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Please do not call yourself a doula if

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You leave a first-time mom when she chooses to get an epidural.

The doctor or midwife spends more time with your client than you do.

You charge extra when a woman labors longer than an allotted time.

You require the client to pay your back-up doula if you have to leave.

You charge extra for “false alarms.”

You are hired by the client but really you are the midwife’s apprentice/assistant disguising yourself as a doula (so that you get paid.). Of course, this is fantastic if you are truly working for the client. But it can be easy to focus too much on pleasing your preceptor and not as much on serving your client.

You tell the client you’re on your way to the hospital and inexplicably fail to show up.

You bring your children to the hospital and ask the client’s family who are in the waiting room to watch them.

You promise to back up a fellow doula but when she calls you have excuses why you cannot. And so does her other back-up. And even her THIRD back-up.

I am sure this offends some of my fellow birth workers and this post won’t win me any popularity contests. We are only human and sometimes there are unusual circumstances beyond our control. But these are real stories I’ve been told in the last few months by women and doctors/nurses who were disappointed by a doula. In my town. A place where the natural birth community is making headway in creating change. Scenes like these send us three steps back.

Birth is sometimes long. It is (usually) inconvenient. Yes, we don’t make as much money when we have to pay a back-up or a birth is long. But at the end of the day, remind youself that you also had some short births (I have many more now that I take Hypnobabies clients!) and scheduled births (thankfully these are rare). These births “subsidize” the long ones. Figure that factor into your fee. Consistently, at the end of each year, when I add up all the hours I spent at births, it averages out to around 12 hours per couple.

Please, dear doulas, stay with your client. Serve her well. We offer continuous care. What kind of message does it send when her doula leaves? Wow, my doula has even given up. Defeat.

We have been honored with an invitation to grace a sacred space. It is a timeless space. We do not punch a timecard. Our shift is not over until our healthy client is nursing her baby postpartum. This might be two hours after the birth or several weeks later. My summer client who birthed prematurely was finally able to nurse her baby after weeks and weeks of coaxing. Only now do I close the file.

I know it is a tough job. Burnout is high. Please weigh the cost of your commitments and represent your birth community with integrity.

And to the moms looking for a doula: read the contract carefully. The doula should list any extra fees and discuss refunds if she misses your birth. Ask how she handles long births and what her definition of long is. My contract, for example, states that after 24 hours, I might call in a back-up doula so that I can rest and return. I’ve never done this but my contract allows it if I must. Knock on wood.

10 responses »

  1. Thanks so much for this post! I’ve been thinking about do the doula thing and this gives me some things to put into the thought mix.

  2. Someone needed to call them out on it. Disgraceful.

  3. I am so glad you posted this. Word of mouth is a powerful thing and if it gets around that doulas are unreliable and leave you when things get hairy, women are going to be even more vulnerable in the long run.

  4. As always, this was written with tact and grace.

  5. Some of this I agree with, some I don’t. (Why the heck would you bring your children to the hospital!?!)

    There are great doulas in this area who charge for false alarms or if mom has an extra long labor. This allows them to charge a lower general fee, instead of raising their fees to accomodate the times that those situations occur.

    I myself have left after the mom got an epidural, as she was going to sleep and I needed to get some sleep myself. (It helps that I live 5 minutes from the hospital). I come back as soon as she wakes up.

    “We have been honored with an invitation to grace a sacred space. It is a timeless space. We do not punch a timecard. Our shift is not over until our healthy client is nursing her baby postpartum. This might be two hours after the birth or several weeks later. My summer client who birthed prematurely was finally able to nurse her baby after weeks and weeks of coaxing. Only now do I close the file.”

    Yes, we have been honored. But that doesn’t mean that we have to give up our entire life and family for our client. The reason why there is such a high burnout in this job is because we all too often put the client first too much. Saying that you do not punch a timecard and that you will be there for your client no matter what is a nice sentiment but not really sustainable long term without suffering burnout, and interfering with relationships in your life.

    What other profession do you know of where you are on call 24/7 and put long hours, late nights, and still do not make enough to support the family that you now barely see because you are with a client and you “never punch a timecard?”

    • Thanks for sharing your thoughts. I appreciate your perspective.

      I guess when I work alongside homebirth midwives who do not charge extra fees, stay as long as it takes, and are also on call 24/7, it is tough for me to justify a doula doing differently.

      If a doula is not covering costs and barely seeing her family, then something is wrong.

      Again, some clients have short births and barely need me in the postpartum. Some have long births or need a little extra support postpartum. It does not seem fair to charge a family extra for something out of their control. My mama used to say, “it all comes out in the wash.”. And so it has. Without fail.



      I have to reply to this too. Because our clients expect us to put them first. When I have a client and she’s in labor SHE COMES FIRST! no matter what. I have cancelled family vacations, christmas, new years, valentines day birthday parties ect… because a clients as in labor. Even when I had two clients in labor at the same time on the same flor I stayed and didn’t miss anything even though I didn’t get home for 4 days!

      I’ve been doing this for 5 years and that is how I have always worked. I have been with clients who have been in labor for 42 hours, and never left the hospital no matter what. Even if mom has an epidural there are so many things that can go wrong, and she may need me, or expertise that I can offer. There are FEW times I sleep in the waiting room, but Mostly I sleep in the room when mom is sleeping.

      A doula is not in this business to make money I can assure you! we are in it because we want to support women, to empower them and enable them to have the birth that makes them feel empowered. My company name is Your Birth, because this is all about THEM, not me, not my family, not any other doula, midwife, or dr. it’s about THEM for as long as it takes.

      You do not become a doula to support your family, there is no way you can do that, this is not a job, it is a passion, a profession, a calling, but it is not a job.


    AWESOME post! I can’t believe some of these actually happened, but some of them happened to me, and there were many doulas in CT that I would not work or recommend with because of things like this.

  7. Fantastic summary you got there! Our doula and her backup ditched us through email on my very due date! They never gave us a contract nor terms nor conditions. They offered everything in terms of meetings, providing us with awesome knowledge and support until then. Then they suddenly surprised us with 2 long emails full of rants saying how they had spent 80 hours working for us and that they don’t offer advice (which they voluntarily offered us happily until a day before my due date). They suddenly decided to ditch us because I wanted a home birth and my husband wanted birth at the birth centre. They even refused to answer my calls on my due date. What a fantastic example of ‘unprofessional’ and ‘unethical’ behaviour! Does this not sound mental? PLEASE do not hire a a doula. Do your own research and be your own advocate. Doulas are unreliable. Its got to be a joke! All you really need is your partner, your midwife and a calm you!


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