Today on the blog, Jeanelle Sloan of Dancing Doula Jeanelle and Full Circle Doula Collective in Edmonton, Canada discusses the differences between “natural” and physiological birth. A fantastic discussion around why the language we use around birth and birth education is important.Read More
When talking to families in interviews or prenatal visits or in my childbirth education classes, I can’t stress enough how important it is to choose your care provider wisely. This amazing article on Pathways for Family Wellness (a site well worth checking out) does a great deal to emphasize some of the red flags you should be aware of when meeting with potential doctors and midwives and how to empower yourself with appropriate questions to weed out those that might not be a good fit.
I know in my prenatal sessions and classes, couples tend to get anxious waiting for me to FINALLY get around to the things they thought they were coming in for–What does labor look like? How do I know when to go to the hospital? What are the tools for having a “natural” birth?–as I spend the entire first pregnancy consultation or the first two hours of my first prenatal session talking about your birth team.
I have to remind them that all the squats and yoga breathing and mantras in the world aren’t going to make an impact if you have a care provider who doesn’t believe birth is an event not necessarily full of management and intervention and doesn’t really seem committed to helping you have an unmedicated birth.
One of the ways you can figure out if they are going to be harmful or helpful to your goals of a physiologically appropriate birth is by paying attention to language like “We don’t allow” or “I don’t do that.” If you’ve done your research and know you want to have a water birth, why would you stick with a care provider who says something like, “Oh some doctors/midwives do that, but I don’t.” or “We don’t allow births in the tub here.”? It’s amazing how often I hear pregnant folks say something to that extent and either don’t know that they can switch providers, or know that they have other options, or for whatever reason just don’t think it’s going to be a big deal in labor. IT IS A BIG DEAL! And though having a doula can be enormously helpful in advocating for your wishes in birth, we can’t make decisions for you or fire a nurse a doctor or a midwife for you, and so there’s only so much we can do in the end.
Sadly, we in the United States have grown accustomed to poor medical care, a lack of true informed consent, and being told that we can’t possibly know much about our bodies. With most women hearing horrible stories of near-death births left and right, they’ve grown to think that they must also have this kind of traumatic birth, so it doesn’t matter if they “like” their provider much, as long as they’re there to rescue you and baby. It’s precisely this culture of fear and misinformation and lack of choice and trust in care providers that is driving the rising maternal mortality rate in this country (we are the only country–developed or otherwise–which boasts a rising rate).
So, it does matter who your provider is and where you choose to give birth. If you are currently seeing a provider who uses language that takes away choice and support, SWITCH! Even if they have a nice smile and good bedside manner, if they’re not on your team, fire them. Now and not when you are fighting them in labor. That’s not fair. If you are early on in your pregnancy interview a bunch of different providers. Seriously. How much time did you spend picking out a stroller or car seat? Spend 10 times that amount talking to care providers and staff at the place where you choose to give birth and don’t stop till you’re sure in your gut that you’ve found the best fit. Take a month to do it. Make them sit down with you for an hour and answer all of your questions.
If they don’t want to give you their cesarean rate, but avoiding a cesarean is your biggest concern in pregnancy, keep hounding them or leave and never look back.
You are 100% entitled to having the birth you want. There’s no being “selfish” or “smug” or “bossy” or “difficult” in asking for care that is supported by evidence and is kind and supportive. Choosing an appropriate care provider who gives you options, supports your choices, and practices according to informed consent is also not just for parents hoping to not use pain medication in labor. This isn’t you not being particularly nice to a waiter somewhere, this is arguably the most important day of your life and what happens in labor has long lasting effects for you, for baby, and for your family. It’s not about being a “smug hippie” or trying to win an award for best mom, this is about you taking control of a very normal, natural process that shouldn’t leave you battered, scarred, and needing therapy.
Do not allow them to tell you you’re not allowed.
If you want more information like this, sign up for a pregnancy consultation package or hourly conversation. That first investment can save you stress, time, money, and help you connect to a care provider in line with your wishes and needs in pregnancy and beyond.
I’m starting a series of challenges to expectant parents to encourage them to take small steps toward better care, more informed decision making, and a smoother transition into parenthood.
Over the next few weeks, I’ll be posting on action item in this vein, with some information for why and some resources for how. I imagine the challenges will be steeper for some families than others. I also imagine that it will vary person-to-person which action items are more difficult than the others. Some families, too, I imagine won’t face a ton of barriers, but just needed some guidance on the fact that these things are available.
What’s on the docket for Week 2?
I challenge any expectant family to start budgeting for a doula.
So I might need to start with answering What is a doula?
A doula is a secondary support person trained in non-clinical support in the childbearing year and sometimes beyond.
Doulas are not primary caregivers, so they work in tandem with midwives, doctors, nurses, midwife assistants/apprentices, lactation consultants, etc. Most often you will hire a doula independently, though some birth centers and hospitals have on-staff doulas you can or are required to choose from. Most doulas work primarily in a hospital setting, but can join you for an intended home or birth center birth, as well.
Evidence shows that the one of the best ways to reduce the number of unnecessary interventions, improve maternal and infant birth outcomes, reduce disparities in care and outcomes, and create more satisfying birth and postpartum experiences is to have continuity of care that includes continuous labor support. Most families are very surprised somewhat late in their pregnancies to discover that they aren’t going to get that from their primary care providers in a hospital setting (and this includes hospital-based midwives who work on a shift schedule), hospital staff, or pediatricians. This is where doulas have come in and where the evidence shows that they can help families have better birthing experiences -- both in emotional wellbeing and in reducing unnecessary medical interventions. Following the first publications of these findings, one author famously said, “If ‘doula’ was a drug, it’d be unethical not to use it.”
Most birth doula packages include 2-4 appointments prenatally to discuss your individual pregnancy and desires for birth as well as common coping practices, community resources, advice on having good communication with your primary care providers and other staff and loved ones that might be present at birth, your options in pregnancy and birth, the typical stages of labor, and some newborn advice. They are on call for you 24/7 for a window typically two weeks prior and two weeks following your guess date (it is a total guess when your baby will arrive, btw). They are available for phone, text, and email support throughout your contract. They will set a plan of communication around the early stages of labor to be your primary point person for what’s going on in your individual birthing situation. They join you when you are in active labor and need additional support and help you stay at home longer if birthing at the hospital help with the communication around when to call your midwives if you are birthing at home or a birth center. A doula will then go with you/stay with you at your intended place of birth till baby has arrived and for a short while after to help talk about baby feeding, what to expect in the first few days, and to check in on how you’re settling in after birth. Most doulas include 1-2 follow visits in your home in the first two weeks following birth to cover a wide range of topics on healing, feeding, newborn care, and other items of need.
Postpartum doulas focus primarily on care for parents and infants in the first 2-4 months after birth. Some birth doulas are also postpartum doulas and are available for extended care packages through the childbearing year. However, it is possible to hire an additional or exclusively work with a postpartum doula, too. They typically work either daytime shifts of 3-5 hours a few days a week or overnight shifts that shouldn’t be longer than 8 hours each. Though it may seem amazing to hire a postpartum doula for around the clock care, most families feel very well educated and supported with having a trained, thoughtful person come in to check on them 2-3 days or nights per week. Ideally, you are working with them on a tapered system where there is denser coverage in the beginning that fades to maybe one day or night shift a week to help you transition into caring for baby on your own once you have a rhythm established.
The cost of a doula varies based on what’s typical in your community, what their packages include, and their level of experience. It is possible to work with a doula who works on trade, sliding scale, or on a volunteer basis, though I encourage you to explore the value of the time, effort, and resources this person is putting in to being your support person in this immensely intense time in your life. Having said that, if you are really wanting to work with a doula and it isn’t in your budget, there can be lots of avenues for finding a fantastic doula that can fit your economic needs. Many doulas will be more than happy to reach out to their community to find you a good fit or to connect you with an organization that offers volunteer support.
Even in high income areas, the upper reaches of birth doula fees are typically under $3,000 for full care and the national average is around $1,500. Postpartum care, especially overnight care, can run into the tens of thousands of dollars over the course of several months. The highest fees don’t always reflect the level of support you’re getting or denote who might be your best fit, so it’s worth researching a wide number of doulas and asking even the higher fee doulas if they’re willing to work within your budget or have a strong recommendation for someone who can.
For this challenge, I want you to imagine setting aside at least $2,000 for doula support if you can. According to Fortune, folks spend an average of $1,300 on Amazon per person per year. Individuals in the US spend about $1,500 each on vacations per year. The average cost of a wedding is almost $26,000, which is also an enormously important day for many, but also just a single day and doesn’t carry quite the same lasting benefits and risks as having a positive birth experience...I mean, even the cost of the cake on average is $500. What would it mean to put that towards several hours of personalized postpartum doula care?
You can make up these costs in a lot of different ways. I have an earlier post on how postpartum preparation can help save you a ton of money you can put towards doula care I’d encourage you to take a peak at, but the gist of it is
BUY LESS BABY STUFF
Can I challenge you to try this : Every time you are about to purchase something for baby, can you either do without it (the answer is almost certainly yes) and put that same amount into a savings fund for a doula? Or can you put a matching amount in that savings fund? Many useless baby items will run you about $35 a pop and will likely wind up in the Goodwill pile where $35 is about the hourly rate of many postpartum doulas. That $120 countertop sterilizer machine…? Guess what, there’s no sound evidence on sterilizing bottles and a lot of good evidence on why not to so there’s $120 closer to your birth doula fund. There is no gadget out there that can replace having quality labor support or someone helping you to navigate the tricky first months with a newborn.
Friends, family, and co-workers are often very very excited to help you greet your little one and want to show you. This often leads to them purchasing a ton of stuff, and it’s up to you to direct them into another option, if you really want support around having a doula. Don’t be shy about talking about your process of hiring a doula, trying to reach your budget goals, and that if you’d prefer it, that you’d rather have some money to put toward doula support over another book or pile of onesies.
What about expensive gender reveal or baby showers? Can you have a celebration with friends around this that isn’t full of cheap decorations you’re just going to throw away? Have it be a potluck with fun games around baby names and the like and ask your guests to chip in to your doula fund in lieu of obligatory baby gifts you might not ever use. You can ask your doula to attend, even, and talk to your guests about how beneficial their support might be to you in the long run. If it doesn’t feel too tacky, you can put out a box/jar/whatever with the label “doula fund” and even if you just get a few bucks, you’re a few bucks closer to $2,000.
Or, if you don’t feel like making a ton of swaps to your plans for celebrating before baby arrives, can you just set a goal of how much money you’ll set aside per week till you hit your doula fee goal? If you have a partner, you can ask them to do the same and set up a mutual savings spot and even make it kinda fun somehow. Maybe get an old school piggy bank and smash it when you’re ready to hire your doula!?
Did you go out for a regular giant fancy coffee drink or regular cocktail that you’re abstaining from in pregnancy? You could calculate how much that cost you per week and put that money directly into a fund for your doula, who will be your new self care and indulgence guru.
Have you ever found yourself saying something like “I’d pay $X for a nap right now?” Well, put a number on that, start setting aside a few naps worth, and think about the beneficial rest your postpartum doula will help you take once baby’s here and think about paying them to help you achieve that when you need it most.
If $2,000 is an unrealistic goal for you or is much more than you need based on fees in your community, just pick a different amount and save away!
To read a bit more about the true cost of a doula, you can check out my article on the cost breakdown here.
If you want more information on how to find, save for, and hire a doula, you can set up a 1hr phone consultation or sign up for one of my full pregnancy and/or postpartum consultation packages where I’ll talk to you about doulas, how to save money in this process, and much more.
If you participate in these #pregnancychallenge ideas and want to share, please comment below, send me an email, or tag us @Rosewoodrepro on instagram and let us know how you are doing! Happy saving!
Here to tell you about my phone and video consultation services!
Okay okay okay, truth be told, I HATE talking on the phone. I don’t even like FaceTime chats except to see my baby nephew so this has been a stretch for me. BUT I loving it.
I was asked to start doing phone consultations by a former client who is building a network of experts to reach Chinese families around the globe who are trying to find more holistic parenting resources. It started as short video workshops (that was challenging enough for me as a rambler) and merged into phone consultations for small groups of parents interested in holistic sleep education. That lead to phone consultations for doula contract writing, prenatal education with families outside my services areas, and more. It’s inspired me to keep going.
I’m going to start offering almost all of my services virtually from now on -- Well Woman Consultations, Pregnancy Consultations, Postpartum Prep Consultations, Sleep Support Consultations, and Doula Contract Writing Consultations and Classes.
Here’s what each might look like :
Well woman consultations :
After you reach out about wanting to work with me to find a more tailor-fit approach to your hormonal and reproductive health care, I’ll send you one of my whopping 10 page intake forms to fill out and send back to me. You can sign up for 1+ hour of support over the phone or video, we’ll pick a day and time, and that’ll be when we can go over your needs and wishes for care.
After we chat, I’ll do a bit of research and reach out to my network for good recommendations in your area and send you a detailed email with everything you need. If you want to keep working with me, we can do so in the same manner on and hour-to-hour basis or you can jump into one of my annual or 6-month packages for further support.
We’ll cover everything from nutrition to seeking a primary care provider to navigating tricky hormonal issues to birth control options, and more.
I’m very dedicated to working with young persons and their parents/guardians to help them navigate the transition from pediatric into reproductive/gynecological health care that’s supportive, inclusive, expansive, respectful of the enormity of these age transformations, and doesn’t scare them out of routine care. We can work as a team and have private sessions so everyone feels comfortable and connected in this process. Privacy, compassion, and empowerment are the keys here and I’d love to be a guide for you and/or your child in this process.
Pregnancy consultations :
These can work the same as my in-person package options where you can sign up for a 2 hour consult at any point in pregnancy or the full 10 month support package. After you let me know what might work best for you (and if you start with the 2 hours and want to jump into a larger package, that fee will just be transferred over), I’ll send you a detailed intake form so you can let me know about your pregnancy journey so far and fill me in on what I might be able to help you with going forward.
For some families, you’re just looking for extra information on a specific topic like choosing a care provider, GBS testing, nutrition, finding a doula, home or birth center birth vs hospital birth options, how to find and interpret high quality research and information, information on comfort measures in birth, or other singular topics.
Other families want to get the support they would traditionally get from an independent midwife (minus the clinical testing) that they aren’t able to access for any reason and want to have me fill in a lot of the huge gaps left in our maternal care system.
With ten years of experience supporting pregnant persons in all sorts of ways (childbirth educator, doula, midwifery student, infant care specialist, researcher, doula trainer) and in many different states, countries, and settings, I’m here for all of it! If you feel like my style is the best fit for you, or you feel like you’re not finding what you need in your area at this time, let me help you virtually!
Postpartum Consultations :
Feeling like you’re not getting the resources on what to expect once baby is home? Feeling like you’re getting a lot of conflicting information or information too focused on risk and fear and opinion? Wanting an infant and mama/birthing person healing crash course done on your own time and with your specific family’s needs in mind? Let’s set up a call or video to go over what you need to know. This also can be done as a one-time 2 hour session or as part of the broader packages.
Unlike traditional newborn basics or breastfeeding classes now widely offered, these consultations don’t follow a standard system. Instead, they are focused on the concerns you have individually and specific to what you feel you’re not getting. We can set these up before baby arrives (ideally) or up to 4 months after baby is here. This can be a truly awesome baby shower gift!
I offer discounts for group consultations, so if you have a few friends or a parent’s group of expectant/new folks due around your same time (minimum 4 participants), the price is dropped to $20 per participant per hour.
Sleep Consultations :
Wanting some basics in infant sleep expectations? Not sure you want to sleep train or what sleep training even entails? Wanting a holistic and personalized approach to discussing sleep difficulties without fear or judgement? Need a point person on standby for those crazy weeks of transitioning sleep schedules? That’s me!
Lack of sleep is one of the number one challenges parents face in the first few months with a new babe. There is no way to make this obstacle disappear -- it’s part of the process, sorry to tell you. However, so much of the sleep training information floating around is not routed in good science or good practice and often leaves families feeling more stressed and tired. This often leads to them either ditching their goals for compassionate sleep adjustment sooner than they’d like, or makes them feel like giving up even trying to get babe to sleep on their own. There is a middle path, friends!
For better or worse, this middle ground takes a lot of extra support, guidance, and respect for nuance. Rosewood consultations aim for realistic, quality information-driven, and non judgemental discussions around safe, healthy, and lengthier sleep options. This isn’t a promise of X hours or a leave your baby to scream bullet point plan, no-sir no-thanks.
There is an option to have a 2 hour basic rundown of common sleep issues and information you can access while still pregnant, or you can reach out to me once baby is here and you feel you need more advice, either as a 2 hour consult or as part of a larger package based on your needs. This can also be a group virtual class at the $20 per person per hour rate (for at least 4 registered participants).
Doula Contract Consultations :
Let’s face it, most doula trainings leave you totally in the dark about how to write a contract that really protects you or supports your individual practice.
With a one-on-one contract consultation and edit, we can work together to go over the basics of contract writing (I send you my full how-to booklet once you register), using your contract to set up healthy and cooperative expectations for yourself and your clients, how long to keep a contract, what goes in your contract vs on your website or handouts, myth-busting scary legal language and legal fears, and how this practice can evolve and grow and be a benefit to your wider doula community.
Individual virtual edits are 2 hours of prep on my end going over your material as-is, 2 hours of virtual meeting time, and 2 email follow ups built in with the option of adding more at a low hourly rate.
Virtual group classes can be done at an hourly rate of $100 per hour for any size group. I’ve loved talking to doula groups and collectives around the country about how to use this exercise together to create better contracts and support one another in this often difficult work.
Want to bring me to your group or training organization in person? I’d love that! We can chatrates and options, so please reach out.
Rates for virtual consults are the same as in person consultations at this time and can be found on my Services and Doula pages. As always, sliding scale and some trades are options to keep this type of support accessible in many areas.
If you are part of a parent’s network or group and think I’d be a good fit for one of your gatherings, please reach out! I love discussing specific topics families want more information on like holistic sleep advice, environmental parenting, choosing a care provider, finding a doula, and more.
If you are a doula group and want me to speak (virtually or if possible in person) about one of my specific focus areas, LET’S CHAT! I do it all the time and love meeting and teaching doulas from all over.