FAQ

No. Doulas do not replace nurses or other medical staff. Doulas do not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postpartum clinical care. They are there to comfort and support the mother and to enhance communication between the mother and medical professionals.

No. A doula does not make decisions for clients or intervene in their clinical care. She provides informational and emotional support, while respecting a woman’s decisions.

No, a doula is supportive to both the mother and her partner, and plays a crucial role in helping a partner become involved in the birth, by giving ideas and suggestions to help the partner support the mother as well. Having a doula and your partner at your birth also means that if your partner or your doula needs to leave to get food or some sleep, you will not be left alone. We support the partner as well. We call it the home team advantage. Doula Family support comes in many ways for the partner - emotional, physical, but most of all, they know he has someone that he can turn to for support as well.

That’s the interesting thing about being a doula - each mom is looking for something different. When a mom goes to hire a doula she usually interviews a few before choosing who she feels is the right fit for her family. So there are many different personalities among doulas. I would say one constant among doulas is patience and trust in the ability of women to give birth and the desire to support them during the process.

Doula work is unpredictable by nature. I’m on-call for each mom two weeks before and after her estimated due date. I have my phone on me and my doula bag in the car packed with clothes and snacks at all times. Along with never knowing when you are going to “get the call,” you also do not know how long each mom will be in labor. Sometimes for a couple of hours, and others for a couple days! A doula has a commitment to stay with the mom as long as she needs, and also should have a back-up doula who can give her breaks or fill-in if she is not available.

Since, 1980 I have found that when there are 2 doulas during the birthing... it sets a standard of insuring focused care and prevention of either dad or the doula is over-stressed or tired. Whether it is a Home birth or hospital births, nursing staff is always appreciative of having a doula on the floor who is working with one of their patients. They know that that mom is in good hands, So many hospitals are short-staffed, requiring the nurses to do even more. A doula supports the nursing staff, and because of her presence they can focus on moms who don't have the personal doula support. 2 doulas working together with the father: their goal is to keep high quality service. If the mom has been laboring for 12 hrs or more, it is reasonable and a benefit for mom, baby and the father to have a team game plan for endurance. The doula(s) and dad each partake in helping the mom during her labor. When the dad needs to lay down, he can Intermittently rest. It is so important for everyone to stay alert. At the hospital there are shift changes, but a doula doesn't go off of her shift until at least 3 hours after the baby has been delivered.

DONA is one organization, fairly new since they were founded 1992. The experience and training of each doula varies. Many are certified through Doulas of North America (DONA). DONA certification involves a 16 hour workshop; 5 books required reading; attendance of a 12 hour childbirth education series; completion of breastfeeding workshop; attendance at three births with good evaluations from a nurse, the midwife or doctor, and the mother; written essays about the births attended, as well as an essay about the benefits of labor support. There are many specifics about each of these requirements. DONA’s website www.dona.org is the best place to see exactly what is involved in the process. Also, it should be noted that not all doulas are certified and this is not a requirement. The benefit of being certified, however, is that clients tend to trust doulas who have taken the time to complete this training. It assures them that their doula abides by specific standards of practice and code of ethics. There are many doulas who are not certified who are excellent doulas. Certification is not a requirement, but focusing on the mother's needs with compassion and experience plus attending a number of births is usually the key.

Reasons Why One-on-One Maternity Care is Awesome! When people see a doula’s fee that is several hundred dollars, or even going into the thousands, they often wonder what in the world could cost so much about “supporting” them through labor, birth and postpartum! So what exactly are you paying for when you hire a doula? Your money goes towards… Her training. Her level of experience. Her knowledge of pregnancy, physiologic labor, natural childbirth, medicated childbirth, breastfeeding, and newborn care. Her constant stream of informational support throughout your time working together. Her emotional encouragement and sensitivity. Her physical support in assisting with comfort means during labor. (This can actually be fairly difficult physical labor for the doula- though granted, not as hard as the mother’s work.) Her unbiased assessment of your labor and presentation of options. Her unflagging commitment to help protect your birth plan, and her flexibility to help you in a new direction if you change your mind or need medical intervention. An extra set of hands to take care of small jobs so you and your partner can focus on the birth. Her communication skills - with you, your other support team members, and with your care providers. Her time at prenatal & postpartum visits. Her on-call availability 24/7, for 4-6 weeks, during your “due window.” Her phone and email availability during your entire contracted time period. Her hours of behind-the-scenes research on your behalf. Her hours at your birth - often without any limits or breaks. Many times a Doula maybe laying on the floor or sitting in a chair near you during very long labors without complaining. Possible prevention of other costly and undesirable interventions through use of natural comfort means, physiologic tricks for labor, and constant encouragement. Her gas expenses in getting to and from appointments and your birth. Her babysitting expenses if she has children of her own. Her food expenses while she is at your birth. Any supplies she brings for you and your family. This maybe her only income source. Your Doula is privately retained - she works with and for you and is an advocate for your best interests. Your Doula also ensures that your children's and spouses needs are supported to so he can support you. Dad has the home court advantage. He can turn to the Doula when he's not quite sure about something. Doula is a huge part of the birthing team - you tell her what your vision is and she helps you make it happen. You retain or employ the services of a health care provider - it makes sense to have a Doula for all the other needs not provided by that health practitioner. A Doula empowers a young mother to be all that she can be. A Doula is a life event coach through the birth. A Doula unselfishly gives up her family's needs for yours. A Doula is all about prevention over intervention - you don't even want to know what you prevented. They involve emotional, physical or financial costs. Although a flat rate charge of several hundred dollars can seem intimidating to you at first when shopping for a doula, remember that the continuous care that she provides can save you thousands more in other preventable interventions - and more importantly, she can help you to make your birth what you hope it will be - a positive, calm, and blessed experience. Memories last forever, so a Doula helps you put the footprints of your newborn in your heart that last a lifetime. Many women are surprised to find that their Doulas actually aren’t making much money at all. Sometimes when I break down my fee into hours worked for a single family, I’ve made as little as zero (Pro Bono) or $2.50/hour, on up; but some Doulas will tell you that they have never made more than minimum wage. (Granted, some Doula's fees are pretty cheap, others are a fair exchange of time and money.) This gives you an idea of what many Doulas are making when it is broken down. A Doula always wants to bring more value to the family she is serving. It is a passion, a life style, a gift of love to serve your family. We can't tell you how many parents have told Doulas (after the birth) that what we provided was worth TWICE what we charge. And some are not cheap! But, when there is a real need, the Doula community comes alongside a family because it is the foundation of our country's best interests. The Golden Rule Paying it Forward ALWAYS pays. It really should never be about the money for a Doula or anyone else…but never, ever, treat anyone just like an employee. Instead, it is a partnership on a mission to achieve your dreams. It should be about respecting yourself and your professional birthing team's intelligence and ability to make informed decisions for you and your baby. It should be about giving you the tools you need to have the birth that you want. It should be about protecting the parents’ desires and the mother’s dignity. It should be about supporting and ministering to a family during a life-changing event in their lives. It should be about all the love she brings to her work, and to you and your family. Period.

Water birth is considered by professional providers and mothers alike to be the most gentle method of natural childbirth. Below are some frequently asked questions about water birth. If you are interested in a water birth please let us know.

It is essential that we adjust the way we bring our children into this world. By providing a safe and comfortable environment with plenty of privacy, and a feeling of love and security for the mother, she is better able to release her baby with an experience of joy, - an experience shared by her baby. The use of water for labor and birth is one way of providing this opportunity for women and their babies.

For a waterbirth, the water in the pool is maintained at a temperature which is comfortable for the mother, usually between 95-100 degrees Fahrenheit. The water temperature should not exceed 101 degrees because it could lead to overheating, which can cause the heart rate to accelerate and it increases the babies oxygenation needs. It is important that the mother continues to drink plenty of fluids. Cold compresses and a cool facial mist make many hot mamas cooler.

A woman in labor should be encouraged to use the labor pool whenever she wants. If a mother chooses to get into the water during early labor, before her surges are strong and close together, the water may relax her enough to slow or stop the labor altogether. That is why some practitioners limit the use of the pool until labor patterns are established and the dilation of the cervix is at least 4 centimeters. The first hour of relaxation in the labor pool is usually the best and can often help a woman achieve complete dilation even in short amounts of time.

There are several factors that inhibit the baby from beginning to breathe during the period when its head emerges into the water and just after the full body has been born. First of all, the water temperature is basically the same as the amniotic fluid in the womb, so there is no shock of a temperature change. Second, the baby is receiving oxygen from the umbilical cord just the way it has for the previous nine months. And third, the baby has an autonomic reflex, called the dive reflex, which prevents it from inhaling any substance that is in its throat and causes it instead, to swallow. This reflex is present for approximately six months after birth and than it disappears. Air breathing begins only after the baby is out of the water and exposed to a change in temperature and air pressure, and experiences a complex metabolic chain reaction of hormones and chemicals that cause the process to begin. Know that it is physiologically impossible for a newborn to breathe until its body is out of the water and in the air.

Here in the U.S., all practitioners bring the baby out of the water within the first ten seconds following birth. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth DVDs that depict leaving the baby under the water, and the babies are just fine. But physiologically, the placenta is supporting the baby with oxygen during this time and it can not be predicted when the placenta begins to separate and stops the flow of oxygen to the baby. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him into his mother’s arms.

The safety of water birth needs to be judged in looking back at the number of cases that have been reported world wide, and the number of problems that have occurred as a result of birth in water. To date, over 100,000 documented cases of water births gives us a good look at the statistics. The opinion of practitioners is that water birth poses no threat to mother or baby, if all the normal parameters are met during labor and birth. If complications arise they are evaluated and sometimes the mother is asked to leave the water before the birth takes place. Everyone’s goal is to keep mother and baby safe and to facilitate a satisfying birth experience. The British government stated in a published health report that any woman who wants a waterbirth, should be able to have one, and that it is up to the practitioner to become familiar with the technique if they are not already educated.

The manufacturers of monitoring equipment and hand held dopplers have developed water proof varieties of monitoring equipment. In typical waterbirths the baby’s heart tones are listened to every 30 minutes during first stage ​and after every pushing contraction during second stage.

For a home birth or in the hospital birth? Complete Prenatal Care for both birthing locations. Midwifery offers individualized and complete prenatal care for home births, including water birth. Midwifery care enables women to actively share in the decision making that occurs during pregnancy, labor and birth by offering personalized prenatal care and education. You receive hands-on assistance during labor, birth, the immediate postpartum and the newborn exam, with an emphasis on establishing a good breastfeeding relationship.

Free consultation and pregnancy testing Midwife on call 24 hours/day throughout pregnancy and 1st month postpartum Lab work appropriate for pregnancy, birth and postpartum, including the Expanded AFP Test and the Newborn Screening (labwork not included in midwifery fee) Referrals for childbirth education classes Attendance at your labor with a midwife and skilled assistant, having a doula present is always recommended Newborn exam A mother & baby check-up within 24-48 hours of your baby's birth Two subsequent mother & baby check-ups in the 1st two weeks A final six week check-up for mother & baby Referrals to community resources You will need a birth kit for a homebirth. ​This contains supplies that are necessary and useful

Postpartum Depression and Anxiety Brooke Laufer, Psy.D. The postpartum period, or the year following the birth of a child, can be a miraculous and terrifying time for a woman. As many women find, life with a new baby is a raw and fragile experience. There are many factors that come into play during this period; beginning with the labor and birth of the baby, women experience dramatic hormone shifts, inevitable adjustments to relationships (husband, parents, friends), new financial stressors, identity issues, and issues of social support. These are experiences typical of a postpartum period. It is not uncommon for other health issues, colic, a traumatic birth, or a loss, to compound stress and emotions following a birth. Emotionally and psychologically, it is a dynamic time that can surprise a woman with depression and/or anxiety symptoms. Psychological and psychiatric disorders occur for about 20% of women during their postpartum period. These disorders are on a spectrum starting from what many know as the "baby blues" -- which lasts only a few weeks and includes feelings of overwhelm, tearfulness, nervousness, and confusion -- to a much more rare and extreme disorder called postpartum psychosis -- experiencing delusions and/or hallucinations. In between lie postpartum adjustment disorders, postpartum depression, anxiety, and postpartum obsessive compulsive disorder. Aside from the "baby blues," postpartum depression is perhaps the most commonly identified postpartum condition, and yet anxiety symptoms are also frequently reported. Postpartum depression or anxiety lasts up to 1 year after delivery and includes excessive sensitivity, low self-esteem, apathy, withdrawal, appetite disturbance, lack of pleasure, function impairment and marked distress. Women may feel overwhelming fatigue or insomnia, disconnection, anxiety attacks, suicidal thoughts, and-- in the case of postpartum obsessive compulsive disorder--intrusive thoughts of harm coming to their baby. A new mom is expected to immediately fall in love with her newborn baby, and to naturally take to motherhood, breastfeeding her baby, and connecting to her baby. To feel anything but this can feel confusing and shameful. To whom can she admit that she doesn't feel connected to her baby? That she has visions of dropping him down the stairs or that she doesn't want to get out of bed to care for her baby? It becomes the job of those around her--a partner, parents, friends--to connect her to support, as it is the mother's health that comes first in these moments. Postpartum depression and anxiety are temporary conditions that are treatable. The sooner they are identified ​and a mom finds the right treatment--whether it be therapy, medication, group support--the sooner she can enjoy being a mom. Resources: In Illinois: Perinatal Depression 24 hour hotline (NorthShore University HealthSystem) 1-866-364-MOMS Outside of Illinois: Postpartum Support International 1-800-944-4PPD www.postpartum.net Local: Adeline's Room Mom Support Group (downtown Evanston) (847) 859-2312 Brooke Laufer, Psy.D. Clinical Psychologist specializing in postpartum issues 847-440-7361 brooke@drbrookelaufer.com www.drbrookelaufer.com