“The Birth Less Traveled” Birth Doula Service

planning birth palm beach wellington jupiter boynton delray doulaTwo roads diverged in a wood, and I,

I took the the one less traveled by,

And that has made all the difference.

-from the poem The Road Not Taken, by Robert Frost, 1916

Birth is guaranteed to be one of the most significant rites of passage in your life.  Nevertheless, only 6% of birthing mothers have a doula attend their labor (according to a 2013 Listening to Mothers national survey).  Why do these outliers choose to hire professional birth support?   What difference — if any — does a birth doula really make, anyway?

A significant difference, actually.  If you’re thinking of taking the “birth less traveled,” to modify Robert Frost’s words, then you’re adventuring into the untamed wilderness of natural labor, and yet, you carry a peaceful conviction that rejecting the pressures of the contemporary medical model will indeed be worth it.  Parents who choose this path are informed of the healthy outcomes associated with natural birth, and know that research has found doulas to significantly reduce the incidence of risky cesarean sections, instrumental births, and medicinal pain relievers.

Perhaps more important than these measures of health outcomes, however, is the truth that birth can be richly satisfying, and even healing to the soul.  Studies find that mothers who labor without the continuous support of a doula, are 45% more likely to have negative feelings about their birth experience.  When you hire me as your doula, however, prevention of poor health outcomes and negative feelings is secondary to my obsession with helping you experience natural ecstasy.

Birth is challenging, but you were made to do this!  With my warm heart, soft touch, and devotion to your family, you know that you will have a reliable advocate and supporter, so you can travel through labor with poise.

When you’ve contemplated what you want your birth to look like, let me know.   Let’s do this together.

What you get from me, prenatally, during labor, and postpartum:

  • Before labor begins:
    • 1 hour complimentary consult / interview
    • 4 hours (1-2 meetings) of private prenatal gatherings are included; additional meetings are available for a fee.  Prenatal meetings are personalized to your particular interests.  You are welcome, but not limited, to use this time for any of the following:
      • dialogue about your pregnancy and birth concerns
      • draft a birth plan and/or postpartum plan
      • practice labor techniques
      • create birth art
      • balance your muscles in preparation for birth
      • prepare your children for what they may witness and how they may be supportive, if you have children who will be present for the birth
    • Access to a library of physical and digital resources
    • Unlimited support via phone and email
  • During & immediately after labor:
    • 24/7 phone support for questions, encouragement, and suggestions as soon as you think you may be in labor
    • Continuous*, physical presence as soon as you decide you are ready for me to meet you at your location.  During my continuous presence, I will provide physical, emotional, and information support, as well as advocacy, as needed.
    • Guaranteed back-up doula in the rare event that one is required**
    • Photography of your labor and delivery on your own personal camera (I will first prioritize physically supporting you during labor, but often am physically free to take photographs)
    • Note-taking of memories and quotes from your labor
    • Complimentary birth pool set up and break down, if you choose to use a birth pool
    • Postpartum and breastfeeding support for up to two hours immediately after the birth
  • During postpartum:
    • Unlimited support via phone and email for the first 100 days
    • One in-home 1.5 hour postpartum follow-up meeting, to debrief the birth experience, offer any desired help with breastfeeding, get feedback, and, time allowing, give you a chance to shower or rest while I take care of some household or baby care tasks.
    • Additional postpartum visits may be arranged for a fee.
  • $125 discount on the birth doula fee applies for repeat birth doula clients

What I expect from you (besides financial obligations):

Beginning in April 2019, I will only attend births for clients who have attained a comprehensive education in childbirth, as detailed below.  Any of the following are acceptable fulfillments of this requirement:

  • Previous experience giving birth vaginally with no pain medications, supplemented with cesarean birth education (see note below for more details).***
  • Attending a comprehensive childbirth education course.  My recommendations are here.  Generally, a class lasting 12+ hours and spanned over 4 or more weeks will suffice, if supplemented with cesarean birth education.***  Comprehensive childbirth classes completed during a previous pregnancy may be used to fulfill this requirement.
  • Attending less comprehensive childbirth education courses (<12 hours and/or not spanned over time), and supplementing with consumption of books, documentaries, podcasts or other sources of information that I approve as adequate to fill in gaps from your childbirth education course.
  • Recent experience working as either a labor & delivery nurse or a doula
  • Being credentialed as a certified doula, childbirth educator, midwife, or OB/GYN

***Pick one of the following for cesarean birth education (clients who also are birth workers are exempt):

  • a previous experience birthing by cesarean section
  • a cesarean birth workshop, led by me
  • reading 3 specified chapters from Ancient Map for Modern Birth, by Pam England.  The subjects of these chapters are: (1) long and difficult labors, (2) informed consent, and (3) cesarean birth.
  • self study, per your request and on a case-by-case basis
 

*In rare circumstances that I am at your birth for an extended period of time, a back-up doula may be called in to trade places with me and bring fresh energy to your birth space.  This is a decision we will make together and only when necessary.   In fact, I have not yet exercised this option, but do want you aware that it is a possibility.

**For families utilizing the Need-based Adjusted Payment (NAP) scale (detailed on the bottom of my services page), I may, unfortunately, be unable to guarantee back-up doula coverage.  This is due to the low cost paid for services, which may not be enough to cover a back-up doula’s fees.

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Questions & Answers
Where do you attend births?

I attend births at almost any location in Palm Beach County, Florida.  Exceptions include the following: I do not attend home births if cigarette smoking occurs inside the home, and I do not attend planned births at West Boca Medical Center or at Lakeside Medical Center — unless emergency necessitates a transfer to one of these locations. 

Would you support a free birth?

Ooh, do I have some thoughts on this topic!  I’m biased, for sure, as I accidentally had a “free birth” (birth with no medical oversight) with my youngest child!  I know that other moms who have had unanticipated free births are sometimes traumatized by the experience, and for that reason, I think that every expecting couple needs to prepare for all possibilities in birth, including free birth.  I, personally, was stunned with wonder in my free birth, and am convinced I would plan for a free birth with intention should I ever become pregnant in the future.  It should not come as a surprise, then, that I have few objections to supporting free birthing parents.  These are as follows: (1) I do not attend planned free births for parents who have not prepared for the experience with adequate self study and childbirth education classes (this we can discuss in more detail in person), (2) I do not attend planned free births for parents who smoke inside their home, or who use illegal drugs, or who heavily drink alcohol; (3) if you have received any indication that your baby may be on a path to fetal demise, I will only attend a planned free birth if you have a medical care provider such as a midwife or doctor present; and (4) if you have received any indication that your health is in jeopardy — due to preeclampsia, gestational diabetes, or any other potentially life-threatening condition — I will only attend a planned free birth if you also have a medical care provider present.   

What exactly do you do during a birth?

I am asked variations of this question by expecting couples more than any other question!  The answer, however, is not so simple, because every birth is different.  Sometimes, believe it or not, I’m sitting down the hall in the hospital waiting room, chatting with your mother in law and / or praying and journaling.  Usually, though, I am demonstrating a massage trick for your spouse to try with you, or I’m wrapping a rebozo around your hips to try to shimmy your baby into a more favorable position.  I do a lot of “hip squeezes” and counter pressure at the back to aid with relief of pressure.  I get coffee for your partner, if the smell is not repulsive to you during labor.  If you experience nausea and vomiting in labor, I’m there to catch your losses and offer some peppermint essential oil.  When you need to reset your breathing pattern to be more effective, I’ll coach you through it.  I’ll offer you encouragement when times are tough, plus sips of your chosen beverage in between contractions.  If you and your husband mutually agree that he would be more helpful to you after taking a nap, then I’ll remain as your helper until he is more restored.  When circumstances arise that seem to contradict your preferences for birth, I’m there as an advocate and can help you and your partner have a strong voice as well as get the information you need to make any pertinent decisions.

Do I really have to take childbirth classes? Can't you just teach me what I need to know?

Do you think it is acceptable to merely hire a sherpa for your ascent up Mount Everest, and skip the experience of summiting smaller peaks first?  No.  A climb like that requires skilled guidance and training.  Birth is no different.  When you hire me, you have your sherpa.  You still need your training.  Trust me on this — knowledge and practice are powerful, and my clients who have the most positive experiences in birth are the ones who invested their time prenatally preparing for this.  I refer out to other childbirth educators because I think very highly of some of the existing classes, and it would require much more time than the approximate 4 hours we have in our prenatal meetings if I were to teach you everything myself.  However, you are always welcome to schedule additional prenatal meetings for $25 hour if you would like to spend extra time together preparing.    

I plan to have a natural birth, so why do I need cesarean education?

I would be foolish to believe that just because I have yet to have a client give birth by cesarean, this will forever remain the case.  When a cesarean becomes necessary in a true emergency situation, I believe it is a disadvantage for families to have had no preparation for what to expect.  Accepting surgery as a possible means for giving birth and becoming aware of what the process will be like is not necessarily a guarantee that the surgical birth experience will be positive, yet it may make you feel more empowered and brave, and it is unlikely to be harmful.  Some theorize that thinking about possible nightmare situations will predispose you to actually having those experiences.  I prefer the stance that entertaining all possibilities helps you conquer fears ahead of time so you can feel more free to surrender to the natural process of labor.    

Do you have a birth philosophy?

Every expecting mother deserves to know her prospective doula’s uncensored perspective on birth.  I definitely have a birth philosophy, and will not shy away from sharing it with you.  Feel free to read my convictions about birth here.

Will my insurance or HSA/FSA pay for this?

Check your policy, but the general answer is: yes, often, but not always.  With an HSA/FSA, the process may be as simple as swiping your HSA/FSA card, but other times, multiple attempts to seek reimbursement may be necessary.  In any case, I will do everything in my power to help you use your tax saving vehicles or insurance to cover the cost of my services.

How much does it cost to hire you? Is there a payment schedule?

In most cases, I collect a $250 retainer fee when you reserve my services, a $250 installment by 37 weeks gestation, and then a $300 balance before I leave the birth ($800 total).  However, some families prefer the simplicity of only one or two payments, which I am more than happy to accomodate.  

There are cases when a family may pay less than $800 for my birth doula service.  If your household income is less than 250% of the federal poverty line and you hold few assets, then you may apply for a need-based adjusted payment (NAP).  The NAP scale and other financial questions are addressed at the bottom of my services page.  

How is having a doula different than having my mom, sister, or bestie present for the birth?

Having obtained substantial training as a doula, plus having the experiences of birthing three children and attending births professionally since 2015, I bring a mature understanding of what language and actions are most helpful to the birthing mother, and I am up to date on what evidence based research has to say at each juncture where you may have decisions to make.    I’m also a bit more emotionally at ease in labor than most of your relatives or friends will be, because they have watched you grow up and have much to lose in the rare event of any emergency.  

Can't my labor & delivery nurse or midwife be my doula?

Research suggests that the benefits of continuous physical support during labor are greatest when they come from a person who has training and experience in childbirth, yet who is not on the medical team.  Because I am not on the medical team, but rather am hired independently and directly by you, I don’t have to be distracted by medical record keeping, and also have no obligations to hospital administrators, state licensing boards, insurance companies, or even just the other laboring moms down the hall.  The end result is that I have the freedom and responsibility to just honor your wishes. 

I think you're the doula I want! What is next?

Yay!  Get in touch with me by phone (561-827-3263) or email (tremendoulas@gmail.com) so I can check my availability and put your estimated date of delivery on my calendar!  I’ll send a copy of my contract to you, and we will plan our first get together to become better acquainted and prepared for your upcoming birth.

I have questions that aren't answered here. How do we get in touch?

Email me at tremendoulas@gmail.com or call/text 561-827-3263 during daylight hours, Monday through Saturday.  (I may be slow getting back because I may be serving a family in labor, however, I will get an answer to you when possible).  


Schedule your complimentary interview