Doula Questionnaire
If you are thinking about hiring a doula and would like some help picking one that is experienced with HypnoBirthing tools, extra comfort measures and training beyond the national certfications, we are happy to help! We have several women that have taken our Doula Finishing series and also have extensive training in "all things birth." If you can answer these questions, we will have a more accurate view of what you are looking for. Most doulas will come to your home for two visits before birth and one after the baby has come to make sure you have the resources you need and to make sure feedings are going well. Most doulas will offer a payment plan if you need it as well. A doula is worth every penny and even a charge on a credit card! You only birth this baby once and you should feel fully supported so it can be spectacular!
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Name of Mom *
Mom's Phone Number *
Mom's Email *
What number baby is this for you? *
First, second, etc.
Any losses or miscarriages? *
What is your estimated due date? *
MM
/
DD
/
YYYY
What area of town do you live in? *
What is your budget for a doula? *
For reference: Newer level experience($300-400) moderate level experience($500-700) high level experience($800-1200). You can also ask about number of births attended and other skills - educator, massage therapist, student midwife etc.
What classes have you taken? *
What hospital or location are you birthing at? *
Who is your care provider? *
Doctor, midwife, medical group, etc.
Are you alone or do you have a birth companion? *
Spouse, boyfriend, partner, etc.
Do you have any pets? *
Do you have any allergies? *
Food, environment, medication, etc.
Do you have any special circumstances that we should be aware of?
Do you want your doula to have medical experience? *
Such as RN or Monatrice. Please note it will cost more for these skill sets.
Do you see a "grandmother, mother, aunt, sister or friend type" of woman at your birth or are you ok with anyone? *
Some women have mom issues so we want to make sure the appearance of the doula doesn't make you tense - for example, if you had an overbearing mom/grandma in your life - you may not want a doula that is older or who looks like that. Or you may want a younger doula because your sister is on the east coast and you want the younger energy in the room. I will tell you that it is a total personality fit and that comes in all shapes and sizes!
What type of women would make your birth companion the most comfortable? *
Are there other skills that you would prefer your doula to have? Is there anything else you would like to add?
All doulas do massage so it is not necessary to have a massage therapist necessarily and pay extra for that skill.
How did you hear about our Doula Matching Program? *
We would like to thank them for the opportunity to help!
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