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A Parents’ Guide to Doulas

by Lily Ostle, Co-Director of NAPS Doulas

To be on the journey through parenthood can be overwhelming. There are limitless classes, costs, books, blogs, products and well-intentioned relatives offering advice. Many parents are experiencing information-overload, which makes trying to discern what will be the right kind of support for the perinatal timeframe especially challenging. Unlike other options that include family members, friends and neighbors, doulas are trained nonmedical professionals who assist families by providing evidence-based information and resources, in addition to non-judgmental emotional, physical and culturally appropriate support.

The two main types of doulas are birth and postpartum.

Birth doulas are on call and attend births in the home, birth center and hospital. Their relationship with families usually begins in the third trimester of pregnancy and focuses on the intense day of the baby’s birth. Birth doulas help families prepare for likely scenarios, in addition to providing hands-on advice and continuous support for the duration of the labor. The birth doula is skilled in pain management techniques and in empowering families to make informed decisions.

Whereas, postpartum doulas work scheduled hours in families’ homes during the day, evening, and overnight. Their relationship with families usually begins in either the third trimester of pregnancy, or the weeks following the birth of the baby or babies. Postpartum doulas are trained in supporting families emotionally during the often challenging days and weeks following the birth, enabling them to screen for postpartum mood disorders and make relevant referrals. They offer guidance with infant feeding; including breastfeeding, formula feeding and pumping. When families find that the usual cooking and cleaning routine becomes difficult to juggle on top of caring for one or more newborns, the postpartum doula fills in the gaps with light household maintenance. In addition, they can help educate about healthy sleep patterns for parents and babies. There are doulas who provide both birth and postpartum doula services.

Doulas are locally trained through The Simkin Center at Bastyr University, and some are certified through either the local (NAPS and PALS Doulas) or international (DONA) professional doula associations. Certification ensures the highest level of professionalism through adherence to Standards of Practice and Code of Ethics, and current knowledge from required continuing education classes. In addition, families have the option to file a grievance should anything be professionally concerning during their time with the doula. If you are interested in certified birth doulas, you can access doula profiles at If you are interested in certified postpartum doulas, you can request a referral at An internet search will find many doulas, but there is no regulation on what is presented on any individual’s website and no guarantee of availability.

Doulas are self-employed and set their own rates. The average rates for certified birth doulas start at $800 and go up to $2,000. The average rates for certified postpartum doulas start at $25 and go up to $40 per hour. Some doulas are able to offer sliding scale rates, or pro-bono work on occasion. For families who financially qualify, Open Arms Perinatal Services matches birth doulas with families at no cost. Open Arms and NAPS Doulas are currently in the process of creating a similar program with postpartum doulas. NAPS Doulas currently offers a way to connect families who financially qualify with members of the organization who are able to work for reduced rates.

Regardless of how you find doulas, it is always important to be thorough in the interview process, and  equally important to take the individual’s personality into account. Your doula will be with you in some of the most vulnerable moments in life, so you want to feel completely comfortable with how that doula’s personality fits within the dynamics of your family. Sometimes that personal connection is even more important than how many years of experience or numbers of clients the doula has served. The most important factor is to trust your instincts with who you connect with the most, and then you can relax about that portion of the parenthood journey with the knowledge that you will have exceptional, dedicated, and non-judgmental support during the perinatal timeframe.

About the Author

Lily Ostle is a certified postpartum doula, and the Co-Director of NAPS Doulas. Lily Ostle has been a birth and postpartum doula in the greater Seattle area since 2007. She is a certified postpartum doula, and the Co-Director of NAPS Doulas. Lily’s interest in perinatal support was sparked while doing research for her BA in cultural anthropology from Western Washington University. The most fulfilling aspect of her doula work has been helping families mediate the larger cultural factors which affect individuals during the perinatal timeframe (like hospital standard protocols and postpartum isolation). Currently experiencing her own transition to parenthood, Lily has been inspired and honored by all the families who have worked with her in the last 8 years.

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