Archive for the ‘birth’ Category

So You’re In Early Labor. Now What?

Monday, April 24th, 2017

 

One night, you are awakened from slumber at the beck and call of your compressed bladder. No, wait. That’s not it. There’s a crampy tightness that feels familiar. Where have you felt that before?

Menstrual cramps! It feels crampy. Weird. You decide to get up and move to the bathroom. After a few minutes, you get back and bed and feel more cramps. Hm. Weird.

Could this be it? It could be! This is it! You’re finally in early labor!

You know this because the contractions are coming, no matter what you do. You’ve had a big glass of water. You’ve gotten up to pee. You’ve had a snack. You’re content to let the rest of your house rest while you anticipate the birth day to come.

So you’re in early labor. Now what?

You think back to what your midwife told you, and you remember that she gave you several things to do during this slow building time.

  1. Let Your Midwife Know. As soon as you know you’re definitely in labor, she’ll want to know. She or her assistant might swing by to check on you and baby, or just triage you over the phone, depending on what’s happening and your needs.
  2. Rest. This is not the time to try and “get things moving” by taking a long walk, doing nipple stim, or anything else that is supposed to speed things along. This is the time to conserve energy. If you can talk through your contractions, you can sleep through them.
  3. Eat & Drink. Whatever time your labor starts, eat normally. One good meal is often enough to sustain you through the work to come. No food is off-limits, though it’s wise to keep in mind that you may throw up, so avoiding choking hazards or harsh foods might be a good idea. Comfort foods are wholesome, nourishing, and encourage happy hormones. Also, keep drinking. Water, juices, herbal teas that you enjoy, smoothies, and broth are all great candidates. Whatever sounds good.
  4. Do Life. There is no reason to put off that quick trip to the store to get milk and bread, or going to the movies. There is no reason to go out if you didn’t plan to, but just going about your day, doing your best to ignore what’s happening. At this point, it’s really no big deal, and it helps your progress if you can be content, happy, and moving.
  5. Distract Yourself. Sometimes, especially when it’s your first baby, it’s so hard to keep your mind off your contractions. But the rule of thumb is that you must ignore them until they demand all of your attention, whether you like it or not. Conserving energy in early labor is paramount! Don’t use breathing or coping techniques from your classes yet either. They contribute to the sense of time, and can make you far more tired than you need to be. Instead, watch funny movies, go to the park, go out on a date with your partner, bake a birthday cake, start a slow cooker meal for after the birth, or call a friend to chat.

I like to tell people to “be in denial” about their labor until their labor gets all up in their face! Just take care of yourself, pretend like everything is normal, that nothing is going on, and let your body keep the secret just a little while longer. You will be shouting to the world in your own way soon enough, so save your breath. Smile. 

“To move into active labor, a woman must give up ideas of how she thought labor might be; in other words, she must surrender.” ~Elizabeth Davis in Heart & Hands

Open up to the path your labor has chosen, and surrender time.

Grace & Peace,
Tiff

Doulas and Home Birth

Monday, May 4th, 2015

Is there benefit to hiring a doula for a home birth? I say YES absolutely.


An oldie but a goodie, from Desirre, in honor of International Doula Month.

As a seasoned doula who has attended home births as labor support and now an  intern midwife who clinically supports the mother, I believe that many women can keenly benefit from a doula when having a home birth.

The most simple reasoning is that the doula is there physically, emotionally and educationally specifically for the mother and family just like at the hospital or a birth center. She (he) is an integral part of the birth team.

  • The doula will likely be laboring with the mother first, providing a continuous care support framework for when the midwifery team arrives.
  • As the midwifery team sets up and prepares the space clinically, the doula is right there maintaining the comfort, peace and encouragement of the mother. Often lessening any disruption that new people in the environment can cause.
  • The doula is there SOLELY for the mother and husband (partner), step by step, eye to eye while the midwifery team is there to first and primarily clinically assess, maintain safety and be unobtrusive as possible.
  • The doula offers guidance and suggestions for position changes, physical/emotional comforts and helping to ensure the mother eats, drinks, voids and rests.
  • The doula gives the husband (partner) the opportunity to rest, have less stress, do the very best he/she can do along with enjoying the process more.
  • A doula can be present specifically to help with the other children.
  • A doula’s presence offers reduction in any interventions and cesarean.
  • A doula’s presence offers increased satisfaction with birth, bonding and breastfeeding……….

Simply put. A doula being present at a home birth is effectively the same as at a hospital or birth center, with the general exceptions that she would have to help a mother and family self advocate or navigate  institutional policies,  protocols and staff.

I again say YES to doulas at home births.

 

 

Childbirth Education Myths 1

Monday, January 27th, 2014

Over the next several weeks, Team Preparing for Birth will be debunking some common myths surrounding childbirth education classes. Check back every Monday to see the newest post.

books

 

 

 

 

MYTH #1: “I’m having a homebirth, and my midwife will do all my education.”

Home birth families often see childbirth classes as an extra, rather than a valuable and necessary tool to help them have the birth they are hoping for. The most common objection they have is that they will be able to get all the education they need from their midwife. While midwives do educate their clients to some extent, this perception that they can (or should) cover everything is a myth, for several reasons.

1) Education is not a midwife’s job.

Just as obstetricians are not childbirth educators, neither are midwives. Just because midwives are more likely to do more education than an obstetrician, does not mean they give comprehensive education, and they should not be expected to. That is not their job.

Rather, a midwife’s primary job is to maintain the clinical safety and health of the mother-baby dyad. This will involve some education, yes, but only as a by-product of good midwifery care.

A good midwife will encourage her clients to be active participants in their care by reading, taking classes, and educating themselves proactively, instead of passively relying on the lack of intervention common to home birth. Midwives want clients who are thinking women, who take responsibility for their own care, and who can integrate what they learn in practical ways.

 

2) The reality of transport.

Another downside to relying solely on your midwife for childbirth education is the preparation for hospital transport. Realistically, around 10% of women and babies need something that cannot be offered at a homebirth, for whatever reason. It is not a midwife’s job to prepare you for the hospital.  Her job is to prepare you for birthing safely at home. Therefore, an expert on the hospital system is needed to prepare a birthing woman, in case of a transport. Most midwives spend very little time in the hospital, due to the low transport rate, so their expertise on local practices may be limited.

On the other hand, childbirth educators work very hard to stay up-to-date on all policy changes, protocols, and the general attitude of the staff in local hospitals. They often work (or have worked) as doulas, and have regular opportunities to interact with staff in the local hospitals that midwives simply don’t have. (This is not a criticism, merely a reality.)

While a midwife can go over what a typical transport looks like in her practice, a good childbirth education class will be able to prepare the client for what a hospital birth will look like. She can help the client to understand how to navigate the environment, and teach her how to communicate with the staff effectively.

 

3) The birth tool belt.

Midwives know that most women need a wide array of pain management techniques available to them, since an epidural is not an option at home. While a midwife will teach her clients the importance of stress management, emotional health, and relaxation, there is no substitute for a good independent childbirth course where you can actually practice tried and true techniques from all kinds of sources. This creates a solid foundation of knowledge, provides varying perspectives, and allows the birthing pair time and space to learn or review valuable tools for labor.

 

4) Prenatal appointments can only cover so much.

Even though midwifery appointments are much longer than typical obstetric appointments, it is still a very limited amount of time for a woman to learn all she needs to know about birth. Not to mention the birth partner, who may not be able to attend very many of the appointments. Childbirth education can fill in the gaps, empower a birthing pair, and provide opportunity to practice valid techniques in a real-world environment.

It is never wise to assume that your care provider will simply take care of everything, no matter who they are. Leaving the decision-making and responsibility solely in your midwife’s hands is not fair to her, to you, or to your baby. You owe it to yourself to take a proactive approach to childbirth education.

 

Dad Matters – A doula’s perspective

Sunday, September 29th, 2013

Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.

In fact, they often doubt and fear and wonder just as much as their partners do, but are often not allowed to express it, because they’re not the ones giving birth, so they feel that they don’t really matter. They may feel like they don’t have much voice in the process, and are just expected to go along for the ride, smiling and nodding whenever the experts speak.

Yet, at the same time, they are expected to know everything about birth, protect their partner, communicate her wishes, and support her physically and emotionally without pausing for breath.

Many worry that they just can’t live up to all of that. It really is an awful lot to ask of one human being, after all. Especially since history shows us that there have always been many support people surrounding a mother during birth.

Still, many men don’t realize just how much they are capable of. They don’t realize that they matter, too, and that they can enter their partner’s birthing space with confidence, ability, and strength to meet the challenges of supporting a labor and birth.

 

So, how do we help fathers to step into the birthing space with confidence?

 

We free them to be who they are, that’s how. We let go of our expectations, and help them to form their own expectations and desires for supporting the birth of their child. We help them to see that they alone can define their role in the drama and sacredness of birth.

I would suggest two important things that may help a father gain confidence and acquire tools to help him fulfill the role he wants to play during birth: 1) Independent childbirth education classes, and 2) Hiring a doula.

The more a man knows, the less he will fear birth, and taking Childbirth Classes is one of the best ways to lower anyone’s fear level in anticipation of birth. Many men appreciate information given in practical, interactive ways, and independent childbirth classes are often right up his alley. He can join with like-minded dads, ask questions, and have his concerns addressed more readily.

Information is a great, big factor in helping couples manage their stresses and fears regarding birth—as much for the father as it is for the mother. As an educator, at the beginning of a series, I usually see high levels of apprehension, which quickly fade from week to week, to be replaced by realistic expectations and informed confidence in both parents.

This is just as powerful for the father as it is for the mother. When Dad has confidence in Mom’s ability, she believes in herself all the more, and Dad begins to see that he has power to influence her for the better! Dad is able to acclimate himself more readily to the realities of birth, and begins to realize that he is an important part of her support team. Perhaps the most important part.

He feels a little more ready to step into his support role, and probably has clarified what he wants that role to look like. He will feel more confident about what he can do, and more realistic about what he might not be able to do.

 

In which case, he may begin to consider…

 

Hiring a Doula to help him fill in the gap in the support team he might not be able to fill himself. If he participates in choosing and hiring a doula, he is much more likely to have his own expectations met, as well as those of his partner. When Mom and Dad are both fully supported, Dad is far freer to just be and do what his partner needs him to be and do.

While he will likely remember a lot of what he has read and learned about, that information may become secondary to him during the birth, and take a backseat to more immediate concerns in his mind.

He may become simply focused on loving this woman who is birthing his child. And why shouldn’t he? Why should he have to remember every counter pressure technique? Every massage technique, position change, or even the water jug and bendy straw? Why shouldn’t he be the face close to hers, his eyes beaming his love, concern for, and confidence in her?

A doula allows Dad to be front and center in the support role he always wanted to fill for Mom, in whatever way makes the most sense for their individual relationship in this particular moment. If he wants to be the Expert – he ought to be equipped to do that. If he doesn’t, then he needs the space and freedom for that, too. Or anything in between.

When he is free, all his anxieties and apprehensions tend to fall away, and he finds that birth is a challenging, beautiful, amazing space to be in with his partner. He finds that he is strong to meet the challenge, just like she is. Together, they grow in strength and confidence, becoming truly ready to meet this tiny new person they have made.

Doulas help open wide the door, making the birthing space more navigable, understandable, and pleasant for fathers. This, in turn, can only benefit the mother as she is able to rest in the support of her birth team. She no longer feels concern for her partner, because he shows no reason for her to be concerned. She is able to just birth.

Then, we can just step back and watch, as he exceeds all the expectations we have laid on him, and as he steps into Fatherhood in the way that makes the most sense to him and his new family.

Tiffany Miller, CLD, CCCE

Scavenger Hunt Contest

Monday, December 3rd, 2012

Preparing for Birth is having an online scavenger hunt to ring in December.

 

You could win this cute pocket diaper.

 

Here is the scavenger hunt:

Answer:

1)      How many births has Desirre Andrews attended?

2)      Name a doula that is working through Preparing For Birth?

3)      How many on average gel capped pills can be made from a placenta?

4)      What breast pump brand does Preparing for Birth have for sale?

 

Answer these and provide a link to the source:  

5)      What is the most common risk of induction?

6)      What is an evidence based reason for induction?

7)      What is the Bishop Score used for?

8)      What are Daniel Berwick’s three principals of patient centered care?

 

Find:

9)      A picture of a child nursing in a funny position.

10)   A picture of artwork that’s at least 100 years old depicting a woman in labor.

 

Bonus Questions:

1)      What is your favorite pregnancy or childbirth related blog?

2)      What is your favorite pregnancy or childbirth related book?

Send your entry to nichole@prepforbirth.com by 9pm Wednesday December 5th.

The winner will be announced Thursday, December 6, 2012, and must be able to pick up the prize in person. Everyone who enters will get a coupon for a free birth or postpartum plan session with one of the doulas from Preparing For Birth.

F.E.A.R.

Thursday, August 30th, 2012

I have been thinking on the F.E.A.R. (False Evidence Appearing Real) acronym.  What else can it mean? Fear itself can be a positive or a negative. Fear can be a stumbling block or a motivator.

I enjoy coming up with affirmations and words that alter the view especially as it relates to pregnancy, childbirth and postpartum. I have been and know so many who have fear thrust upon them by friends, provider, family, strangers or have deep fear from previous experiences or from the unknown lurking ahead.

Take my words, come up with others and make your own acronyms to work with the FEAR surrounding you, inside you and take away its power.

 

F                      E                     A                     R

Feeling, Freedom, Fix, Fire, Fierce, Forge, Find, Fortitude, Frame, Fight, Force, Free, Forever, Forgive, Feel, Fearless

Everything, Exist, Eradicate, Excite, Envelop, Empowered, Encourage, Enhance, Expectation, Effort, Exquisite, Endearing, Encourage, Enhance, Effort, Expectation, Exquisite, Equal, Excel, Expert, Ease, Engage

Admit, And, Am, Advocate, Amplify, Armed, Above, Answer, Awareness, Act, Assist, Attitude, Ally, Appear, Admire, Ask, Alter, Apprehension, Action, Alive

Rest, Respect, Rise, Release, Rage, Rights, Ready, Resonate, Relief, Repair, Rely, Resist, Rejoice, Roar, Risk, Release, Re-frame, Rephrase, Remain

 

Please share additional words you come up with!

EMAB and Doulaparty Team Up

Friday, June 22nd, 2012

 

 

Join the #doulaparty on Twitter or follow along at DesirreAndrews.com, June 22nd 6pm PT/9pm ET to kick off summer birth work with something extra special!

 

I am very excited that Earth Mama Angel Baby is sponsoring this weeks live chat. EMAB has amazing products for all types of birth professionals and families.

 

A note from the EMAB Team:

 

Are you a midwife, doula, nurse or obstetrician looking for pure, safe products to comfort postpartum mamas and brand new babies? You’ve come to the right place! Earth Mama Angel Baby offers safe alternatives for your clients who are concerned with detergents, parabens, 1,4-Dioxane, artificial fragrance, dyes, preservatives, emulsifiers and other toxins. Earth Mama products are used in hospitals, even on the most fragile NICU babies, and they all rate a zero on the Skin Deep toxin database, the best rating a product can receive. Earth Mama only uses the highest-quality, certified-organic or organically grown herbs and oils for our teas, bath herbs, gentle handmade soaps, salves, lotions and massage oils.

Earth Mama now offers a Birth Pro Cart for wholesale pricing available for birth support professionals! Join Earth Mama Angel Baby on the #doulaparty chat Friday June 22 to talk about their new shopping cart plus answer any questions you may have. Earth Mama will be giving away Postpartum Bath Herbs and Monthly Comfort Tea, Mama Bottom Balm, Mama Bottom Spray, and a grand prize of their new Travel Birth & Baby Kit!

Low Intervention Birth Plan

Sunday, October 9th, 2011

A birth plan has a few real purposes. It can act as a values clarification exercise for you and your partner. Then it is a vehicle to open communication with your care provider about your needs, desires, wants for labor, birth and postpartum.  What you want and need matters.

 A brief one page plan with an opening paragraph with bullet point information specific to individualized care and desires not usually within your care provider’s standing orders or usual protocols of the birth location.

I advise you take the written birth plan to a prenatal visit at least a month prior to your given estimated due date. This gives time for conversation, to have a clear understanding of expectation and agreement.

If it becomes apparent that you and your provider are not on the same page, you then have time to seek out another provider that fits you and you fit with.

Remember it is not a legal document that your location of delivery or care provider must adhere to.

=======================================================

Birth Needs and Desires for: _______________________. 

Care Provider:_________________.

Estimated Due Date: _________________.

I am planning on a no to low-intervention labor and delivery.  I plan on being mobile, lightly snacking, drinking orally, and having ___________ present.   I understand that intermittent monitoring of me and my baby will be necessary.  I want to be fully consented for any procedure that may come up and fully participate in the medical care for myself and my baby.  I understand that there is pain management available to me, I will ask for it if I so desire.

  • I plan on wearing my own clothing. I will ask for a gown if I change my mind.
  • I would like a saline lock in lieu of a running IV.
  • Limited vaginal exams after initial assessment.
  • In the event an induction and/or augmentation is medically necessitated-
    • Ripening – Foley Catheter instead of Cytotec (misoprostol), Cervadil or Prepadil
    • Pitocin – A very gentle and slowly administered dosage increase.
    • AROM – will only consent to if an internal fetal monitor is a must.
  • Spontaneous pushing and delivery in any position I am most comfortable with.
  • External pressure and/or compresses instead of any perineal or vaginal stretching.
  • No cord traction or aggressive placental detachment, including deep uterine massage.
  • Delayed cord clamping for at least 10 minutes or until my placenta spontaneously detaches (baby can receive oxygen or other assistance while still attached to me).

Postpartum and Baby Care

  • Request that my baby is on my belly or chest for assessments and warmth (even oxygen can be given on me)
  • Delayed bathing
  • Delaying vaccinations including eye ointment and vitamin k.
  • Exclusive breastfeeding, no pacifiers, sugar water, or formula. I will hand express if necessary. I will hand express if needed to syringe feed my baby.
  • No separation from me unless absolutely medically necessary not just protocol.

Cesarean: In the event a cesarean becomes necessary and is not a true emergency requiring general anesthesia.  I would like to keep the spirit of my plan A to plan C so the delivery can be as family centered and intimate as possible.

  • Only essential conversation related to the surgery and delivery
  • Lower sterile drape or have a mirror present so I may see my baby emerge
  • Only one arm strapped down so I may touch my baby
  • Pictures
  • Aromatherapy as I desire for comfort, abate nausea and to mask surgical odors
  • Baby to stay with me continuously in OR and recovery
  • If baby must leave OR for treatment, my partner/spouse goes with baby and I would like my ____________ to stay with me so I am never alone.
  • Breastfeed in OR and/or recovery
  • Delayed immunizations
  • Delayed washing and dressing of baby
  • No separation from me except what is absolutely medically necessary
  • I am willing to hand express if baby cannot get to breast right away.

This “plan” may be copied, pasted and edited  for use by others.

Could this be labor?

Wednesday, September 21st, 2011

For first time mamas, previously induced mamas or those who have loads of prodromal labor, getting a handle on the nuances of when labor is going to start or if it is lasting labor can be really confusing. There is no way to know exactly when labor is going to start, but there are many things to look out for that can give clues and signs that onset of  labor is sooner rather than later.

Here are my favorite categories to look at and simple ways to decipher what is going on with your body at the end of pregnancy.

Remember to take a look at the whole puzzle picture not just one piece.

  • Vaginal Discharge:
    • Loss of mucous plug (after 38 weeks);
    • Steady mucousy output;
    • Thin and watery mucous;
    • Blood tinged – similar to the beginning or very end of a menstrual period. This means there is effacement and ripening of the cervix going on and even a bit of dilation happening.
  • Contraction Characteristics:
    • Longer and more intense contractions that most often find a pattern;
    • They do not stop or even increase with activity change;
    • Sudden increase or onset of regular Braxton-Hicks;
    • Low period crampiness, pelvic heaviness, off and on backache, thigh achiness.
  • Other symptoms
    • Increased nesting;
    • Insomnia or excessive tiredness;
    •  Flu-like symptoms;
    • Intuition/Instinct;
    • Loose bowels;
    • Weight Loss in the last week.
  • Testing out contractions for possible labor:
    • Change activity level – if resting get up and move, if moving sit down and rest;
    • Drink a large glass of water;
    •  Eat a snack, preferably higher protein;
    • Take a bath or shower.

After doing these things if contractions continue and increase in intensity over another hour or so likely labor is becoming established. Congratulation! As always, contact your care provider at the agreed upon time.

A Guide to Finding Your Doula

Tuesday, August 2nd, 2011

Building a labor support team is part of conscious preparation during pregnancy for your labor,  birth and life with the very newborn. Hiring a labor doula continues to gain in popularity for the expecting family. Your doula comes alongside you in pregnancy through labor and delivery with some additional early postpartum follow-up.  For additional after birth support, a postpartum doula is a great addition.

Step 1: Finding a Doula

  • Inquire with friends, family, local support/informational groups (for example – ICAN, LLLI, Birth Network, Birth Circle, Cloth Diaper store), childbirth educators, care providers, prenatal massage therapists, prenatal exercise instructors, lactation experts and chiropractors for referrals.
  • Use your favorite search engine and type in your city or area name with the keyword doula
  • Search training and certifying organizations such as CAPPA, DONA, ICEA ToLabor , Birth Works and Birth Arts International
  • Search general doula sites such as All Doulas, Doulas.com, About.com, Doula Match or Doula.com

Step 2: First Contact

Once you have located local area doulas, the next step is  to make contact. You will likely find that most doulas are women though occasionally you will find a male doula in your area.  After visiting any websites; phone or email only the doulas that most interest you and fit your particular needs.  Generally there is not much need to contact more than three perspective doulas.

During your initial phone conversation or in your email be sure to include:

  • Full name
  • Contact information
  • Estimated Due Date
  • General location where you live
  • Care Provider
  • Birth Location
  • Top needs and desires for birth
  • If referred, by whom
  • Any financial considerations

Step 3:  Setting up the Interview

I encourage after the phone or email contact and response, set-up in-person interviews with the doulas you found most compatible with you.

  • Unless the doula you are meeting has her own office, interviews are usually held in a public place such as a coffee house, restaurant, library, park, or shopping center. If you meet at a place where beverages or food will be ordered you can offer to pick up the tab for everyone if you desire, but it is never expected.
  • Your partner, husband or other support who will be attending the birth needs to be at in-person interview if at all possible.
  • Expect the interview to be approximately an hour and to be free of charge.

Step 4: The Interview

The interview is to gain more detailed information from the doula, as well as, share more  about yourself and what you want.  It is customary for the doula to either email ahead of time her client packet or bring it with her to the interview. It may include her professional profile, client agreement, services, and support details, as well as, additional offerings.

Suggested Interview Questions:

  • Why are you a doula?
  • What is your philosophy of childbirth?
  • Where did you get your training?
  • Are you certified? Why or why not?
  • How long have you been a doula?
  • What is your scope of practice?
  • What types of births have you participated in?
  • What types of birth locations have you been to?
  • How many births per month on average do you attend?
  • How many clients would max you out in a month?
  • Have you ever missed a birth? Please explain why.
  • Do you specialize in working with a specific type of clientele or birth plan?
  • What has been the most challenging birth you have attended? Why?
  • How do you work with my husband/partner/other support?
  • Have you worked with my provider before? If yes, please describe the experience.
  • How many prenatal visits would there be?
  • In general, what is covered in the prenatal visits?
  • Will you help me make a birth plan?
  • Please explain how your fee is structured.
  • Do you accept barter?
  • Do you have a back-up and do I meet her ahead of time?
  • When do you go on-call?
  • Do you labor at home with me?
  • What do you do if I am induced or need to schedule a cesarean?
  • When will you see me postpartum and what does it include?
  • What are your expectations of me as a client?
  • How long do I have to decide before you would contract with someone else around my EDD?

Of course that is a fairly long list of overview questions. Brainstorm some of your own. The interview is not meant to be a free prenatal visit, it is simply to find out if you and the doula are a fit personality wise and in how she practices.  Most doulas do not expect to be hired on the spot. You  need time to think and process after each interview. If a doula is pressuring you to hire on the spot because she fills so quickly, that could be a red flag and cause for you to take a pause.

Step 5: Hiring the Doula

Within 1-2 weeks,  contact the doula you would like to hire and proceed and those you did not choose to let them know you have hired someone else so they will not be holding your EDD space open any longer.

Details to be clear about when initially hiring your doula:

  • Sign and return the agreement/contract she gave you at the interview (if applicable).
  • Return any intake paperwork by mail or email.
  • Payment  – First portion of fee is usually paid upon hiring a doula.
  • Ask her usual business hours and contact preference for non-emergencies or labor related needs.
  • Let her know your contact preferences and all phone numbers to reach you and your spouse/partner or other support.
  • Set the date and time for the first prenatal appointment. Give her directions if your home is not easy to find.
  • Get clarity on what routine contact she would like from you (updates after care provider appointments, etc.)

Happy doula-ing!