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Choosing the best care provider for your birth is an individual choice.  Having a friend or family member that liked a care provider won't tell you what that care provider can do for you.  The best way to choose the best care provider for your birth is to interview at least one home birth provider and one facility provider.  If you can get to know multiple providers to really understand the way they practice, this is your ideal.  Trusting your provider for their skills and experience and feeling comfortable communicating with them as you would a friend will enable the highest levels of oxytocin flowing in your birth space, rather than nervous adrenaline suppressing your labor progression.

Why are You Hiring a Care Provider?

If your answer to this is, "Because I'm pregnant," or, "Because I need myself and my baby checked regularly to make sure nothing is wrong," then there is a chance you haven't dug deep into the understanding of birth physiology nor sought a provider that works for YOU.  These two types of answers illustrate a belief that birth is risky and that any provider with a midwifery or obstetric related title provides quality care for YOU and for support of biological birth.  Not all providers practice the same.  They shouldn't, either.  We're not looking for cookie cutter providers any more than we're looking for cookie cutter births.  But we are at a time in history where we have access to a LOT of traditional and modern knowledge that can be (and IS being) blended to provide families with holistic support of the entire perinatal period.

Use the table below as a guide to help you find the best care provider, doula, birth team, birth location and birth environment for your #happyhealthybirth.

Thoughts and questions to ask yourself and to research about your chosen birth environment Biological Birth Supportive May want to seek other support
I am excited to see my provider at my prenatals YES NO
My provider listens to my questions and thoughts and engages in respectful conversation with me and is willing to provide me with the birth I desire, or kindly recommend I seek the care of someone else should our views not align YES NO
My provider encourages me to research recommendations and make informed decisions about my pregnancy, birth, and postpartum and does not push any recommendations as required YES NO
Many mothers birth in upright, forward leaning, all fours, or squatting positions with this provider YES NO
My provider knows how to use physical and emotional support including quiet, calm, and dark environments, water therapy, a peanut and birth ball and this is a standard part of their birth support YES NO
My provider doesn't use induction or cesarean as a treatment for "big babies" YES NO
Many baby's have their cord clamped and cut after the placenta birth with this provider YES NO
My baby will be skin to skin with me as a standard practice through postpartum YES NO
My provider takes all the time I need to answer all the questions I have, or schedules time for this specific purpose, and suggest holistic therapies to remedy any fears YES NO
My provider works with fetal positioning guidance during pregnancy to reduce labor and birth complications YES NO
My provider encourages balanced meals and provides information on eating balanced rather than prescribing a standard Rx prenatal to cover nutrition.  If prenatal vitamins are recommended, they are whole foods (with folate, not folic acid) and test to determine specific areas of deficiency are encouraged to know what supplements would be beneficial for you. YES NO
My provider believes the body is capable of laboring, birthing, and healing during postpartum and doesn't use medical technology as a standard means of practice for normal pregnancy and birth during any part of the perinatal stages YES NO
My provider actively refers to other providers and specialists for areas they feel would benefit from another perspective or for care they are unable to provide YES NO
My provider does not get aggressive or sarcastic at the mention of home birth YES NO
My provider understands the influence of birth practices on breastfeeding YES NO
My provider uses emotional and physical guidance during labor to increase oxytocin, decrease fear, and naturally support the physical movement of the baby through the pelvis during labor YES NO
My provider ensures I am provided with (and know resources for) breastfeeding support immediately after birth and the first days and weeks after birth YES NO
My provider doesn't use "at least you have a healthy baby" as a justification for birth experiences YES NO
My provider checks on me, or has someone on their team that checks on me, multiple times throughout the first six weeks postpartum YES NO
My provider's backup, and any staff working with or for my provider, practices in the same way as my provider YES NO

Of course, the ideal is a YES to all of these, right?  At least much more than the majority. Are these the only priorities?  No, of course not... and there are many other factors that will play into the quality and care of a provider.  These may not even be a priority to YOU for THIS birth.  However, this is a general overview of how to get to the deep down of how a provider practices.

Well, hello there!  While we've seen a lot from each other through "Esali Birth," I wanted to take a moment to say a personal hello from me, Danielle from the Mid-Ohio Valley, and share a basic service and price list for all of you looking for perinatal support through the childbearing years in the Mid-Ohio Valley.

If you're new to Esali Birth you may not know my story which I love sharing throughout the many times we may meet on your journey.  Mostly, I am a modern gal living in rural WV that loves to intertwine instinctual, historical, knowledge with only the most beneficial parts of our modern world.  I wear many hats in my family and life and love the diversified options I have in this beautiful world.  I also love supporting families during the childbearing years from the most basic loving hug to the scientific ins and outs of childbirth.  Whatever you need in this moment is what I strive to provide.  Sometimes that is advice, sometimes it is research, sometimes it is nutritional guidance, and it is always understanding of your personal journey which is ever changing.

My services range from pre-conception counseling to childbirth education and doula support.  I have a variety of herbal blends available and custom blends that can be created for your specific needs from soothing foot soaks and beverage tea blends to body balancing while transitioning from medicinal birth control and perinatal support.  See my service menu below for a basic list of options in the Mid-Ohio Valley.

While I do require services be paid in full, I provide my NPI number and guidance for my clients to submit claims to their insurance to help cover doula education and support fees upon request.

Want to learn more?  See me chat with Marilee Marrow on Moms Everyday and visit my Support Page.  Find me on Skype @esalibirth for my online [free] "Office Hours."

Have questions?  Get in touch!

A lot of people have a very skewed perspective of what a professional doula is and how this differs from other birth support.  This is because doulas, like all birth professionals... and humans, are different.  Their perspective on birth is different, their practice is different, the locations that they work within are different.  This doesn't make one way right or wrong... just different.  A lot of hype has come up recently about a doula's ability to "really help" a birthing mother.
I wanted to shed some light on one perspective of this...If someone is a part of certain doula certification organizations - those organizations limit what their certified doulas can or cannot say/do. It is different for each one. It is a liability for the company if a doula starts telling moms "no, you don't need that medicine. No, there isn't anything wrong...etc...etc." It is also an issue for the women when the doula should not be providing medical care... that isn't her experience or area of expertise (as a doula).  A doula is support NOT a care provider or nurse.  An independent doula *can* say whatever she wants without risking her certification... but if she starts giving medical advice, she risks issues from the hospital or care provider regarding that... and possibly lawsuits depending on what her suggestions affect.  It will be her personal business if she offers that service or not.  (Esali Birth mentors are completely independent and accept their own personal risks for how they carry out their services.  They should, however, practice logic and understanding).
A doula can't tell a provider or hospital staff what to do... but neither can her husband. In the end, it is the MOTHER's choice to do or not do anything until she is in a position of not being able to make a decision for herself - in which case she has already signed her rights over to the care provider to make decisions on her behalf in the moment.  If a situation is not "in the moment" then a living will provides someone else rights to make decisions for her - that is, if she has a living will.  Esali Birth mentors encourage birth students/clients to make their wills when they're pregnant if they haven't already.
However, in the US, we do have laws protecting people from abuse... any abuse... and anyone can speak up about that.  We also have programs like Improving Birth that shed light on various maternity related issues which also include birth abuse.  A lot of people (doula or not) won't, however, because it can be an awful feeling to have a bully come down on you for speaking up against any form of abuse.  Right or wrong to not speak up, it is one of the reasons it doesn't happen when it could.  Additionally, not many will say when... or if... medical staff are abusive; they just go along with it believing a birthing women has to "listen to her doctor." What can a doula do in this situation?  A doula can *remind YOU* of your rights and unbiased options.  They can speak up against #birthabuse.  If they will is individual.  What your responsibility is, as with all birth responsibilities, is to interview your potential doula and ask what THEY will or will not do for you.  Every doula is different, just like every care provider is different.   An OB is not the same everywhere.  A midwife is not the same everywhere.  Hospital birth is not the same everywhere.  Home birth is not the same everywhere.
 
All this being said - the reason women hire a doula is FOR the emotional and physical support because even with a hospital that supports birth plans, there is usually not enough staff to provide continuous support to the mother - and because birth is *mostly* an emotional event (OXYTOCIN gets the baby out AND provides mom with a satisfying experience... when its natural oxytocin) - moms NEED to feel safe. For most moms, feeling EMOTIONALLY safe is often only attainable through a doula.... like a mother that *really* understands birth.... not understands birth in the past 50 years... but real, raw, birth.  Some of us have this, others don't.  This doesn't mean a doula replaces a mom or a husband...  it is just a different, often incredibly beneficial, style of care.
 
Doulas rates on increased positive outcomes (both emotionally AND physical health of the mom and baby) are because of their *continuous* emotional and physical support.... NOT because of medical or perceived medical assistance.
 
That being said. If you NEED someone telling you your provider is lying to you.... then you NEED to hire a new provider. If you NEED someone whispering that the nurses at the hospital are lying to you... then you NEED to birth somewhere else.
[heading type="h3" margintop="28px" marginbottom="28px" bordered="no" align="center"][color]Whether a doula can or cannot say things doesn't fix a choice that should have been changed because you know you're not birthing in a supportive environment. [/color][/heading]
Most doulas I know don't provide on the spot childbirth education... they either recommend/require childbirth education before taking on a client, offer classes themselves and/or won't take clients unless they've proven they're educated or taken a class from that specific doula.  This isn't just for the doula, it is also so the mom... family... can have the best birth (health and happy) possible.  It is so that the client isn't expecting the doula to be a superhero during the birth. They can certainly seem like superheros, but they want to enjoy their job, too... and they want to be able to do their job to the best of their ability. 
We wouldn't have so many issues in births as it is if providers *required* ....  offered... excellent perinatal education.  Unfortunately, again, most classes that are scantily recommended are "how to be a good patient."  Or, "you can have a great birth if you don't have an educated birth philosophy or wish to do things 'out of the norm' - just do what we say, and here is #whattoexpect."  At Esali Birth we share how to make choices and why they're important.
Knowing your options and making choices that support your birth beliefs comes *before* hiring a doula. The doula then supports you AFTER you've chosen a supportive environment. No matter what a doula can or can't say - if the mom hasn't chosen an environment (provider/location) that supports her wishes - the doula can't magically create a positive experience.  It might happen (because doula support can make that big of a difference) - but it isn't the best situation for anyone. If anyone has to fight for the mom's rights - even though that's a legal option - it makes the birth space an intense place to be for someone... often the mother or the father... and neither of them need to be doing anything other than bonding with each other and their baby!  We're trying to build oxytocin, right?  Not just because its safer for mom and baby... not just because it progresses the birth process... but also because oxytocin builds in everyone in that birth space.  This is an event from a higher power that knew that mom and baby will need a lot of love and support during the postpartum period. 
[heading type="h3" margintop="28px" marginbottom="28px" bordered="no" align="center"][color]Make birth as simple as it can be by understanding that birth is a profoundly intricate transformation.[/color][/heading]
Believe this, make the choices that support it, and birth is (in most cases) incredibly simple.
 
In an environment (location/birth team) that SUPPORTS biological birth AND a mom that has a birth partner (her husband is wonderful when they're relationship is connected and respectful, or mom, or friend...etc....... a midwife)... that truly understands biological birth and the need to be quiet and let mom instinctively do her thing... a doula might not be necessary. Or, a doula might be that birth partner that is quiet and lets mom do her thing - and giving her the confidence to do so.
 
You have to understand that [color]BIRTH IS EMOTIONAL[/color]. Almost all complications with birth these days stem from an incredible misunderstanding that humans can or should meddle with birth. If you don't believe that you can #freebirth (birth unassisted... birth alone... birth without a care provider) - then I would encourage positive continuous support... which is exactly what a doula provides.  Someone else on your birth team may already provide that, I don't know... but it isn't a black/white "a doula does this" kind of situation.  It depends on what you need, what you want, and where you're preparing to birth.
 
A montrice on the other hand is often a midwife who is providing doula services. They can do limited provider care for the mom because of their midwifery background.... but they don't intend to catch the baby as a provider nor take responsibility in that manner. Once they get into a birthing facility or hospital, their ability to act as a sort of care provider stops because of liability with the hospitals and providers in that location.  Their role moves towards that of a doula.
I hope this clears up some of the issues regarding if you should really save/spend the money on a doula.  What have your experiences been?  Can you add to this?
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