Doula 101: Finding a Doula in the Bay Area
What does a doula do? Why do they do these things?
In general, birth doulas provide physical, emotional, informational support and advocacy for the birthing person, partner and baby. During labor, they can help you stay informed so you are able to make decisions and advocate for yourself. Doulas can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, guided meditation and visualization, massage, positioning and other techniques for comfort. Many doulas have a background and/or training in bodywork and are happy to provide some of those services therapeutically in the forms of breathwork and movement guidance, massage, and postpartum care. Doulas are not licensed therapists, but are able to talk through the process with you and act as a sounding board for your experience. Doulas do not perform clinical tasks, such as blood pressure, fetal heart checks, or vaginal exams. Doulas work for you, not your caregiver or the hospital, so you can rest assured that you always have someone in your corner. Doulas can support a variety of birthing environments: at home, at a birthing center or at a hospital.
Postpartum doulas can provide guidance around baby care, feeding cues, breastfeeding issues and how to care for your own body after birth. They often provide other services such as postpartum massage (sometimes even baby massage!), meal prep, other types of bodywork, light house chores and birth story processing. There are two types of postpartum doulas: day and night. Day shift doulas often help parents with the baby for 2-4 hours per day performing the above mentioned tasks. Night shift doulas often watch over the baby while they sleep in 8 hour shifts. Night doulas can either take care of the baby independently when bottle feeding, so that you can get a full 8 hours of sleep. If you’re breastfeeding they can work with you to bring the baby to you for feeding in the middle of the night. It might sound strange to have someone in your home, waking you up to feed your baby, but it does shorten your awake window in the middle of the night. When a baby wakes up hungry, they need to be fed for 10-45 minutes, burped, maybe changed and then settled back into sleep. This process can take anywhere from a half hour to 2 hours depending on your baby’s temperament!
What training or licenses or background should a doula have? What skills do they learn in these trainings?
In the US, there is no governing body for doulas, therefore there is no formal licensing or certification process for doulas. Likewise, we do not have universally agreed upon requirements to receive certification to become a doula. Some programs result in a certification and some do not. Within the doula community, there are a wide variety of opinions regarding certification, with many believing that certification should not be necessary, as it can create an accessibility issue for low-income doulas or that greater regulation on doulas will just end up in doulas being required to follow the same logic as hospitals. Others believe that regulation is necessary because it will further legitimize a doula’s role in birthwork.
At Brilliant Births, we run a background check and assess the skills and training of each doula that works with us. We also require CPR training and business liability insurance. When you are finding a doula, we recommend using doulas who come with references, are open to background checks, and who make you feel comfortable and secure.
DONA International is the largest doula organization in the world and they list several approved training programs on their website, however that does not mean that a doula trained elsewhere is less knowledgeable than a DONA trained doula. Below is a list of training programs that are popular among Bay Area doulas.
Hospital Friendly Doula Training
These various trainings cover topics such as common hospital procedures, evidence-based information about the benefits of doula support, the history of birth, the significance of doula support to families, practical hands-on techniques, as well as the steps to begin a career as a birth doula.
There are some things that are considered “out of scope” for doulas, meaning that we are not allowed to do them. These are typically clinical tasks that must be performed by a licensed medical professional, such as blood pressure, fetal heart checks, or vaginal exams. Doulas also cannot make medical decisions for you. They can act as a sounding board to help you arrive at a decision, but ultimately the decision is yours and/or your partners.
What does a doula cost? Why do they cost this?
Birth doulas typically charge a flat rate for their services. At Brilliant Births, our doulas charge anywhere between $1800-$3200 for their services. Pricing depends on many factors including level of experience, extra services offered, extra education taken (beyond basic doula training), and sometimes required travel distance. Some doulas are sliding-scale, meaning they are willing to work with low-income families who otherwise would not be able to afford doula care. It is also important to mention that the length of labor is very unpredictable and so doulas must guess how much their time is worth, hence the flat rate.
Postpartum doulas charge on an hourly basis. At Brilliant Births, pricing ranges from $35-50 per hour for daytime shifts and $45-65 per hour for night shifts. A day shift can be anywhere from 2-6 hours long and a night shift is typically 8-10 hours long.
When should you start looking for a doula?
We strongly recommend starting your search for a doula between 3-5 months ahead of your due date! This is especially important if you are due in July, September, November & December or around any major holidays. The fall/winter is an especially busy time for doulas and hospitals alike! Did you know that the majority of babies globally are born in September? Apparently New Years is a very romantic holiday! Our recommendation is to plan ahead as much as you can to be sure you are able to find your perfect doula!
Bay area hospital policies: are there doula friendly or unfriendly hospitals?
While having a doula as part of your birth team is not that new of a concept, you might find that some hospitals aren’t thrilled with your decision to hire one. There are definitely hospitals that are not doula friendly and those that are. How do you determine whether or not your provider will be on board with a doula? We recommend asking both your provider and your doula! Ask about policies and about their own experiences. Hospitals may be doula friendly, but employ doctors who don’t approve of doula friendly policies. Talking to doulas about their experiences with healthcare providers at local hospitals can provide insight and help you to choose a more doula friendly hospital, or create a plan to navigate a less doula-friendly one.
How do you find a doula?
There are many ways to find a doula. We recommend our Doula Connection Service because of our large selection of doulas, the comprehensive vetting process we employ before they can join our group, and we offer multiple doulas to interview so you can pick the one that fits best.
There are also other ways to find a doula. Natural Resources in San Fransisco has a doula finding program, with lovely doulas and a less stringent vetting process. Berkeley Parents Network offers word-of-mouth reviews and advice for Bay Area parents. Asking your doctor or hospital is an option as well. There are so many amazing doulas in the Bay Area— you’re in the right place!
