Q.  Why would we want a doula?  Wouldn't that be like having a stranger at our birth?

A.  Unless you know your doula before pregnancy, she does start out as a stranger.  During the course of your meetings, though, you get to know each other.  She gets a good feel for your needs and desires for birth, and you experience the way she cares for and nurtures new families.

What expectant families don't often realize is, the day your baby is born, your doula might be the only person in the room (aside from family and friends) who ISN'T a stranger!  The option of choosing your medical birth team is not always available.  In offices with many practitioners, you may meet with all who may potentially catch your baby, but rotation schedule is most likely the factor in deciding who will be there on your baby's birthday; likewise, a practitioner in a solo practice -- if unavailable -- has a back-up whom you may not have even met before.  In these situations, a doula can help remind you of your birth intentions, and she can support you and your partner no matter who is on your birth team that particular day.

Q.  My partner is planning to be my support-person -- what good would a doula be then?  Wouldn't she make my partner feel displaced?

A.  Most partners plan to be the main support person during birth -- and a doula doesn't interrupt this plan.  A partner's support is different than anyone else's on the birth team:  The partner is the only one at a mother's side because he or she LOVES the mother, cares about the mother, and has a great interest in the outcome and future for mother and baby.

Every partner is ready to participate in the birth process at varying levels.  Some are very comfortable with the scenes, sounds, and smells surrounding birth; others need a little more space to process the events going on.  Regardless of level, a doula supports mother and partner where they are at, and helps bring them where they wish to be.  Doulas allow birth partners to participate at the level THEY are comfortable with.

Q.  How else can a doula help besides actual birth support?

A.  All doulas offer prenatal support before birth.  This is a time to learn about birth options, birth planning, and expectations for becoming parents. In addition to this, many doulas also offer breastfeeding support, infant/mother massage, postpartum doula services, information about local resources, and a continued listening ear about the transition to parenthood.

Attention:  I personally authored these FAQs.  Please do not copy them without permission.

Many expectant moms find the last weeks before their baby’s arrival to be fraught with a rainbow of emotions.  The excitement builds as the due-date comes.  This date has been the goal.  Although realistically only 5% of babies are born on their due dates, we still cling to that date as if it means something bigger than it does.  Just as every fruit on the same tree reaches ripened maturity at different points in time, so do our babies.  Another survey suggests 7 out of 10 babies are born past their estimated due dates (as a birth doula, I can say this backs-up my experiences with mothers and babies). 

Babies aren't just hanging around after their due date filing their nails and looking at their watches -- they are still growing and developing, and important changes are taking place.  Babies at this late stage are storing up "brown fat," whose sole purpose is to generate heat -- this helps a newborn maintain his or her body termperature.  Other last week events include:  weight gain, iron storage, sucking and swallowing practice, and of course, lung-maturation.

There is new evidence that babies being born via elective cesarean birth are healthier and have less problems if they are born no more than 7 days before their estimated due date.  The New England Journal of Medicine published these results January 6, 2009.  According to this study, babies "delivered at 37 weeks were twice as likely to have health problems, including breathing troubles, infections, low blood sugar or the need for intensive care."  As far as complications went, the total breakdown (and know this study focused on over 13,000 women) was:

15% of those born at 37 weeks

11% of those born at 38 weeks

8% of those born at 39 weeks

From my limited knowledge, and my (weak!) math skills, I would throw out a guess that of babies born at 40 weeks, 6% might experience complications.  Although this study focused on timing of elective cesareans, the information applies to all babies -- and this is good stuff to remember if an induction of convenience is offered.

Mothers and fathers aren’t the only ones anxious to greet the new stranger; well-meaning family and friends can cause undue stress on the expectant family with their calls, visits, and inquiries as to whether the baby has arrived yet.  Some ways families have alleviated the pressure these loved-ones can unknowingly bring are:

·        Appoint a family member to field phone calls.  Update this family member as needed, and direct phone calls to his or her line.  Have family members call this person for the most up-to-date information. 

·        Leave a message on your machine that lets people know baby has not been born yet, the expectant couple (or family) is resting and gearing up, and you will share the news as soon as there is news to share.

·        Place a sign on your door which explains to visitors (if you do not feel like answering the door, or maybe you are catching up on sleep) that you are resting and wish to not be disturbed right now.  Assure them you will welcome a visit (and a lended-hand) once the baby is born, but for now focus is elsewhere and you are busy resting and nesting.

It is not uncommon for an expectant mother to start to go within herself at this point.  Her inner focus is being shifted from her environment, her house, her life-to-this-point, to her body, her baby, and the process which will unite out of the womb what was united inside those many months ago.  Often she will want time to meditate, journal, rest, enjoy her partner and their last days together before they greet, together, this new human they took part in creating.  Emotions can come freely, including fear, sadness, joy, excitement, relief, apprehension, with interminglings of feeling overwhelmed, unsure, and stressed.

Remember to take care of yourself; rest when you want to rest, work when you want to work, eat when you want to eat.  Pamper yourself – get a massage, have your nails done, visit your acupuncturist – whatever makes you feel special and taken care of.  Have your partner read books to your baby, share in this time together. 

Final words for mom and dad:  Rest, relax, and enjoy each other – strengthen your bond so you can welcome your new baby with love and strength.

Your heart pounds, your mouth dries, your ears begin ringing, and your face suddenly feels so hot!  You just got a call that a potential client wants to meet for an interview.  This often leads to a mad-scrambling of resources, or the paralyzing shock of sudden responsibility.

No need to fear!  First off, keep in mind these people have contacted you because they are aware of the services you provide, and they are wondering how you as a doula can help them as expectant parents. 

Place:  Where to meet?  There are many different ideas about this.  Many doulas feel there is nothing better than to meet in the expectant parents' space -- their home.  The advantage here is, you are able to show them you can fit into their home and life.  Pregnant women are traipsing to a lot of different places -- the doctor's office, the ultrasound office, the hospital to pre-register, their childbirth classes.  Nothing is really accomodating, so to be able to visit a mom in her home can help with the whole why-one-might-want-a-doula-in-the-first-place:  Having an advocate to help with physical, informational, and emotional support who is more just a random stranger on shift.

Sometimes a doula might feel meeting in one's home, without any prior meeting or credible information about a potential client can be a safety issue. I have personally had times where I did feel comfortable going to a stranger's home for an interview; there are also times I feel more relaxed scheduling an interview in a public place.  Going with your gut can be helpful here -- we encourage women to use their intuition to aid in their process of birth, we need to remember that and apply it to ourselves, as well.

There is another school of thought that says, this is an initial meeting where no commitment has been agreed upon yet, so the doula and the expectant family should try to meet in a public location about as in-the-middle as can be, which can be helpful if a doula lives a distance from the potential clients.  This saves her gas money and travel time.  Often if a doula is hired, she makes the full trip to the clients' home for her prenatal meetings.

A good alternative to meeting in a private home is a comfortable, public location.  I often meet clients at a tea bar I frequent.  The atmosphere is light and calm.  There are many different types of tea and drinks, plus food if the meeting is at a meal-time or if someone needs a snack.  I have met at coffee shops before, although I don't drink coffee.  I have found they are often bouncing with noise and turnover-crowd.  Other places I have had interviews are parks (good in the weather is nice or the interviewee has other children), restaurants, medical office waiting rooms (this helps streamline a woman's appoinments), her work place at lunch (then we went on a nice walk), WIC Office, baby store, and an apartment's recreation center.

It would be naive not to take some cautionary measures for your safety when going to an interview.

-Leave a note detailing where you are going, who you are meeting with, and how long you will be gone.  Information that should be included:  The names of the folks you are meeting, the address of the location, the email address or access to any online exchanges you have had with the person.

-Bring a cell phone with you, especially if you are meeting at a private home.

-If you feel something's fishy about the situation, choose a public place, and perhaps have someone come with you, incognito at another table, or as a doula-in-training learning the ropes -- saftey in numbers.  I know this sounds odd, and if you really felt strange about something why go at all?  There are times, however, where you aren't sure about the situation.  I have never had a "this is not right," kind of situation at or after an interview, but I have had those feelings from initial phone or email contact.  Proceeding with a back-up plan is just an added measure of protection in an uncertain situation.

It is important to note I have not experienced anything scary or dangerous as I have worked as a doula.  The point is not to strike fear into your heart, the point is to remember to listen to your gut and be mindful of your safety as you proceed down this road. 

Stay tuned for part 2:  No Need to fear...the Interview:  What to Talk About?