What do doulas do?

October 31, 2011 5:19 PM

What is it like to be a doula?

In my post-college period of casting around for potentially interesting careers, I've begun keeping a list of jobs that I think might interest me, no matter how weird or crazy. For most of them, I know how I'd get there and what, generally, they would be like- teacher, city planner, therapist, hell even carpenter- but the one thing on my list that I really have NO idea about is being a doula.

A friend of mine was a doula in college, and worked pro-bono in our university hospital. She is a wonderful and interesting person, and she's the one who got me thinking about this in the first place. She made the work sound very compelling, but she was, after all, doing it part-time in college, so I'm sure the experiences of a professional doula would be quite different.

I know that, in America, the training is sort of... free wheeling, so how would I choose the best/most credible program? I gather that some doulas work through agencies or hospitals, and some are sort of 'free agents'- how does that work? What's the difference? What are the working hour like- obviously you'd need to be up for an entire birth, but is it generally a 40-hour week, or less than that? That sort of thing.

I plan to seek out some doulas in my community to talk to, but I thought that if anyone here had experience to share or blogs to point me to or something, it could be useful.

posted by showbiz_liz to work & money (9 answers total)

I only know experience from my mom being a doula. It isn't like a normal 40 hour work week, like definitely not, most weeks will be less depending on how many clients you have. You have client meetings that will happen during more normal hours but can frequently happen in evenings or weekends if the mom is working FT but that is up to you. Obviously you can set your own "office" hours as you see fit.

My mom, and most of the doulas that she works with, did her training/certification through DONA - Doulas of North America. I don't really remember much about the training but to get certified you then have to actually do a couple births, under a certified doula, and basically write an essay about them to get certified.

My mom works though her local doula association (they aren't associated with hospitals there). She gets most of her clients through word of mouth but sometimes people contact her from the association website. Your birth schedule is not going to be set so you can't schedule too many births for near each other or you may not be available. There are other things like she has missed birthdays and a Christmas morning because that is when the babies decided it was time.

Thinking about her work, I can't imagine filling 40 hours/week in non-birth weeks and I can't think of doing much of anything else in a birth week. When not actually participating in the birth there isn't a LOT of extra work. You meet with your clients and you answer questions as they arise. My mom would certainly not be able to survive on her doula salary alone but you may have better luck in a lower-cost of living environment. Most of the doulas I've met through my mom have husbands with full time jobs.

My mom is a birth doula though, if you are interested in being a postpartum doula things are different.
posted by magnetsphere at 7:11 PM on October 31, 2011

I'm new to the doula scene, and the most I plan to do is the occasional volunteering rather than making a career of it, but I did train recently and have met tons of professional doulas, so here's what I know.

Any training program you do should be DONA-approved; that would be my main advice for finding quality training. You can search for DONA-certified workshops by location here. If you want to certify with DONA, you may need to also take some training in breastfeeding (free online) and in childbirth education, which is included in some but not all doula training courses. Even if you weren't planning on getting certified, those would be things you would need to know to be a good doula. I think most professional doulas do get certified, either by DONA or a local organization.

After training, if you don't have much or any birth experience, you might seek out a doula who's willing to take on an apprentice and be co-doula on a few clients. (My local doula organization has a formal apprenticeship program, which was awesome for me.) Once you feel confident enough, you're free to set up shop and start looking for clients. Most doulas seem to start out working for free and gradually ramp up their fees as they gain experience. You don't have to be certified by anyone to work as a doula, and you can set up a solo practice and start working while still uncertified. A minority of doulas are opposed to certification at all but personally I think it's a good thing.

In my area (Seattle), the vast majority of doulas are, as you say, free agents. There are a variety of websites where doulas can list themselves, and having one's own website tends to be important as well. Seattle doulas tell me that most of their clients come to them by just doing a Google search and finding their website. In that situation you are a small-business owner, and you need a business license and stuff like that. The only agencies and hospital programs I know are volunteer-based but I'm sure that varies by location. Some doulas have group practices where several doulas operate one business together.

Typical "full-time" work is around 4 clients a month. Each client involves, I'd say, 5-10 hours of work before the birth when you factor in 2-3 face-to-face meetings, e-mails, calls, etc., plus the birth itself. I agree with magnetsphere that it seems to be quite a bit less than 40 hours/week. As far as meeting with clients, you set your own schedule, but of course, birth means your schedule is never solid! It's hard to take on more clients than 4 or 5. Issues with exhaustion from too many births, higher chances of missing a birth because two clients overlapped, etc.

The wages that doulas make vary really dramatically across the country. In Seattle, very experienced doulas can get $1500-$1800 per birth, and even the newcomers with only ten births under their belts are charging $1000+. Business expenses can take a decent chunk of that, but it's definitely a living. In places where cost of living, wages, and demand are low, though, a doula might only get $400 a birth.

As far as what the work is actually like, well, doulas tell me that the hardest part is being on-call. It means being tied to your phone and checking it constantly, knowing that you might get called away at a moment's notice at any time. Sometimes you're super active at a birth, and you really feel like a huge help, and sometimes you just sit there like a bump on a log while the client does her thing. You can be at a birth for two hours or twenty. I found this blog post about life as a doula helpful. Other blogs I like: Radical Doula, Public Health Doula.
posted by mandanza at 8:02 PM on October 31, 2011

Oh, also, I didn't factor in transportation time when I estimated time spent on clients. That can be huge, depending on how far of a radius you're willing or compelled to work in. You will often hear that "doulas live in their cars!" Doulas generally don't have offices; instead you meet clients in their homes, so you're almost always going to them, and then of course there's getting to the hospital, birth center, home, whatever.
posted by mandanza at 8:06 PM on October 31, 2011

Oh, I should mention that I live in NYC- I wonder how much of a difference that makes?
posted by showbiz_liz at 8:18 PM on October 31, 2011

The woman I trained with, who has turned doula work into a full-time gig *teaching* doulas, says that doulas generally do three things. Most often, this looks like: mother, work part-time, doula. In my case, it's mother, doula, renovate my home. I know very few doulas for whom doula-ing is their full-time job. The ones who approach that are doulas AND childbirth educators/lactation consultants/postpartum doulas/something else birth-y.

In Portland, most doulas are free agents. There are a few affiliated with larger doula groups. There is a doula group that enables networking and general support; a quick Google for someplace similar in New York found this Yahoo group. They might be really helpful.
posted by linettasky at 10:38 PM on October 31, 2011

I'm a former doula. While I loved the work, the hours at a birth, without sleep, can take a big toll. One time I had three births in about ten days, and it's hard to explain why that was so depleting, but it was. Just not catching up on three missed nights of sleep was really hard. But it's wonderfully satisfying work for the right person. Two or three births a month were plenty for me.
posted by Ellemeno at 2:22 AM on November 1, 2011

I'm an outlier, but my poor doula had three missed nights of sleep IN A ROW because I was in active labor for four days. I would love to be a doula, but man, I could NOT handle the sleep deprivation.
posted by rabbitrabbit at 1:58 PM on November 1, 2011

I am getting my labor doula certification through DONA International - it's a little more comprehensive than magnetsphere mentioned. You have a 16 hour training session/workshop with a DONA educator, a required reading list, a required lactation unit, you have to take a birthing class (like Lamaze, Brio, etc) on top of the 3+ births, evals, and write-ups you need for certification. Once you've taken your workshop, you have 4 years to get your certification, or you start over. So, you do put a bunch of work into getting certified with DONA, but I really enjoy my organization. And once you're certified, $700-$1500 a birth is pretty much your window, in DC anyway. I imagine it's even higher in NYC.

Here, there is a local birth center that provides services to low-income mothers and they have a volunteer doula program so that everyone who gives birth at the birth center and wants a doula can have one. So, that is something I would look for if I were you - a birth center, or even an independent midwife practice.

I am nthing that it is generally not a full-time thing. I think it can also be difficult to maintain a normal otherwork schedule, though, because of how unpredictable births are, so I think it's something that doulas pair with another flexible part-time, or with parenting. Connections with other doulas are absolutely necessary, for backups. You always have to have backups. This is part of the reason that the required DONA doula workshop is so great, it's like having 10 backups that you meet right off the bat!

I have been doing informal postpartum doula work, without going through certification or training anything, so I can't tell you what that process is like. it's hard to find DONA postpartum doula workshops, they're few and far between (you can't get certified w/o workshop). I know that the DONA workshop for postpartum is longer than the labor workshop - 21 hours or something. There is much more extensive training on breastfeeding and recognizing PPD, etc. Even without that formal training, I find it to be very, very rewarding. And, compared to labor doula work, it is something that is more schedule-able, once the baby has come. Some families want 9am-5pm help for the first 3 weeks, some want help in the evenings 2 days a week, or anything, it depends on the family. You have to be brave enough to work with tiny, tiny babies, and that can be intimidating at first.

I don't know your background of pregnancy/labor/childbirth, but if you haven't seen The Business of Being Born, I recommend it. It's on Netflix Instant, and I think you can even watch it on the movie's website. And if you've never seen a live birth, at least youtube a few! it's awesome, but it's not for everyone.
posted by brave little toaster at 10:20 PM on November 1, 2011

My wife is a doula, and it is really a calling for her. Babies tend to want to come out in the middle of the night, so it is routine for her to miss sleep.
It is also pretty much poverty level wages. A normal load for her is 2 or 3 clients a month, and she charges $650, certainly nobody around here is charging over $1000.
It is a demanding job with unpredictable hours that can get in the way of a normal life. I would also suggest it might be something that fits well with women who have had a few kids and have some first hand experience.
Your question sort of sounds like you might be young, and I think it would be an extra struggle to convince a prospective mother to hire you if you don't have much first hand experience.
posted by bystander at 2:29 AM on November 2, 2011