Birth Doulas. A dying breed?

Birth Doulas. A dying breed?

I used to be a Birth Doula. It was a labour of love. I gave all I had to my clients… even at the expense of Christmas day with my children one year.

I have supported the most amazing women, with and without their husbands. I have seen the most beautiful babies born in a variety of ways to birth.

I have felt the most incredible pleasure and honour to have been present at such a personal, intimate and important moment in a human beings’ life.

So, why ‘used’ to be?
One of the reasons is because of the guilt of charging people to be there for them. And the “I can’t afford a Doula” words that I hear.

A powerful reminder of this came recently when a conversation made it on to Doulas. I believe they are worth their weight in gold, as do the majority of women who have had a Doula.
I wouldn’t dream of birthing without the support of a birth worker whose job it had been to get to know me and my preferences. To support me no matter what. To put the kettle on when needed, hold the hot water bottle on my back for a potential infinite number of hours, to hold my hair back when I’m sick, to put the straw in my mouth when I grunt for a drink, or anything that I need, without the need for me to voice it because she’s taken the time to get to know me beforehand (which most midwives in the UK do not get the opportunity to do, unless private or independent.) She stays with me from the moment I want her, until I am settled and resting. She supports all those around me that need supporting, whether it’s a cuppa for the midwife, distracting my children when I want peace, opening the front door to the next shift of midwives, or calling the hospital to let them know we are ready… (I think I’ve had experience of all of those personally with my own births)… She’s been there at the end of the telephone, text, email, on my doorstep when I’ve been approaching 43 weeks and desperately fed up, emotional and just need a shoulder to cry on. She’s been there before, during and after. A couple of false starts!

She’s got her husband to get a train over and find the car in a random car park near the hospital, so he can drive her home, because after so many days she is not fit to drive.

So when I was recently asked how much Doulas charge, I responded that it varies, but is between about £300 and a £1000 locally… not always priced due to experience either. Mostly priced on the confidence that person has in the value of their time.

When the frequent response of “I can’t afford that” response comes back, I generally just stay quiet, as who am I to say what people charge, or what people can afford. Or what their financial priorities are. I am also not into trying to justify the cost of any profession normally… but I feel it’s time to share my thoughts on the cost of a doula.

Your Doula is self employed
There is often a bittersweet business relationship for doulas. I bet if she was a wealthy woman, she’d still do this as a ‘job’.
But doulas are very rarely wealthy! By charging it means that she can be there for you, instead of having no doulas, because they all work in employment somewhere.  She has the usual overheads – tax, NI, membership bodies, insurance, CPD ‘Continued Professional Development’ etc.

Doulas hours are incredibly unpredictable
With a bit of luck your Doula being there will result in a nice quick birth. Maybe she’ll spend most of her time clearing up the birthpool and making you tea, when your baby pops out at 39 weeks.
But maybe she will have been on call 24 hours a day, 7 days a week, since 38 weeks, and you are now approaching 42 weeks, and she’s been re-checking her doula bag, preparing a packed lunch before each bedtime, showering and washing her hair before bed in case you call her, as she wants to be fresh for you. She’s possibly been sleeping lightly every night as she is afraid of dreaming through your phone call. She’s possibly had to prepare her children every night that she may not be there in the morning if her lady has called. She has a bag that is either by the door ready to grab and run, or in the car when she’s visiting friends. She either becomes a hermit and doesn’t make plans to go out anywhere, OR she has lots of appointments to cancel or friends to drop last minute if you call her. She lives with her phone in her hand. Heaven forbid there is no signal where she is.
Being on call is hard – for the doula, and for her family.

After all is said and done, she returns home, ready to sleep for a week, after not just the hours put in, but all the energy and emotion she has invested. But her children haven’t seen her for a while, and need some mummy time. She just gets on with her day, as if nothing much has happened, no matter how the birth has been.
She then arranges to see her mentor/supervisor/best buddy/cake eating friend as she needs a little mothering after holding the space for the parents for so long.

She does ante-natal visits, post natal visits, answers texts, calls, emails whenever you need her to.
She rarely stops thinking about you.
She doesn’t travel outside of a zone around your area, so she can whiz there whenever needed. She can’t go fell walking as it would take too long to get back to the car of you called her, then the journey back to you, all hot and sweaty from rushing.

A day off?

She invests in you
A Doula cannot ethically overlap clients, unless you are happy with that. So if she’s on call from say 38 weeks, and you may go over 42, and she needs to give herself some off call time too. (Personally I miss having a drink so flipping much when I’m on call. My glass of red wine wind down is out of the window) I also need to have a little time out where I am not on tenterhooks, ready to run at any minute. Just to let my nerves relax and just breathe…

So realistically she can only have clients on her books for times when they won’t overlap. That means limiting potential income, and remember that income is what she will no doubt be using to pay her bills, as most people do. We work to pay bills usually. If my doula work afforded me some ‘disposable income’ I would be over the moon.
Oh Em Gee… what I wouldn’t give for a holiday for me and my children this year.

She invests in her knowledge and toolkit
I don’t know a single Doula that doesn’t engulf herself into a world of self development to be able to serve womankind. Study days, books, workshops, training, training, training. All from the desire to help women and babies (and their partners) to have the birth they deserve.

See if you can find a Doula that hasn’t been on a Rebozo workshop or invested in a ‘homeopathy/essential oils  for birth’ kit, been on a study day with professionals they aspire to be like, and knowledge they want to soak up.

Jay Kelly with Shiela Kitzinger   Jay Kelly with Michel OdentJay Kelly with Ina May Gaskin at the Mama Conference, Troon.Jay Kelly with Sarah Buckley





She puts her family on call/hold
Most Doulas are mothers, and last minute childcare is rarely easy to find. But she’s on it. It often comes at a cost, even if it’s a friend. No one calls a friend into action for unpredictable amounts of times without compensating for it (or at least I hope not!)

When a Doula says yes to working with you… she is usually saying no to other sources of income.

If only I was a wealthy lady – I would Doula again.

Sadly, in my local area there are only a handful of Doula’s left… as most of us cannot afford to work for the amount of money most people are willing to invest in their births.

If you still think a Doula’s time isn’t worth it, then I urge you to look at how much people are willing to spend on holidays, or to pay for wedding day “essential”. Even the most expensive Doula probably costs less than it cost to hire chair covers and the car hire for a hour or few… all because commercialism has deemed it to be the most “important day of your life”. I wish more couples put the emphasis in preparing for their birth day than they do their wedding day. The birth is your baby’s most important day of his or her life.

That is why I USED to be a Doula.