When to hire your LABOR doula???

Evidence on: Doulas Updated on May 4, 2019 by Rebecca Dekker, PhD, RN. Originally published on March 27, 2013.

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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

Author

Michelle has been a doula and childbirth educator for 15 years. As a professionally trained scientist, evidence based practices are her focus. Building trust with families through experience, education and a sense of humor puts birth into a human frame of mind and creates space for empowered miracles.