Surrogacy and Doulas: 4 Ways A Doula Can Help Your Surrogacy Journey

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As a surrogate, you will be preparing your body to carry the most precious gift you can give someone. Your health and well being is vital to having a happy and safe surrogacy journey, so that you emerge from your journey stronger than ever. As part of our All-In Surrogate Care and Compensation Package, we provide you with resources to ensure your surrogacy journey is the best that it can be, which includes information on doula care, fitness & health, birth preparation and labor support.

How can a doula help surrogates in their surrogacy journey? Lisa Waldo founded Balanced Beginnings, a collective of birth and postpartum doulas, serving hundreds of families in Boulder and surrounding areas of Colorado at all stages throughout their pregnancy journey.

What Is A Doula?

A doula is somebody who is there as an advocate and a teacher. We provide emotional and logistical support to help the family transition into parenting, have a positive birth, and have an empowering postpartum experience. Statistics show that having a doula present at your birth greatly improves birth outcomes in terms of lower rates of caesarean sections, improved satisfaction, decreased postpartum depression, and decreased issues with pumping, if a person chooses to pump. As a doula, we do a lot of resourcing. If we don’t know the answer, we can definitely find somebody who does. We will refer lactation consultants, therapists and psychiatrists, pelvic floor specialists and acupuncturists. It’s definitely holistic care that we want to provide for families. You can learn more about Doulas at DONA International.

What Is The Difference Between a Birth Doula and A Postpartum Doula?

A birth doula supports a woman through her pregnancy. We are there throughout the whole process and then typically join her during the birth and stay with her through the birth. We then follow up postpartum to help process the birth. Having a doula there really helps families make sense of their whole birth process. Even if it doesn’t turn out exactly like they had wished that it would be, a postpartum doula is there to support a family after the birth. So we can go into the home and help with sleep coaching, provide breastfeeding support, make sure the family’s being nourished, and support families that are struggling with postpartum anxiety or depression.

What Is The Ideal Time For Someone To Bring A Doula Into Their Birth Plan?

It’s never too early or too late to hire a doula. Some hire us as early as when they start trying to get pregnant and some are at 39 weeks and they decide in the 11th hour that they want doula support. The earlier you hire us, the more access you have to us in terms of resourcing for you and providing emotional support. You can choose to hire a doula at any time!

Find a doula near you at Doula Match.

What Is Your Role in the Birth Preparation Birth Plan and The Birth?

As a birth doula, I help prep women for appointments and what to expect and provide advice on any classes to take during pregnancy. We stay in contact by phone and text leading up to the third trimester. I want to make sure whatever classes they’re doing, whether it’s childbirth classes or breastfeeding classes, that they’re wrapping those up. Then we’ll have our big sort of prenatal meeting. And that’s when we go over their birth wish versus birth plan. Because if you look back on your life, a lot of your “plans” didn’t necessarily unfold as you would hope that they would. I go through a list of questions and we try to do that meeting before their 36-week care provider appointment, because that’s when their care provider is going to dig into what you are hoping for with your birth. We also talk about the postpartum plan. I feel like I have failed if I haven’t set them up for a positive postpartum period. And if they’re planning on pumping, we address that. Or if they’re not going to pump, we talk about that. We will discuss their support system. My intention isn’t just to get them through a great birth, it’s also to help them start on their best foot forward when they enter the postpartum period for long term success. If you are going to run a marathon, you need to prepare your body. If you’re going to birth a child, you need to prepare your body for that. So we talk about nutrition and exercises that they can do and things they can do to help really prepare their body for labor. And that’s where having a doula can impact birth outcomes. We can help make their birth easier and shorter with the education and the resources that we have for clients.

What Are the Benefits of Working With A Doula?

Community resourcing and emotional support throughout the whole process and then advocacy in their birth, whether it’s with the hospital, birth center or home birth. And then continuity of care when she gets home if she is struggling with breastfeeding or sleep issues. If we can’t help them, we can resource them appropriately.

How Can A Doula Help A Surrogate and Her Intended Family?

My role as a doula is to be there for her emotionally and explain what’s happening during birth. I’ve been doing this for 30 years and observed over a thousand births, so I can talk them through what’s happening in layman’s terms to help reduce anxiety. Having a peaceful birth will make the experience for the surrogate and the intended parents better and less stressful. One birth I attended with a surrogate, her partner, and then both of the intended parents was such a beautiful thing to witness. There was an issue with the epidural where it wasn’t working properly and I was able to help her change positions and get more comfortable and call the anesthesiologist back in and advocate for her. I was actually hired by the intended parents, but it was beautiful that it was comfortable that I could support both the surrogate and the intended parents.

How Should Surrogates Prepare For Birth?

Self care is really important. I put a lot of emphasis on hydrating and resting. I’m also a big fan of prepping your body for labor to make it as easy and short as possible. And, I believe surrogates should create a birth plan with her intended parents that includes her wishes. Postpartum planning is very important as well. I think a lot of times it may be easy for a surrogate to forget her postpartum period. And so I try to put some focus on that. Not just the birth itself, but what her postpartum period is going to look like because she deserves to heal and to be nourished during that fourth trimester time period.

What If The Birth Doesn’t Go According to Plan?

I try to educate families about the unpredictability that comes along with birth. Expect a curveball, because something is going to be different. It’s important to be talking about things before they potentially happen versus having to address it in the moment. One situation is when you have intended parents flying in to be at the birth. While there’s no guarantee, there are things that they can do to keep an eye on the cervix with something called the Bishop score calculator. If her numbers are increasing on the Bishop’s score, then perhaps they might want to consider coming in a little bit earlier. They also need to prepare that perhaps the baby then doesn’t come till a week after the due date. We also try to educate on some warning signs with labor, like losing your mucus plug, increased loose stools or increased Braxton Hicks. So there are things that can be discussed, but we can’t hang our hat on them, because there is no rhyme or reason to when babies decide to come.

What Role Does A Doula Have in Postpartum and How Does That Differ for Surrogates?

When we are hired to take care of the surrogate in the postpartum period, we make sure she’s resting and nourishing. If she’s pumping, how’s pumping going? If she has other children, how were they doing and what does her support system look like? So with the surrogate, the focus is on the surrogate and her family.

What Are Some of The Things That Women Should Prepare For After Birth Physically and Emotionally?

Continuity of care that begins before birth and continues into the postpartum period. It’s important to have a postpartum plan and support team in place to reduce anxiety and promote healing. New parents or a surrogate who’s just given birth are exhausted. Have the best lactation consultant or the best postpartum massage therapist already set up in your postpartum place so they know who to call. Store up on sleep for both the intended parents (for sleep deprivation while taking care of the baby) and surrogates to help their recovery. It’s also important to identify your village who will help you after giving birth. Make sure you have a freezer full of food. One of the hardest challenges after just giving birth or bringing a baby home is feeding yourself. And so one thing that is really within your control is to have a meal train set up, a freezer that’s full, or family members that come in and help. I often make sure a client is resourced with a therapist after they give birth to help with their emotional recovery. Having these plans already in place is going to make the postpartum period so much easier.

What Fitness Advice Do You Have for Women Through Their Pregnancy and Fourth Trimester?

Always follow your care provider’s orders because some women have some physical limitations. I would encourage surrogates to stay fit for birth because birth is an endurance event, and also the intended parents, because parenting is physical. The more rested, healthy and strong everybody is going into a birth situation is going to be beneficial for everybody. And, I’m a big believer in squats during pregnancy.

Can you talk to me a little bit about the pelvic floor?

We are big advocates of our clients working with pelvic floor therapists in pregnancy and postpartum. Working with a pelvic floor therapist in pregnancy can definitely help protect the pelvic floor in birth. We also like clients to follow up after the birth. In Colorado, we live in an area where women want to get back to running or their workouts right away. And we’re like, whoa, whoa, whoa, let’s make sure your body’s ready to do that. And so we really encourage them to see a pelvic floor therapist before they get back into impact sports and things where their pelvic floor needs to be really strong.

Do You Have Any Advice for Surrogates Who Are Pumping for Their Intended Family?

It would be great for a surrogate and an intended parent to work together to have a really nice solid plan before the baby is born. Having really clear communication between the surrogate and intended parents about expectations, the baby’s weight gain and how are you doing on the milk supply is very important. It can be stressful to parents and the surrogate if there isn’t a plan in place for those growth spurts that might occur, so having a plan for a backup in case the supply is low is key.

What Advice Would You Give A Woman Considering Becoming A Surrogate?

Make sure you have a really great support system in place including family, therapy and emotional support. If you decide to hire a doula, they can help you get all of that in place. And then just self-care — making sure that you really take care of yourself and you have the support system to be able to do that.


Learn more about ConceiveAbilities All In Surrogate Care & Compensation Package here.