Do you doula?

I grew up in Ohio and had never heard of a doula until I moved to the east coast.  I know a handful of people who have used them and know a friend of friend of a friend’s cousin who is one, so I wanted to understand more about what they do. I vaguely remember that there may have been a Frazier (Best. Show. Ever) episode on doulas. I reached out to Melissa Carrick who is a doula and educator in West Seneca New York for some helpful Q&A.   

You can find Melissa here:

I have heard of birth doulas, post partum doulas, etc.  What types of doulas are there and can you give an overview of what services they provide?

* The term Doula is Greek for “to serve.” I literally use the term for anything! I have a business coach who is my business doula. A fitness coach who is my fitness doula, etc. What we hear and see most commonly are birth and postpartum doulas. A birth doula provides birth preparation and support, usually accomplished through two or more prenatal visits which include options for birth, birth planning, and coping & comfort measures during labor; continuous labor support throughout; and usually one postpartum follow up visit. A postpartum doula helps the family after birth to assimilate and integrate their “new normal.” They may help with such things as feeding and sleeping patterns, baby care and soothing, and providing additional resources of any mood disorders are a concern. In both cases, doulas do not replace the partners or take over, but rather give the families the tools and hold space for them to empower themselves in any situation. There are also end of life doulas that can help people and their families as they near end of life, to help the transition and the coping process be more comfortable, peaceful and respectful. 

How do you choose the right doula – how do you know if they are right fit for you?

When choosing a doula, consider the skills that are important to you, rather than their experience. A doula should be kind, genuine, respectful of all choices, compassionate, caring, empowering, a great communicator… Experience in birth is important, for sure, but you want to be comfortable, uninhibited, and yourself around this person. Inviting someone to your birth space is a big deal. Are you comfortable making noises, being naked, being vulnerable around this person? It’s more of a feeling that you get when you meet with them. If you have any special circumstances or high risk consideration, it may be valuable to ask their experience. Ask open ended questions like, “how would you handle….?” “How will you support me and/or my partner, or include my partner…?”

What type of training do doulas typically have?

Training may vary. There are many online certifications, and some in person trainings. It usually involves doing some amount of “book work,” and reading, the learning part; in addition to The practical part- taking a childbirth education class, a breastfeeding class, finding a mentor to shadow 3 births, and then leaning on that mentor as you begin to take on your own clients. Currently there are no regulations on doulas so certification is not yet “required.”  You may find a doula that’s been supporting births since they witnessed their siblings being born! I believe it is a calling that seeks you out!

Does the doula’s role change if you have a c section, whether scheduled or emergency?

The underlying role does not change. That is, to provide comfort, support, and coping strategies for the family. If it is planned, the doula and family have time to mentally prepare (which is all birth! Birth is more mental prep than anything!) and discuss options to have a gentle or family oriented cesarean, which would include a clear drape or cropped drape to see the baby as they are being born, skin to skin in the OR, the family staying together throughout the process, music, essential oils, delayed cord clamping, etc. If it becomes emergent, the doula will have already discussed the plan for this ahead of time during the prenatal education sessions. Hopefully the family has planned and understands the options and urgency that arise in this situation.  I encourage the partner and myself to stick right by the moms side as long as possible to keep our attention on her, keep her grounded and focused, as all other attention is on getting things moving quickly.

If you are hiring a doula, at what stage in pregnancy should you start interviewing them?

Anytime!! It’s never too late or too early. I’ve had people hire me at 8 weeks at 36 weeks! Those that hire early don’t usually schedule a first visit until the second trimester and the second visit in the third trimester, but every doula does things differently.

Do doulas work in groups  -or what happens if you are not available when I go into labor? 

A lot of doulas are independent contractors, or work for themselves, but often have back up doulas in place. Some doulas work for agencies or collectives where there is a partner system and the two (or more) doulas share an “on call” schedule, and rotate.  This is a great question to ask when interviewing: “do you have back up? Vacations planned? How many births do you take a month? Can I meet your back up?” 

What are the typical fees for services performed?

Fees can vary. A lot of “doulas in training” offer lower rates until their training is complete. Some students offer free services until qualified by their certifying company. On the low end, average could range from $300-$600. For more experienced doulas, it may range from $800-$1500. In larger metropolitan areas like NYC, they may be well over $2000. Please consider the prenatal and postpartum visits, the on call nature of the job, the unpredictable hours and continuous support throughout labors that may last upwards of 48+ hours. Invaluable!

Have you hired a doula or are you a doula? We’d love to hear from you.


Pregnant over 40

Have you ever woken up and asked someone when did you turn 40?! And have them answer, “3 years ago”. Does this happen to anyone else?! I didn’t mean to get this old, but I guess it’s better than the alternative!

Because first off, I didn’t want to have kids too young. Married at 28, just a baby I thought, and to an exciting man who loved to travel and live life to the fullest, and with both of us being career focused, it just seemed silly to rush into kids. Then because when it seemed just the right time to have baby #1, you know like 33.8 years old on the nose, (cause you think it’s gonna just happen right away) it wasn’t easy, I woke up one day pretty old and still childless.

I had my first bring home baby, sweet son #1 in May 2016, exactly 4 years after my first RE appointment, at 39 years old. I had my second baby, the sweetest little man ever, in October 2018, and celebrated my 42nd birthday the day after he was born. Did I mention he was naturally conceived? Oh the irony.

Where I live, just north of NYC, bordering the Bronx, if we see a young girl with a stroller we assume she is the au pair. I am not an anomaly at all. A very unscientific Facebook poll in a local mom’s group concluded that 37 was the average age for first baby around me.

When pregnant I felt tired. I was never very sick. I felt pregnancy brain and some strains and pains here and there, but ultimately never felt what I imagined it to be. It didn’t hurt that I work from home and can essentially wear pajamas all day if I need.

I don’t have anything to compare to, being pregnant over a certain age vs being pregnant in my 20s, but I spoke to some women in my groups to get their take.

Vic G. had 3 pregnacies, at 28, 31 and 43. At 28, it never crossed her mind that anything could go wrong and she told everyone early on. By her last pregnancy, she held it in till 23 weeks due to a string of 10 miscarriages. I can relate to that so much. After our twin loss, I wouldn’t even use the P word (pregnancy) till we made it to viability. As we age our chances for miscarriage go up and up, and the heartbreak of 10 is unimaginable.

Surprisingly, Vic G. also found her last pregnancy to be the easiest. She was fit and healthy and in better shape than before. But recovery from birth was more of a challenge, easiest she reports, at 31. This makes total sense to me too. I don’t bounce back from cold as well as I used to, let alone hours of labor!

Interestingly, with advanced age sometimes comes a specialist. In my area you must meet a couple of criteria to qualify (though there may be a certain age when you just qualify). The criteria are above 35, used fertility treatments, carrying multiples, diabetic, etc. The specialist, a maternal fetal specialist or perinatologist is essentially the baby’s doctor while they are in your womb.

Having an MFM in addition to an OB is golden. It means more visits, more scans, a bigger team looking out for you. I was thrilled to have the extra set of specialized eyes. Should anything come up that you need to be prepared for, you want an MFM you trust coordinating the care of your baby.

My last point about advanced maternal age is to focus on attitude and appearances. I know I am lucky to be in the community I am where I fit in with the other moms trying to cover our greys and schedule our Botox before daycare pickup, but in many parts of the country, that isn’t the case. Being a mom that is in any way not the norm in your area can be isolating.

Janet spoke to me about her experience. She is in a community of predominantly young families and often feels left out. At a birthday party for a classmate of her 5 year old, she was asked if she was the grandmother then left out of all the small talk. Her advice to others in her shoes is to keep trying. She kept her head up and eventually found her people. Though still 10+ years younger, they get her and make her feel welcome. They bond over playdates and yoga classes and have become a small tribe.

Have you got a story about being an older mom? Please share the good, bad and ugly!