Frequently Asked Questions

If my partner will be in the delivery room, won't he/she feel put out by the presence of a doula?
No, the doula's primary focus is to assure that both the mother and father are comfortable with every aspect of the birth.  A doula aids the partner in becoming involved as much or as little as the couple feels comfortable.  A doula can offer suggestions to the partner about how best to comfort and support her through the progressing phases of labor, and can be come an invaluable resource to a growing family. in fact, many couples have reported feeling closer and more satisfied with their partner's role in the delivery when they have a doula present as well.  You can also use this link to view an article by DONA International on Doulas and Partners.

If I am planning a medicated birth or to have an epidural I don't really need a doula do I?
"Your doulas role is to assist you during birth. With or without pain medications, you are giving birth, and your doula will be there to comfort and support you. Giving birth to your baby is much more than a medical procedure. It is an emotional as well as a physical journey, and having a doula with you can help smooth the crucial transition from pregnancy into parenthood. Both parents will benefit from the nurturing care a doula provides.

Epidurals do not usually take all the pain away. You will still be required to use some other forms of comfort measures at times.
Although good to excellent pain relief is obtained in 90% of epidurals, few epidurals take away all the pain. Some hospitals advertise "painless childbirth," but few women experience it that way. There are several reasons why an expectation of "painless childbirth" may be unrealistic. Often you must wait for the anaesthesiologist to become available. You may need to wait while you receive 1-2 liters of i.v. fluid. The procedure itself can take up to 30 minutes, and you may not have complete pain relief for another 20 minutes. Once you are close to complete dilation, the epidural may need to wear off, or you may experience breakthrough pain. Rarely, the epidural gives only patchy pain relief, or doesn’t give pain relief at all.

If you experience any of these situations, or if you prefer to avoid using the epidural until you are 5cm to reduce your chances of needing a Cesarean, your doula will be invaluable in helping you use breathing and relaxation techniques, suggesting position changes, and using non-medical forms of comfort measures.

Epidurals often (over 70%) come with mild side effects, which are unpleasant although not medically serious, such as itching, nausea, and shaking. Your doula will stay at your side, helping you cope with any side effects you have, and giving you information about your options.

While an epidural relieves most of the physical pain, it does not affect your need for reassurance.
You might expect that with pain relief, all your worries will go away. Interestingly, this does not seem to happen. Women experience the same emotions during labour whether they use epidurals or not. Many times, the medical staff feel that if a woman has pain relief, she doesn’t need the same type of gentle emotional support. Women often feel even more frightened and worried when they sense this emotional withdrawal. Your doula will continue to focus on what you are feeling, and will give you the reassurance and comfort you need.

Help in coping with pain is only one small part of your doula’s role.
Epidurals do not hold your hand, rub your shoulders, explain what is happening or help you make decisions. Epidurals do not get you ice chips or remind you to urinate. Epidurals cannot suggest position changes to help labor progress. Epidurals will never advocate for you or help you get what you need from the hospital staff."

Doulas and Epidurals  by Kelli Way, ICCE, CD(DONA)
Can the doula give advice if an intervention is suggested and I am not sure what to do?
A doula does not provide you with any medical advice, but does empower you to ask questions of your care providers, until
you feel educated enough to make a decision.  A doula can help explain if there is a procedure, intervention or other event that you are unclear about, but will under no circumstances impose her viewpoints on you.  A doula will provide support for you and your partner through any decision you make, and help you cope with the discomfort and stress of childbirth while following your birth plan, as closely as possible.

What is the process of hiring/using a doula like?
The initial interview will be just a getting to know you visit.  We will discuss your ideals for your birth, how you are progressing, and you can ask any questions you like in order see if we would make a good fit.  If we decide to work together we will schedule 2 to 3 Pre-natal visits (depending on how far along your pregnancy is) to discuss your progress, and practice some comfort techniques.  We will go over your birth plan if you have written one, and decide which comfort measures will work best for you and your partner, and we will encorporate the partner into your relaxation exercises as much as he/she is willing.  We will also practice some massage techniques and guided relaxation, to help you rest and feel at ease in those last few weeks before the birth.  As we get closer to your due date, I will be on call 24/7.  You may call me anytime day or night with questions or concerns.  When labor begins I will meet you at either your home or the hospital and we will continue our work together until you have a beautiful newborn in your arms.  I will usually stay for 1-2 hours after the birth depending on the needs of the family.  We will have a follow up meeting a few days after the birth to discuss the birth and how you and your partner feel about it.  We will say our farewells and if all goes well, I will get to work with you again if/when you have another child!

What is Birth Plan Counseling and why do I need it?
You don't necessarily need birth plan counseling, but some couples like to have a little bit of guidance while they explore their options and decide what is best for them.  Your birth plan will reflect what you as a couple would like from your birth experience.  I will never try to influence you, or pressure into choosing something for your birth plan that you are not 100% comfortable with.  I will support you, and give you as much information as I can, on any options you are considering.  I will help you to format and word your birth plan so it is easy for your caregivers to read and abide by as closely as they are able.  It is important to note that when writing your birth plan, you should always include a section on interventions and how you want them handled, even if you are planning a non-medicated birth.  Things do not always go as planned and it is important to include back-up instructions, in case and intervention becomes necessary. 

Is there a particular hospital you are affiliated with?
Most doulas are not affiliated with a particular hospital or birthing center, but I may be familiar with the hospital if I have had a client deliver there before.  I do like to contact your care provider once we decide to work together so that I can introduce myself and ask/answer any questions we have of each other.  If you would like we can do a tour of the birthing floor at your chosen hospital together.  I can be involved with your caregiver as much or as little as you would like, but I generally like to establish contact with them at least once before the birth so we know what to expect of each other professionally.  

Do you work with midwifes if I want a home birth?
Yes I do.  Generally your midwife will have a specific doula that she prefers to work with, but if you would like to talk to me about your home birth, I would love to be involved.  I would do most of the same things I would with an OB; introduce myself, and get to know each other so that we can learn what to expect from each other once the labor begins.  

What if I go into labor and you can't make it to the hospital/birthing center/home in time?
All doulas work with a partner.  If for some reason your doula is unable to make it to your birth, or will take longer than she anticipated, a back-up doula will be called to attend. You will always have the opportunity to meet and speak with the back-up doula at one of the pre-natal meetings, in order to ensure that you are all comfortable with each other. 

What kind of comfort measures would you generally use for a woman in labor?
In our pre-natal meetings we will discuss the types of measures you would feel most comfortable with (some people are not as comfortable with touch as others etc.) in order to determine what will work best for you.  Some people do well with a focal object and breathing techniques, others do well with position changes and warm showers or baths, still others do best when I am just present and understanding of the pain that they are feeling.  Most couples thrive with a combination of many different comfort measures.  No two births are the same, but it is always important to establish relaxation, rhythm, and rituals to get a mother through those difficult contractions, and on to the best part--meeting the baby! 

What if I get very emotional and yell at you in the delivery room?
Labor and delivery is a very emotional and stressful time for a mother.  I am there to support you through the wide range of emotions you will encounter.  You cannot hurt my feelings in the delivery room.  Nothing you say to me while under the stress of pregnancy and labor will in anyway effect the level of care and comfort that you receive from me, as your doula.

A Tender Touch        New York, NY 10040