BIRTH DOULAS

1. How do Birth Doulas insure they’ll be available when I go into labor?

Baby Caravan’s model is unique in that all of our Birth Doulas work in teams of two. As described in the “What is a Birth Doula?” page, we believe that having two Birth Doulas on your team is better than one. Both Doulas bring their background and education to you, thereby doubling the resources, insights and depth of experience available for you to draw upon. They will both meet you for the interview and prenatal visits. During these visits you will get to know both of them equally. When you go into labor (or have a scheduled induction or Cesarean birth), one of your Birth Doulas will be present to assist you for the duration of your labor until a few hours after the baby is born. You will know which Birth Doula is on-call for you each day because you will be provided with an on-call schedule several weeks before your due date.

The other main reason behind having two Birth Doulas on your team is so that you can be assured that one is always available. The last thing we’d ever want for you is that your Birth Doula is not available, for some unforeseen reason, during your birth. Having two Birth Doulas committed to you is our insurance policy that no matter what, you will have one of your Doulas by your side, at your birth. Birth Doulas who work independently occasionally have to request help from a back-up doula whom the client has never met. We think that it’s far preferable to have a minimum of surprises when your body decides to go into labor. Because you have an established relationship with both Birth Doulas, neither face will be a surprise when they meet you to assist you with your labor.

Both of your Birth Doulas will attend your postpartum visit. This visit usually takes place about a week or so after you’ve delivered, at your convenience. Again, the benefit of having two Doulas is that you can draw on the knowledge and expertise of two minds during this challenging and exciting postpartum/newborn phase.

 

2. When should I interview and hire my Birth Doulas?

Birth Doulas are hired anytime during pregnancy. The only downside of waiting until later in pregnancy is that there may be more limited availability because Birth Doulas can book up quite early. Also, if hired later on, the relationship between Birth Doulas and a client/partner have less opportunity and time to develop. The earlier you hire your Doulas, the more time you have to get to know them, begin to trust them, and use them as a resource as you’re navigating your way through pregnancy. Your Doulas are always there to bounce ideas off of, make recommendations, answer questions, provide encouragement and so the sooner you and she have decided to work together, they become your allies and join your team.

However, sometimes you may be undecided about whether or not you would like Birth Doula support until the very last minute. In which case, it’s still well worth inquiring into the availability of a Birth Doula team. Even if there’s only time to meet just once before the big day, it very well may be all you need to get a sense of one another before becoming your companion in the birthroom.

Ideally, the best time to inquire about a Birth Doula and schedule an interview is in the beginning of the second trimester. You are (hopefully) starting to feel a little more like yourself at this point, having waved goodbye to the morning sickness and overwhelming fatigue of the first trimester for the most part. You may need to interview a few Birth Doulas to really feel confident in your choice. This is recommended! Once you hire your Birth Doulas, you can sit back and relax in knowing that someone else, besides your partner and medical team, have your back. The first time you and your Birth Doulas will meet up after the interview will usually be around 30 weeks and then again around 36 weeks for prenatal visits. The timing of these visits are of course negotiable and entirely up to you.

 

3. What’s the difference between a Doula and a Midwife? Are they the same?

Birth Doulas are trained, professional birth attendants. They offer support during pregnancy, labor and birth, and the postpartum period. This support takes many forms. It might be information support, helping a mother and partner become educated about the process of birth and ways to mentally prepare for it. It might be emotional support: helping the mother and partner cope with the uncertainty and unknown that often characterize the experience of this year. It might be physical support: providing and teaching comfort measures during labor such as massage, acupressure and assistance with position changes. It might be support in the form of guidance and coaching: offering encouragement and affirmations during labor, as well as guided visualizations and suggestions of different breathing techniques. The support might also be functional: such as explaining what is normal, decoding medical jargon and advocating for the mother/partner. For more information on the role of a Birth Doula, please see the page “What is a Birth Doula?”

The Birth Doula does not perform any clinical tasks for her client. For example, she does not take blood pressure or perform vaginal exams. She is not a medical provider and cannot consult with or advise her client on medical issues. However she can help her client brainstorm and come up with questions for her health care provider. She can supply referrals and resources as needed as well.  Her training consists of obtaining certification by a professional Doula organization such as Doulas of North America (DONA), Childbirth and Postpartum Professional Association (CAPPA) or Birthing From Within. Many of our Birth Doulas are also certified in Neonatal Resuscitation and Lactation Counseling.

A Midwife is a professionally educated and licensed health care provider. There are two types of Midwives and both are recognized legally in New York State. Certified Nurse-Midwives (CNMs) have a Bachelor’s degree in Nursing, followed by a Master’s degree in Midwifery. Certified Midwives (CMs) have a Master’s degree in Midwifery. Licensed Midwives (LMs) as both types of Midwives are called in NYS, provide care for women throughout the lifespan. Their area of specialization is in pregnancy and childbirth. For low-risk women, an LM can be the primary care provider offering all prenatal care, delivery of the infant, postpartum and newborn care. They can write referrals and prescriptions. They either practice independently, with a group of LMs, or in a group practice with LMs and OB/GYNs.

If a woman is high-risk, she may still be able to be primarily cared for by an LM, but may need to consult with an OB/GYN or a Maternal-Fetal-Medicine specialist as well. An OB/GYN and an LM provide the same care except that an OB/GYN is a trained surgeon, and an LM is not. However, LMs can perform all manner of vaginal repairs after childbirth, they can first-assist with an OB/GYN in Cesarean births, and perform circumcisions. Ninety-eight percent of LMs deliver babies in a hospital and the remainder deliver at a client’s home or birthing center. Hospitals in the New York City area that employ Midwives are: Bellevue, Beth Israel, Mt. Sinai, Mt. Sinai West (aka St. Luke’s Roosevelt), Jacobi, Maimonides, Methodist, Metropolitan, Lutheran, Woodhull, Coney Island, Montefiore, Bronx Lebanon, North Central Bronx… among many others. For a list of homebirth Midwives, please visit: http://nyhomebirth.com/. For more information about LMs, please visit:

 

4. Will working with a doula exclude my partner/husband/spouse?

The goal of a Birth Doula is for the mother to feel as safe and at ease during her pregnancy and delivery as possible. One of the best ways to reduce fear is for the mother to feel surrounded by support. The person who likely knows the mother best is her partner. Birth Doulas assume that she will want him/her close by, providing reassurance, stability and strength. We assume that he/she will always be the primary birth partner, unless otherwise requested. We liken it to an onion: the mother is the core, the partner is the next ring encircling her, and the Doula/Doulas are the next ring out. We all play our part in embracing and enfolding the mother during the intense physical journey of labor. We would never overstep a partner in this primary role, for he/she is just as central to the birth experience as the mother. This is his/her pregnancy, labor and birth too.

During the labor, often the partner needs encouragement that his/her support is useful-- the Birth Doula can provide this. The partner might request suggestions about things he/she might do to comfort/assist the mother-- the Birth Doula can offer these. There may be times when he/she is frightened about what is happening to his/her partner-- the Birth Doula can deliver reassurance. Often the partner likes to hear that what he/she is witnessing is normal and expected—the Birth Doula will give explanations. The partner might wish for a time out, a rest, a breather— the Birth Doula can take over until he/she returns. We are the partner’s Birth Doulas also, tending to his/her needs and offering him support when desired.

Birth can be a momentously unifying experience for a couple. Our desire as Birth Doulas is to bring the two of you together in this process. Birth Doulas try to help soften the edges of labor, provide padding and buttressing so that the two of you can enjoy the journey as much as possible. We try to help take fear out of the room and in its place, leave an assured, empowered team.

 

5. How do doulas work with/interact with OB/GYNs, Licensed Midwives and medical staff at the hospital?

The best way to serve a couple is to ensure a harmonious relationship with their medical team. As described in Question 2 above, Birth Doulas are not medical providers and therefore cannot and should not interfere in the care that the mother is receiving from their Midwife or OB/GYN. A Birth Doula is always deferential and courteous toward the team that her client has chosen. OB/GYNs, Midwives and nurses are accustomed to working with Birth Doulas because they are so common these days. It’s extremely rare that a doula isn’t a welcomed sight. In a hospital setting, more often than not, the medical team is busy dividing their time between multiple patients so they are grateful for the Birth Doula’s extra hands helping support the mother during her labor (in a non-clinical capacity). In a homebirth or Birth Center setting, the same is true: Birth Doulas strive to help the mother in whatever way she needs without being obtrusive to or interfering in her medical care. In this setting, it’s often assumed that a mother/partner will hire a Birth Doula.

Ultimately, the Birth Doula wants her client and partner to experience the best care, and the best care means a team that works together and is respectful of one another. She will do everything in her power to maintain positive, affable relations with her client’s team members.

 

6. What if I want an epidural? Can I still work with a Birth Doula?

A Birth Doula serves a mother and her partner. That is her singular role. This means that she is at service to the mother’s judgment. Her place is never to judge one way or another how a mother acts, reacts, or what she needs. If the mother desires an epidural, this is a good and appropriate decision for her, because only she knows what her body and her baby need. Epidurals can be extremely effective tools if this is something the mother choses. Whether the mother chooses to forgo medication or receive an epidural, her Birth Doula is there to support and validate all of her decisions because this is the way to be truly supportive.

 

7. What if I have a planned Cesarean Birth? Should I work with a Doula?

Absolutely! If you’re having a baby, you’re going to want to be supported, no matter the delivery method. There is much to prepare for as well as many questions, and many unknowns that face a mother who is planning a Cesarean Birth. The Birth Doula can be an ally and an aide in painting a trajectory of how the procedure will look and how to prepare mentally and physically. She can decode medical jargon and provide reassurance and encouragement. Once the baby has been born, she can help with comfort measures, breastfeeding, and newborn care education. The Birth Doula will visit you for prenatal visits as well as postpartum visits. These visits can be catered to whatever topics you feel need reinforcing.

 

8. Are doula services covered by insurance?

Contact your insurance company and ask about out-of-network benefits. We can provide you with a receipt that you might be able to submit for reimbursement. At this point, most insurance companies do not cover Birth Doula services, unfortunately. Hopefully in the future this will change. If you have a flex-spending (FSA) account, Baby Caravan is able to accept FSA and HSA debit cards for Doula services.


POSTPARTUM DOULAS

1. What is a Postpartum Doula?

 Postpartum Doulas provide mothers and partners with emotional, physical, and information support following the birth of the newborn baby. While Postpartum Doulas are primarily educators, doulas support mothers, fathers, the new baby and the baby’s siblings through the newborn transition.  The doula usually comes to the home a few hours during the day or for overnights during the first few months following the baby’s birth.  Some families work with Postpartum Doulas on a short term basis, and others for a long term basis.  

 

2. When should I hire a Postpartum Doula?

Ideally, families typically meet with and hire a Postpartum Doula during pregnancy. There are a few benefits to lining up your postpartum support prior to giving birth. First, we can help you prepare for your postpartum period before your baby arrives, to help you have as smooth a transition (as possible). Our team is excellent at strategizing, and helping with logistics. Second, you’ll have time to develop a relationship with your doula, and third, you’ll have the support and guidance all set-up ahead of time, so it’s one less thing you’ll need to do after your baby is born.

Although many families will also hire a Postpartum Doula after the baby is born to help out. If you’re already given birth and would like some postpartum assistance, please reach out and we can introduce you to available doulas, or simply send someone over to meet you.

 

3. What does a Postpartum Doula do?

This is an excellent question! The short answer is, whatever you need in the moment. Postpartum doulas work within the newborn space on a daily basis. They are very familiar with the common needs of new mothers and babies. There is no “typical” because we do whatever is needed in the moment. Some common tasks we assist with include:

  • Assistance with breastfeeding, pumping, and breast milk or formula bottle feeding 
  • Assist in breast feeding education and support 
  • Support for emotional and physical recovery from birth 
  • Support with parents bonding with their baby 
  • Tips and tricks for infant soothing 
  • Run errands 
  • Light house cleaning, tidying up and organizing 
  • Meal Prep and assistance ordering groceries 
  • Sibling care 
  • Offer local resources and support groups as needed 
  • Screen for perinatal mood disorders 
  • Help you achieve your short term and long term parenting goals

 

5. What’s the difference between a Postpartum Doula and a Newborn Care Specialist (also referred to as a “Baby Nurse”) 

A postpartum doula is a trained and experienced professional who aids new parents through education, information and support. Her focus is on the whole family as a unit (mom, partner, baby, siblings, pets), providing care and support, assisting the family wherever help might be needed and allowing mom to recover from birth. A baby nurse is a non-medical care provider, who may also be called a newborn care specialist.  Her primary focus is on the baby and many times taking over care for extended periods of time.

 

6. Does a Postpartum Doula do overnight baby care?

 Some members of the Baby Caravan Postpartum Doula team are available for overnights. We bring a team approach to the work we do. For clients looking for overnights 7 days per week over the course of a month or more, we’ll put together a team of 2-3 doulas to work with you and your family. This way you’ll always have a refreshed doula, and adequate coverage in the rare instance of illness. Baby Caravan handles all the logistics and scheduling, so you can enjoy having your nights covered stress free.

Our overnight doulas have experience supporting families who exclusively breastfeed, or bottle-feed, either breast milk or formula. Overnight doulas are familiar with the needs of newborns, and safe sleep. For families interested in developing their babies sleep habits, we have a sleep consultant available.

 

7. What are the rates for Postpartum Doula Services?

Our rates vary from $40-50 per hour, depending on the number of hours booked.