Posts Tagged ‘birth doula’

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

 

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

A Guide to Finding Your Doula

Tuesday, August 2nd, 2011

Building a labor support team is part of conscious preparation during pregnancy for your labor,  birth and life with the very newborn. Hiring a labor doula continues to gain in popularity for the expecting family. Your doula comes alongside you in pregnancy through labor and delivery with some additional early postpartum follow-up.  For additional after birth support, a postpartum doula is a great addition.

Step 1: Finding a Doula

  • Inquire with friends, family, local support/informational groups (for example – ICAN, LLLI, Birth Network, Birth Circle, Cloth Diaper store), childbirth educators, care providers, prenatal massage therapists, prenatal exercise instructors, lactation experts and chiropractors for referrals.
  • Use your favorite search engine and type in your city or area name with the keyword doula
  • Search training and certifying organizations such as CAPPA, DONA, ICEA ToLabor , Birth Works and Birth Arts International
  • Search general doula sites such as All Doulas, Doulas.com, About.com, Doula Match or Doula.com

Step 2: First Contact

Once you have located local area doulas, the next step is  to make contact. You will likely find that most doulas are women though occasionally you will find a male doula in your area.  After visiting any websites; phone or email only the doulas that most interest you and fit your particular needs.  Generally there is not much need to contact more than three perspective doulas.

During your initial phone conversation or in your email be sure to include:

  • Full name
  • Contact information
  • Estimated Due Date
  • General location where you live
  • Care Provider
  • Birth Location
  • Top needs and desires for birth
  • If referred, by whom
  • Any financial considerations

Step 3:  Setting up the Interview

I encourage after the phone or email contact and response, set-up in-person interviews with the doulas you found most compatible with you.

  • Unless the doula you are meeting has her own office, interviews are usually held in a public place such as a coffee house, restaurant, library, park, or shopping center. If you meet at a place where beverages or food will be ordered you can offer to pick up the tab for everyone if you desire, but it is never expected.
  • Your partner, husband or other support who will be attending the birth needs to be at in-person interview if at all possible.
  • Expect the interview to be approximately an hour and to be free of charge.

Step 4: The Interview

The interview is to gain more detailed information from the doula, as well as, share more  about yourself and what you want.  It is customary for the doula to either email ahead of time her client packet or bring it with her to the interview. It may include her professional profile, client agreement, services, and support details, as well as, additional offerings.

Suggested Interview Questions:

  • Why are you a doula?
  • What is your philosophy of childbirth?
  • Where did you get your training?
  • Are you certified? Why or why not?
  • How long have you been a doula?
  • What is your scope of practice?
  • What types of births have you participated in?
  • What types of birth locations have you been to?
  • How many births per month on average do you attend?
  • How many clients would max you out in a month?
  • Have you ever missed a birth? Please explain why.
  • Do you specialize in working with a specific type of clientele or birth plan?
  • What has been the most challenging birth you have attended? Why?
  • How do you work with my husband/partner/other support?
  • Have you worked with my provider before? If yes, please describe the experience.
  • How many prenatal visits would there be?
  • In general, what is covered in the prenatal visits?
  • Will you help me make a birth plan?
  • Please explain how your fee is structured.
  • Do you accept barter?
  • Do you have a back-up and do I meet her ahead of time?
  • When do you go on-call?
  • Do you labor at home with me?
  • What do you do if I am induced or need to schedule a cesarean?
  • When will you see me postpartum and what does it include?
  • What are your expectations of me as a client?
  • How long do I have to decide before you would contract with someone else around my EDD?

Of course that is a fairly long list of overview questions. Brainstorm some of your own. The interview is not meant to be a free prenatal visit, it is simply to find out if you and the doula are a fit personality wise and in how she practices.  Most doulas do not expect to be hired on the spot. You  need time to think and process after each interview. If a doula is pressuring you to hire on the spot because she fills so quickly, that could be a red flag and cause for you to take a pause.

Step 5: Hiring the Doula

Within 1-2 weeks,  contact the doula you would like to hire and proceed and those you did not choose to let them know you have hired someone else so they will not be holding your EDD space open any longer.

Details to be clear about when initially hiring your doula:

  • Sign and return the agreement/contract she gave you at the interview (if applicable).
  • Return any intake paperwork by mail or email.
  • Payment  – First portion of fee is usually paid upon hiring a doula.
  • Ask her usual business hours and contact preference for non-emergencies or labor related needs.
  • Let her know your contact preferences and all phone numbers to reach you and your spouse/partner or other support.
  • Set the date and time for the first prenatal appointment. Give her directions if your home is not easy to find.
  • Get clarity on what routine contact she would like from you (updates after care provider appointments, etc.)

Happy doula-ing!