Everyone deserves a doula.

A 2017 systematic Cochrane review showed that having continuous labor support makes one more likely to have a spontaneous vaginal birth and shorter labor, and less likely to have a cesarean delivery, instrument-assisted delivery (vacuum, forceps), regional pain medication, low APGAR scores, or a negative birth experience.

In 2014 the American Congress of Obstetricians and Gynocologists released a statement that the single most important thing someone can do to decrease their change of cesarean is to have "the continuous presence of support personnel, such as a doula".

The US national average for cesarean was 32% in 2019.

My client's statistics look even better than that, 2008-2020 (500 births):

• Vaginal delivery: 94%
• Cesarean delivery: 6%* (excluding planned cesareans)
• Instrument-assisted delivery: 3%
• Low 5-minute APGAR score: < 0.006%

I can't guarantee your individual outcome, but working with a doula can set the odds in your favor.

Ideally, around the start of the second trimester. The price for text and phone call exchanges is a flat rate in our fee. The earlier you hire us the sooner we can be of service in preparing you for the latter stages of pregnancy, birth, and postpartum and build a trusting relationship.

We often have room to fit in late-to-care clients, but that is never a guarantee.

We will join you during your labor whenever you feel ready for us. For most people, this is before the hospital at their home.

If you are being induced, our preference is to join you at the start of the induction and stay long enough to help you ask questions about the process and procedures. We then return whenever you need us or anytime a "next step" in the process is being performed. Some inductions can take several days, our goal is to help you pace yourself, provide as much or as little support as needed in the early labor and first contractions, and then provide continuous presence as we would normally do during active labor.

A doula is beneficial assisting with planned mediated or un-medicated births. There is quite a lot we can do to keep the baby moving down and to keep you comfortable during a labor with an epidural.

Physically you might not feel it with an epidural, but emotionally, you are still laboring. While you rest, we continue with acupressure and massage, body positioning, and more.

The Harmony Doula team makes no judgments about how you choose to manage your labor and what you choose to feel physically or not feel. It's your birth, your way.

A midwife is there as your medical care provider. You may have a strong emotional bond with them, but their priority is to ensure a safe outcome for both you and the baby. A midwife needs to stay rested and alert for the delivery.

A doula compliments the presence of a midwife, there to support you emotionally and physically for however long it takes.

Teri has been invited to train doulas at birth centers throughout the Bay Area and Central Valley for the last several years. We understand the unique role of the doula at a homebirth and are a welcomed presence to the midwives with whom we have worked.

Before a planned cesarean, we will join you upon arrival at the hospital to help get you settled in and comfortable, making sure your questions are all asked and answered.

Sometimes it can be quite awhile between the scheduled arrival time and entering the operating room. Our goal is to keep you relaxed and calm while you wait.

If allowed into surgery, we will be there to provide support throughout. We will also stay with you in recovery to help with initial latch and bonding.

Postpartum support for people recovering from a cesarean is especially important. You will usually be discharged after only a few days into the care of family and friends who might not know how best to help some one recovering from major surgery. We want you to be able to rest and heal and know that your needs are taken care of so that you can care for your baby.

We encourage partners to participate at their own comfort level and we work before the labor to learn what that is and to reduce anxiety and build confidence for partners who might feel that don't know how to help you in labor. Our goal at your birth is to complement and strengthen your partner's role. We work in collaboration with them to best support you. If they need or want a break, we're happy to step up.

Studies show that partners participate more actively during labor when a doula is present. In combination with your doula's professional expertise, the team creates the very best support system.

You can read more about partners and doulas in our article and how we support them too.

We officially go on call for you at 37 weeks. However, once you hire us, we are committed to serving you no matter how early your baby is born.

The most satisfying birth experiences happen when you and your partner(s) feel physically, emotionally, and mindfully prepared. The reason we offer a childbirth education class to all our clients is because labor is not the time to learn about labor progress, position changes, comfort measures, or all the choices and options you have from the first contraction to the delivery.

It is ok to be flexible in your birth planning, but very difficult to know what would make it your best day if you never consider what would make it your ideal birth. In the classes, we give you the tools to start thinking about and practicing those things.

You wouldn't run a marathon without first making sure you had shoes that fit and taking at least a few practice laps, would you?

Visit our article on insurance and FSAs. The short answer is that most insurances do not cover birth doula services unless specified in your plan, but some will cover it as "out-of-network". If you work for some of the larger Bay Area tech companies, like Google and LinkedIn, check to see if they include postpartum doula services in their benefits package, as several of them do. Carrot, Maven, Progeny, etc. have all accepted our invoice for your reimbursement.

We have never had a problem with clients getting reimbursed from their FSA for doula services. We will give you a universal invoice to give them once you have paid in full.

We are passionate about providing doula care to anyone who needs or wants it, including many who cannot afford the out-of-pocket costs. A complete doula package which includes an invitation to attend all our group childbirth and lactation classes for free, physical and emotional support during labor and delivery and the immediate postpartum, as well as 8 postpartum check-ins is $3500.

To make this accessible to families for whom the regular doula fee is too high, we offer payment plans and/or a sliding scale on our homebirth and virtual birth doula services. We encourage everyone who can afford the regular fee to start there so we may offer reduced fees to more clients who cannot. Everyone deserves access to respectful, unbiased, loving care.

If you need to use the sliding scale, we ask that you pick whatever number within the advertized range for virtual or homebirth services that is right for your budget in accordance with what you feel the services are worth.

Visit the Harmony Doula Mentoring page to find upcoming training dates and locations, registry information, and more. Our goal is to make the training process as accessible as possible. Our training is a 40-hr combined birth and postpartum doula program with lactation education. Attend and complete the training and you'll be ready to start a new career as a perinatal professional. Newly trained doulas can volunteer with mentorship at Homestead Natural Birth Center, Nightingale Birth Center, or Welcome Home Community Birth Center. Getting started is really that easy.