Frequently Asked Questions

When should I hire a doula?

  Your doula can be hired at any time during your pregnancy or postpartum. However, to receive the optimum care, we recommend hiring as early in your pregnancy as possible. We love to educate our clients, and earlier in your pregnancy is to your advantage. Our early support can include fitness classes for pregnancy, childbirth classes, education/evidence on subjects of your interest, daily activities to balance your body for birth, and information on other care providers such as chiropractic care and massage.

How do I choose my doula?

 Simply contact our office by filling out THIS FORM.  Our office manager will contact you to explain the details of our program and get you set up with some doulas to meet. Once you feel a connection, let the doula know and you'll get things set up directly with her.

   If you'd like an individual interview with Brenda, just give me a call 817-67Doula!

Do I need a doula if I’m planning to have an epidural?

   At Tarrant County Doula Associates (TCDA) we support the birth our clients wish for. Whether you plan on choosing an epidural or later on decide that you want or need one, your doula is by your side completely supportive of your choices. 

   Your birth doula helps you prepare mentally and physically for labor, labor along with you using position changes, smooth the ambiance in the birth room and keeping you grounded and connected to your baby through the experience. If an epidural becomes part of your experience, she is highly skilled at helping you stay connected to your experience and helping minimize some of the more common, annoying side-effects of medication. Pushing with an epidural can be a confusing experience. The calming voice of your doula can help ground you and keep you focused on the muscle memory that helps guide your baby down the birth canal. She also helps you make the best use of the rest periods in between pushes.

   She supports you as a family providing information on what may happen next and helping you navigate your plan as you go. TCDA doulas are they’re marvelously helpful in guiding you to help your baby with the first latch and positioning.

Do I need a doula if I’m planning to have a planned cesarean birth?

   Cesarean birth is still a birth with all the feelings, anxieties and a few more thrown in! Your birth doula helps you relax in the hours prior to surgery, providing massage, calming breathing techniques, and keeping the room light in excitement of the coming new baby, helping both mom and dad know what to expect and how to make the experience more meaningful to them. Her experience in supporting families through surgical birth makes her an ideal team member. 

   Your doula is the only person in the operating room whose sole purpose is to offer you calming ease and providing emotional support for you and your husband or partner.

   Should your partner need to be with the baby, you will no doubt appreciate your doula by your side. With your doula in the room, Daddy gets to be IN the pictures instead of behind the camera. What could be nicer?

   Breastfeeding in the OR or recovery room is a little less challenging with an expert by your side. If, for any reason, your cesarean would be performed under general anesthesia, TCDA Doulas are well trained in how to help your baby nurse even while you are asleep. Dads are most appreciative of these extra hands and a calm spirit that provides nurturing to him and baby while Mom recuperates.

Will my doula replace my husband/partner?

   Your husband/partner loves you like no other. The doula does not have this skill. Her duty is to support you as a couple. She provides calming reassurance that all is progressing normally, offers tips and suggestions to make further progress, provides good information & emotional balance to keep your confidence high. We help him perfect his support techniques, make sure his physical needs are cared for and give him a break when he needs it. Supporting your partner means he will feel totally free to do what he does best, loving you and the baby and he enjoys his own experience much more. Doulas are highly respectful of your personal space and honor your loving relationship with one another.

   Often, the partner expresses how much he relaxed once the doula arrives! We can't count the times that we receive a big daddy hug as we leave with his genuine, "I couldn't have done it without you!" and our hearts overflow!

Will my doctor and hospital be okay with my decision to hire a doula?

   TCDA Doulas are well known for working well within birth teams at all locations. Your doula respects your ability to hire the care provider that you trust the most and choose the hospital location that best serves your needs. We will help you plan to discuss your wishes to have a TCDA Doula attend you at home and at the hospital as emotional and physical support with your provider. In the rare instance that your provider is resistant to your choice, we can also help you navigate your options so that you are completely satisfied in your decisions.

Is it too late to hire a doula?

   Likely not!! Understandably, we’d love for you to have some time to get to know your doula team and we want to know you as much as possible. In some circumstances, however, this will not be possible. As long as we have the room in our schedules to offer you the high quality assistance that you deserve, we will make you a priority. Even if we only have a few days to get to know one another, we are still able to learn quickly how to best support you in the birth that you want. There have been instances where our doulas have been hired on the same day as the birth.

When will my doula arrive at my labor?

   Labor can be tricky. As you will learn in your Lamaze Healthy Birth™ Class, labor is not a spectator sport. Your doula will be helping you over the phone or virtually to determine when just the right time for her to come might be. In order for you not to get unnecessarily tired out, she will make suggestions to you until it is agreed that you are truly ready and in need of her support.  Some mothers would like to have their doula labor at home with her for a while. In your own private home environment your labor will progress more smoothly and without distractions. In the case that your labor seems to be progressing rapidly, your doula will meet you directly at the birth location.

Can I speak to my doula during my pregnancy, before my labor begins?

   Your doula is most interested in hearing all about your pregnancy, your emotional life and how you deal with normal everyday stress. She is interested in your family and the beliefs that you have come to have about birth in a non-judgmental and compassionate atmosphere.  

   She is available by email and phone calls during business hours to answer any questions that may arise. In the case that you may be in labor or have any other type of emergency, she will provide a number to reach her after hours as well.

   Be sure to register early for our Lamaze Healthy Birth™ Class, which seamlessly complements your doula's support. These classes provide you with the absolute confidence necessary to have an empowered birth experience. Your doula's guidance is solidly based on the curriculum and will reinforce your classroom and homework with her experience and wisdom. 

What if my labor is very long? Is there a limit to how many hours my doula will stay with me?

   No. A laboring woman cannot control how fast or slowly her labor may progress. We are dedicated to staying by your side, offering continuous support throughout your entire labor and birth. Some births are extremely rapid, most first time mothers labor 24 hours or more, but most of this is the early latent phase when you will labor best while continuing to rest without distraction.

Should your birth take an unusually long turn, we always offer to have a back up doula step in so that you have a fresh set of eyes, arms and a warm heart to care for you while your doula rests up a bit, although this is rare. You are our priority and we aim to offer the highest quality of care at all times.

What if my doula gets sick or has an emergency?

   In the rare instance of an uncontrollable circumstance, your doula's back up will be able to step in and care for you. Doulas with TCDA have the same experience in supporting women and families. 

Do you offer payment plans?

   Our office manager can discuss this with you individually.
We require 50% of your fee as payment at contract signing. This ensures that your doula will be available to take as many calls or emails as you might desire. She can begin to make prenatal appointments with you and even attend them.

   You may even like to add gift certificates to your baby registry. A person only has to email the office for us to send them an invoice that gets credited to your account. Your final payment must be made in full by 37 weeks.

Are doula services covered by insurance?

   At this time doula services may be paid for with your Health Care Flexible Spending Account in Texas.

   The following is a partial list of insurance companies who have reimbursed in whole or in part for doula services. (If your insurance company isn’t listed, it’s still worth attempting reimbursement. This list was first published in 1998, so policies may have changed.)

• Aetna Healthcare
• AltPro
• Baylor Health Care System/WEB TPA
• Blue Cross/Blue Shield
• Blue Cross/Blue Shield PPO
• Cigna
• Degussa, a German Chemical Company
• Elmcare, LLC, C/O North American Medical Management
• Foundation for Medical Care
• Fortis Insurance
• Glencare Managed Health, Inc.
• Great-West Life & Annunity Ins. Co.
• HNTB (Peoria, IL)
• Houston New England Financial, Employee Benefits (Fort Scott, KS)

• Humana Employers Health
• Lutheran General Physician’s Organization
• Maritime Life
• Medical Mutual
• Oschner HMO, Louisiana
• Professional Benefits Administrators
• Prudential Healthcare
• Qualchoice
• Summit Management Services, Inc.
• Travelers
• United HealthCare of Georgia (San Antonio, TX)
• United Health POS
• Wausau Benefits, Inc.


HOW TO REQUEST INSURANCE REIMBURSEMENT FOR DOULA SERVICES

1. Pay your doula in full.

2. Get an invoice from her which includes the following information:

     a. The doula's name and address

     b. Her social security number, taxpayer ID or NPI number

     c. The date and location services were provided

     d. The ICD-10 code for the services provided (Birth Doula: CM Z33.1 and/or Postpartum Doula: CM Z39.2 )

     e. A diagnosis code

     f. The doula's signature

3. Submit the invoice with a claim form to your insurance company.

4. Within 4 weeks, you may receive a letter telling you that either:

     a. they need more information before they can process your claim.

     b. this is not a covered expense.

5. Ask your doula to send you the following:

     a. a copy of her certification document

     b. other credentials or relevant training

     c. a letter detailing her training and experience and what she did for you

6.  If possible, ask your obstetrician or midwife for a letter explaining why a doula helped you, was necessary, or saved the insurance company money (i.e. Did you have a high-risk pregnancy? Did the doula's suggestions appear to prevent complications or help your labor to progress more quickly? Did the doula's presence decrease your need for expensive pain medications?).

7. Write a letter explaining why you felt the need for a doula and how you believe the doula was beneficial to your health.

8. Submit to your insurance company:

     a. the doula's letter and credentials

     b. the letter from the doctor

     c. your cover letter

     d. abstract of 2017 update to the Cochrane Review study, Continuous support for women during childbirth.

     e. abstract of 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery.

9. If they refuse it, write a letter to Health Services requesting that they review the claim, as you feel it was a cost-cutting measure and they should cover the cost. Include the abstract of both the 2012 update to the Cochrane Review study, Continuous support for women during childbirth and the 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery.

10. Follow up by telephone if necessary.

11. If they refuse, write a letter to the CEO explaining why you feel that doula care should be a covered expense. Again, include the abstract of both the 2017 update to the Cochrane Review study, Continuous support for women during childbirth and the 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery. They may not pay your claim, but they will consider it for the future.

(c) Kelli Way, ICCE, CD(DONA) 1998, Reprinted with permission.