Saturday, January 2, 2010

My Doula Services

I thought I would give a short overview of what a doula typically does, or at least the services that I offer:
Initial meeting- I usually meet with people for a free initial consultation. They can ask me lots of questions about my experiences, philosophy and just see if they like me. It's kind of like dating in the sense that a client needs to "click" with you and trust you in order to want to invite you to be with them at their birth.
Contract- Once we agree to go forward, we sign a contract that ensures that I get paid and that the client gets the services that she wants. After that point, we stay in touch via email and/or phone, if questions come up during the pregnancy or if she just wants to talk. I also give referrals for child birth ed classes, postpartum doulas and other birth-related fields.
Prenatal meeting- Around 36 weeks we have a prenatal meeting. I devote an hour or two to go over my client's birth plan in detail and make suggestions. This meeting is really to make sure that we are all on the same page and that I understand my client's needs and wishes. We discuss comfort measures during labor, pain medication and any other concerns they may have.
On call- Generally, I am on call for a client from 38 weeks till she gives birth, which could be up to 42 weeks. That is a 4 week period I am committing myself to- to be available pretty much 24/7 and drop everything else when the big moment comes.
During labor- I advise my clients to call me sooner rather than later. Even if things are just starting, and they don't need me to come just yet, I like to have the extra lead time to prepare myself.
We will be in touch over the phone until she decides she needs me there. Generally this is when contractions are 5-7 minutes apart but it is hard to set a specific time frame because things are so individual.
Either way, when I get that call to come, I try to be with my client at the latest within an hour of that phone call.
If there is time, I go to the client's house and labor with her there for as long as she feels comfortable. Otherwise we meet at the hospital/birthing center of choice.
Once I get there, I start working with my client right away- breathing, massaging or finding comfortable positions. Sometimes my client knows exactly what she wants and I just follow her lead. At other times I need to be more assertive and take the lead in order to encourage her and help her get to a better emotional place or to be more comfortable. I also try to take care of all the little things- making sure she stays hydrated, has a snack or has the music that she likes. I stay with my client until the birth, helping with transition and of course pushing.
After the birth, I stay for an hour or so to help with breastfeeding and to help the couple transition to their postpartum room.
Postpartum follow-up- I will call within a day or two of the birth to make sure everyone is doing well. If there is interest, I offer a postpartum visit to the home to discuss the birth, answer baby-care questions and give some sense of closure.
That's what I do in a nutshell. There is much more I haven't even touched on like the doula's role in relation to the father and also in relation to the doctors and nurses. But that's for another post. Stay tuned.

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