A Free Doula Never Hurt Anyone, Right?

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There’s a buzz happening on the doula community, a buzz that doulas offering free services hurt other doulas.

There is no doubt that for many doula work is heart work. Historically most doulas seem to enter the profession from a place of passion.  A place of love of women, babies and all things birth.

I, like so many others, came into doula work from a place of passion. My passion was born into helping women have an amazing birth experience where no matter the outcome. It is important to me that they feel supported, loved and find their own power. Not all doulas come from this type of positive place though. Many are what my friend and colleague Randy Patterson of ProDoula call “birth avengers.” Individuals who become doulas to heal their own birth traumas. To save other women from their own experiences.

There is an exceptionally high burnout rate among birth doulas. The average lifespan of a doula averages 3-5 years.

Doulas come, they give their all and they’re a flash in the pan and are gone. The two trends I’ve come to notice since I became a doula in 1999 that lead to this high rate of burnout are vicarious trauma and lack of financial sustainability.

The doulas that I see that come into this work and stay have the ability and resources to process the traumas they experience and they almost always have a financially sustainable business. The two go hand in hand. Financial sustainability allows the doula access to resources to help her grow her business and as a result gives her access to more ways to help emotionally and physically process the trauma she experiences at births.

In the past 10 years I’ve seen an overwhelming amount of what I’d label white & class privilege in the doula community. The majority of doulas I encounter are Caucasian and as a result we are seeing a growing movement to bring more doulas of color into the doula community.

Class privilege bleeds out around the edges with destination conferences that require passports and extensive travel.

Upper middle and upper class doulas express openly that they’ve come to this work for the emotional payoff it gives them of “giving back” because they don’t need to worry about the financial gains to have what they would label a sustainable business. Sustainability is often defined by the number of births attended, not the exchange of monies for services that actually creates sustainable business.

You often hear these doulas comment that they do this work for the “love of it” and for the emotional satisfaction that serving families gives them and that their compensation is the feeling of reward they get from giving back. On the surface it seems pretty great, but look more closely and you see that the doula is seeking her paycheck not in money but from the oxytocin rush she receives from making herself a part of the expecting family’s birth experience.

I know it’s not going to be a popular opinion, but sit on that for a bit.

That a person would seek to enter one of the most intensely private and vulnerable life events a woman will experience for their own emotional payoff makes me intensely uncomfortable.

Beyond the emotional whys, doulas who do this work without financial compensation hurt not only other doulas who must create and maintain a financially sustainable business, but damage the public’s perception of doulas. Right out of the gate many doula certifying organizations teach new doulas that they need to do their qualifying births for free or that as “students” they don’t deserve to be compensated at the going rates so they are encouraged to charge mere pennies. Some even have explicit requirements that the doula must do so in order to gain certification.

Doula training varies from organization to organization and the cost of training and completing the certification process and establishing a financially viable business will vary from one doula to another but the cost is not insignificant. For many it will require a financial investment of upwards of a thousand dollars right out of the gate. Not such a terrible price tag to start up a new business that one can in theory start seeing an immediate return on once they begin taking paying clients.

But what happens if that doula is in an area saturated with doulas where many of them offer services for free?

What happens to our lower income doulas who need to turn a profit in order to create a business that is sustainable so that they have a revenue stream that allows them to both support their families and also allows them to serve the under-served in their community without paying out of their own pockets to do so?

Let’s face it, if the client isn’t paying the doula for her services, if there is no grant funding or funds set aside to adequately compensate the doula for her time, basic costs like travel, supplies and childcare, the doula is paying money out of her own pocket to attend these “free” births.

These doulas have a tenacious passion for the work but the out of pocket costs become too much to sustain and they need to look elsewhere for the financial ability to contribute to and/or support their families.

Potential paying clients are swayed away from doulas who must earn a living wage by those who will gladly work for them for the emotional payoff alone. The public is taught that doula services are not to be valued or budgeted for and of such little importance and significance that of course it should be had for free. The perception that doula care is something that can be had for free or cheap and with little regard for the work and out of pocket expenses the doula incurs remains and the problem soldiers on.

I see often in online forums women searching for free doulas. Yet when you dig deeper they are choosing to invest in brand name cribs, high end accessories, baby carriers and other luxury baby items with high price tags, but not placing the same value on doula services. Occasionally I’ll suggest that they can borrow money from family or friends, use PayPal’s 6 month financing, put the doula fee on a credit card or even start a “Go Fund Me” for doula care and that is almost always met with great resistance with replies of “I can’t ask my friends and family for money.” Yet not an eye is blinked at expecting a doula to work for free.

We as a community of doulas have created this perception. It is up to us to break it down and rebuild it.

Is there a place for charity in doula work? Of course! But we as doulas don’t have to be the heroes in every story. I liken this to the saying “Give a man a fish and he eats for a day. Teach a man to fish and he never goes hungry.” As doulas we can give back in many ways.

Create a sustainable business model and set aside funds toward scholarship funded services based on financial need. Accept donations from paying clients toward this fund. Set up a non-profit and seek out grant funding for at risk populations. Host free educational classes on labor support for your community and teach families or other women how to support each other through labor.

But wait, I hear that voice in your head saying “But if I teach them how to support their partners or friends or each other, then I won’t be able to support them.” Did you hear that? We’ve come full circle back to “I do this work for the feel goods.” I’ll let you think on that a while . . .

At the end of the day we should help the client find ways to empower herself to obtain the doula care she desires.

Because isn’t that what doula work is all about? Empowerment. Supporting families in their choices.

And to the “sisterhood” of doulas who believe we should be building each other up and not tearing each other down, consider if offering free doula services is building up your “sister” doula or tearing her business down.

Here at Tucson Doulas we have a long term plan for implementing a internally funded program for not only serving the under-served, but helping the under-served to support each other while be compensated a fair wage for the work they do.  We want to train doulas to provide support in their own at risk communities where there is an identified need.  The best part?  Our program will pay to train them, and pay them for the support they provide.

It’s a big task.  But it’s one that we are actively working towards.

With over 10 years experience in non-profit doula work, I have a vision and a plan.

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5 Responses

  1. […] you have to figure out how much those doulas should get paid and compare it to how much cost savings the lower cesarean rate would bring to determine if it’s […]

  2. Lauren Condron
    | Reply

    Fabulous. Fabulous article that so speaks to me. I can have heart with sustainability; however I need to be able to support families without sacrificing my own. Great read.

  3. Nicole Tyc
    | Reply

    This is SO on point.
    If we want long term sustainability for this work as a career path, we cannot continue the “white knight syndrome” approach in giving it away to serve our own need to feel like saviors and hero’s!

    • AC
      | Reply

      Are you a working doula currently?

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