The Practical Guide to Working with a Doula

Practical Guide to Working with Doulas Pittsburgh Birth Doula The Midwife Center

Although more expecting parents have heard about doulas, there is still a lot of mystery around the mechanics of how it actually works to hire and work with a doula. 

Many parents don't know that there are just about as many ways to be a doula as there are doulas themselves! There are differences in the way doulas take on clients, what doulas include in their service packages, and even how long doulas stay with clients during labor. 

Even with more families interested in the support of a doula during birth, there are a lot of questions about the logistics of how having a doula on your team actually works in real life.

We thought we'd write a post explaining how our own birth doula support process works, from booking all the way through the end of a contract.

Note: Things will look a little different if you book one of our planned c-section doula packages.

From A-Z, here's what it looks like to work with us as your birth doulas!

Light blue watercolor line Pittsburgh doula

The booking process

  • Contact us through our website to inquire about birth doula services. Please share:

    • Your estimated due date (to make sure we still have room for another family due around that time, since we accept a limited number of birth clients each month)

    • Where you live and your intended birth place (to make sure we serve your area)

    • Any other details you want to give us about yourself, your plans/wishes for birth, etc.

    • Any initial questions for us

  • We’ll send you an email and:

    • Answer any questions you asked

    • Share a few resources to help you learn more about us and our practice

    • Send a link for you to book a free Zoom consultation so we can get to know each other and make sure it’s a good fit

    • If we aren’t available for your due date or don’t serve your area, we will send you some referrals of other folks who may be able to support you

  • We meet for a no-cost, no-obligation consultation by Zoom.
    This 1-hour meeting gives us a chance to get to know each other. We normally have a few questions to ask, and parents often have many questions of their own!

    Here's a cheat sheet if you're looking for questions to ask in a doula interview!

  • We follow up after the consultation with a link to book your package online.
    If you decide you'd like to move forward with us, you can build your birth doula package, fill out a short intake form, sign your contract, and pay your deposit - all easy and online! We try to make this part as quick and painless as possible. (The deposit is half of your doula package, and the remaining half of the payment is due at 36 weeks.)

  • We reserve space for you for 1 week.
    Choosing someone to support you in birth is a big deal! Take your time, talk to your partner or other support people, and interview other doulas. We'll reserve your due date slot for 1 week while you decide. We’ll check in with you if we haven’t heard from you at that point.

  • Once you book your package, you officially have doulas!

 

Working together during pregnancy

  • Use us as a resource!
    Get in touch if you need any referrals or support, let us know if you have questions about something your care provider mentioned, ask us for recommendations for continued reading on a certain subject... we're here to support you however we can!

  • Schedule your first monthly check-in visit
    Our monthly virtual check-ins arose out of necessity in the beginning of the pandemic, but our clients loved them so much we made them permanent! In your booking confirmation email, you’ll get a link to keep on hand so you can book these 1-hour visits throughout pregnancy.

    Some of our clients like to save up their questions for those sessions, and others like to text us as questions come up. (This is a HUGE plus to booking us earlier in pregnancy! The longer you have doulas on your team, the more support we can give you.)

  • Start creating your birth plan with [M]otherboard Birth.
    We include a free membership to the amazing resource [M]otherboard Birth for all our birth doula clients. We love the simplicity of their birth plan template and the collaborative nature of their approach. It’s a wonderful resource for learning more about your options for birth too!

    We’ll share a little walkthrough video to show you around the [M]otherboard tools so you feel comfortable getting started. Then when you’re ready to build your boards, let us know and we’ll send you an invite link to sign up for free.

  • Get your birth preparation classes on the calendar.
    Two private classes are included in your package. We’ll send you booking links for both after you register so you can schedule. Many of our clients like to do their Birth Basics class fairly soon after booking with us, so that can be a great place to start. 

  • Schedule your infant sleep Q&A session
    Marlee is our resident sleep consultant. This 1-hour session is a chance for you to ask your questions about infant sleep, find out more about babies’ biological sleep needs, and learn some general strategies to help everyone in the family get more rest.

 

As your estimated due date approaches

  • Schedule your in-person prenatal visit around 35 weeks.
    This visit is usually an hour or two and takes place in your home. You don't need to prepare anything in advance! We normally take some time to catch up, talk about any new developments in your emotional or physical experiences, and then spend time preparing together for your birth.


  • Pay your balance by 36 weeks.
    We’ll email you a reminder - again, quick, easy, and online!

    If you want reimbursement from your health savings account (HSA) or flexible spending account (FSA), let us know so we can send you a specialized receipt at this point.


  • We are on call for you 24/7 starting at 38 weeks of pregnancy.
    We'll set up a group text message or WhatsApp thread with both of us, you, and your partner (if applicable) so everyone is in the loop and easily reachable in preparation for labor.


  • Keep in touch.
    At this point, it's hard to give us too much information. You can send us updates after appointments with your care provider, let us know about shifts and changes you may be feeling emotionally or physically, and of course tell us if you're starting to feel contractions or other signs of labor.


  • Let us know about any signs labor may be on the way:

    • Loss of mucous plug/bloody show

    • Any consistent contractions (even if they're pretty far apart)

    • Diarrhea/flu-like symptoms

    • Amniotic fluid leaking or releasing with a gush


  • Let us know about changes to your care plan.
    If your plan of care for birth changes please let us know, especially if any procedures or medications are suggested to induce labor. If something like this arises, we usually schedule a phone call to get up to speed, talk about your options going forward, and answer any questions that might be coming up for you. If you want to debrief after an appointment with your care provider, just ask!


  • If a cesarean birth is scheduled in advance:
    You have the option of having us come meet you for pre-op and be there during birth and the first several hours postpartum, or exchanging that time for some extra postpartum support instead.

 

When labor starts

  • Early labor can last awhile.
    And by that, we mean anything from hours to days. We'll be keeping in close communication by text when labor begins, and can offer suggestions for things you can do to keep your body rested and your mind distracted (one of the best tools in early labor is to ignore it as much as possible!)


  • Don't give labor more attention than it demands.
    Usually our clients spend time with loved ones and try to labor at home for as long as is physically and emotionally comfortable for them. We will be in touch by text and phone to support you from a distance during this earlier part of labor.


  • When something shifts and you find yourself in need of more support than you have available to you at the moment, call us.
    Yes, we do mean CALL! We have our phone volume up at all times when we’re on call but our texts are always silent. When you’re ready for us to join you in labor, a phone call is the way to guarantee we’ll get the memo!

    We'll plan to meet you at home or birth place, wherever you are at the time. We share an on-call schedule, so whichever one of us is up at the time you're ready for us will come join you.


  • We will provide continuous support during labor.
    Sometimes that means we need to switch places to make sure you have a well-rested person with you. This is always done as unobtrusively as possible. We usually like to spend a little time with you together before the other person leaves, just to make sure you're comfortable with everything.

    Some doulas set a time limit for how many hours they will stay with their clients during birth (sometimes called a "12 hour clause"). We do not include this time limit in our doula contract and instead provide continuous support during labor.

    Read here to learn more about how doulas support partners specifically.


  • We will stay with you for a little while after baby is born.
    Normally this is between 1-2 hours after birth. to support you through the immediate postpartum (which can be quite involved). We can help initiate nursing if that's your goal, answer any questions you might have, and help set the tone for a restful time after birth.

    To learn more about our role during this period specifically if you're planning to birth in a hospital, check out our blog post: Little-Known Ways a Doula Can Help after Your Hospital Birth.


Just a reminder - we support all types of birth without judgment. No matter your preferences regarding pain management, medical procedures, or anything else that might come up during labor and birth, we're here to support you through the process.

 

After birth

  • We're still your doulas! Get in touch if you have any questions.
    Many times parents have questions in the first few days after birth - don't be shy! We're here to help.

    If you’re having any lactation challenges, let us know! Marlee is often able to visit clients in the day or two after birth for some additional feeding support.


  • Let us know if you need additional resources.
    There is a lot of help and support available for new parents in Pittsburgh, and we're always happy to send you our favorite resources if you need them.


  • Extra postpartum support
    If you booked additional postpartum support to your package, let us know when you feel ready for that to begin! Some families like to have their first visit in the first week of baby's life, others prefer to wait a while.


  • Lactation & feeding support
    Remember you have a postpartum visit with Marlee to focus on any challenges you may be experiencing with lactation/feeding. Reach out anytime with questions, and Marlee will help you decide when your in-person lactation and feeding support visit may be most helpful.


  • Schedule your virtual postpartum check-in visit around 6 weeks after birth.
    We allow our clients to take the lead when it comes to scheduling this visit. This is typically 1-2 hours and offers an opportunity for us to catch up and talk about your birth (if you’d like). It’s a great chance for us to reconnect and wrap up our time together.


Most importantly - let us know how you're doing! We love to hear from our clients, and we never say no to family pictures!

Light blue watercolor line Pittsburgh breastfeeding consultant

That's our process from start to finish! We hope this helps you get a better idea of the types of support we can provide throughout pregnancy, birth and early parenthood.

Let us know if you have any questions for us, and get in touch today if you want to work together!


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Megan Malone-Franklin

Megan Malone-Franklin (she/they) is a childbirth educator and birth doula and has been a birth worker since 2014. Megan supports families alongside her wife, Marlee in Pittsburgh, PA. Together they offer skilled, compassionate classes and doula services during pregnancy, birth, and beyond, with an emphasis on supporting people with marginalized identities. 

https://riverbendbirth.com
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