Doulas--"on call" protocol...

[redpajama]

I am currently attending births voluntarily as I work towards my certification.

I have a client due late in July and a couple in August.

I don't currently have back-up (trickier to find when you're not getting paid yourself and therefore can't offer back-up doula any money). I'm looking.

From what I've heard/read from other doulas, I felt it was reasonable to consider myself "on call" (meaning I stay within a reasonable proximity) beginning two weeks before a client's EDD. I planned to take a trip up north with my family either the first or second week of July (to be sure to be back 2-3 weeks before her EDD.

This client sent me an e-mail last week (at <35 weeks) saying that she'd seen her OB and he told her to expect the baby early, "maybe even in the next two weeks." I asked what he based this on. She said, "On how I'm feeling." She's very dramatic and tends to complain a lot, so I sort of wrote this off.

A week later, today, she sends an e-mail saying, "I'm pretty sure I'm in early labor, but I don't expect anything to really happen until next week."

There doesn't appear to be any legitimate reason to think she will have the baby early. ( To be fair, this is her second child and #1 was early.) Although I like her well enough, she's a very negative person who is very difficult to please. I find it hard to schedule prenatal appointments with her, because when I say I'd like to get together and talk about her birth plan, she asks me to stop by a park where she's meeting a playgroup (so I'm there with her and two or three other women and children, trying to carry on a conversation with her while she's also carrying on several other unrelated conversations, and everyone's giving their input on everything we discuss.)

So the question is: what's the right thing to do? I don't feel that I "owe" her four weeks of staying nearby (not to mention if she happens to go *past* her due date, which would be so poetic I would probably write a song about it), but I know she's going to get pissy if I respond to all these "I'm going early" e-mails with "I'm leaving town next week." I haven't mentioned this trip because we hadn't (still haven't, exactly) nailed down the dates, and because I didn't have anyone due nearby, so I didn't think it was pertinent. I've looked for back-up, and I plan to post in "tribal areas," but I can't be sure I'll find anything (plus she's *super* picky, and I suspect she'll be unhappy regardless of how any of this works out, so I'd like to avoid giving her a reason to think it's my fault). But, on the other hand, time with my family is important, and I deliberately set aside these first two weeks of July so that we could travel together. So...what would you do?

ETA: This is a little complex, but finding back-up is extra difficult in this case, because I know she won't be happy with whoever is my back-up (not to suggest she'll be happy with me, but at least she *chose* me, so I think she'll feel some ownership). So I don't want to be "blamed" by her for having chosen a "bad" back-up doula, but I also sort of feel bad setting another doula up with her. I know I sound like I don't like this woman...it's not that. It's just that I'm a pretty confident person who can take things with a grain of salt, and I know to bring the whole spice rack when I go to visit this client.

[1stimestar]

Why should she expect you to stay home before your on call time. She HASN'T invested in having a doula at all. She hasn't paid for your services. She hasn't invested in time for your prenatals. I would just tell her when you will be going and when you will be back, period. If she doesn't like it, she can try to get another doula who thinks they need to give their services away and see how THAT works out. This is just one of the obstacles you will run into by offering your services for free.

[DoomaYula]

Well first of all, attending births for FREE is a mistake, imo. I realize that when you're certifying you need to attend births, but our work is extremely valuable and we deserve compensation for it. When I was getting in my first 10 births, I charged $100. Way less than what most doulas charged, and I definitely lost money on my end (paying for babysitting because everyone went into labor when my dh was out of town, or had just left for a 10h work day).

I am going to paraphrase pamamidwife : volunteer doulas are just asking to be taken advantage of. It sounds to me like this woman really wants you at her beck and call. Meeting you when she's conveniently attending a playgroup? Not cool.

So, although it sounds like this woman may guilt-trip you, don't go on THAT trip (the guilt trip, ha ha, tip your waitress, thanks) and instead go on the trip you're planning with your family. I'd be back when she's 38w -- that's when I consider myself on call.

And don't take any more clients for free!

[1stimestar]

Almost got us a simulpost Yuma!

[teachinmaof3]

Do you have a contract with her?

I would just tell her when you will be going and when you will be back, period. If she doesn't like it, she can try to get another doula who thinks they need to give their services away and see how THAT works out.

That's exactly what I was going to say.

There's no reaon to be anyone's doormat just so you can get births in for certification.

And ditto about not doing births for free. You really should start charging something.

[redpajama]

Yeah, with regard to attending births for free...when I decided to certify, I ran out and post a craigslist ad offering my services for free. Didn't even consider charging anything, because I didn't feel like I "could." This was before I had even attended my training. So, in some ways, I've learned my lesson--but it's sort of a moot point now, since I've already agreed to it.
On the other hand, I've taken on some clients who probably couldn't have paid me, and they have been so fantastic to work with, and so gracious and forgiving as I sort of feel my role out that I don't regret for a second that they aren't paying me. If I had it to do over again, I can't say that I wouldn't accept clients for free, but I would look at our initial meetings more as *me* interviewing potential recipients of my free services, rather than *them* interviewing me as their potential doula. I could have been more selective in some cases.

Anyway, you confirmed what I already knew, and I appreciate that. (Of course, if someone is of a dissenting opinion, I want to hear from you, too.) I'll probably let my client know that I'll be leaving town next Monday. And if there's a god, and he/she has any sense of humor, I'll be attending this woman's birth at 42 weeks.

[1stimestar]

In general, there is a difference between people who are looking for a free doula and people who want a doula but can not afford one. There is nothing wrong with offering reduced fees to someone who really wants YOU as their doula but can not afford your normal fee. There are things they can do to show you that they really do appreciate you. You can offer them reduced rates or they can offer bartering services or something to make it more worth your time. The ones who just want a doula because they hear the word free are just so different then the ones who want something more from their birth but can't afford it.

[Stephanie L.]

Originally Posted by 1stimestar

In general, there is a difference between people who are looking for a free doula and people who want a doula but can not afford one. There is nothing wrong with offering reduced fees to someone who really wants YOU as their doula but can not afford your normal fee. There are things they can do to show you that they really do appreciate you. You can offer them reduced rates or they can offer bartering services or something to make it more worth your time. The ones who just want a doula because they hear the word free are just so different then the ones who want something more from their birth but can't afford it.

Perfectly stated. I have not charged for births (yet). I feel like it's a bit competitive here and charging without any experience won't get me anywhere. But there's a difference between clientele.

At first, reading your post I was thinking, you signed on with her, people are people, you get what you get, you're there to be supportive regardless.... But these more experienced doulas make such a great point: you need to extablish boundaries. Something to think about beforehand (IF you can).

I will try to do that next time---or maybe I'll just charge.

[tlcdoula]

I have to agree with the other ladies - this woman is not invested in you or your services. Whenever I do free births (which is very rare these days) I actually make sure that the person understands my "requirements". I require them to be vested in what I am offering them and actually even give them homework. To some this might sound mean, but I will not give away my services to someone just because they want a doula or just because they cannot afford it. When I used to do lots of free births with teens I would set my rules and the day before my prenatal would call them and see if they accomplished what I asked them to and if they didn't I would tell them I could not attend their next prenatal until it was done (you should have seen how fast they accomplished whatever they had to do). I set my rules like that so that i wouldn't be taken advantage of and so that I knew they truly wanted my services.

I would call this woman and explain to her that the prenatals that have been done are unacceptable and that you would like to meet with her on x day or x day (give her two dates to pick from) and if she cannot do so then you cannot be her doula. Unfortunately you have let her get away with a lot and now she expects "more".

Now as far as the on call period goes - that is a tricky one because if she has a record of going early she truly could have this baby early. I know with me I always had my girls 3-4 weeks early (I have six daughters and one son) and when I was pregnant with the girls I always commented on how they would come early and no one believed me which upset me. Had I hired a doula and she blew me off I would be upset (of course you do not have a client who is vested her time and energy in you so this is slightly different, but I am sharing this for potentially other clients you might have). Anyhow, the doula I would like to hire when I have my next baby (if I have one) already knows my history and so honestly I would expect her to be in town prior to the on call period.

I think it is important to be available to clients once we hire on with them unless they know about events prior to hiring us. For example, I have three clients due in July (19th, 20th, 26th) and prior to each one hiring me they knew I was going to be out of town the first week of July and wouldn't return until the 8th. They all knew, they all were okay with that and they all hired me, but I don't think it is fair to spring something on a client (again maybe it doesn't apply to this client as she isn't invested in you or your services but for future clients).

[memiles]

I think it's important that our on call times are strictly defined in our contracts, and that we get a signed contract even for a volunteer birth. For me, I state it as "I will be considered on call from 38 weeks of pregnancy until the birth of your baby. If I am unavailable at any time during that time, I will provide a backup doula of similar experience and training. If requested, you may meet that doula prior to the time they will be on call for you, unless my unavailability is due to unexpected illness or emergency. Reasonable attempts will be made to attend preterm births, but I cannot guarantee my availability prior to 37 weeks".

When we discuss this part of my agreement, I let them know that my windows for travel are very brief, as I am usually on call for someone. I plan my vacations well in advance, so I let clients know before they hire me if I plan on travelling. If an oportunity to go out of town comes up after a client has hired me, I always let them know before I make firm plans if the plans are falling after they are 36 weeks or so. For a client with a history of early babies, I probably wouldn't plan a trip for 36 weeks on, IF I felt like we had a good working relationship.

In this case, though, it sounds like the client doesn't have much respect for your time. I'd put out another call for a backup (I'm willing to back up for an unpaid birth for new doulas if possible, because I feel like it's a way that I can contribute to the doula sisterhood) and see if you can find someone to take that on call time for you.

[redpajama]

memiles--You're absolutely right, and I guess this is a big part of the reason I *did* take on these first few births for free, to allow myself opportunities for learning lessons that I really couldn't learn in a weekend workshop. I definitely should have defined my on-call time clearly and concretely from the beginning--in the future, I will (I may even borrow from your wording, if you don't mind).

[bryonyvaughn]

Originally Posted by memiles

I think it's important that our on call times are strictly defined in our contracts, and that we get a signed contract even for a volunteer birth. For me, I state it as "I will be considered on call from 38 weeks of pregnancy until the birth of your baby. If I am unavailable at any time during that time, I will provide a backup doula of similar experience and training. If requested, you may meet that doula prior to the time they will be on call for you, unless my unavailability is due to unexpected illness or emergency. Reasonable attempts will be made to attend preterm births, but I cannot guarantee my availability prior to 37 weeks".

I've never had a doula but I like the idea of stating this up front. I had one spontaneous labor 10 days early but the rest were 42, 43, and 44 weekers. If you normally were "on call" 38 to 42 weeks, a client with a history like mine could negotiate a doula being on call 41 to 45 weeks and one with a history like tlcdoula's could negotiate a doula being on call from 34 to 38 weeks.

~BV