Thursday, June 28, 2012

Finding, Interviewing & Choosing a Doula

We did it! After 30+ inquiries, six interviews, and countless emails later, we finally chose a doula! Although daunting and foreign at first, we figured it out and I feel like I have some great wisdom and advice to share with you. Here is a bit about how we went about finding a kick-butt doula.


First, maybe some of you wondering what the heck a doula is. Don’t feel dumb; you’re not alone. I think this is a great article that describes the role of a doula, but in a nutshell, a birth doula is a trained support person for the laboring mother and often, her partner. Some of the roles of a doula are to provide continuous emotional support, aide in breathing, relaxation, movement and positioning, help a mother become informed about various birth choices, advocate for the mother and help facilitate communication between the mother and care provider, and support and give breaks to the partner. Doulas are not medical professionals and do not perform clinical tasks like vaginal exams or delivering the baby. They are generally paid out of pocket, although I’ve heard that some insurance companies might cover doula fees with the right submission process. I’ve found that doula fees range from $400–$2000+, depending on how many births they have attended, what certifications they have, and their general reputation. Postpartum doulas are also common, but are very different from birth doulas.

I guess it started with recognizing that having a doula at our birth was an option. Honestly, I can’t even remember where or from who I first heard about doulas, but the seed was planted in my mind. I knew I wanted to at least research the possibility. So I began reading articles and talking to friends about doulas. It quickly became clear to me that this was definitely something I was interested in and wanted to try interviewing some doulas. But first I had to convince my husband. Frankly, it didn’t go over well. He wasn’t opposed, but he just didn’t understand why we would need to PAY someone to “take on his duties” during our labor and birth. He was seeing dollar signs and feeling infringed upon. I got it, but was annoyed that he wasn’t pumped at the idea. He agreed to do interviews though, knowing that at this point there was no commitment.

So, I began where most quests for knowledge begin—Google. I Googled the heck out of Seattle doulas and just began sending inquiries to anyone in our price range that didn’t have a sketchy website. I would simply write, “Hi there, I am pregnant with my first baby—due October 25—and interested in learning more about your birth doula services. My husband and I are doing our prenatal care through and planning to deliver with the Swedish Ballard Midwifery. I look forward to hearing back. Best, Kelsey.” I think my goal at this point was to contact everyone I possibly could, see who responded, and take it from there. I also contacted every doula who served Seattle via the website. And later found, which is where I would recommend anyone start. Unfortunately, I had already contacted enough people once I found Doula Match and wasn't interested in looking any further.

Much to my surprise, only about 40% of the doulas I contacted got back to me. What’s up with that? Even so, I was asking God to put the right person in our path, and trusted that if I didn’t hear back from someone then they weren’t the right match. After all, this person would be with us during some of our most intimate moments, moments that we are asking the Lord to be boldly present in. He gets to decide who is with us. I was not taking lightly the idea that our labor and birth could be a powerful ministry opportunity.

I began scheduling interviews, but hadn’t felt like I covered all my bases just yet. So I put out an SOS to my Facebook buddies and also my church’s online marketplace and was able to gather a few more recommendations. I was also given a personal recommendation from one of my co-workers for a friend of hers that was a doula and “gave amazing massages.” I sent a few more emails, scheduled a few more interviews and started thinking about what the heck I was even going to talk to these ladies about. I barely knew what a doula was, so how was I supposed ask them all the right questions?

I came across this helpful article with suggestions of what to ask a prospective doula. It seemed well rounded, so I copied and pasted it into a Word document and began editing to my needs. Some of the modifications I made were asking such things as, “Have you had any births with the Swedish Ballard Midwives?”, or, “How would you work with and involve Arthur?” I also wanted to make sure they were comfortable with prayer, scripture reading and talking about the Lord, so I asked each of them that too, but told them it wasn’t a requirement that they be Christian. I just needed to know that they would support us in our faith, even if they wouldn’t participate. The document looked good and I couldn’t think of anymore questions, so I printed a handful of copies, clipped them together and waited for our first interview.

The doulas are so sweet, they all want to come to your home, or at least offer to meet at a coffee shop by your house. I really appreciated this since we are so busy and it would have been a big hassle to have to drive all over the city during rush hour night after night. Our first interview was at our home. We started off each interview by greeting the doula, offering her water (although I kept forgetting to), and telling her that we had a set of questions we were asking everyone and would love to get started if that was okay. In addition, we also asked her to elaborate on anything she wanted to, fill in areas we might have missed, and ask any questions of us. The first woman was a hit; a total 10 out of 10! Arthur was sold and I was relieved that if no one else seemed fit, she would be perfect. He agreed.

I think Arthur's change of heart happened by actually meeting the doulas and getting to hear them respond to our questions. I would always kindly ask him in front of each woman if he had anything further he wanted to add or ask. Sometimes he would have a thought or question, sometimes not. It was essential that he participated in these interviews. Not only so he would be fully on board, but also so he could have a say in who he connected with. My intent is for our doula to be just as much of a support to Arthur as me, even if it's a less direct form of support. His opinion mattered immensely to me. It was also helpful for him to talk to friends and co-workers who hired doulas. Neither of us have come across anyone who regrets having hired one. Learning this was a huge push for him in the pro-doula direction.

We finished out our interviews over the course of a couple weeks. I didn't want to wait too long between interviews so everyone stayed fresh our minds. We had a goal of deciding by the end of June, which we have. I was told by one woman that I was definitely ahead of the game time-wise (just for reference). I would say anywhere between 20–30 weeks is a good time to choose a doula since most doulas hope to schedule their first prenatal appointment with you around 34 weeks, with another a few weeks after that.

Settling on one was a really tough decision, and we actually ended up vacillating between two doulas for over a week. Arthur made a really poignant statement one evening when he said that each woman we interviewed was so qualified and would make an amazing doula, but we needed to decide who we connected the most with on a personal level. I also had another conversation with a friend who encouraged me to think about who I felt most comfortable being vulnerable with and who I trusted the most to take care of me. Arthur was leaning toward one person, and me the other, although he was happy to defer to whoever I decided.

In the end, I decided to choose the doula who felt like a go-getter and had a really upbeat attitude about her work. She seemed like she won't be afraid to step up in the thick of labor, but is also flexible enough to step back during the times that Arthur is coaching me. She was the one that Arthur was pulling for, which was really settling to my heart, and also the one my co-worker recommended that gives amazing massages. It was such a joy to deliver the good news to her earlier this week, and now we are in-process of filling out paperwork, sending the retainer fee, and scheduling our prenatal sessions. I've always been excited for labor and birth, but now I'm over the moon and can't wait!

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Tuesday, June 26, 2012

Pregnancy: Week 23

I feel like I'm at the point in pregnancy that I'm going to enjoy the most. There is no imminent panic about the baby arriving soon, things are slowly but surely getting done, I still have time to read all the baby books I just bought, I actually look pregnant, and am overall feeling pretty decent. On the other hand, I am definitely starting to feel the achy woes of pregnancy. Some days my body feels so tired and heavy, while others I feel energetic and ambitious, although the go-get-'em days are becoming fewer as the weeks pass. Most days end with swollen feet and a back that just won't quit aching. I'm also experiencing some irregular Braxton Hicks contractions, but so far it seems there's nothing to worry about. Otherwise, very minimal whining coming from over here.

Did you notice we skipped week 21 and 22? We did. One of those weeks was out of nothing to say. However, the other half a week is because at my last ultrasound appointment our due date got moved up a few days, and considering I'm now starting to countdown the weeks I have left instead of the weeks I've been pregnant, it seemed like the right time to get caught up here. My posts always felt like they were a week behind with the way we did belly shots and postings, so I'm excited to mentally feel more real-time on this blog. My new gestational week mark is Monday instead of Thursday, so my usual Monday posts will be nice and accurate. Anyways...

LB is now the size of a large mango(?!)—over 11 inches and right around a pound (P.S. I've never seen a mango 11 inches long)! I keep saying to people that it blows my mind that I have a little baby a foot long inside of me. I know she's still tiny, but considering she was the size of a lentil not too long ago, I find that nuts! Despite her small stature, LB definitely likes to make herself known by her ninja kicks these days. My mother-in-law says that Papa K was a squirmy baby and she predicts our little lady is going to be just like him considering how much she's already moving.

Speaking of LB's ninja kicks, Papa K was FINALLY able feel her for the first time. The look on his face was priceless and I could feel him just melting with joy. It was one of the most special moments we've ever experienced together and a reminder of what a blessing our little girl is. I won't ever forget this.

Another side effect of Baby getting bigger is my stomach getting squished. Considering I already have trouble eating, this new development isn't helping the cause. I've taken to pretty much grazing all day long, and we've made a pact to keep the house stocked with healthy food like fruit, hummus, Field Roast and whole grains so I don't have any excuses not to eat. Check out this amazing online interactive exhibit (click that link) from the Museum of Science and Industry Chicago that simulates where everything shifts to as the baby and uterus grow. Woah! 

We had a Centering appointment this past week, which went great. Actually, I thought it was the best one yet. We got to hear LB's heartbeat, per usual, but this time she kept kicking the doppler and would continue to every time they tried moving it. Cute and hilarious. Here are some highlights/learnings from this month's class:

  • I got my Tdap (Tetanus, Diphtheria, and Pertussis) booster. This was the first shot in my arm I've had in probably 10 years. I was so nervous, but it ended up feeling like nothing! Blood draws hurt way more. I did feel like I got punched in the arm for a few days after though. Arthur signed up for his and will get it at our next month's appointment. Note: EVERYONE should get their Tdap. You don't need to be in special circumstances. 
  • Most people got orders for the gestational diabetes glucose test, but since I'm due at the end of the month, I will get my order next class. 
  • Our hospital does 2-hour fasting glucose tests. I asked about this and our midwife for this class, Heather, said that they choose to do it this way because it's diagnostic. In other words, I will get a yes or no answer from the test. Whereas the non-fasting 30 minute (I think?) test has to be followed up with a 2-hour test if you "fail." Often the 2 hour will show a "pass" when the 30 minute shows a "fail." This made sense to me.
  • During my 2-hour glucose exam I have to sit and do something quietly. No eating, exercising, or really anything else but reading and sitting. I can drink water. 
  • Gestational diabetes can be controlled through diet and exercise, and is mostly genetic, versus a result of poor eating and exercise habits. 
  • "Parenting" was the main focus of this session. We got lots of recommendations of child development books. It was fun to hear what everyone had to say. This was the first time I had really thought much about parenting...which was the point of having this as our topic. 
  • Who knew there were so many methods of getting your baby to sleep? Everyone is class was talking about the Ferber method. I have also heard about the No-Cry Sleep Solution and Healthy Sleep Habits, Happy Child
  • We discussed raising children in our current digital age (iPads, TVs, portable game players, etc) and how to keep a balance. I brought up that we intend to incorporate Montessori methods into our children's day-to-day as an analog way to counterbalance digital interactions. 
  • I got my first fundal height measurement (from pubic bone to top of uterus)! A solid 22"! 
  • I asked the midwife about the very irregular Braxton Hicks contractions I've been having and how to determine preterm labor versus Braxton Hicks. She said that if I have more than 4–6 in one hour and are consistent, I should call immediately. 
  • Some methods for calming Braxton Hicks': Hydrate, empty my bladder, calm down if I'm stressed, and lay down if I can. 

I immediately went home and ordered a stack of books off Amazon. I'm trying to be cautious about what we read since there are so many baby/parenting books out there on what and what not to do. But I feel confident in my choices so far: The Womanly Art of Breastfeeding, Ina May's Guide to Childbirth, Brain Rules for Baby, The No-cry Sleep Solution, and Solve Your Child's Sleep Problems (the Ferber method). Arthur is starting with Brain Rules, while I dive into Ina May's Guide to Childbirth. So far we're both loving our respective books.

In other exciting news, we painted the nursery this weekend! Actually, Arthur and my stepdad painted. It was a hoot to watch and so much fun to see the final result. The change is subtle, but just what I was hoping for. The nursery feels so much fresher with our new light warm gray walls and white accents. We also made a trip to IKEA to make some returns and get new items. We ended up leaving with curtains and a window seat that both work perfectly, among other things. Both of our favorite upgrade was the book shelves. Our friend Owen came over to help hang and assemble, which made the afternoon that much more fun.

We also found a screamin' deal on a used Boon Flair high chair with lots of extra accessories on Craigslist. I know, I know...I really need to stop buying things off our registry. It's hard not to snatch up a good deal when I know we most likely won't get everything off our registry and will have to buy some things in the end. I'm planning to stop until after our showers.

Finally, exercise has become more regular. I've been getting in a few walks each week, which feels great. But more importantly, I got my booty to prenatal yoga! I'm so glad I went and am eager to go back. There were women from 7–37 weeks along in class. I went with my sis-in-law who is 31 weeks. I can definitely see myself doing this until the end. Prenatal yoga seems like a good combination of relaxation and strength building. I was so sore the next day, which made me thankful I'm working on these muscles now so they are strong and ready to go during labor. I can't imagine what I would feel like postpartum without doing yoga.

A mish-mash of thoughts. Overall I feel less frantic these days, and more just interested in staying as relaxed as possible, focusing on the Lord and steadily tackling baby to-do's. It's not all perfect, but I'm enjoying our current cadence and rhythm.  

Weight gained: 8 lbs (official weight from my last Centering/prenatal appt.)
LBs shoe count: 5
Shoes that fit my pregnant feet: 2
Doulas I am torn between: 2
Baby kicks: Countless
Friends due within eight weeks of me: 4
# of us having girls: 5/5 (crazy!!)

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