Advice for Doulas Thread

[art_teachermommy]

I've looked for a thread like this and couldn't find one...sooo...

What would be your one (or several) piece/s of advice for those studying and practicing to be Doulas?
I know that experience is the best learning tool...but it never hurts to get advice from the vetern doulas and midwives in the field!

or mama/client's point of view (thanks yarngoddess)

[MidwifeErika]

-you don't need the large amounts of tools that you will think you do. People are hiring you, not your back massager that has 15 settings.

-if someone doesn't hire you after an interview, don't take it personally

-make sure to be yourself, that is who people want to see

-read as much as you can and always read more

-be humble, we aren't doing anything that special, it is the mom who is doing it all. we are just lucky enough to watch a real miracle

-always look for ways to get the father (or partner) involved in ways the mom will remember. It is important for them to connect as much as possible during this event. After the birth, give them space as a family... that might just mean taking a few steps back and staying so you are useful for breastfeeding help, but try to let that bubble of love and those love hormones to be used on the right people

-have fun

[yarngoddess]

Are you asking for advice from other doula/midwife's only, or are you asking for advice from a mother/client's point of view?

[art_teachermommy]

originally i was going from the doula/midwive angle...but i think it would be awesome to get the perspective from a mama/client view

thanks for bringing that up!!

[Mamato2and2]

:

[avalonfaith]

oooo i like this thread. subbing.

[BirthIsAwesome]

Always keep reading and never stop learning!
If a woman ends up with a birth that she didn't plan for, don't feel bad or like it was your responsibility: My first hospital birth mom ended up with an epidural after 16 hours of prodromal labor and 10 hours of active labor with 90-second contractions every 2-4 minutes, at which point she was told that she was 4 cm and "was just starting good, hard, active labor"---having a nurse VERY unsupportive of NCB didn't help a bit. I felt like a total and absolute failure. But a few months later when I talked to the mom, she said that she was so grateful that I was there, that I had been a crucial aspect in her birth, and that she felt that I helped her prevent a C-section.

Those are my only tips, but I thought you might like to see what I carry to births. Some of these items I learned that I needed by trial and error--hopefully I can prevent that from happening to other new doulas!

This is what I have in my doula bag:

For the client
A cherry pitpack: A pack filled with cherry pits that you can microwave for a hot pack. My mom's have LOVED the way it feels on their backs--not just the heat, but the massaging effect of the cherry pits.
Massage oils/lotion: A small bottle each of almond oil and Arnica infused oil (my mom's love this for foot and shoulder rubs; it dissolves tension and is good for achyness). Homemade organic lotion---unscented, mint & eucalyptus (great for back labor; it has a numbing effect), and lavender.
An inexpensive birth ball
And of course, my hands, heart, and brain, which are the most important tools!

For me
My nametag and membership card with ALACE: This is essential if you attend hospital births--on my first hospital birth, the nurse chewed me out for 20 minutes about not having "identification" and a "credential". She even asked specific questions about what it took to get certified.
Deoderant and toothbrush: I really needed this on a 36-hour labor but I didn't have it; now I always carry it.
Something to do (a book or knitting): Sometimes the couple just want some time alone. Also, at a hospital birth, sometimes the mom is in triage for an hour and they only allow one person with mom--she always wants her husband/partner (of course!), so I'm stuck in the waiting room forever (it seems!).

I also second hotwings advice--all VERY good tips!

[yarngoddess]

Doula advice from Client

*I would say to be knowledgable about ALL types of child birth- whether it's lamaze, bradley, or hypnobabies- have a general "Knowledge" of how each method works and is taught. Try to learn how you could help in each of those method's.

*I agree with PP- don't waste your money on the gagetry- your attention to detail, such as dry feet needing lotion, bed linnens that are wrinkley and maybe causing pain. I also think that you should try to incorperate the DH/DP as much as possible- even if it's just to ask if he needs anything.

*We, as mom's/clients really want your business to flourish, and for you to learn- however we don't want you to seize that opportunity DURING our labor, or RIGHT after we have given birth. If you want to ask the Dr. questions, do so at the nurses desks- they will more than likely answer your questions there! The nurses the same thing.

*Learn what pushing sounds like. Most women make a noise that is unmistakeable when they are pushing- because some of us cannot talk once they hit a certain point of labor. I'm one of those people, and I warned my doula that I can't talk once I hit about 8 1/2 cm. She still was unprepaired for me pushing- something I wasn't conscious that I was doing. Also, ask if the mom's having a cold/stuffy nose, because if she is, she can't swallow and breath at the same time, and is therefore NOT holding her breath. There is a difference! If she's sick, try to remember what that is like.

*Birth is AMAZING- and we know that, but please try not to act like a little kid in a candy store. We are glad that your excited, and glad that you love your job, but we still NEED you once the baby is here.

*Please don't leave until we have been clened up, sat back up, gotten some juice and some food. It would be ideal for you to stay until we get transfered rooms, but that isn't always possible. At least until we are upright, with drinks.

*If the baby has to go to the nursery/NICU - PLEASE, PLEASE, PLEASE don't leave. Don't leave mom alone until she understands what is going on. Get an update on the baby before you leave, so that mom isn't clueless. Ask that she has a breast pump taken to her room ASAP- so that she can atleast pump for the baby.

*Please try to keep your cost down, as a lot of us NEED you, many of us can't afford you.

*Finally, we really value the service you are providing to us, even when we don't act real appreciative!

[BirthIsAwesome]

*Please try to keep your cost down, as a lot of us NEED you, many of us can't afford you.

I've been meaning to start a thread about charging for my doula services, but since yarngoddess mentioned it, I thought I could ask here. I am currently charging $300 for:
-one free consultation
-two prenatal visits, including birth plan assistance, education, a 50-book lending library ect.
-on-call 38 weeks until birth
-continuous support at home and at the hospital during labor
-limited birth/postpartum photography
-immediate postpartum care ie. 2 hours after birth
-one postpartum visit, including breastfeeding assistance and referrals
-a meal at 4 days postpartum
-unlimited telephone and e-mail counseling throughout pregnancy and 6 weeks postpartum

yarngoddess--is this reasonable to you? I've been struggling with needing to make some money after doing many free births, but I want EVERY woman to have a doula that wants one. What would you suggest for couples that can't afford me--sliding scale (where would I find one), barter, payment plan, discount ect.--and how do I offer it without people that CAN afford it taking advantage of me?

Sorry to hijack the thread, I hope no one minds. Thanks for any input!

[Rockies5]

Hmmm great thread. Be sute to check out the Doula/Doula students thread in the Tribes section too!

I only charge $250, in my community the norm. is 4-600.

This includes (pasted from my website)

phone contact at anytime during pregnancy, or early labor. I am on call 24hrs a day for the two weeks before and after your EDD. I offer labor support individualized to your needs, Birth plan counseling, lending library and referral list, continuity of care once labor begins, three prenatal and up to two postpartum visits, prenatal and postnatal client packets, discounted attendance at any childbirth class I teach, Breastfeeding support, parenting and newborn support and dinner for the new family.

This is enough to cover my babysitting costs. I do it because I like birth, and offer free services if an induction is planned for any reason (because I don't need sitters in that case, and I don't have the stress of being on call. I HATE being on call!

I'm trying to get a volunteer program started in my area, where we would just be on call a few days a week and show up to help mamas who want it.

[rnchrista]

Originally Posted by yarngoddess

*Please try to keep your cost down, as a lot of us NEED you, many of us can't afford you.

What doulas charge is such a tough issue. Of course I, and probably most others, will reduce our cost if there is a woman that truely can't afford to pay. But I've also had people say to me before that they can't afford a doula but in their next sentance they are talking about a very nice vacation (or another luxury) that they plan to take.

I try to keep my fees reasonable but I don't think many people realize what goes into this job. How much I have to spend in daycare for 2 children (and finding a place that will take your kids on a drop off basis is not easy, and usually more expensive then average). The general cost of doing business....cell phone, website, gas, hospital parking fees, client handouts, advertising, doula equipment, lending library books, etc. There is also the cost of education....continuing education classes, additional certifications, membership in Doula organization, subscribing to professional journals...all so we can continuously increase our skills and keep up with new issues in obstetrics. I am also on call 24/7 almost every single day of the year, and I believe my family deserves to be compensated for the challenging life that I lead. When my husband sees me bringing home some money, it is so much easier for him to accept when I am gone for 36 hours and he has complete responsibility for the kids and household, in addition to his job.

As much as I love my job, I think all birth workers deserve to be paid fairly, just as other professions are.

[sheilige]

Subbing! Great thread!

[mamallama]

Regarding fees--when I was practicing, my fee was $350, including the typical 2 prenatals, 1 postpartum, phone support, and labor support. I've never figured the average amt. of time I spent with each client, but for the sake of argument, lets call it 40 hours. That works out to $8.75/hour. That doesn't include on-call time. Out of that I paid taxes, put gas in my car, and shelled out big bucks for on-call/drop-in childcare, in addition to handouts for the families and continuing ed. for myself.

$8.75 is not a whole lot of money, especially considering that I often worked 24 hours (or more) straight, and more often than not I started that shift after a full day of my own life.

I hear the concern that not every family who wants or needs a doula can afford to pay $350 out of pocket. I've lowered my fee (sometimes drastically) for women who are truly in need. But like Christa said, it is very common for a client who balks at paying the full fee to enjoy other luxuries that are simply out of reach for my own family.

[mamallama]

My advice for aspiring or new doulas is to find and make friends with the other birth professionals in your community.

Networking is good for your business. Meet the CBEs and chiropractors. Stop in
the herbalist's shop. Referrals are nice, whether you're giving or receiving.

Doula friends are good for the soul. Try to find a couple. You might have a client that perplexes you. You might need to debrief after a difficult birth. God forbid you ever face an unexpected outcome, but if you do, you need another doula to lean on. If nothing else, you don't want to leave your client high and dry should your kid come down with the flu. Find out who the other doulas are and get to know them. If you don't find one you can develop a relationship with, keep looking.

[yarngoddess]

I agree with you all about fees, as they are so very important. $250-$300 is a very reasonable rate, what I paid. The normal here is $500-$650 and that isn't something I could afford. Maybe you could offer a different set of options, like a menu of what people need. While some may not need prenatal support other than to meet you, they may need more support in the hospital and first visit at home. I do like the idea of a bartering system, but that would have to be up to you and the client.

It dosen't even dawn on me about how mean people can be, by asking for a discount when they don't even really, REALLY need a discuount. I, on the other hand had asked 3 doula's about a reduced fee, and was shut down very rudely. So while I understand your wanting to protect your finances, sometimes you could take a risk too...

Has anyone ever tried to partner up with a physician/midwife group where you would have access to their patients, if the patients so wanted, and get help from the physician in regards to fee. I asked my OBGYN about this, and he since has proposed a bill to the local hospital to have a set of people on call- and paid by the hospital.

[BirthIsAwesome]

Originally Posted by yarngoddess

It dosen't even dawn on me about how mean people can be, by asking for a discount when they don't even really, REALLY need a discuount. I, on the other hand had asked 3 doula's about a reduced fee, and was shut down very rudely. So while I understand your wanting to protect your finances, sometimes you could take a risk too...

OMGosh!!!! I can't believe a doula who really loved birthing moms would REFUSE a mom a discount if she ASKED. My problem was not giving a discount, but trying to offer it without being taken advantage of. I was just afraid that if I said on my intro sheet "discounts available to those in need" that everyone would want a discount. Do I even need to mention it, should I just expect that if a woman really needs a discount, she will ask me for one?

Maybe you could offer a different set of options, like a menu of what people need. While some may not need prenatal support other than to meet you, they may need more support in the hospital and first visit at home.

That's a GREAT idea! So far I have only had primip moms or multip moms with previous traumatic experiences (and want a natural birth this time), so I have had to do a lot of educating. But for multips that have already had a natural birth or are self motivated and self educating, I could do less prenatal visits.

Also, I forgot to add in my other post that I only charge $150 for homebirths. I know the financial strain of shelling out $3000 for a midwife (my parents did it 4 times after 2 NCB in the hospital and it was a trial) so I want to make my services affordable for women who are paying for their births out of pocket versus in the hospital where insurance pays for their birth. Secondly, the midwife does SO much educating, that I really don't have to do much prenatal education, if any. And thirdly, in the home I can be free just to support the mom without having to fight for her every minute, like in the hospital.

[Rockies5]

There is some great information here. It's easy to ask how much they make per year. 99% of my clients make more then my husband and I make (and we raise 5 children and are both in school).

I still volunteer whenever it fits my schedule. Its about loving to be there, supporting women. The paycheck is always a bonus.

[sacredma]

its good to know how much other doulas charge in your area. i charge the same as they do, and i offer a sliding scale. another option is to have a payment plan.

[1stimestar]

Another option is to offer fundraising ideas. If a client is willing to work to raise her doula fees, and still don't quite make it, then it hurts a lot less to accept less in payment. Having a doula fund tree at their baby shower is popular. Having a doula fee fundraising garage sale (where I can send all my doula friendly friends) is another idea. Going on a three month haitis from lattes and putting that money towards my fee can add up quickly for some families. Anyways, there are a lot of ways women can make money to pay doula fees if they get creative enough. I depend on my fees to pay my rent. While I do offer a sliding scale if asked, I don't offer to do it without some work from my clients.

[tlcdoula]

Originally Posted by BirthIsAwesome

Massage oils/lotion A small bottle each of almond oil

I just wanted to caution with almond oil for those who have nut allergies which are becoming very prominent! I also don't mean just for the mom but anyone who comes into the room. I have a very severe nut allergy and do not even have to touch the mom to send myself to the ER. Once I observed a massage and was about 5 feet from the mother and had one of the most severe allergies ever. Another time I went into a massage place the used almond oil and within minutes of being in the room (clean sheets were on the table, etc) I had an allergy going.

Unfortunately for whatever reason nut allergies are on the rise and they are severe often and people don't always think about massage oils. Therefore if you are using almond oil I would be very careful and caution or question anyone that enters the room on their allergy status (including family members, nurses, healthcare providers, etc).