What Is A Doula?Doulas Are Professionals

A birth doula is professionally trained in how to support families during pregnancy, labor, birth, and immediate postpartum. Doulas do not perform any medical procedures but instead provide you with continuous emotional, physical, and informational support.

Half Doula Package, Portland Oregon
Half Doula Package, Portland Oregon

What Is A Doula?

Doulas Are Agenda Free
Birth doulas do not have an agenda, give advice, or assume there is a “right” way to give birth. Your goals are their goals, and they offer education and information so you can make informed decisions that are congruent with your family’s needs and values.

Doulas Are Flexible
A birth doula is flexible and knows how to navigate birth’s unexpected twists and turns. If unforeseen circumstances should arise, your doula remains calm, keeps you informed on what is happening, and helps you adapt to changing circumstances. Doulas are attentive to your hopes and fears, respectful of your choices, and inspire confidence in your ability to labor and birth.

Doulas Support Partners
A doula does not replace the vital role of partners or other family members. Instead, birth doulas encourage partners to engage in the process with greater confidence and effectiveness and relieve partners of the pressure to know and do everything by themselves.

Doulas Work Collaboratively
A doula knows how to work collaboratively with medical staff even while advocating for your rights, needs, and preferences during labor. A doula works for you, not for the hospital, so their care can be individualized to fit your needs.

Why Hire A Doula?

The many benefits of hiring a birth doula are recognized by the World Health Organization, the American College of Obstetricians and Gynecologists, and the National Institutes of Health. Current research consistently shows that women who receive continuous support during labor from a doula are less likely to need medical interventions and are more satisfied with their birth experience. These studies show that a doula’s continuous support, practical knowledge, and labor enhancing techniques help to reduce pain and anxiety in laboring people. When people are less frightened and feel less pain, labor is more likely to progress without the need for interventions.

Research shows that a doula’s presence during labor and birth results in the following positive outcomes:

  • reduction in the rate of cesareans
  • reduction in epidural requests
  • reduction in the use of Pitocin (a contraction induction method)
  • reduction in vacuum-assisted deliveries
  • shorter labors
  • an increase in successful breastfeeding and bonding
  • a reduction in “baby blues” and postpartum depression
Benefits Of Doulas

Source: Rebecca L. Dekker, PhD, RN, APRN at evidencebasedbirth.com

What Does A Doula Do?

People frequently ask us what a birth doula actually does, and our answer goes something like, “Well, it depends. We tailor our services to each client’s particular needs, but basically, we offer families professional support during pregnancy, labor, and the postpartum.”

While this answer does faithfully represent our services and dedication to individualized care, it does not always satisfy the inquiring mind that asked. Often what the person is wondering about is the hands-on nitty-gritty of what we do when we’re at a birth.

So, in an attempt to make our doula skills more transparent and understandable, here’s a list of things we typically do for clients who are in labor (please note that this is not a complete list, nor does it include the types of support offered during pregnancy or in the immediate postpartum):

  • We answer questions and provide reassurance.
  • We show you all the ways a birth ball can be your friend.
  • We squeeze aching hips and apply counter-pressure to sore backs.
  • We encourage partners to bring on the love.
  • We help you stay in the moment and take it one contraction at a time.
  • We fill the tub and get the shower ready.
  • We laugh at your jokes and make some of our own.
  • We encourage, encourage, encourage.
  • We hold hands, ease fears, and normalize the birth process.
  • If you hit “a wall,” we help you climb right on over it.
  • We slow down communications with medical staff and ask important questions.
  • We respect any and all decisions you make (no judgment anywhere).
  • We remind the hospital staff of your hopes and preferences.
  • We guide you on how to use your breath during contractions.
  • We listen with compassion to what you and your partner are thinking and feeling.
  • We massage your shoulders and help you release tension.
  • We suggest positions that help labor progress.
  • We put heating pads and ice packs where you want them most.
  • We dig into acupressure points and give awesome foot rubs.
  • We check in with you to see what’s working and what’s not.
  • We help create a positive birth atmosphere.
  • We inform you about the risks and benefits of various medical procedures.
  • We provide evidence-based information so you can make informed choices.
  • We quench dry mouths and feed hungry tummies.
  • We strive to help you reach your childbirth goals.
  • We know our way around a hospital room and can find things quick.
  • If you’re using a particular childbirth preparation method, we use it, too.
  • We let you know about potential alternatives to medical interventions.
  • If something doesn’t go as planned, we help you ease into and accept this change.
  • We offer partners much-needed breaks.
  • We mop sweaty brows with cool wet towels.
  • We dim lights, get warm blankets, and hush beeping machines.
  • We use positions and rebozos to get babies in a good spot.
  • We offer soothing words and visualizations to help you sink in.
  • We suggest a variety of positions for the pushing phase.
  • We take photos to capture memories of this life-changing event.
  • We stay up all night until your baby is born.

How Do Doulas Work With Partners & Family?

The role of the partner during labor is essential. Laboring people need to know that their partners are there for them and that they are on this journey together. A doula encourages partners to be the primary source of emotional support and do not attempt to replace the partner’s role.

Most partners are inexperienced with childbirth and unsure of how to offer their loving support during this unique experience. Even the most attentive partner may be overwhelmed by the hospital environment, the changes unfolding in the laboring person, and the emotions that surface in anticipation of the baby’s arrival.

While childbirth educators do their best to equip partners with useful information and techniques, it is just too much to expect partners to remember everything and to know how to assist a person through labor instinctively.

A doula’s knowledge, skills, and expertise allow partners to be less pressured and more present. The doula will offer practical suggestions, information, and techniques as needed, which enables partners to be much more relaxed, loving, and emotionally present. A doula can provide partners with helpful tips along the way and make it possible for partners to take much-needed breaks.

There are also times when the labor or birth process can get intense or when things may take an unexpected turn. In these circumstances, partners may need as much emotional and informational support as the person in labor, and a doula can step in to reassure and care for the entire family.

How To Find A Doula?

The Portland and Vancouver metro areas have a rich and thriving doula community with lots of wonderful doulas to choose from, but all of that choice can be a little overwhelming when you’re unsure of how to find the right doula for you and your family.

That’s where our Birth First Doulas Matchmaker comes into play! Our free matchmaking service gets to know your preferences and helps you narrow down the options, so you can save you time and energy by only interviewing with doulas who are likely to be a great fit!

When interviewing a doula it’s always good to have a list of questions ready and to ask about things that are important to you (e.g., experience level, number of births attended, specialty areas, doula style, etc.), but the level of connection you feel with a doula is equally important and trusting your gut and intuition can be especially helpful in the decision making process. The doula relationship is one of connection and trust, so notice who makes you feel most comfortable, confident, and respected.

Will A Doula Be On-Call For My Birth?

Yes, our Doula Package includes on-call services so you can get support right when you need it! When you reach out, your doula will promptly reply. It’s so simple but so important to know that a compassionate and knowledgeable doula is just a text, phone call, or video away.

Being on-call means your doula has her cell phone on at all times and she’ll answer your communications 24/7 once you reach 37 weeks. It also means she is available to show up for in-person, hands-on doula support whenever you go into labor.

What Is A Doula, Portland

How Much Does A Doula Cost?

Many people want to know how much a doula costs in Portland, Oregon. The cost can vary depending on several factors including the training and experience level of the doula, the number of births the doula has attended, the additional skills or services the doula may offer, whether you hire a single doula or a doula team, and which Doula Package you choose.

The fee for our Birth Doula Package differs based on the doula’s experience level, number of births attended, and other specialty perinatal training. Currently, our fee range is $1400-$2600. Both packages also include our full lineup of childbirth education and newborn care classes. Please Contact Us to discuss package options and your investment in doula services.

Are Doulas Covered By Insurance?

Oregon is the only state in the nation that reimburses doula services through the state Medicaid system/Oregon Health Plan. At this time, doula services have to be provided through a Coordinated Care Organization in order to qualify.

While doulas are non-medical providers without specific insurance billing codes, some private pay insurance companies also reimburse for all or part of doulas services depending on the insurance provider and individual plan.

We hope that private pay insurance coverage becomes standard for doula services in the future, but in the meantime families can use their Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) to pay for a Birth First Doula.

How Do Doulas Work With Medical Providers?

A doula does not perform any medical procedures but does work collaboratively with the hospital staff to create a supportive team atmosphere during your labor and birth.

An experienced doula knows how to create a good rapport with your nurses, midwives, and doctors while simultaneously advocating for your choices, needs, and desires.

A doula helps you to voice your needs and wishes without becoming confrontational or disrespectful, and works to maintain the delicate balance between respecting hospital protocols and ensuring your autonomy.

Who Hires A Birth Doula?

Virtually anyone preparing for the experience of having a baby can benefit from the presence of a birth doula, including people who are looking for support with:

Unmedicated Birth

Doulas are well equipped with comfort and coping techniques that effectively support people’s goals for unmedicated vaginal delivery and avoiding pain medications and medical interventions. A doula’s skill set is made up of emotional, physical, and informational tools designed to help people achieve the experience of undisturbed childbirth within a hospital, birth center, or home setting.

Epidural Assisted Birth

Doulas can enhance the labor and birth experience of people who want to use pain relief medications by providing useful information about epidural procedures, suggesting appropriate times to receive an epidural, recommending in-bed positions that enhance labor’s progression, and offering advice on how to minimize the “cascade effect” leading to undesired interventions.

Vaginal Birth After Cesarean (VBAC)

A birth doula may be one of the most important and effective resources available to people striving for a VBAC. Doulas can help you “leave no stone unturned” in your effort to have a vaginal birth and help you to navigate the mental and emotional uncertainty that often accompanies this path. A doula offers indispensable reassurance and encouragement as you strive for the VBAC experience.

Out Of Hospital Birth

In a home or birth center setting, doulas offer an additional layer of ongoing emotional and physical support while your midwife focuses on your medical care and the health of your baby. In an out-of-hospital setting, doulas focus in on comfort techniques, labor progression, optimal fetal positioning, and help with tasks such as setting up the birthing tub, preparing food, and cleaning up after the birth.

High-Risk Pregnancy & Birth

Some pregnant people are considered to be in a higher risk category due to conditions such as IVF, advanced maternal age, hypertension, pre-eclampsia, diabetes, etc. Doulas can help relieve some of the anxiety and tension generated by these conditions by offering clear information and explanations, helping you to talk with medical providers, and ensuring that you have continuous support throughout your pregnancy, labor, and postpartum.

What Does A Doula Do, Portland

What Is Continuity Of Care?

Continuity of care is a continuous caring relationship between a client and health care professional over time. For most people, continuity of care is valuable because it allows clients to build a relationship of trust and understanding with their provider.

However, in today’s fast-paced obstetric and nurse-midwifery models, continuity of care is often sacrificed to provide large-scale services to growing populations. This means that even if you’ve hired a doctor or midwife that you really connect with, that person is not usually present when it comes time to birth your baby. Instead, whichever doctor or midwife is working at the hospital when you go into labor is the one you get, and it’s often someone you’ve never met before. While this model may be effective at delivering services within a strained healthcare system, it does not always work well for individuals and families looking for a more personalized labor and birth experience.

This is where birth doulas can fill in the missing link! Having a doula ensures that there is at least one birth professional in the delivery room with whom you have a secure, comfortable, and trusting relationship.

This relationship is built during the prenatal months so that by the time you go into labor your doula is well versed in your family’s unique style, hopes, fears, and goals. A doula works just for you, which means your priorities are her priorities.

This trusted relationship helps families feel more secure, confident and respected within the hospital environment and at a time of significant transition and intensity. It also assures that there will be a familiar and understanding presence during the postpartum to review your birth story with, support breastfeeding, and provide newborn care information. If continuity of care is something you value or desire as a part of your childbirth experience, please contact us so we can discuss our services and begin the connection.

Supporting Vaginal Birth After Cesarean (VBAC)

Over the years, dozens of clients have hired us as part of their preparation for vaginal birth after cesarean (VBAC), and it’s some of the most rewarding work we do. These people usually arrive in our office with a complex combination of determination and anxious uncertainty.

They are hoping to birth differently this time and committed to doing what they can to deliver vaginally, but they are simultaneously anxious about the possibility of a repeat cesarean and uncertain of their body’s ability to birth vaginally. These emotions are normal and reflect the multifaceted experience of people who have had a cesarean birth.

As doulas, we support VBAC families in all the same ways we support other clients, but we also attend to some of the unique concerns and considerations. We spend time talking about evidence-based research on VBAC, we discuss care providers and their VBAC success rates, we go over the importance of optimal fetal positioning, we explore alternatives to medical induction, and we dig up the seeds of doubt planted by extra prenatal testing and try to blow them into the wind.

In addition to these kinds of preparations, we also spend a good deal of time on emotional preparations. Each person and family approaching VBAC has a unique and often difficult previous birth story that has brought them to this crossroads. Some people are at peace with this story, while others are still tender and feeling varying degrees of sadness, disappointment, fear, confusion, guilt, and anger. Either way, we make plenty of space to hear the details of your birth story, to help you process it at your comfort level, and to identify parts that were particularly difficult or frightening so that we can offer extra support and advocacy in those sensitive or vulnerable areas.

And, even though we will bend ourselves into pretzels to help you realize your hope of having a vaginal birth, in our heart of hearts we want everyone to feel empowered by their birth experience regardless of how it happens. No matter how your baby is born, it takes strength and courage, and every type of birth experience deserves recognition and admiration. We love that line in Roanna Rosewood’s popular book on VBAC: “Birth isn’t a battle to win or lose. It’s the result of delving into your vulnerability and finding your power.” Our goal is to help you find your power in whatever way, shape, or form that happens.

Kind Words From Our Lovely Clients

Birth First is amazing! I still can’t believe how magical my birth experience was. I am a single mom, by choice, with children already, I really needed someone who could support me. I could go on and on but really all you need to know is that they are the best. A million stars doesn’t even scratch the surface. My doula had decades of experience, the perfect personality for this work, kindness and patience, vast knowledge and experience and skills, and a sense of humor as icing on the cake.

Mishka, NE Portland, Oregon

We had the excellent fortune of finding Birth First Doulas. Our doula helped us feel very comfortable in a situation where it would be easy to stress out. Her skill and her talent were on full display during the birth of our daughter. She helped my partner get through and even find comfort and rest between contractions and immediately recognized when it was time to push and call the midwife. Five stars doesn’t begin to describe our experience. She helped our very special day be perfect.

Jess, Portland, Oregon

Hiring Birth First Doulas was the single best decision we made during our pregnancy. As an expectant father, I initially questioned the value of having a doula. After meeting with our doula for the first time, I quickly realized how much I was mistaken. Our doula helped to reduce our anxiety about our first pregnancy and feel more prepared and confident moving forward. We highly recommend Birth First for any expectant family, and we couldn’t have been happier with our choice.

Steve, Portland, Oregon