I recently had the opportunity to be part of a training for a local hospital's BFHI process. I wanted a tactile way for people to feel the differences in palate shapes. Needing the models to be comparable to a newborn's mouth-size, I had the idea of using plastic spoons.
Although Chelsea is in my area, Bakersfield, I "met" her in an online doula group. I love connecting doulas together, so immediately we began talking, and soon after we met. I knew she was busy last week, with some surprise early babies. I asked her to share what she learned as far as meeting the need of her clients and her families -- thus this post was born!
I believe I’m the youngest doula in my area at just 20. I have two young babies of my own and I’m learning to balance work life with mommy life, along with being married and having my own home. This last week has been crazy with two births back to back -- six long days of trying to get my footing and figuring things out. I learned five key facts this week that will help me get through many more times just like this one!
1. Have stable childcare! I’m serious. I wasn't expecting two clients to have babies so early so I still hadn't set up childcare. I was rushing around like a mad woman trying to find people to keep my two while I ran off at odd hours to births. My dad and my best friend ended up taking the blunt force of my lack of planning. Random calls of “Can I drop them off right now?” and having to answer the question of, for how long with, “ I HAVE NO IDEA." So this is definitely of primary importance as a doula and a mom of 2.
2. Remember you need to eat too! We are constantly encouraging moms and dads during births to eat and stay hydrated. Well I forgot that I needed to, too. I got home from day one of births this past week and realized I had eaten a pack of mini donuts and a Dr. Pepper -- and that was it all day! I suggest having small snacks in your bag like granola bars and a bottle of water that can be refilled. How can you care for mom and dad if you, yourself, have no energy whatsoever?
3. This one is super difficult. Balancing sleep/work/ motherhood. I was coming home from nights at the hospital at 3 and 4 am. I would come home to my very lived-in house and shudder, knowing that I needed to do housework. I would go and lay down in my bed and fall asleep doing none of it. My husband, I’m one of those super lucky women by the way, would get up with the kids in the morning allowing me a few extra hours in the bed. I would then get up, still exhausted, to spend time with my kids, not knowing when I would need to rush off again. You have to find a balance between them all. I know its hard, but it's a necessity!
4. I had to learn when enough was enough. I sat in a client's room until 3am while she slept, and I watched her every movement, waiting to get up and walk her through the next contraction. When she was asleep and her meds were working, I was still on that super uncomfortable doctor's stool. I waited and waited until finally, I was okay to head home. I was burning myself out much too quickly. I was tired and hungry and frustrated that I couldn't have done more. You have to learn that it's okay to take care of yourself, too.
5. This one is the closest to home. I was sitting up at the hospital at random intervals for 6 days. I missed my babies. I missed my husband. I missed my puppy and sharing my bed with them all. I got close to crying several times from missing them. But I had to sit back and realize doing what I was doing was beneficial for us as a family. Jumping head first into my work while the timing is right, giving myself the chance to bring in more income helps my family! We plan to have more children, and I know doula work will come and go according to our family life. Right now I can show my babies that moms can do amazing things. Know that if you are doing what's best for you and yours, that not only brings security to your family, but also it offers support to the expecting family -- that helped me when looking at all the hours gone by.
This past week has been crazy for this brand new doula! Two births back to back. Preemie ones at that. I’m exhausted. I’m happy. I’m PROUD. I’m helping change our birth community one birth at a time, and that feels amazing.
Chelsea attended her first birth in February of 2015. She was led to doula work when she realized how little women understood about their bodies and their choices around pregnancy and birth. Motivated to help that change, she is training formally through Birth Arts International, with the ultimate goal of becoming a midwife. Chelsea and her husband have two little ones, and a brand new puppy. You can learn more about her by visiting her Facebook page.
Deanna Dawson-Jesus is a force to be reckoned with! Not satisfied with how she found her environment as a new doula, she set out to do something about it. It is amazing the way she utilized her prior computer and tech skills to build up the doulas around her. Huge thanks to Deanna for sharing her encouraging story with us today!
In my pre-doula life, I was an IT Professional. I taught users how to use their software and their computers. I explained highly technical aspects of their business to the users in language that they could understand. I drew pictures, I made analogies, and I got “down” to their level. Fast forward twenty years, and I’m still training people…but this time, I’m doing it as a Doula, Childbirth and Lactation Educator and Doula Mentor. I have been a Birth Doula for about thirteen years. I have helped almost two-hundred families be born. I remember what it was like when I was a brand-new Baby Doula.
When I started, I was older, had been in the Professional Business world for almost twenty years. I had experience about how to run a business…and I still struggled. Thank God/dess, The Universe and Little Fishies for my amazingly supportive husband. Starting your own business is scary, amazingly hard work! I needed to make money…get clients…build my network. I knew I needed to make connections, meet other doulas, and learn from more experienced doulas...that meant meeting them. But how? Twelve years ago the Internet wasn’t what it is now. There was no Facebook. AOL groups existed…but the concept of Social Media was a baby too. So, I started looking, reading, and talking. I GOT OUT THERE! If I met anyone in the Birth Community that was willing to talk, I asked for a coffee-date. Then one day, I don’t remember how, I saw a posting for a doula group at a local retail store. So, I went. It was me and two experienced doulas. That was it. And I sucked up everything I could from them. One of these fine ladies was Holly Wiersma, whom I still consider a dear friend and mentor, the other has since moved away.
Then I started doing what I do best. I organized. I socialized. I got active in the community…and started gathering Birthing Energy where-ever and when-ever I could find it. I created the Birthing Babies ~ Breakfast Club…a social networking group so other professionals could connect; OBs, Chiropractors, Massage Therapists, etc.…anyone that worked with women through Childbirth and Breastfeeding. I got involved at local retail stores, volunteered for local organizations…but I was doing this mostly all on my own…but I needed more. I continued to go to that local doula group…and volunteered/took over anything that I could do to help those doulas organize and participate even more in the community. Baby fairs? Yes. Meet The Doula Nights? Yes. Letter writing and mailing campaigns? Yes. Anything I could! Flash forward to 2014 and I am one of the Leaders of that same San Francisco East Bay doula group.
That group is the Mt. Diablo Doula Community (Facebook Page) and we currently have about 25 active members. The MDDC meets on the first Wednesday of every month. The members have a meeting at 5:30pm where we have a Guest Speaker or Peer Review…or we just sit and share. Then at 7pm the evening is open to anyone that wants to come and learn about Birth and Postpartum Doulas…and they get to meet the members. Part of being a good leader is sharing your experience. Helping others learn from your successes (and mistakes) so they don’t have to re-invent the wheel. I like to talk and share and I love to help. As time progressed, I had new doulas always asking, “Can I shadow you.” I remember asking to shadow experienced doulas when I was new as well; and never felt welcome. It’s hard to get that experience. I’m sure you can understand that asking a client “Can a stranger can come in and watch you birth?” isn’t really going to go over well…but what if it was a benefit?
Part of my Business Plan is to always have a “1-year,” “5-year,” and “10-year” plan. I had been thinking about what I wanted to do when I wasn’t physically able to participate in 24+ hour births. I’m fifty years old now; births are hard on a body. What can I do to continue to make my doula business successful, now and in the future? I knew that teaching was the answer. And then I got to thinking about mentoring and training new doulas. Helping Baby Doulas seemed to be the perfect fit. So now, I am one of the only doulas in my area that actually “sells” a Shadow Doula in my Doula Service Package. This Shadow Doula is a new doula that comes to all the client’s meetings, and would be present for the birth…and if I couldn’t be there, the client KNOWS this doula and has continuity of care with their back-up. The Baby Doula gets to watch and learn, gets experience with me, and we have debriefing meetings. At the debriefing meetings the Baby Doula can ask questions, discuss their business practice with me, get ideas and I also challenge them if they might be straying from their “Scope of Practice.” It’s kind-of like Life Coaching…but it is Doula Life.
This has lead me to have a Facebook Doula Mentoring Group. There is also a free online doula mentoring session once a month; on the fourth Thursday at 10am. I have an in-person Group Mentoring Session monthly as well; it's associated with the MDDC and free to MDDC Members, but anyone can attend for a minimal fee. I also do one-on-one mentoring sessions (online or in person) for a fee.
This is me using all my experience, talents and wisdom to help Baby Doulas be the best they can be. At the same time, I continue to build my Doula Business and am enjoying watching my passion morph in to the next phase. I love birthing Baby Doulas. I love seeing these doulas become strong and capable and trusting of their own Birth Wisdom. I love my work.
Deanna Dawson-Jesus has been practicing as a Birth Doula and Childbirth Educator for eighteen years and has helped over 160 families. She has been certified as a Birth Doula (by both DONA and CAPPA), is a Certified Lactation Educator, and has been a certified HypnoBirthing Practitioner. Deanna has additional extensive training in Assisted Reproductive Technologies, VBAC support and Perinatal Loss Support. Deanna’s birthing philosophy is simple; “Your Birth, Your Way.” Find her via her Facebook page or on Twitter.
Doula work is hard! Let's just get that out of the way! Planning life, working another job or going to school, taking care of family needs -- and knowing at any minute you could be called away to a birth -- that's stress! Burn-out rates can be high for doulas, and if it doesn't send you away from the work permanently, it can leave you reeling in chaos and discontent while you try and regain your doula spirit. Find hope in these 13 ideas to keep yourself grounded and satisfied.
1. Be picky about what clients you accept. It is normal, in the beginning, to take every client that seeks out your services without thought to how you might work together. This can be draining, though. You have ideals, and while we know the mantra, "it's not my birth," it would be unrealistic to say you need nothing out of the experience simply because you are the hired help. If, for example, you feel useless sitting by your client while she gets an epidural at 2 centimeters, then it is okay to ask yourself: What would my ideal client look like? As doulas, it is rewarding for us to work alongside the client. That doesn't mean we stand in condemnation of the mother who wants an epidural as fast as she can get one, that simply means, be true to yourself and honor your feelings. During your interview, ask how she envisions her birth. If that is the information she shares ("I want an epidural as fast as I can get one"), there may be a doula that fits her better than you fit her.
2. Find something else that fills your doula cup. I taught childbirth classes for a midwifery practice. I remember sitting across the desk from one of the midwives, having a breakdown, because suddenly my doula life felt like it was crushing me. I am grateful for her words: "If you keep going when you feel like this, you may lose your love for doula work -- it can be hard to come back from a burn-out. See if there is another way you can get those feelings -- like teaching -- and then come back to doula work when your heart feels ready." In the midst of this career crisis, I felt like a failure for wanting to just walk away. This was my passion! This is what I worked so hard for, and yet, I was ready to trash the whole thing in a time of severe stress. I am grateful for the wisdom of a sister birth worker and her words of love that day. There is no shame in stepping away for a while and rebuilding your faith and restoring your energy, so you can serve better in the future.
3. Take on a partner. I remember exactly when my first burn-out occurred. I was at an especially long and difficult birth. I stepped out of the room in a moment of calm and called my very good friend, who is also a doula. "I hate this!" I cried. "I would leave right now, give them all their money back, if I never had to see them again!" I had been piling on more and more and more. I probably took this birth sooner after the birth of my own baby than I should have. The mother was not responding to any of us. The hospital put her on the clock. And nothing was working. I realized if I had a partner, I wouldn't bear the full weight of this -- I could call in support after so many hours awake and apart from my baby. My same friend and I agreed to begin working in a partnership. We didn't change our business names or websites, instead we just created an agreement between the two of us (we didn't know how long we would work like this). When a phone call came for either of us, we would explain we were working in a partnership with another experienced doula. We would attend all prenatals together, and then we generally had agreements about which client we would be on-call for (simply taking turns worked), barring another birth or life event coming up. We split the deposit, and then the doula who attended the birth kept the remainder of the fee (and she also did the postpartum visits). It was amazing! Unlike simply having a back-up, where I often feel I am spending money to keep her around "just in case" I need her (but I really try to never have to call her), with a partner it feels easier to share the births, and the guilt isn't there if I am not able to attend, because the clients know they will have support from one of us.
4. Offer gratis service to someone. When you are paid for your services, it can be a nice break to find a mama who really could benefit from having a doula. Contact pregnancy crisis centers, womens' shelters, churches, OB/midwifery offices -- someone is bound to know a woman who could use birth support. This is a way to get back to the basics of why we became doulas in the first place -- to mother the mother so she can mother her baby -- and a mama struggling is in need of that scaffolding so she can be at her best for her baby.
5. Raise your fee. The flip of that is, it may be time to raise your own fee. Feeling undervalued can lead to resentment. When I first began working as a doula, I offered clients a sliding scale. This worked well for me, and I found that clients preferred to pay my top fee. Something I noticed: the clients more likely to pay the bottom end of my fee were, in my eyes, the ones who most could afford to -- double-income professionals, in owned-homes with brand-new cars in the garage. The clients who had noticeably less more often paid me from the top end. After two births in a row where I felt I was being taken advantage of, I raised my fee and kept it there -- no more sliding scale.
6. You're stressed, so destress. In one of his lectures, Tal Ben Shahar shared "stress is not the problem, lack of recovery is." He offers a way to regain ourselves through three different ways of recovering: micro=15 minutes of every hour, mezzo=good night's sleep, macro=vacation. Realistically this may not seem practical -- we can't often walk away for 15 minutes of every hour while at a birth. But we can find small moments, even if it is just going to the bathroom. Sharar also said, "To create, you need to (re)create." Find your recreation. Do what you can as you not only care for the clients, but also as you care for yourself.
7. Work with a doula group. My third burn-out resulted in creating a doula group with 5 other women. It took a lot of time to put this together, is wasn't just a random grouping of doulas who decided to work together. We had to hammer out a lot of agreements and policies before we were ready to hang our shingle, but once things came together, this was an amazing way to work as a doula. In addition to sharing call by picking 4-5 days a month on each calendar (which clients were given so they knew who to call), we also held free mini-workshops every other week that were open to the public. Those lasted about 45 minutes, and then we excused our non-clients and paired up as doulas to work with our clients. This was a great way to attract clients, as well as devote specific time to our contracted families. Although I moved away, this doula circle is still up and running.
8. Let go of someone else's experience. We all walk away from births where we think, "What just happened???" In your prenatals, mom sounded so sure she wanted her birth one way. She seemed confident in her ideals, you felt she had done her homework and had prepared herself to have the birth she talked about. Then at the hospital, it all comes undone! It can be easy as a doula to feel you failed -- you were going to help her achieve her perfect birth, then you watched as she continued to make choices that led her further and further away from that possibility. "I can't want it more than she wants it." I say that to myself a lot. This is her experience, and for whatever reason, it didn't stack up to her before-labor plans. IT IS NOT YOUR FAULT. In order to help the clients understand they have the control, you might phrase your statements with words like, "Choosing (intervention) can lead to (side effect); are you sure that is your decision?" It is not that you are blaming her, you are helping her see she has the liberty of choice. This is assumed, of course, after gentle reminders from you about alternatives, trying 3 more contractions, etc. It is a fine line between helping/advocating, and then staying silent and happily continuing to support her once she has veered from her birth plan. She makes her choices, and you continue to support her efforts.
9. Say no. Just because you are a doula, that doesn't mean you have to answer every pregnant person's questions. Once in a while doulas get locked into conversations with women who act interested in hiring them -- the doula is hoping for a client, and the woman is hoping for free help. Decide how far you will get entangled in this before you let the woman know you would be happy to meet with her for an hourly fee (you are being her free research assistant!), or as her doula, but her requests are demanding more of your professional time than you are able to give her.
10. Set limits. As doulas we want to make ourselves available to our clients. While the average client may not need an excessive (or annoying!) amount of care, once in a while we encounter a client who is always in need of some advice, information, or help processing things. It's okay to set guidelines on when you are available and on what topics. I have a friend who is a breastfeeding counselor, and she let's families know they can call her "during daytime hours," meaning, when the sun is up. Communicate to your clients how best to contact you and regarding what topics, with the exception of when labor may be beginning.
11. Refer, refer, refer. It is too easy to get pulled into wanting to be EVERYTHING for a family. We are only as capable as our professional skills and training deem us. For issues out of your scope as a doula, if you have no additional trainings or certifications, a client's issues are best supported by the professional made for the job. For breastfeeding problems, know your IBCLCs and LLL groups. If she is having mood disorder issues during or after pregnancy, find out who helps mamas in those situations. Who are the postpartum doulas in case she needs after-birth help in that way? As her doula you offer physical, emotional, and informational help related to labor and birth. Brush up on your local resources if she needs more so you can help her get the continued support she needs.
12. Pay your back-up. When I began teaching childbirth classes twice a week, I knew I could not leave my group if I had a client in labor. This was a huge stress for me, even though it was only 4 hours a week that I was unavailable. I wasn't sure how I could take clients until I realized, with a solid back-up, I would have no worries. She could step into the doula role while I was at class and manage things until I returned. For this peace of mind, I would pay her half the deposit, and she would attend one prenatal with us, as well as be on-call for me.
13. Find your support community. Doulas support families, but who supports doulas? Although like anything, a real-life group of fellow birth workers is ideal, that isn't always practical, so online groups are also an option. There is something that runs through our veins and our hearts, and it bonds us. There are some things it seems only other doulas can understand. Gathering together with others when you are feeling disappointed is a way to be buoyed up, and we all take our turns being the one lifted, as well as being the one doing the lifting. Turn to you doula sisters when your heart hurts and your mind is telling you you aren't making a difference.
There is a lot of talk about what your ecological footprint is -- meaning, what impact do you have, because of your lifestyle, on the earth and its resources? Being in the world of moms and babies as a doula and an educator, I have seen a different footprint we can leave, a Birth Footprint.
Basically, your birth footprint is a combination of your personal experiences, beliefs, biases, and philosophies that could be projected onto other women and families -- instead of the pressure you put on the earth, it's the pressure you put on others.
Here are a couple examples of exerting your birth footprint (and they happen to be mine!):
Giving clients opinions instead of actual facts. We don't try to do this intentionally, but rather, we give anecdata from what we have seen or experienced, versus evidence-based information that comes from reputable sources such as Cochrane Collaboration.
With my second pregnancy, on my due date, my midwife asked if I would like my membranes stripped. I was tired of being pregnant (who isn't by 40 weeks, huh?) and I willingly agreed. Nothing happened, not one thing -- I was pregnant for another week. In my mind I equated membrane-stripping with a low-risk intervention, not inclined to do much.
Back when I was certifying I had a client who was offered a membrane-stripping by her practitioner. She agreed, and immediately began contracting every 9 minutes. This was the start of hours of uncomfortable, non-progressing labor. She went to the hospital after 12 hours with contractions still no closer together or longer in length. She begged her practitioner to allow her to stay the night and he agreed. The next morning, 24 hours after the membrane-stripping with still no change in contraction pattern or cervical dilation, her practitioner broke her water, offered her an epidural, and began induction procedures. This mama hadn't slept all night, her epidural wore off three different times, and by six pm, she was offered a cesarean birth -- exhausted, she agreed.
I had no part in her decision, we had not discussed this topic beforehand; but if she had asked me about membrane-stripping, I might have said, "It's no big deal, it doesn't do anything anyway." My answer would not have been true! While Cochrane states, "to avoid one formal induction of labour, sweeping of membranes must be performed in eight women," it goes on to mention "sweeping can cause discomfort during the procedure, bleeding, and irregular contractions" -- all of which my client experienced. Her contractions didn't change her cervix, but they did wear her down, diminish her spirit, and factor into the making of decisions she previously wanted to avoid.
Letting personal biases interfere. As we work with different practitioners in the birth world, we get good ideas about who we like, and who we would like to avoid. A woman sought out my doula services, and I was thrilled when she shared her midwives were my midwives. An assumption came from this: I knew these women well, I valued their skills and their style, and I had two of my babies with them in amazing-to-me births -- I guessed my client felt the same. But guess what? I was wrong. My client was having doubts about her connection to the midwives, and while she tried to process her own feelings, I was trying to talk these women up, in the hopes that my client would feel better about her choice to birth with them.
What I didn't realize was, this chipped away at my ability to be the non-biased sounding board my client deserved. My attempts to smooth the rough feelings my client had were actually setting us up for division, as I was supposed to be on the mom's side, and it seemed like I was on the midwives' side. Before things got to an uncomfortable point, I saw my job wasn't to fix the situation. Instead, I offered communication strategies my client could implement, including role-playing with her so she could practice conversations before her appointments. She had a memorable birth with just the right midwife, and I had a memorable lesson in my client's needs and feelings coming first.
Questions to ask yourself if you are a birth-worker:
1-Do I bring up my own experiences of birth and share them readily with my students or clients? No doubt having babies is exciting and life-changing. We do have a need to share our stories, this is human nature. I have joked that every woman has to share her birth story 78.4 times before she can move past it to help another woman. If she tries to move into birth work before she is ready, her expectations can be either to help women avoid an experience like she had (if it was less-than-satisfying), or to share a formula that other women should follow to have an experience identical to the one she had. This is the client's experience, let it be shaped by her education, desires, personal beliefs, and choices, and she will come out with an incredible story of her own to share.
2-Do I encourage her to find her own way? Another trap if you already have children is, when your client is presented with a decision, she asks, "What would you do?" It can be the easy way to just simply answer -- you have experience, you know what you are comfortable with. But that would be taking away this family's experience of facing a tunnel of indecision and coming out the other side with an answer they feel fits for them. In the short run, you can look like a hero with the solution, but in the long run, that doesn't help this family build up their confidence in parenting and making choices for their baby.
3-Do I have strong feelings about choices families make regarding birth and parenting? I have a close friend who admitted she couldn't work with pregnant or new moms because she can't handle when they make choices she feels are wrong. Instead of trusting parents to make their own educated decisions, she wants to "bully" them into parenting as she does. For example, she has always co-slept with her babies, and it drove her mad to see parents put their babies in cribs. Instead of offering evidence-based information such as Dr. James McKenna's research, she wanted to jump to scare-tactics to push parents into making their decisions. This is not choice, this is force fueled by strong statements full of fear. We must trust families to make the choices they feel are right for their situations.
4-Do I include myself as an integral part of their birth story? I admit, it feels good when a family says, "We couldn't have done it without you!" And it would be great if I could really believe that and walk around with that feather in my doula cap. Maybe it's altruistic (more likely, insecurity!), but that doesn't rest well with me. I once read a birth story where the doula went on and on to list all the things she did (10+, all numbered and acknowledged) to make this birth experience amazing for the mom and dad. Did the parents walk away feeling the power of themselves and their baby? Or did they walk away feeling like without their doula, they would not have been equipped with the tools and strength to have their baby? My response in situations like these is the same: "You could have done it without me -- I could not have done it without you."
5-Do I have specific requirements for parents? I had a former doula client who moved states away after the birth of her first baby. She was pregnant again and interviewing doulas. She texted me: "Is it normal for doulas to say they will only take you as a client if you agree to specific things?" The doula they interviewed said, she taking them as clients would be contingent upon them taking "approved" childbirth classes, committing to breastfeeding, and signing a statement to say they would agree to "nighttime gentle parenting." This family already believes in breastfeeding and the family bed, but they weren't prepared to take additional classes. Equally upsetting was, they were prepared to interview the doula, and instead they felt they were the ones being interviewed. "This was not what we were looking for, it kind of goes against the reason we wanted a doula in the first place." After a few more interviews with different doulas, they were able to find one that better fit their family. Of course as doulas we need to take clients we also feel fit our needs, I understand that. The process, though, can still be about the parents while we quietly assess how the fit feels for us, and then act accordingly after the fact if we know we aren't the right doula for this family.
There are many ways we can shape the births of our clients, these are just a few to consider. Doulas, what other ways can we impose our birth footprint on our clients, and how can we best avoid these roadblocks? I would love to hear from you.
Wherever I have lived, I always worked hard to bring doula trainings to my area. Why, some might ask (my husband included!)? Why would I want to bring in more competition? I guess my reasoning there would be, so birthing families in my community have more options about the doulas they are able to select from.
♥ four young boys and a boy dog (offspring)