Here are some answers to the questions I get most often, sorted by doula, lactation and payment/OHP.
Doula FAQs
what is the difference between a doula and a midwife?
While doulas and midwives both support births, are roles are very different. The simplest way to put it, is that midwives are medical providers and doulas are emotional and physical support people. As your doula, I do not give medical advice, listen to baby’s heart tones, perform cervical exams, take blood pressure readings, etc. Those are the tasks of a midwife (or nurse).
What do we talk about during prenatals?
Most often we have two prenatals together. This time is spent getting on the same page as far as your wishes, hopes and plans for your birth go. Or rather, I get on your page. If you’ve given birth before, it is helpful for me to hear your birth story(ies). I want to know what worked for you, or what you want to be different this time.
We discuss preferences you may have, we may write your birth preferences (bc plans always change anyway). That can include contingency plans, should birth move in a different direction than we hope for: induction, assisted delivery, cesarean (emergent or non-emergent).
We also spend time talking about postpartum and breastfeeding or any other type of infant feeding.
What do you do when I am in labor?
I come when you call me. Usually it is not yet time for me to be with you if you are in early labor. As sensations get longer, more frequent and more intense, you call me and I come to you.
The biggest part of my job during labor is offering you tools to cope well with the sensations. This may be (and usually is) through breathing techniques, frequent position changes, hydration and emptying the bladder, etc. I also help guide your partner, should they want me to, in how to best support you.
can i have a doula if i want an epidural?
Absolutely! As a doula I support all of your choices in labor. Already know you want an epidural? Great. Let’s talk about how to best utilize that epidural, how it may change things such as pushing, etc. We can also talk about having back up choices; no one wants to think about this, but occasionally epidurals fail. Sometimes we have to get them redone and that’s that. Other times -and this is rare- an epidural fails all together and we have to continue to cope with contractions without one.
What if i need/choose to have a c-section?
There are two main scenarios here: planned and unplanned cesareans. How things work with a doula is slightly different, depending on which one occurs.
Planned c-section
With a planned c-section, the hospital schedules you for a day and time. I meet you at the hospital when it’s time to check-in. Depending on which hospital you choose to have your cesarean at, I may or may not be allowed in your pre-op room as they only allow one support person in there with you. If you are partnered, or have a family member with you, they are that one support person. The same goes for the operating room: you can have one support person in there with you. If I am not allowed in because you have someone else with you, I will be in the waiting area and available to you by phone or text. After your surgery, post-op rooms still only allow one support person. Once I am able to see you, I provide the same postpartum support that I always do. This may include support with feeding your baby, emotional support, etc.
Unplanned c-section
Unplanned c-sections typically become relevant during labor. I am with you, at that point. Once the decision is made, I help you understand what to expect, I may explain what the doctor or nurses mean in more plain terms, I will help you get ready for your c-section and I will still provide postpartum support as described above. Afterwards, on your timeframe, we can debrief the experience and process what happened.
In the event of an emergency cesarean before you have gone into labor, I will do everything I can to provide as much support as possible, which looks most like what I described under ‘planned cesarean’, even if that terminology is not fitting.
what does it cost?
Check our different support options and what the investment on those is, here.
Lactation FAQs
is lactation support covered by my insurance?
Currently the only insurance provider reimbursing CLCs is TriCare West. I am in the process of credentialing with them and will be able to offer lactation services to their members soon. Once my credentialing process is completed, you can self-refer as I will be an in-network lactation care provider.
when do i reach out for lactation support?
As soon as you want to have your questions or concerns addressed! It’s never too early, or too late. I even offer prenatal lactation consults to help you prepare for breastfeeding, know what to expect and when to reach out to a lactation professional for help. And as a reminder: pain with breastfeeding is common, not normal. You don’t have to grin and bear anything- that’s not how we roll here.
where do visits take place?
That is up to you. I offer in-home visits in Ashland, Talent, Phoenix, Medford, Jacksonville, Central Point and Eagle Point. Farther out may incur a travel fee and is subject to availability.
You may also choose to come to my Ashland office. Our little clinic space is comfortably outfitted with seating options, pillows, etc.
what can i expect from an initial consult?
Initial consults are aimed at getting a really clear picture of your goals/concerns, your and baby’s history and figuring out which (if any) factors may be impacting your experience. Rarely is there ever only one thing that is contributing to our lactation questions. Initial evaluation is basically all about gathering information. In most cases, it will also involve addressing your questions and goals, and coming up with a preliminary care plan.
It is realistic to expect most issues take more than one visit to fully address. Expect it to take at least 2-3 visits, or more. During our initial evaluation, I will provide you with an estimate of the number of follow-up visits I expect we will need.
Are you an ibclc?
No. Not yet. I am on that path working toward being eligible to sit for the boards, but currently hold a CLC credential. CLC stands for Certified Lactation Counselor, whereas IBCLC stands for International Board Certified Lactation Consultant.
I have extensive lactation training and have had to complete exams on both breastfeeding knowledge, and have had to demonstrate skills in counseling techniques to obtain my CLC credentials.
what does it cost?
Check our different support options and what the investment on those is, here.
OHP FAQs
I have ohp- can i use you as a doula?
Yes! I am an OHP medicaid provider and as such, I can bill your insurance for my services.
how does it work? do we need permission to work together?
We do not. There is no prior authorization required if you decide you want to work with me. You choose me as your doula, sign an agreement giving me permission to bill your insurance and submit your insurance information through my HIPAA compliant portal. That’s it. Easy as pie.
It is encouraged to inform your pregnancy provider that you have decided to bring me on as your doula, so they may record that information in your chart.
what about if we need a back up doula? Will I have to pay them out of pocket?
When I select my back up doulas, I make sure they are also medicaid providers and would be able to work with your insurance.
In the event that I am not the one attending your birth, for whatever reason, the back up doula would bill your insurance for attending your birth. All the visits that we have done together would still get billed by me. This is why there is a line in our financial agreement that you consent to a back up doula billing your insurance for services rendered, if that becomes relevant.
Does it matter which Cco i am with?
Nope. If you are living in the Rogue Valley, odds are good that you are receiving benefits through either Jackson Care Connect or AllCare CCO. I work with both of those.
You may also be insured under something called ‘open card’, which usually is reserved for people who have OHP as their secondary insurance. I can bill your insurance as well, with the exception of those planning a home birth. Unfortunately, for some unknown reason, the Oregon Health Authority will not reimburse doulas for members on open card, if they birthed at home.
I’m on medicaid- will you bill me if ohp rejects your claim and you don’t get paid?
No. You will not (and should not) receive a bill from any medicaid provider, ever.
I know some people are being told that they still have to pay if OHP doesn’t reimburse their doula, and that is false. And illegal, by the way. As a medicaid provider, I accept the risk that I cannot bill medicaid clients should a claim get rejected.
does it matter where i give birth, for my ohp to cover a doula?
No, OHP covers doula support for home birth, hospital birth and freestanding birth center births. The only combination that currently is not reimbursable is home birth for those on open card. See above for more info.
Private insurance and private pay FAQs
which forms of private insurance do you take?
Currently (as of October 2024) I can bill your insurance for doula services if you are with any of the following:
Jackson Care Connect, AllCare CCO, OHP open card and Moda Health OEBB.
Starting 01/01/2025 I will also be able to take Moda Health PEBB.
If you have an FSA or HSA, you can also use that to pay for my services.
Superbills are available upon request, if you want to submit for reimbursement to your insurance plan.
what about if we need a back up doula? Will I have to pay them out of pocket?
When I select my back up doulas, I make sure they are able to either bill your private insurance or able to provide a superbill. If you have made your payments directly to me, I will collect the final installment and see to the backup doula’s payment.
In the event that I am not the one attending your birth, for whatever reason, the back up doula would bill your insurance for attending your birth. All the visits that we have done together would still get billed by me. This is why there is a line in our financial agreement that you consent to a back-up doula billing your insurance for services rendered, if that becomes relevant.
if you can’t take my insurance, how does it work with private pay?
If payment is going to be an out-of-pocket expense, there are several ways we can go about it. By default I will send invoices that split my fee into three equal payment. The first installment of $500 is due when you decide to retain me as your doula, and is non-refundable. The second installment is due around 37 weeks gestation. The final installment is due 2 weeks postpartum- whenever that ends up being. Alternatively, you can choose to pay the whole balance in full, up front. Different payment plans may be available upon request.
will you bill me if my insurance rejects your claim and you don’t get paid?
Possibly. You are ultimately responsible for my fees, unless otherwise determined by law.
How about my fsa/hsa or my eligible moda health plan- do they cover doulas in all chosen places of birth?
Yes, to the best of my knowledge, FSAs, HSAs and other insurances that include doula care in their benefits have no limitations in place when it comes to chosen place of birth (home, hospital, birth center).