What should I look for when choosing a doula?

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When exploring the use of a doula plan to visit with them over the phone. Ask them to tell you what they usually do and see if it matches with what you are looking for. If conversation flows well then set up a consultation visit to get to know each other and make sure everyone is comfortable with each other. What a doula should not do is tell you to change your location/provider/birth choices without being asked. If you ask for recommendations we can give you locations/providers that we enjoy working with. But honestly, I have had great experiences with a variety of providers and locations. It is your relationship with your provider that matters the most. You are looking for the doula that you are able to relax with and trust. Here are some questions you may want to ask. Trust your heart and you can't go wrong! Some questions include:

*What training have you had? Are you certified?
*How many births have you attended?
*Why did you decide to become a doula? What is the best part?
*Have you worked with our provider? At our location?
*How do you see your role?
*May we meet to discuss our birth plans and the role you will play in supporting me through childbirth?
*May we call you with any questions/concerns both before and after the birth?
*When will you join me in labor?
*What postpartum services do you offer?
*Do you work with one or more back up doulas for times when you are not available?

May we meet them? Choose our own?
*Do you have an all-inclusive fee or by the hour? (Never pay by the hour!)
*What are your fees and refund policies?

*What are your favorite labors?

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I am planning on using an epidural do I need a doula?

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Absoluetely! A person with an epidural still needs and deserves sensitive and appropriate labor support, because emotional distress and anxiety do not necessarily go away when pain is alleviated. I can help you find the perfect time to get your epidural, keep contractions manageable until the epidural, keep you calm and still during placement and cheer on the sweet nectar of epidural as your contractions get shorter and shorter until gone! I still provides emotional support, reassurance and information as labor progresses. I help you remain focused on your labor and baby. I help with favorable positions for pushing and how to push effectively. The doula's role is still to nurture and protect the woman's memory of the birth. John Kennell's recent study found that even when the use of epidural anesthesia is very high, the presence of a doula reduces the cesarean section rate. I still provide a written account of the experience, take photos, get breastfeeding off to a great start and offer postpartum support. An epidural can be a great option for many reasons--- to help labor progress, to give baby room to move and drop, to rest after a longer early labor, to allow the person to be comfortable and present during labor and birth, etc. My clients are evenly split with those planning on the epidural and those who are not. The epidural is just another tool to use if needed or requested.

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I am hoping for a low intervention birth. How can you help?

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It can be very helpful to have a vision for how you want to bring your baby into the world. Birth is a crazy good system. If baby's are in a favorable drop down position, labors tend to move smoothly and contractions remain manageable. It is not the pain of a contraction but rather the exhaustion that can make them difficult to manage. We create an early labor plan to maximum rest and conserve energy. I provide a much more extensive when to go the hospital list that makes that decision black and white and allows you to labor comfortably at home in the early phase. We work with your OB/CNM to get standing orders that support your vision, get your wishes charted ahead of time so that everyone is on the same page when you have baby. Growing up with an OB nurse/House Supervisor mom gave me an inside edge on how to navigate the hospital world. We work on using the hospital stuff to your advantage and not your disadvantage. Your partner and I work together to keep you comfortable, hydrated, changing positions and breathing. By prioritizing comfort and balancing active vs restful positions we work to bring this baby into the world as efficiently as possible. And then slather in a whole bunch of support, encouragement, massage, counter pressure, reassurance, empathy and an unlimted supply of eternal optimism-- this is how we support you through labor! And then we see what happens. Babies will always "tell" us what they need. If labor is moving slowly, exhaustion is creeping in or pain is moving from manageable to unmanageable then we adjust our plan as needed. We will look at the big picture, see where you are at in labor and then make a decision. I like to slow the moment down so you can make decisions in a non panic state and feel confident in your decisions. I trust that you know where you are in labor mentally and physically. If we need to do an epidural to rest, regroup. make more space for baby so baby can move down then we do that. There are a million ways to healthy baby and healthy mom. And I trust you to create your own story.

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What have you learned by doulaing over 500 babies?

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When I first started doula-ing and teaching everything seemed very black and white and had a direct cause and effect. If we do this then this will happen. Try this then this would happen. But in reality birth does not work like that. There are too many variables. Families are being told "if you have to be induced you will have a cesarean." When in reality, with a patient provider, a cervix that is nudge-able and the right softening meds we deliver most inductions vaginally. "If you get an epidural you will slow things down." When in reality a lot of times it speeds things up, allows a baby room to move and a family to rest. Timing is really more important that anything else (And that doesnt mean you have to be writhing on the floor in agony-- I NEVER want to see that! I have a true appreciation that birth is a crazy good systerm. Birth works amazing the majority of the time. But Mother Nature is not fail proof. And I am thankful we have ways to nudge a baby through labor if needed. A uterus is just a muscle. And it gets tired. There are complex hormonal systems at play. Babies have free will; they move whenever they want and however they want. But we have gravity on our side. And science. And intuition. and generations of wisdom passed through each birth. When we can draw on everything available to us, we can help families make the best decions for their birth. I have learned that at the end of the day, after baby is born, if you look back on your choices and decisions of the day they will all make sense. Sometimes a decision seems a little out of place or unexpected but I wholeheartedly trust that it will make sense and will be a great decision when we see the day play out. There are truly a million ways to healthy families and healthy babies. And at the end of the day my hope is that you guys look at each other and say, "That was a great day!" Because baby days should be great days. But more so, you didn't feel steamrolled through the process, you understoon what was happening and you made the best decision for you at the time. So even if your world got flipped once or twice, you can still say, "That was a great day! I mean we would have rather avoided that and that and oh yea that. But we understand what was happening and are happy with our decisions." That is a great baby day in my book!

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Why is certification important?

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I value certification for numerous reasons. First and foremost it demonstrates a committment to you, the client. It shows you that I am continuting my education. It gives me a framework to work within-- having a clear written scope of practice and code of ethics -- keeps me in my lane. It allows me to serve you, work well with your care providers and not overstate my duties. The most important reason is to give you recourse. If I ever step out of my lane you have an organization to go to and file a complaint. Care providers can report negligent behavior. Without certification there is no way to hold doulas accountable or protect their clients. I certify with DONA International. They are the original doula organization. They have an outstanding board of directors, are non profit, promote the health and safety of families. collaborate with LAMAZE to advocate for maternal and child laws and value education as a key tenet to doula work. I am proud to say I am a DONA Doula!

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How well do you work with the OB, CNM, Nurses?

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I like to earn my keep with everyone! I have had a partnership with Women's Health Associates for the last 17 years-- teaching prenatal classes, providing birth doula services and breastfeeding support for their patients. Seventy five percent of my clients are direct referrals from local OBs and CNMs and am routinely recommended by 2 local JOCO hospitals. A cohesive team only makes birth better.

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How does payment work?

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After you accept the proposal/sign agreement a non-refundable deposit of $300 is due to secure your due date. I will send you an open invoice where you can pay any amount at any time until paid in full-- essentially creating your own payment plan. I am flexible on payments-- some pay deposit ($300) and then the rest in full, others split up the payments along the way or you can pay in full. FSA/HSA accounts will pay for certified doula services. Currently KS/MO insurance does not cover doula services. A $25 discount will be applied if paid in full prior to baby.

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When would you use Allison as a back up?

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I ALWAYS try and make all of my own babies! I do everything in full disclosure-- if I have an induction scheduled for Friday I will call and let you know, "Don't have a baby on Friday!" ;) If I am in a labor and you are starting I will have Allison start your birth and I will join in as soon as 1st baby is here. I also try and do most of my births at the same hospital to make life a little less stressful. Advent Health Shawnee Mission and Overland Park Regional are my two favorites! Occasionally I have to teach a class/attend a conference for work but will let you know as soon as I know. And then there's life--- if I get sick/my kiddos have a program/family emergency--- I will let you know asap. But we try and minimize all of those things! And as much as I can I have my life scheduled out 9 months in advance-- but babies are a bit unpredictable! But I have full faith in Allison should you need her.

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How exactly does virtual doula support work?

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Providing virtual birth support involves a lot of ground laying work before you give birth (ideally). We do a Prep and Pep review over the phone/video to walk you through when to go to the hospital, what to expect when you get there and laying down a game plan for labor. We are essentially sharing all of our tips, tricks and phrases so your support person can feel prepared to serve you in labor. We review the most common positions people do in labor, comfort measures, strategies to work through contractions, knowing when is the perfect time to do an epidural (if needed/requested), pushing strategies and anything else that may be helpful. We created a Cliff Notes handout and a Comfort Measure Checklist for quick reference too. On baby day we will remind you of the guidelines of when to go to the hospital or call provider. And then we are available throughout your labor either by text, phone or video. We have found most of our communication runs through text so your partner has instant access to any questions/concerns/needs without distrupting the labor flow. We have been doing phone calls via speaker when any decision points come up that you both want to talk through (ie. starting pitocin, breaking water, etc.) or to help work through contractions/pushing/etc. with voice. And finally, video works great for demonstrating positioning or comfort measures with a quick visual. And baby is here we will continue to be available for any recovery, feeding, nursing, newborn questions. Being a board certified lactation consultant I can pick up your breastfeeding care when you get home. You would be surprised how much we can work out over the phone (as I have been doing lactation counseling for WIC for 7+ years via phone and text). We will check in to make sure your transition home is smooth and everyone is doing well mentally and physically. And when this pandemic has subsided we are doing a mini session family photo shoot so we can meet these sweet babies!

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