What do Doulas do?
A labor doula stays with you through all stages of the labor and provides whatever support is necessary to set the stage for the best possible outcome for you. For example, a doula may suggest laboring positions that can be less painful or help speed labor along, provide hands on techniques such as sacral pressure for back pain or hip squeezes to help open the pelvis. Doulas can also provide more subtle services like keeping you hydrated, protecting the space of a laboring woman who wants privacy or making sure the lights aren't too bright. Sometimes the doula helps the birthing mother by taking care of other family members, keeping track of relatives and making sure everyone eats. Most doulas also offer emotional and practical support postpartum, usually coming to your house to check on how things are going. Some have additional skills regarding breast feeding or nutrition, for example. This continuity of care is quite reassuring, helping a new mother adjust and building her confidence as a new mother, in a society where many of us live far away from our own mothers.

What to look for in a doula? What questions should you ask?
One of the best pieces of insider advice we can give you is to interview a doula to make sure the chemistry between you (your partner) and the doula is good. We also suggest you ask if they were familiar with your healthcare provider (and on the flip side ask your healthcare provider about their feelings about doulas to get a sense of their support in this matter). A good rapport between doctor or midwife and doula can go a long way to ease communication and provides a built in sense of trust. To that end, if you know you want a doula and don't have any recommendations, ask your healthcare provider if they they have recommendations. If they don't encourage the use of doulas, ask them why. If you feel strongly about having a doula, you may want to switch providers to one who supports your decision.

Of course, a doula’s education, training, experience and credentials are important too. Ask about any continuing education courses they take, and about their training and practical experience. All doulas should let you know what their backup plan is if they are unavailable and disclose their fees and refund policies. Usually the fees for inexperienced doulas is significantly less than for experienced doulas or doulas with multiple certifications. We've seen price ranges between $500-$3,000.

Do I really need a doula?
Doulas offer a really nice service. Further, clinical trials indicate that a doula's presence is associated with a reduction of cesarean rates, reduction in use of forceps, less requests for epidurals, shorter labors, increased success with breast feeding and increased maternal satisfaction among other things.   On the other side, some woman prefer to labor alone, and many hospitals and birthing centers have wonderful staff, it's just that you will not know who will be on service when you go into labor.

How do I find a doula?
DONA International (www.dona.org) is a highly respected doula organization and that offers certifications. The web site offers great tips on what questions to ask a potential doula and has a searchable database so you can easily find a doula in your area. You can also go word of mouth, getting recommendations not only from friends and family but from practitioners in allied fields.

We also like the Transparency in Maternity Care Project (www.TheBirthSurvey.com ) which has consumer ratings for practitioners, The Continuum Center For Healing (www.healthandhealingny.org), The Metropolitan Doula Group (www.metrodoula.com ), Doula Network of Long Island (www.doulanetworkofli.com ) and the Long Island Doula Association (www.lidoulas.com ) for referrals and general information.