Lamaze has done a great job with this …

Common sense tells us and research confirms that the Six Lamaze Healthy Birth Practices featured in these video clips and print materials are tried-and-true ways to make birth as safe and healthy as possible.

Check out this page for some great video clips and even some printable material!

This is definitely worth your time to check this out!

I have written before about being on call being a difficult issue for doulas. Many times I get a call from someone wanting to be a doula. But besides the erratic schedules, the need for excellent childcare and a supportive partner- it is essential they understand the idea of being on call. We are on call “officially” for the due month- which is 38 weeks to 42 weeks- but of course if a mom goes prematurely we make sure she has a doula, even if her primary is not available. But there was a conversation today that I wanted to share with you.

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When you are a doula, you may be hire months in advance of the woman’s due month. We have folks who hire us as early as 12 weeks- we will not accept a retainer prior to this time. But things come up sometimes unexpectedly. I am not talking about illness or family emergencies- I mean things like a friend’s wedding, a special concert, a last moment opportunity for a vacation, etc. But in Labor of Love’s business workings- we ask that when you are hired by a couple, you are fully available during her due month- meaning those things you want to do that arise are back burnered to the mom in labor. The exception to this is of course if when you are hired- you enlighten a couple to a possible date conflict within their due month and they hire you irregardless- knowing you will have a back up in place when that special event occurs.

Well we discussed as a group today the idea of a couple hiring the group- not a specific doula. We came by this idea based on two things. First since this is a difficult if not the most difficult part of doula work it would make our lives so much easier if we knew specific days we would be on call and days we could be free to do other things without worry about not being there for a mom. Second,we get couples all the time who attend the Meet the Doula Tea and say they would be be happy with any of us.

But as we discussed the logistics of offering this as a potential service at a lower rate than the average doula in our group, we realized it benefited us as doulas but was not in the best interest of the couples. Already moms often have no idea who will be the care provider on call when they go into labor. In fact there are several groups who now share call with other groups- meaning you will not have ever even met the doctor who shows up to catch your baby- he or she has never read your birth plan- has no idea what your birth ideals are- and really is not that concerned about it. Their job is to show up and catch your baby and make medical decisions for you but is not invested in your birth experience outside of that.

Often times a woman will even entertain the idea of induction with all of those risks in order to get her preferred doctor. Although that is not guaranteed either since often inductions go longer than expected and the shift change of on call changes too. The last thing we would want is someone to consider an induction to get their favorite doula who would be on call. The risk of induction is somehow out weighed by the familiarity of desire for those who will attend her. This is awful.

Continuity of care is something we offer. We will stay with you during the duration of your labor- no matter how long. I talked with a doula with another group in town recently who has small children- she said she would not be able to attend a mom irregardless of the length of her labor… she said she would call another “fresh” doula in place. We may call in help to allow us a power nap with the mom still fully supported- at no additional cost to the mom- if her labor went unusually long- but that is rare. We have found we make 97% of our births- the other 3% are covered during those rare occasions when an emergency arises for the primary doula- by a back up doula. The fantastic thing about our company is we have several wonderful doulas who folks get to have met at the teas we do bimonthly.

Penny Simkin was quoted in a publication the IHS Provider page 155 “Doulas “hold women” by supporting them emotionally during their pregnancy, labor, and birth. The doula meets with her expectant mother one or more times before the birth and discusses the mother’s expectations or ideas of what the birth will be like, and issues of importance, such as pain medication preferences or infant feeding choices. During these meetings the doula supplements information the mother has learned in prenatal classes and explores misinformation she may have gleaned from what she has heard or read. The doula empowers the client to eat well, observe healthy lifestyle practices, and exercise, all to prepare for a healthy and positive birth experience. A doula may use this time to enhance communication within the woman’s support network, including family and partner, and/or may give advice about how to communicate effectively with the medical staff.

During early labor, the doula and her birthing partner stay in close contact until the mother needs additional support, at which time the doula will join her, meeting the mother at her birth place. She will then stay throughout the entire labor and birth and for up to two hours during the postpartum period. She will talk about normal contractions with the mother and will provide an objective viewpoint. Knowledge of what is normal replaces fear of the unknown. The doula listens to the mother and responds to her needs. The presence of the doula, who is calm and committed to the mother’s well-being, counteracts the effects of elevated stress hormones (adrenaline and noradrenaline), which are released when the mother becomes anxious, fearful, or insecure. A trusting, relaxed mother is able to continue producing oxytocin, which then keeps the labor in its normal rhythm, with the perception of pain diminished greatly. Most importantly, the doula lessens the anxiety of the laboring woman with quiet reassurance and enhancement of the unique talents and strengths the laboring mother brings to the birth.”

And at Labor of Love we agree.“She will then stay throughout the entire labor and birth and for up to two hours during the postpartum period.”

That relationship, “supporting them emotionally during their pregnancy, labor, and birth.” is essential and one we are not willing to compromise by having a varying and rotation of doulas on call for the mom. We love having a well established relationship built prior to the labor and birth. We love the phone calls, the personal talks, the emails along the journey.

So, although it would make our lives easier- we realized it would not be easier for the moms themselves. We want to be the consistent,non variable support to couples in their labor and birth. We want them to know we will do our very best to be with them- the doula they selected as their primary- and insure that is our goal. If it makes our life a bit more difficult, then so be it- we love the work we do. For us it is our calling. We love being with women in birth. We feel blessed to do it. Our families are understanding although it is difficult for them at times. But if they love us and they understand our work is in our hearts and gives us that which we need- they support us none the less.

So, know where our hearts are- with you… for you… in support of you.

A few years ago I had the pleasure of being a part of a PBS special show about doulas. Here is the link you can view and enjoy!

I was interviewed a few years ago with a client who I have been the doula for two times previously. Here is a video online you can access to see it! http://www.realsavvymoms.com/season-5/episode-2/doulas/

If the link stops working above- then go to
Real Savvy Moms
is the location of the video- I wish I could upload it but it won’t upload here- so go to this link- click on watch videos on the left hand sidebar. Then click on pregnancy. Then in the section at the top in the middle- it says search by topic. Put in Doulas. Then click on Doulas. The segment has Penny Simkin in it as well as me!

It is the video we usually show at our teas. Hope you can figure this convoluted way of finding it to watch it.

Brenda at South GA Birth Services has a blog and offers podcasts of different birth related subjects. She recently interviewed me and has the podcast up for you to listen to if you are so inclined. It is about being a doula- becoming a doula and what a doula does. http://bellycaster.blogspot.com/

Hope you enjoy it!

Brenda has since moved to the Atlanta Metro area as a home birth midwife. You can find her at https://www.facebook.com/metromidwife

“Upon your recommendation, we submitted your fee to our health insurance (United Healthcare) and received word back from them just before the year ended. They covered the doula fee almost 100% (they wrote me a check for $7 less than the fee we paid you)!! I couldn’t believe it when I got the claim notice. I thought for sure we’d have to resubmit a few times with explanation or backup documentation, but it all went through without any of that. I was thrilled to get the notice in the mail and wanted to let you know too. We would have still contracted you as our doula even without the option of getting reimbursed by insurance, so this was just a bonus. Please feel free to relate this on to Teresa or any of your clients.”

We think you should always consider filing with your insurance company. We provide a form – a superbill – for you to send in to your insurance company AFTER the birth. Don’t contact them ahead of time. Wait to send it in afterward. If you have a less interventive birth, then the likelihood increases that they will consider it. If they tell you up front they will not, no matter what- they will not since it is documented that they told you so.

We provide on our form the CPT code for doula services, a federal ID for taxes and a national provider identifier number- all of this helps with getting insurance companies to see we are a valid provider.

You can go to www.cappa.net or www.dona.org and copy their position paper documenting the effects of using a doula to substantiate the cost being a benefit to your labor and birth outcome.

Most pretax programs not only cover doula services but also many of our classes.

We offer a Meet the Doula Tea that many folks enjoy attending. We host it every six weeks on Tuesday evening. We provide a video about doulas, great refreshments and a time of discussion regarding our services prior to you having an opportunity to meet the individual doulas and mingle to ask them questions. You may choose to hire a doula that evening having had time to meet her and her back ups. But…

If you are unable to attend the tea we have other ways to meet us. We provide a free interview where you can meet with how ever many doulas you desire. Some of use have an office or childbirth class space where we usually conduct interviews but we are willing to meet you elsewhere if that is needed.

And once you have talked to a few of our doulas on the phone you can usually decide if that doula is a good fit once you have met her in person. Hiring a doula is what officially retains her- that means getting the agreement and retainer received in our office.

Once you hire a doula, she usually contacts you to let you know that you have been officially added to her calendar in our office. At that point it is up to you to contact your doula with questions, concerns or just sharing how your pregnancy is going- how your appointments are going with your care provider and any thoughts you think will help her to get to know you better. (more…)

Labor of Love offers apprenticeships to aspiring doulas and an extra pair of hands to our labor doulas if parents desire to include them.

If you are a new doula… who wishes to be involved in our apprentice program, please read the requirements below and contact Teresa for more information.
One of the requirements of being an apprentice is assisting Teresa,with a Birthing In Awareness Childbirth Series. This offers a new doula a new perspective in childbirth education that all the doulas of Labor of Love have shared. We feel this is an important approach to supporting women.

Although we support women in whatever choice of childbirth education they choose, since so many of our clients do take the classes we offer, it is important for an apprentice to understand this approach. We only have one apprentice per childbirth series. You may begin the apprentice program without having completed the childbirth apprenticeship if a class series is not available for you to have completed, if you have read the book Birthing From Within and have observed some of the techniques that are used within the method. But ideally we would like you to participate in this area of the apprenticeship. (more…)

It is frustrating to me that folks spend more effort and time planning and preparing for their wedding day than they do for the birth of their child. Yet the birth of their child will effect a woman for the rest of her life…much more so than the flowers she chooses for the ceremony. I get it that it is expected that they will plan their wedding- but I think we need to change the perspective on preparing for their births. Many folks will not take a class since their friends said that the class they took was worthless. But then if you ask more, it was a one day, slam bam class where they hardly had time to formulate their questions before the class was over. I am not sure that is a good measure of a class that prepares you for your birth.

I get calls from folks who have not scheduled in the time to take a childbirth series- they want one private class or maybe two… because they do not have time to attend a full preparation course. Now granted that is better than nothing, but it is not ideal. (more…)

Sherpa: “The term sherpa is also used to refer to local people, typically men, who are employed as guides for mountaineering expeditions in the Himalayas, particularly Mt. Everest. They are highly regarded as elite mountaineers and experts in their local terrain, as well as having good physical endurance and resilience to high altitude conditions.”

At my last birth, (my 400th as a doula!) the dad said that just as they had used me for their first birth, they would not consider having a baby without a doula. In fact he sings my praises to many pregnant couples. His sister was present during the labor and just after the birth and she was told by both the mom and the dad of this baby, that they need to hire me when they have their first child!

But a comment that the dad said resonated with me. He said just as you would not climb the Himalayas without a Sherpa, you should not give birth without a doula! I loved the statement. It made me feel like smiling! It was great because I consider myself a birth guide.

If the dad or the woman’s mother or sister want an active part in the labor and birth, I am more than willing to step back and only offer suggestions along the way. But when the other support people need or want to step back, I am there to offer any support needed. But considering myself a labor sherpa is kinda sweet! Thanks Trey!