What does a Doula do?
A doula is an essential member of a pregnant person’s support team, providing non-medical care in the form of evidence-based education, hands-on labor techniques, emotional support and assistance navigating the health care system. There are many ways that doulas work to serve pregnant people, couples trying to conceive, and new parents - click here for our deeper dive on the benefits of doulas and virtual doula support!
When to hire a Doula
Having the right doula for you is an incredible gift, whether you are a first time parent or you already have children. Just like healthcare providers, doulas come in all forms, with different personalities, passions and specialties. Consider the options below to figure out what kind of doula support might be most helpful for you, and how to hire a doula that meets your needs, preferences and budget.
Doulas offer a variety of support options depending on your stage
As described above, there are different types of doulas who can serve you at different points in your journey. Pregnant? You probably want a birth doula, and maybe one who also offers postpartum support. The sooner you hire a doula, the more quickly they can start supporting you, and many birth doulas are contracted as early as 20 weeks or sooner, which gives you all time to become familiar as well as cover educational materials at a comfortable pace.
Maybe you just had a baby, or you also have a toddler, and a postpartum doula could help you to optimize your healing, recovery and life with a newborn. Hiring a postpartum doula can be done at this stage, or earlier on before a baby is born so that the doula can support the family with the immediate postpartum transition.
Maybe you are new to all of this, still trying to conceive, and looking for an experienced doula who can help you to meet your preconception health goals and navigate fertility. Or perhaps you’ve done this before and really just want someone to come attend you in labor, and that’s it!
Wherever you are in your journey, here are some of the ways a doula might assist you:
- Creating a birth plan and understanding your options
- Anticipating and managing your body’s transitions through pregnancy and beyond
- Non-medical techniques to reduce pain and discomfort
- Understanding the process of labor and delivery
- Helping partners to learn or practice support measures
- Understanding your pain management options for labor
- Emotional support for challenges, including miscarriage
- Celebratory ritual, helping you make affirmations, spiritual support
- Techniques for labor, including breathing, movement, and positioning
- Understanding procedures before they occur
- Aiding you in advocating for your preferences and needs
- Engaging the rest of your birth team as you’d like
- Emotional support and encouragement
- Helping you to manage stress, liaison with family, etc.
- Breastfeeding guidance
- Emotional and physical recovery from birth
- Parent-baby bonding tips and education
- Infant and newborn care, demonstrations and modeling
- Referrals, networks, community resources
Doulas come with varying levels of experience, from new or student doulas who are just starting out to grand-doulas who have served hundreds or thousands of families. Some are parents, some aren’t, and some are focused on serving specific community members, such as LGBTQ+ clients or BIPOC families. A doula’s beliefs, experience, and economic status might impact their practice style, costs, and capacity to serve you well, so below we outline some basics to consider in hiring a doula.
How to find a Doula near you or virtually
Finding the right doula match near you
You’ve reviewed the amazing benefits of working with a birth or postpartum doula, and perhaps you’ve decided that you are ready to hire a doula - congratulations! There are lots of ways to find a doula, including peer referrals, online directories, or asking your prenatal health care provider for recommendations.
Many cities have regional or even neighborhood-specific doula groups, and doula agencies are companies that match expectant families with a doula or team of doulas. Some listings are language-specific, geared towards Black clients, or uniquely equipped to serve families of specific faiths or ethnicities, so if you are seeking a culturally-matched doula, there may be options.
Once you’ve identified some potential doula matches, you’ll want to review any materials they provide and arrange for a phone call or interview. Confirm they are available and local during the weeks surrounding your estimated due dates, as well as other details of their service. Write down any preferred questions you may have in addition to the ones below:
Questions to ask a Doula
Background & Approach
- What is your background and experience, how did you become a doula?
- Are there any certifications, specializations, or additional skills you offer?
- Is there anything you look for in particular in working with a client, or any reason that we couldn’t work together?
- How many clients do you take on at once? How many births do you serve per month?
- How will you attend to me in labor? Do you have a time limit on your service? Do you have backup and will I meet them ahead of time?
- How do you navigate advocacy in the hospital setting?
- How does your support look if I have an epidural, or if I have a Cesarean section?
Service & Scope
- What is your fee, and what does it include?
- How many prenatal visits do you do, and what do they include?
- What happens if you cannot fulfill your commitments? What happens if we have a medical emergency?
- Do you provide any service or continuity between visits and labor itself? How do we reach you when you are not on-call for our labor?
- How does your on-call process look, how do we access you when we need you?
- What does your postpartum service look like? Do you provide any education or support in infant care, lactation or postpartum healing?
- How can you support my partner/primary support person?
Other things to consider in hiring a doula…
- Sense of humor, relating and respect
- Timeliness, logistics and coordination style
- Ease of communication
- Shared experience, background or faith
- Personal philosophy on care, advocacy, health in general
- Additional referrals, partnerships, resources, community events, educational offerings, etc.
How much does a doula cost?
As with many wellness-related professions, doulas offer their services at a range of price points. Some may have insurance coding or superbills that you can use to submit for reimbursement. Prices are, of course, strongly impacted by the regional cost of living, so take that into account along with your doula’s experience level and what is included in their fee.
Unpaid doulas may be available through a volunteer organization, a hospital partnership, or because they are new doulas seeking experience. None of these rule a doula out for quality service - a new, less experienced doula could be the perfect fit for you, or a volunteer might be very hospital with a local clinic. It’s okay to ask a prospective doula why they are a volunteer if that helps you to make your decision. Just know that a volunteer through a hospital or clinic might be restricted in some of the ways they can support you, especially if they are dependent on the medical institution’s oversight to continue serving at that location.
Paid, flat fee services mean that a doula has one price, a universal service, and it is the same for everyone. The full fee for a birth doula package might be anywhere from $300 to $3,000 depending on your area, but a more typical range is about $500-$1500. Postpartum doulas often arrange for hourly or nightly rates, starting at minimum wage but usually closer to $30-$60/hour.
Paid, sliding scale services are popular among doulas who might serve a wide variety of clients, with different needs, lifestyles or incomes. Some doulas offer scholarships or discounts to single parents or parents considering adoption, and still others simply want to make their services available to as many clients as possible without sacrificing a stable income. For example, a top-of-scale contract might cover the costs of service for someone who could not otherwise access the same doula. In most cases, a sliding scale payment does not determine a difference in the service you receive, but it’s worth asking to clarify what the sliding scale covers.
Packages are sets of services that a doula might offer at different price points. For example, they might have a basic package, as well as an add-on that includes prenatal massage. While packages can make services available for a wider range of people, they can also have the unintended effect of wealthier people receiving essential care that would greatly benefit someone with a tighter budget.
You are making an investment in yourself, first and foremost, and your money also supports your doula, their family, and the profession as a whole. After deciding what your budget range is for hiring a doula, also know that it is fair to ask about payment plans, refunds, and extension of services. Once you decide to hire a doula, they should provide you with a full written agreement or contract so that you know what is expected in terms of payment, refunds, and scope of services.