Archive for the ‘All Things Doula’ Category

I Am A Doula

Monday, January 5th, 2015

CalebDoula.

I am a doula.

Those words, filled with so much meaning over the years, were my starting point in this birth journey I’m on. Doula is a weighty word. It’s a very different role than almost any other in birth. It encompasses so much that used to be taken for granted: that a sister, a mother, a grandmother, an auntie would be there for our births.

With our scattered society, and its driving desire to prove individual independence, that doesn’t happen as much any more. I think the rise in doulas in this country is just one sign of a shift in society’s thinking about that independence. The resurgence of old-fashioned life skills such as knitting, crocheting, quilting, canning, gardening, keeping small farm animals, bartering/trading for goods and services, and more all indicate that our society might be beginning to see the value in interdependence.

A very different concept than independence. Independence declares, “I can do it myself!” Usually in ALL CAPS. Interdependence says, “I can probably do it myself, but I would really like to have you by my side, because many hands make light work.” It’s a humble honesty that admits that we need each other, while acknowledging individual responsibility.

I like this shift in thinking. It means that each of us are needed by one another. Isn’t it a wonderful feeling to be needed?

We see it in the blog posts encouraging us to ask for help when we need it. We see it in the abundance of people who come out of the woodwork in order to sign up for meal trains. We see it in baby showers, scrapbooking parties, childbirth classes, book clubs, community gardens, homeschool groups, and knitting circles. We long for community, especially as women.

Birth is not an independent act. While it is “your” birth in one sense (individual responsibility), it is very much “our” birth in another (we need safe community in order to do it well). There are very few women who don’t need other women around them to birth, and each birth has a ripple effect on the community around it.

Enter the doula.

She brings interdependence back to birth. She encourages the mother’s individual responsibility in decision-making, while helping to meet the mother’s need for community. A doula bridges the gap between our precious, American independence, and our desire to have another woman to lean on. It is finally acceptable to need the help.

This is no bad thing, and is slowly, birth by birth, making a big impact on the way women, babies, and birth are viewed in this country.

“What’s a doula?” is a question asked less and less frequently, though we do need to keep putting the good word out there!

I am a doula.

The words still carry great weight. I have not yet burned out on standing beside women in my community while they usher new life into the world through their bodies, with the strength of Creation behind them. It is an honor, a privilege, and a blessing for me.

I am a doula.

I don’t yet know when the day will come that I utter these words for the last time, as I move forward into midwifery work. I wonder how that will feel, when it finally happens, as it surely will in the next few years.

Until then, I am a doula.

And I am grateful to be one.

Grace & Peace,
Tiffany

So It Begins.

Monday, December 22nd, 2014
Image credit: knowyourmidwife.com

Image credit: knowyourmidwife.com

In November, The North American Registry of Midwives accepted my application into the PEP program.

That should really have about eleventy-one exclamation points behind it. After all, it is the ripening of a long-blossoming fruit. The result of  a dream hatched over seven years ago, when my youngest was just a baby. I called the midwife who had walked with me during my last two pregnancies, Merrie, and asked to meet with her in order to discuss becoming a midwife. In her wisdom, I remember that she said to me, “You don’t want to be a midwife,” and proceeded to tell me all the reasons why it was not something to just walk into.

It was at that meeting when I first heard the word, “doula.” A what-a? Her assistant at the time was one, and Merrie encouraged me to meet with her. She assured me that if I could hack it as a doula, then midwifery might become an option later. That is how I was born into the life of a birth professional. I took my training in the fall of 2007, when my youngest was only two months old. A lovely babysitter came with me, and I nursed him through sessions, and she played with him in between. I worked slowly through my training, taking the maximum amount of time CAPPA gave me to finish my certification, but it was worth it.

Through it, I gained experience outside my comfort zones. I learned that I can live on call, and work around my family.

Soon, it wasn’t enough. I wanted to teach. So, I trained through CAPPA (of course), under Desirre Andrews (who was a doula, lactation educator, and a dually-certified childbirth educator at the time), to become a childbirth educator. Teaching has always been at the heart of who I am. I often find myself teaching, even when it isn’t wanted or needed–a character trait I hope is being shaped into a far better tool than it has been in the past. At this point, it became obvious that I needed a place to teach, but not having a regular income, nor a family budget to pay for a place, I sought help from Desirre again. She had a lovely office and classroom space, and was wanting an educator to help her as she began to assist a midwife (the same one mentioned above, in fact). I approached her, and asked that she become my professional mentor, and allow me to work with her to grow, teach, learn, and have space and time to build Birth In Joy into whatever it needed to become.

I haven’t looked back since. It has been a wonderful working relationship, and I have been blessed with a treasured friend whom I feel is my “big sister.” Working with her has challenged my perceptions, my biases, my experience, my emotions, my mind, my heart, and my very character.

Soon, even that was no longer enough for me. I have always taken a light client load, because my family needed me to. So, I knew I wasn’t beginning to burn out. Far from it! My passion and love for this work has only grown, over the years. Thanks mostly to my fabulous, beautiful clients and students, who have shown me quite a cross-section of birthing women and the strength they each have in common. What a world we live in, and what a privilege to have walked with so many through such a sacred, intimate time in their lives!

Desirre declared to me, when she started assisting Merrie, that she only wanted to gain insight and skills she could use as a doula. She wasn’t going to become a midwife.

Ahem.

She is now a Certified Professional Midwife, registered in the state of Colorado. Ahhhh, life. We never really know, do we?

Except that I do know. Midwifery has always been my goal. My dream. What I want to be when I grow up.

So, as soon as Desirre became a preceptor with NARM this past September, I started my paperwork. Phase 1 has been accepted by NARM, and I am working on both Phase 2 and the 43 pages of skills I must master and prove. (No, shaking chicken bones and chanting are not on the skills exam. Just so you know.)

So it begins.

My journey to becoming a midwife. “With woman.”

I didn’t know I was ready until one day, I was.

What is your passion? What dreams are you pursuing?

Grace & Peace,
Tiffany

My Ideal Client.

Wednesday, October 22nd, 2014

Me holding the fruit of my sister's labor, Baby Ellie.

Me holding the fruit of my sister’s labor, Baby Ellie.

Recently at an interview, I was asked the following question:

“What is your ideal client, and why?”

I think that might be one of the most intelligent questions I have ever been asked. I knew the answer immediately, and had to keep it short.

As a doula, part of my training is to identify and evaluate my personal biases, and how they might affect the care I give. From the beginning of my career then, I have always had to think about these kinds of questions. I have had to evaluate whether or not I ought to set boundaries around which kinds of clients I will or will not take on. If I do set boundaries, what should they be, and why?

I started doula work because I wanted to be a midwife.

That has a great impact on the types of clients I prefer to serve. (And doulas – admit you have a preference – we all do. Anyone who says they don’t is selling something.) Of course, I have often served outside my comfort zone, and while I don’t regret it, I have often been burned. Not by the client, but by really rough rides. Birth work is hard.

In order to be a good doula, there is a certain amount of emotional investment I must make if I am to be effective at all. The line between professional and personal relationship gets a little bit blurred, and so I carry a bit of each birth with me, wherever I go. I can remember every birth I have ever been to, and how it made me feel as a woman, mother, wife, and human being.

So, yes. I have an ideal client, and I have discovered that it has very little to do with circumstances, and everything to do with the client herself.

My ideal client is one who educates herself, and who takes full responsibility for the choices she makes along the way during her birthing year.

She doesn’t take her care provider’s word for everything. She doesn’t take my word for everything, either, but makes her own decisions.

My ideal client educates herself by taking classes, or reading evidence-based books and online resources. She knows how to evaluate information, weighing it against her instincts and risk factors, confidently choosing what is right for her and her baby.

My ideal client understands informed consent and refusal. She understands her patient/client rights, and asks intelligent, informed questions to gain insight into what is best for her and her baby. She is willing to keep an open mind and explore the benefits, risks, and alternatives to each option available to her.

My ideal client understands that a birth plan is not a list of demands to be met, but a conversation to be had. She understands that her choice of provider and place of birth is important. If she cannot make her ideal choice (because that can’t always happen), she is able to communicate her needs effectively, and to make the best she can of a tough situation. She knows when to compromise, and when to stand her ground.

My ideal client is flexible. She understands the wisdom of learning non-medical pain management, because her birth may go too fast to get the epidural she planned for. She knows that her labor may go on longer than she thought, and she needs the nap an epidural can help her get.

My ideal client knows that there is no “one-size-fits-all” birth, and she is prepared to advocate for her needs, and the needs of her baby.

My ideal client almost doesn’t need a doula, but she will benefit greatly from hiring one.

Probably 99% of women who hire me fall into this ideal. Women are intelligent, thoughtful, flexible, and strong–and I am there for them when all they need is the reminder that these things are true of them.

In your line of work, who is your ideal client? Why or why not? As a mom who hired a doula, how does this post make you feel?

Grace & Peace,
Tiffany

Life Lessons Found As A Doula

Monday, July 28th, 2014

Being a doula has taught me…

  • I have to disappoint people I love sometimes. At any moment, I may have to leave people I care about high and dry while I bolt to the side of a mother in labor. Babies don’t care about the date on the calendar.
  • I will be growing and learning forever. I will never “arrive” at a place where I cannot possibly learn any more.
  • It is not only okay to ask for help, it is imperative.
  • It is also imperative to walk in gratitude for all the help I receive.
  • Self-care is really important, and I am not very good at it most of the time.
  • To value the friends who stick around, even though they can never really depend on me as if I were a normal person.
  • To take myself and my work seriously. This isn’t just a feel-good hobby. It’s hard work, and it is worth it to invest time and resources into growing professionally.
  • Never to take anything for granted. There are no guarantees of good outcomes in any decision I make.
  • There are risks and consequences to everything in life. All we have to do is decide which ones we are willing to live with.
  • Having a mentor is critical.
  • Growing to become a mentor is a privilege.
  • Peer review in the safest context possible is essential to avoiding burnout.
  • I can never care more about a birth, and its outcome, than the mother. Ever.
  • Humility is the first pillar of solid bridge-building between the staff, care providers, my clients, and myself.
  • When I walk into a birthing space, I walk in with the reputation of all doulas in my hands.
  • To be flexible.
  • I don’t have to know everything. I just need to know where to find good information.
  • Scope of Practice is one of my most valuable assets.
  • How and when to say “No.” The rubber has met the road, where my family is concerned, and saying “No” is becoming a little less difficult.
  • While I will never check my faith at the door, my hands, my heart, and my love are far better tools than my tongue.
  • How to actually listen, though I think I will always be working at this.
  • There is no such thing as perfect balance in a person’s life. I can only do the best I can with what I have.
  • I cannot be all things to all people in all situations. However, I can love all people in all situations, and I can be fully myself in whatever moment I am living in.
  • My best is enough.

Above all, being a doula has helped me grow in love–for my God, my husband, my children, and all who come across my path.

“And now these three remain: faith, hope and love. But the greatest of these is love.” ~1 Corinthians 13:13 (NIV)

As a doula, I finally understand what it looks like when love wins. It doesn’t always mean that everyone is happy, or that everything works out perfectly. It means that choices are made that encompass what is truly best for the other person. It means laying down my desires, opinions, passions, hopes, and putting the best interest of the other person at the top of my priority list. In all situations, love of God, and love for my neighbor (beginning with those in my home) is the answer, and is the deep water my roots drink from.

I am so grateful for the growth I have experienced as a doula, and I pray that I never stop growing. That I always stay teachable. That I always walk in what I know to be true.

What life lessons have you learned from your work, either as a mother, wife, birth professional, flapjack flapper, or whatever it is that you do?

I have to give a shout-out to my mentor and friend, Desirre Andrews. More than anyone, she has challenged me to take risks, get up after I fall, and to widen my view while staying within the bounds of a very narrow path.

Grace & Peace,
Tiffany

Being A Doula

Friday, July 18th, 2014
Image credit: tumblr

Image credit: tumblr

Being a doula, for me, is not about changing hospital policy, or steering women away from “bad” providers. It is not about disseminating information to every client. It’s not about birth plans. It’s not about informed consent. It’s not about vaginal birth, home birth, or cesarean birth. It’s not about statistics. It’s not about rebozos, crock pots, or rice socks. It’s not even about making a difference or changing the world.

Being a doula is about laying aside my notion of what a particular birth ought to be, and instead surrendering to what it actually is. It is opening my eyes to the reality of each woman’s circumstances, and meeting her right where she happens to be.

It is seeing beyond myself, and stepping into someone else’s experience. It is opening my hands in service, in whatever way the mother sees fit. It is about humbling myself, and understanding that each birth can and will teach me something I did not know before.

It is about respecting the care provider(s) my client has chosen, simply because she has chosen them. It is about learning how to show respect and compassion to everyone in the room, even when I don’t feel like it, because it is the right thing to do. Many times, it’s about being an example.

It is about protecting space around a birthing woman and her partner, so all they see is each other. It’s about becoming invisible, so that the birthing woman can focus on what is most important.

It is about being with this woman, right here, in this moment in time. It is often about helping her surrender fully to this great work she is doing. It is looking her in the eye and lending her my strength when she runs out. It is opening a door when she hits her wall. It is about believing her when she expresses pain, and validating her struggle.

It is believing in her, even if no one else does.

It is about bringing a little bit of sunshine into this storm that feels so big, and reminding her that it will not last forever. Being a doula is a lot like trying to be a rainbow in someone’s cloud.

It is about love.

And I love being a doula.

Grace & Peace,
Tiffany

 

Book Review Friday: “Giving Birth” by Catherine Taylor

Friday, May 23rd, 2014

Giving BirthGiving Birth by Catherine Taylor
My rating: 5 of 5 stars

This is one of those books which I wish I would have taken notes throughout, to better enable me to review it accurately. Her tone, her writing style, and the content were all excellent.

Her writing style is accessible, honest, frank, and open–the way a good journalist’s should be. Her descriptions of the various women she meets, the places she goes, and the births she attends as an observer or doula are vivid without being wordy.

I found myself moved to nearly to tears several times (I’m not much of a crier, so “almost to tears” is saying a lot) throughout the book.

It’s picture of midwifery as a profession, from Certified Nurse-Midwives to direct-entry midwives is respectful and unbiased. She shares the reality of the political landscape all midwives must work in, the challenges they face, and the little triumphs on behalf of women and their babies.

Even if you are not into birth, I would recommend this book to every woman – whether you plan to have children, have children already, or plan to never have children. It can speak powerfully to any of us.

View all my reviews

Doulas Benefit Care Providers, Too.

Monday, October 28th, 2013

Image credit: apperson.com/support

I’ve written a lot about the measurable benefits of trained labor support for women and their families, which is important. However, I believe firmly that doulas have great potential to benefit care providers and staff as well. As one more important piece of the birthing puzzle, doulas can either add to or detract from the big picture of any birth they attend.

When a doula is at her best, when she understands her role and her scope of practice, she brings freedom, communication, and peace to the place of birth.

Part of my Scope of Practice as a CAPPA-certified Labor Doula reads as follows:

During labor and birth, the labor doula provides the mother and her partner with physical, emotional, and informational support. She facilitates and promotes self-advocacy, informed choice, and effective communication between the family and care providers. She seeks to foster a cooperative, respectful, and positive atmosphere with all members of the birth team so that the mother can birth with confidence. (emphasis mine)

What does “effective communication” look like at a birth?

It looks like a bridge. A sturdy, well-built bridge that begins with openness, humility, and an extended hand from the doula to the staff member or care provider that does not interrupt their conversation with the client.

It’s remembering that the client chose her care providers just as much as she chose her doula.* That fact alone should elicit basic human respect from the doula toward those caring for her client. Period. Regardless if that respect is returned or not. Doulas do no one any good unless we do our best to leave those chips on our shoulders at home. We do best when we take the high road, and treat everyone on the birth team with dignity and respect.

Side note: respect doesn’t mean agreement or likeability. It simply means getting along, and choosing to work together toward a common goal: The safety and health (physical, mental, and emotional) of both mother and baby.

When a doula sees herself as an integral part of the birth team, and understands that everyone else there has their place (as long as her client chose them), there are a lot of benefits she has to offer to the care provider and staff she is working with.

Among those benefits:

  • Added perspective–Doulas can often get very creative when coming up with ways to help a labor progress effectively before medical interventions are truly needed. Care providers often appreciate suggestions that don’t interfere with safety, and that seem to help the mother.
  • Someone labor-sitting–Care providers are rarely available to labor sit as long as a doula can. Even home birth midwives may not have as much opportunity to do so, and usually arrive later in labor than a doula would. This means that a doula can fill in the provider and staff on what has been going on, what tricks have been tried, and things that may be relevant to improving her client’s care. The doula can often provide clarification where the mother’s or partner’s recollection is fuzzy. This helps the care provider have a more accurate picture of how labor is going.
  • Continuity of care for patient–This is one of the hardest things to provide as a care provider. Nurses, doctors, and hospital-based CNM’s change shifts–no matter what. Even home birth midwives may have to send a backup if two births are happening simultaneously. The doula provides one continuous thread of care, and we all know that this works out to better quality care in general. Also, can bond more quickly with the new people on shift, making her care easier for the staff and/or care provider, as they have to spend less time establishing trust.
  • Bridge of communication with patient–Doulas teach their clients to ask good questions, relevant to their own care, and how to understand the answers they’re given. This helps the client to build trust in her chosen provider, which makes caring for her easier for the care provider. A doula’s presence should facilitate togetherness at a birth, not a sense of “us vs. them.”
  • Extra set of hands–As much as care providers love to do hands-on care, many times they are simply not able to do so. Doctors, nurses, and even home birth midwives and their assistants, can easily get bogged down by charting, checking and setting up needed equipment, and (in hospitals) caring for other patients. This is as it should be, since the safety and health of the mother-baby dyad rests on their shoulders. Any non-clinical care they get to do is icing on the cake. Doulas have no such worries impeding their care. Non-clinical care is their only focus.Therefore, care providers are able to focus solely on their number one priority: the health and safety of mom and her baby.

I know that the above benefits are really more indirectly beneficial to the care provider. However, when there is benefit to the birthing woman, there is benefit to her care provider as well. The patient load of most OB’s is such that it can be extremely difficult for them to individualize care. After all, the care provider has as little time, per appointment, to get to know their patient as the patient has to get to know them.

Therefore, if there is any way for a doula to help build bridges, encourage their client to ask good questions, and utilize whatever time they have with their care provider, it enables and empowers the care provider to do what they want to do most: Provide evidence-based, individualized, humane care to their patients. This results in good feedback for them, and encourages them to be more open to the next client asking questions or wanting something different than the basic standard of care.

In short, the presence of a doula can mean heightened communication, empowerment, and a positive experience for everyone on the birth team, not just the mother.

*I understand that many women only have very limited, or no choice, when it comes to their care provider, due to geography, local/state laws, financial constraints, or other factors. Still – they ultimately still have chosen their care provider, rather than birthing unassisted at home. Therefore, they are placing some modicum of trust in that care provider. I appreciate feedback on this.*

Care providers: How often do you work with doulas? What do you appreciate most about good doulas? What tips might you offer to doulas who are still learning, or who need to understand your perspective better? What ideas do you have to foster better relationships between clinical and non-clinical professionals?

Thanks for reading!

Grace & Peace,
Tiffany

How To Find Moolah For a Doula.

Saturday, October 19th, 2013

Image credit: primecoordination.wordpress.com


So, you’ve read the literature, or seen the infographics on the measurable benefits to having continuous, trained labor support in the form of a doula. (You haven’t? Oh. Well, then. Click HERE to read the best, most recent evidence, then come back here and finish this post.)

Based on that measurable evidence, you’ve decided that you need a doula, but are wondering how on earth you can afford one. You’ve seen that doulas are worth every penny they charge, but it doesn’t matter if you don’t have the pennies, right? Right. I know that feeling! I think we all do, in this current economic climate.

As I mentioned in my last post, doulas in the Colorado Springs area charge anywhere from about $300 up to $650 at the moment. Of course, insurance doesn’t consistently cover us yet, though there are reports of some insurances doing just that after claims are submitted by clients. It’s slowly, but surely happening. Still, that upfront cost is still there.

To start, I would like to cover the basics of what you must have for a newborn. (Stick with me, I’m going somewhere with this.)

  • Boobs. With milk in them.
  • Something to cover & clean their behinds.
  • Maybe two weeks’ worth of clothes, depending on how often you do laundry, and how often your baby blurfs on you, or has poopsplosions.
  • Car seat. Must-have, if you ever need to go out and buy food or something.
  • Some sort of barrier between spit-up and your clothing.
  • Some sort of well-made babywearing device.
  • Small diaper bag.

Really, everything after that is gravy. Sure, there are a lot of very handy devices, contraptions, and doo-hickeys, but most of those are luxury items, that add up very quickly to hundreds of dollars or more. Of course, many of these items are covered by the ubiquitous Baby Shower. Everyone is eager to pick up your Target registry list and go crazy!

There are…

  • fancy nursery sets
  • cribs
  • high chairs
  • various swings
  • pack n’ plays
  • child-proofing devices
  • baby gates
  • teething rings
  • toys
  • floor mats
  • wall decals
  • strollers
  • blankets
  • socks
  • hats
  • specialized bath tubs
  • giant diaper bags
  • SO MANY THINGS!!!

Do you really need all of that? No. Most of those are created needs. They come in handy, certainly, but most aren’t needed in those newborn days before six to eight weeks postpartum. Oftentimes, it makes sense to put off getting most of these items until you know for sure it’s something you will use. Time will tell very quickly in that case.

So, instead of creating a registry for SO MANY THINGS! for your baby shower, might I suggest: Have a simple money tree, or card box set up, and ask people to contribute what they would have spent on stuff to your Doula Fund. Most people tend to be as generous as they can toward new mothers and babies, and will be happy to do just that.

In lieu of all the stuff, you will likely end up with plenty of money to pay the doula you would like to hire. You may even have some left over to pick up one or two items that you find you really would like to have. It’s a win-win!

Of course, that’s not the only way to go about it. I just think it’s often the easiest way. Still, there are other options.

Some other ideas to help you pay the doula you’ve chosen:

  • Bartering. Many doulas have need of the skills you or your partner possess. Offer a dollar-for-dollar trade, up to a certain amount, then pay cash for the balance.
  • Sell some stuff. Maybe you’ve already had a baby, and found you didn’t need that $400 jogging stroller, and barely used it. Perhaps your garage needs to be cleaned out. You may be able to scrape together enough to afford the doula you’d like to hire.
  • Make and sell some stuff. Do you sew at all? Crochet or knit? Make fabulous cakes? Jewelry? Do you paint? Photography? Put those skills to good use!

When all else fails, and you honestly can’t pull together the entire balance…

  • Hire a training, or newer doula, and work with her to pay her what you can afford.
  • Ask for a discount. Be specific. “I can’t afford x, but I can afford y. Can you do that?”
  • Ask for a payment plan. Again, be specific. “I can make payments of x amount, over 6 months.”

Most doulas are willing to work within certain parameters, as long as a client is upfront, honest, and is willing to put a financial agreement in writing. We hate to say no to someone in need, and most doulas will bend over backwards to help you make it work. We know that we have measurable benefits. We know that doulas are much more of a need than a luxury, especially in the current birth climate in this country. We want to help, but communication runs two ways.

You only have to ask.

It’s almost always feasible to afford a doula – you just have to get creative, be flexible, and find a doula that can work with you in your particular circumstances. Remember, you are trying to secure evidence-based, customized, continuity of care for yourself and your baby. It’s more than worth it. You will likely never regret spending money on a doula, because you are really investing in yourself and your care.

What ideas do you have for raising moolah for a doula? What have you done in the past — either as the doula or the client — to make it work?

Grace & Peace,
Tiffany

Nuts & Bolts: What exactly am I paying my doula for?

Monday, October 14th, 2013

Image credit: shipulski.com

Next to finding a good personality fit in a doula, financial concerns are probably the biggest factor in choosing which doula to hire, and many potential clients ask me exactly what the fee covers. In some ways, that’s an easy question to answer: “My fee covers x number of prenatals,  labor, birth, and immediate postpartum, and x number of postpartum visits, as well as unlimited phone/text/email support.”

In other ways, not so much. Doulas have to strike a balance between affordability for clients, and maintaining a sustainable practice. This can be tricky sometimes, and often takes a lot of time (and mistakes) for a doula to figure out how to structure her individual fee. Finding that happy medium is essential: 1) to prevent burnout from being constantly on-call, and 2) to reach the widest economic base they can.

Basically, a doula is going to base her fee on a combination of a few factors. Her experience, how many births she can take on in a month, and her business expenses are all part of the equation.

Now, no doula enters this profession thinking, “I’m going to make it rich doing this!” No, indeed! Doulas are all heart, and do this work because they can’t not do it. Beyond their hearts, though, a doula does have to consider the financial part of the equation, because it would be unwise not to. After all, just because she had a light month, as far as births go, doesn’t mean her rent won’t come due.

That said, I would like to explain, as simply as possible, what a doula’s fee covers–both for the client, and for the doula herself.

Nuts and Bolts–What the fee covers for the Client:

  • 2-3 prenatal visits.
  • Labor, birth, and 2-4 hrs. postpartum.
  • 2-3 postpartum visits.
  • The tools in her birth bag.
  • Unlimited phone/text/email access. A doula’s time spent just communicating with her clients can quickly add up to several hours a week in order to make sure the client has all the emotional and informational support she needs.
  • Usually four full weeks of on-call availabilty, during which she cannot leave the area, must take her own car everywhere, and cannot make any firm commitments.
  • Objective help writing a custom-tailored birth plan.
  • Continuity of care throughout pregnancy, labor, birth, & postpartum period.
  • A walking birth encyclopedia.
  • Someone dedicated to keeping the environment peaceful.
  • A skilled communicator that helps create positive dialog among members of the birth team.
  • Specific to the doulas here at Preparing for Birth: Guaranteed back-up doulas, and continuous access for the doula to an experienced mentor when things get “interesting.”
  • A professional person with an emotional investment in each client’s care, who answers only to the client–not to hospital staff, doctors, or other family members.
  • If you’ve had a doula in the past, what might you add to this list that your doula did for you?

Balanced with the above are the doula’s financial needs. In order to do such demanding work, doulas need to charge enough that they can take enough births to meet those needs, but not so many that they burn out. Let’s face it: Living on-call nearly 24/7 most of the year can get exhausting for anyone–no matter their profession. Below is a basic explanation of where the doula will put her fee to good use.

Nuts & Bolts–What the Doula needs the fee to cover so she can keep working:

  • Childcare, if she has children too young to stay home alone. Most doulas pay their childcare person by the hour, and if a birth is long enough, that can add up to a significant portion of her fee. It’s probably the single biggest cost factor in this work.
  • Her time. Probably the second-biggest cost factor when setting a fee.
  • A back-up doula, on the off-chance she can’t make the birth.
  • Phone & internet bill, including website fees.
  • Gas money & mileage on a personal car.
  • Office space, even if it’s in her home.
  • Basic business supplies (paper, printer ink, files, etc…)
  • Business checking account
  • Certification Fees
  • Taxes and state business fees
  • Birth bag tools, some of which are costly, and all of which need to be replaced periodically.
  • Promotional materials and marketing.
  • Continuing education.
  • Professional memberships.

Most doulas spend a minimum of four to eight hours with their clients prenatally, as well as another two to four during the postpartum period–not including phone calls, emails, or texts. When the time spent with a client during her labor and birth is factored in, many doulas will need their fee to cover anywhere from 16 up to 36 hours or more of time, in total. If that were the only factor to consider, let’s take a look at what a Colorado Springs doula “brings home.”

Doulas in Colorado Springs charge anywhere from about $300 up to $650, which is actually somewhat less than other cities in the U.S. of similar population size. Doula’s fees range from $500 up to $850 or more (some go higher than $1,000) in other comparable cities (based on an informal poll I took in a birth professionals group).

So, if hours were the only factor, a Colorado Springs doula grosses about $19.00 to $40.00 per hour, for each client, at the minimum amount of hours she might work. This is before any of the other listed factors come into play. When those are factored in, what’s left for her time is often less than minimum wage.

Do you know what? It’s worth it for doulas! It’s enough for many just to be there, in that sacred birth space, participating with a family the way they do. Quietly going about their doula business caring for and nurturing a new family in the moment of its expansion, melting into the background, and holding space for the mother-baby unit to hold their focus. There is nothing like that moment when a woman looks up at her partner, that wet baby held tight to her chest, with tears in her eyes, saying “I did it!”

Doulas love what they do, and they share that love and passion with each family they serve.

Taking all this into consideration, hiring a doula is probably one of the most valuable things a mother can do for herself. Forget the fancy nursery decorations, stroller, and extra stuff. Instead, a mother can invest in customized, top-of-the-line, evidence-based care by hiring a doula–and get the best deal of her life for one of the most important times in her life!

Wondering how to afford a doula? Keep an eye out for my next post, with tips on how to get creative with finances to do just that!

I had a lot of help in putting this post together, and I just want to give a shout-out to my fellow doulas at Preparing for Birth: Sarah York, Christin Yorty, Rachel Madrigal, and Jamie Nyseth. Each of these women serve as wonderful peers and fresh perspectives, and I am privileged to work with them. Click HERE to visit each of their profiles.

Grace & Peace,
Tiffany

At Preparing for Birth: A new blog post for dads!

Monday, September 30th, 2013

Beso-EmbarazadaI wrote my first post for the blog at Preparing for Birth, and it’s up today! Go check it out, and come back for more when you can!

“Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.”

CLICK HERE to read more at the Preparing for Birth blog.

Grace & Peace,
Tiffany