't know, what you don't know!"

Hiring a Community Doula:
Depending upon the community program there may be several procedures in place that would warrant getting started early. There may or may not be an interview process.
Some programs will assign a doula to you. In any event, resources and information will still be available in this collective of Community Doulas. The beauty of this program is the community based aspect, culturally appropriate and usually low-cost or subsidized if you qualify. In-house back-ups! As birth is unpredictable having a community of doulas can ensure someone will be at your birth. With a limited amount of doulas serving a large community, these doulas can be overbooked as well.
Call early to GET ON THEIR CALENDAR and/or see if you qualify. 

​Here is a great community doula program in my NJ area!
https://spanadvocacy.org/programs/doulas/


Hiring a Doula from a Collective/Agency:
Almost similar to the community doulas, this is a private group of doulas covering a specific area or demographic. The likelihood of interviewing your doula is greater in this format with the option for an in-house back-up. Covering the same benefits and resource aspects as the private doula with a greater pool and maybe even some discounted services due to referrals and packages. The volume of work coming through this collective almost ensures the need to reach out early to GET ON THEIR CALENDAR!

I also coordinate the Doulas affiliated with the Birth Center of NJ :)
http://birthcenternj.com/doulas/

And Baby Please Birth Services is now a Doula Agency, covering NJ, NY, PA, MD and GA. 

Hospital Doulas:
There are some hospitals that will have doulas on staff. You are likely not able to meet them beforehand to establish a rapport but it would be handled similar to nursing staff. If you are able to select your doula, antepartum care is limited. How you pay for this service depends heavily on the individual hospital policies. Call ahead to determine if and how your hospital handles these services, they may be on a first come first served basis and might be difficult to reserve. 

These programs seem to come and go. Or they just aren't advertised well, so calling the hospital directly is your best bet!
 
The last thing a doula wants to do is turn away an expected parent because their calendar is full, we usually work with other doulas to ensure support and good coverage. The majority of my repeat clients almost as soon as they get that first positive pregnancy test! 

Doulas have specific "on-call" times, for some it's at 37 weeks until delivery. For others, it's as soon as the retainer is paid or some variation in between.  So, you have to be clear and READ the contract you are signing. Being "on-call" means that should labor begin they will answer their phone no matter the time of day to support you and be ready to attend your birth. 

Nevertheless, sometimes it is just too late in the game to help.

Signs you are NOT on the doula’s calendar!

·       Calling the day before your induction for a doula consultation is too late

·       Emailing about services near the end of your 8 month with a list of different  pregnancy conditions is too late

·       Setting up an initial consult, signing the contract, never paying a deposit but calling while you are in labor is too late

·       Talking about hiring your friend/colleague as a doula, never signing or paying anything or even talking about it anymore but calling when you are in labor is too late

·       Calling when you aren’t pregnant and looking for a ton of information via dozens of emails means you need to take my SAVVY BIRTH 101 Workshop or any of my Childbirth Education Classes. 

·       Having a great connection during the interview, then ghosting the doula and never paying a retainer,  but you call to “ask for advice” and then decide if the doula wants to “show up to the birth for experience” without pay you wouldn’t mind them being there ...is just plain wrong

I have been a doula for over 15 years and all of the above have happened to me, one of them just a week ago. This is a business and warrants business transactions and contracts, (to protect you and the doula).  I am certain there are some unprofessional doulas who just don’t show up for births.
They do not represent us all! 

This is not just a passion to serve but a career for many. If you want a doula at your birth, hire us at the appropriate time in your pregnancy so that we can be most beneficial to you! Provide great care and improve your birth outcome!
Reach out as soon as possible and don't wait until the last minute. If you are holding out for refund checks or lottery winnings you are missing your window of opportunity to find the best doula for you. Talk to them about payment plans or gift certificates your family/friends can purchase. 
We are worth every penny and so is your birth story!

Need a postpartum doula?
​You should start that process in your 7th month of pregnancy or less ;) 
 
Written By
Michelle Gabriel-Caldwell
Owner of Baby, Please Birth Services Agency LLC
Childbirth Educator and Doula
​Evidence Based Birth® Instructor

(These stigmas were also listed in an interview for the West Orange Patch dated 2/28/2020)

1) Under educated; Barriers to prenatal care and birthing options are often seen as a lack of willingness on the part of the black parent to either seek proper care or learn more about their options. The truth is black families aren't given the same options as white families. The conversations regarding alternatives are barely spoken since the assumption is we either can't afford them or don't understand them. 

As a doula my first step is providing the necessary childbirth education, clear discussion on interventions, birth options and alternatives. My goal is to empower birthing parents with the information needed for true informed consent. 

2) Black women are difficult; We are seen as angry, loud and difficult. When the reality is we are not heard! Listening to our daily stressors, micro aggressions and challenges of navigating health care built on systemic racism is the first step to changing this narrative. We only want the best for our families and our voices simply aren't heard. 

Having had two children myself and helping hundreds of women navigate the birthing spaces in NJ and NY, I listen to black women. Understanding their values and concerns should be of interest to medical providers, so when that doesn't happen their doula is there to amplify their voices. 

3) Black bodies are imperfect; reading any risk factor for a condition from hypertension to diabetes a common risk factor is simply being "an African-American". More black women are labeled "high risk" than any other group during pregnancy. This leads to greater chances of inductions and cesareans sometimes unnecessarily. When we are seen as a mass of imperfections straight from birth it is no wonder we have greater risks during labor itself.

Once hired, I reassure my clients that pregnancy is not an illness! That their bodies aren't broken, the system is broken. I work with them to ensure they stay 'low risk" and are seen as an individual and that blanket statements about black women are merely stereotypes. 

4) Black women don't have partners; pregnancy is normally a very special time in a person's life. For black women in relationships, they spend an enormous amount of time convincing people they aren't alone. This 'poor pregnant black girl image' is one that most married or partnered women have to shake. Answering questions like "do you know who the father is?' is something very few white women are asked during prenatal visits. 

My husband and I teach a childbirth education course with the partners in mind. It provides them the tools they need to support their wife or partner 

during this beautiful time in their lives. Coaching and advocacy from the partner also helps amplify the birthing person's voice!

5) Black women don't breastfeed; This unfortunately is tied to slavery after being seen as "wet nurses" for white families the stigma of breastfeeding has been passed on through generations. Formula is also heavily pushed and advertised in our communities. This leaves black babies vulnerable without the benefits of breastfeeding, especially if the option was viable one. As a result many healthcare providers just assume it's not wanted or rarely offer support when things get difficult.

Immediately after birth I work with families to ensure skin to skin and breastfeeding initiation. We talk about the benefits to mom and baby while working on a plan for success. Additionally two more home visits ensure correct latch and proper feeding techniques. We also tackle any other postpartum issues as they arise, particularly anxiety or depression.

As a full time coatings expert for BYK USA, a chemical additive company, most people ask how I got into the birthing business. It's rather simple, I'm needed! As a mother of two who had natural physiologic births in a hospital space and at home, my birth experiences were not traumatic. So I know first hand there are options not given to other black women. Honestly, some of these options aren't given to most women regardless of race. The freedom to eat and drink during labor. The freedom to walk and rights of refusal of drugs, IV's or constant monitoring in low risk situations. When we remove the stigmas of birth and the routine procedures predicting that EVERY person needs a heavily medicalized approach we can start saving lives. But perhaps equally important we can empower ALL women in their own birthing spaces.

​written by:
Michelle Gabriel-Caldwell
Childbirth Educator and Doula
Owner of Baby, Please Birth Services

​🛑 This blog post is protected intellectual property of Baby, Please Birth Services™. Use of this content for AI training, data scraping, or algorithm development is strictly prohibited. All rights reserved.

While bringing doula work to light is important, it must be done with integrity. I had the extreme pleasure of being the only doula on the Netflix episode of 'Childbirth Explained'. It was part of a 4 series episode of 'Sex Explained', beautifully narrated by Janelle Monae. My initial excitement of actually seeing myself on video clouded what the 30 minute episode was actually discussing. You see, we had no idea what the context or even what series our involvement would appear. I venture to guess that most of the other participants had no idea either. 

​When I say we, I am referring to the mother I was assisting and the doctor who was attending her birth. We were in the last minutes of the episode and we were the only black women. The Birth Center of NJ had been open for less than a year, when Netflix approached them for a series on "natural birth". Pre and post interviews were asked of the doctor and the birthing mother. I was not granted such a luxury. To be fair, the Netflix crew that arrived at the birth had no idea what a doula was until the day of filming.  So when I was asked to sign the release form I provided a description of doulas, used by the narrator much to my surprise!. 

​So, what was wrong with this video? A lot! Namely the focus on pain during childbirth and the misinformation about the average length of labor...9 hours? I think they meant 9 months gestation. More to the point, our main goal at the birth center was ruined. We wanted to provide evidence in action regarding natural childbirth, freedom of movement and the low intervention environment that a birth center can ensure. Instead we were in a mash up cervical stretching, primate birthing and numerous birth stories of trauma and pain. Not exactly what we had planned. 

​What was captured? A few snippets of me administering oxygen to an exhausted laboring person. What wasn't captured?  The hours in the tub, walking the hallways of the birth center, showering, on the birth ball and the CUB.  All the love, encouragement and peaceful moments were narrowed down to her final pushing minutes. Birth is more than just the pushing stage!

​I'm glad this new mother felt strong, empowered and supported during her labor.
​I'm upset it will be viewed permanently as a typical birth in America. 

​Michelle Gabriel-Caldwell, Doula and Childbirth Educator
​Owner of Baby, Please Birth Services

​🛑 This blog post is protected intellectual property of Baby, Please Birth Services™. Use of this content for AI training, data scraping, or algorithm development is strictly prohibited. All rights reserved.