Is finding a job as a doula difficult?

Continuing my tradition of posting answers I get via email here, I recently got a question from an inspiring doula wanting to know about what education background she might need, and if it would be difficult to find a job as a doula.

My answer:

Thanks for your email. Doula work can be really rewarding!

In terms of your questions, it’s not a traditional profession like others you might know about. While there are many doulas who do that work professionally, there is no formal education requirement (meaning a college or master’s degree or some sort). Instead, people of all education backgrounds participate in doula trainings (usually a long weekend) and then decide if they want to pursue certification as doulas (not required).

The jobs, then, are also less formalized. With few exceptions, most doulas work independently and find clients directly. Kind of like a massage therapist might. Those doulas build their own client base through marketing and word of mouth, and work on a fee for service basis (aka you charge people directly for your services, anywhere from $300-$3000 per birth, depending on experience, location, etc).

So the job search is a very different process.

I hope that helps! If you’re interested in doula work, I’d recommend signing up for a training and there you will learn a lot more about how it works.

The whole idea of being a self-employed doula, I’ve noticed, is really new for a lot of people. If you’re going to live off your doula work it really will require a lot of self-motivation and some business savvy. You also have to figure out how to get your own health insurance, and paying taxes is more complicated when you are self-employed. It’s a lot to learn! I’m only just now starting to hear about more formal full-time jobs as doulas, in hospitals or with agencies.

If you want to read more about my musings on the future of the doula movement and institutionalization, read this column.

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What’s the goal of the doula movement?

In my latest column for RH Reality Check I muse about the question of the goal of the doula movement.

I felt a bit nervous putting this one out there because it touches on issues of money, sustainability, access to our services for those who need it most, and how institutional affiliation impacts the ability to make change.

When I talk about these issues I’m very conscious of the fact that I don’t make a living as a doula. While a few of the things I do that relate to doula work–publishing the Radical Doula Guide, writing my column for RH Reality Check, the occasional speaking gig–brings in some modest income (we’re talking under a few thousand dollars per year), the bulk of my pay-the-rent money comes from non-doula related work (primarily my work with non-profit orgs as communications consultant). So, I know that all of my commentary on these issues comes from the position of someone outside the doula work is my living community.

And I want to make clear that I find nothing wrong with doula work as a profession, it’s just not the path I’ve chosen for myself or my work, for many mostly personal and logistical reasons.

So, the column:

There is no easy answer to the question of where the doula movement is headed. It’s clear to me that doulas provide an important and potentially transformative intervention for our maternal health system. But it’s also clear to me that institutionalization and professionalization threaten the very model we’ve developed, a model that, because it is outside the medical system, allows us to shift the dynamic and improve outcomes.

An alternative that I think may be more feasible is working to bring the doula model of care to existing participants in the health-care system. How could the doula model transform the way current providers, like doctors and nurses, care for their patients? Rather than creating a vast doula profession, could we transform maternity care by turning everyone into doulas? Could family members, for example, be trained or shown how to provide the kind of support that doulas provide?

I think doula work is valuable and important, and I also don’t believe the essence of doula work—non-judgmental and unconditional support for pregnant and parenting people—needs to be locked away in a system that says only a certain amount of training, certificates, or other paperwork bestows upon someone the right to provide this support. We run the risk of replicating the model we’re trying to revolutionize. And I don’t think that is where real social change happens.

Read the full thing for my whole analysis, including one example of a midwife bringing doula-like training to existing members of the broader health care network.

I would love to hear from you, fellow doulas, what do you think is the goal of our movement? How do you think we’ll get there?

DC Doulas for Choice recruiting new volunteers

An opportunity to get involved with a full-spectrum doula group in the Washington, DC metro area. About DCDC:

The DC Doulas for Choice Collective is a DC-based, volunteer-led-and-run, pro-choice organization that seeks to provide doula care to people across the full spectrum of reproductive health, pregnancy, and choice.

The Collective began in 2011 with a group of pro-choice birth doulas and reproductive justice advocates who believe that people seeking abortions may desire and benefit from the same type of patient-centered, non-judgmental physical and emotional support that doulas traditionally provide to people during labor and birth.

The training will be June 1. More info about the training and how to apply is here.

Can I be a doula if I’m physically disabled?

Over the last year or so I’ve received a number of questions via email from doulas with disabilities writing to ask if they can pursue doula work. I am no expert on disability, disability justice, or disability and doula work. But I know that these questions come to me because there are very few people even addressing this intersection, and I’ve done it in modest ways on this blog and in the Radical Doula Guide.

So here are snippets of my answers to two inquiries about disability and doula work. Have additional resources? Leave them in comments below, or email me at radicaldoula@gmail.com.

One question from Ashley:

I stumbled upon your blog recently, as I’ve begun research on becoming a doula myself. I’m trying to touch base with real life doulas to get opinions on my particular situation. I’m incredibly interested in becoming a doula, particularly a Postpartum doula, but there’s a bit of a catch. I have Cerebral Palsy, so I have to use a walker or crutches to walk. However, I have full use of my hands, and live on my own and am able to function daily with minimal to no issues. I just wanted to know where you think I should start my journey to becoming a doula. I also hope that once I become certified I can work with physically disabled mothers, as I can understand and relate to some of their personal struggles. Do you have any suggestions as far as how to start the process? I’ve looked at various online certification programs and the one downside is that they’re pricey. Because of my disability, job options are limited and therefore I don’t have much extra cash coming in.

If you have any advice for me, I’d be incredibly thankful!

My response:

Thank you for your email and for reaching out. I’m glad you’ve begun considering the beautiful work of doulas!

I would say that yes, you could definitely serve as a postpartum doula if you feel like you’d be able to support a new parent in their home with newborn chores like baby changing, cleaning and of course support with breastfeeding and other newborn things. Some of this expertise you’d learn in a postpartum doula training.

As long as you were clear about what you could offer to new parents in that role, I think you’d be fine. I also love the idea of trying to work with other physically disabled mothers–I believe there is a lot of power in serving those within our own community.

In terms of cost I would say this: certification is not always necessary. Is just the training financially accessible to you? That is where I would start, and only explore certification if you feel like it’s necessary for your work. I am not certified as a doula, and have not felt compelled to take that route (you can see more on this here and here). While the training orgs are presenting it more and more as a requirement, there are many doulas out there who are not certified, and I think it’s up to each individual to decide what works for them.

Ashley is looking to connect with folks, so feel free to email her beautifulashes328@gmail.com.

I received another question via email from a doula with cerebral palsy asking about the potential of being a birth doula. I’ll paraphrase her question as I did not get explicit permission to reprint it here. She shared that she has cerebral palsy and is confined to a motorized wheelchair.* She asked about how her disability might impact the amount of physical support she could provide during labor, and how much physical support plays a role in birth doulas work. She also asked about how often birth doulas attend clients at home, as that might be a challenge due to accessibility concerns for wheelchair access in private homes.

My answer:

I think you can definitely be a doula and be wheelchair bound. The amount of physical support required to do doula work depends largely on your style and the client’s desires, but what I would suggest is thinking of teaming up with a co-doula who could provide some of the physical support techniques that might be challenging for you. (Things like the double hip squeeze, or massage). You could even choose to partner with the co-doula only when working with someone who is definitely interested in physical support (some folks may not be interested in touch).

Also, alternatively, if the people you work with have partners, you might be able to guide their partners to do some of the physical support techniques that you cannot. This is something I have done anyway, just as a way to involve the partner more in providing support.

In terms of setting, I actually think most doulas provide support in hospital settings because that is where the vast majority of births take place (98%). I personally have only worked in hospitals. That’s good news for your questions about accessibility. Doulas do often do prenatal visits with clients, but that doesn’t have to be in their home–it could be in a public space, or in your home. Sometimes doulas will go to a person’s home when they are laboring but not ready to go to the hospital yet–but if the client’s home is not accessible to you, you could discuss this in advance, and if necessary, use a co-doula for that support.

Lastly I would say you might consider a really important and unique niche in your work as a doula: supporting other disabled folks who might be pregnant or parenting. I’ve found little out there in terms of resources for pregnant disabled people, and some people might appreciate getting doula support from another person who is disabled. (Not that this is all you could do, but it could be a great fit as part of your work).

Do you have additional advice or resources for disabled doulas, or potential doulas? My research has not turned up much in this arena, although I expect that will change as doulas become more prevalent. Please add them in comments.

I’d hazard to say there is almost no one to whom I would say “no, you shouldn’t be a doula.” We all have limitations, things we can and cannot provide or offer, and there is no perfect template for doula work. It’s about knowing your limitations, being clear in what you can offer folks, and finding additional resources to fill the gaps that you cannot.

*On twitter someone asked about my use of the word “confined” here. I paraphrased from the original email, but used her language in this instance. I know that issues of language and (dis)ability are complicated, and while I will undoubtedly make mistakes, I try to mirror language folks in the community use to describe themselves as much as possible.

Asheville, NC full spectrum doula group looking for new volunteer doulas

Check them out and apply if you are interested.

We are looking for people interested in training as abortion doulas to work with clients in the clinic. Doulas will be present and provide emotional support to clients before, during and after abortions. We are looking for people who can work at least 2 days a month as well as complete the required training, provided by the Open Umbrella Collective in September of 2012. Trained birth doulas are particularly encouraged to apply, though we are excited to bring on reproductive health and justice activists who have no prior doula training.

Details here.

Bay Area Doula Project launches at home medication abortion support

I absolutely love seeing how the different full-spectrum doula groups around the country are developing their models. At this point, the majority are working to support people having abortions by partnering directly with clinics, so that everyone who comes to that clinic for a procedure has the option of doula support.

BADP just announced yesterday that they’ll be beginning to offer medication abortion support directly to people having abortions.

While providing the obvious benefits of privacy, confidentiality, and comfort, medication abortions pose some challenges to patients who may require extra support during their experience. Our doulas are prepared to offer in-home physical, emotional, educational, and spiritual support during the medication abortion experience. BADP has created a comprehensive model for providing in-home support after months of careful planning and training. To do this, we have consulted with medical experts, home-birth professional doula groups, and abortion access communities to ensure that it has responded to various practical concerns: for example, client contracts will be used to address issues of doula and client safety and legality of practice. The BADP has also created internal procedures to provide on-going guidance to volunteer doulas as they provide in-home support to clients.

Medication abortions are done through a series of pills that the person takes at home (sometimes the first dose is taken at the clinic) and then goes home where they will experience cramping and bleeding for a few days. BADP will send their volunteer doulas to support folks at home while they deal with the after-effects of the medication.

It’s possible there are other doulas out there who have already been providing this kind of support, but I’m excited to see a group organize volunteer care in this model. They’ve also created a training so that the doulas are adequately prepared. I can imagine a lot of the techniques we use during pregnancy and labor could be useful for dealing with the possible discomfort caused by the cramping and bleeding.

Pro-choice pregnancy and the politics of language

I was inspired to write my latest column for RH Reality Check because of a number of emails I’ve gotten over the years with various questions about the issue of the language we use to talk about pregnancy and it’s impact on pro-choice politics.

From the column:

As a blogger and a doula, I think about this question of language a lot. What language to use when talking with people I’m supporting during their abortions? What about when supporting someone with a miscarriage? Should I use different language in one scenario over the other? How about when I write about these issues? If we call it a baby at only eight weeks, does that compromise our right to access abortion?

For me the answer is no. The reason that abortion is a decision best left to individuals who are pregnant is because it’s a complicated ethical and personal choice that one can only make for themselves. While there may be a lot of science regarding fetal development, when hearts beat and nervous systems are developed, there is no right answer when it comes to when life begins. It’s a question and a choice that every individual person has to grapple with for themselves. The same is true for the language of pregnancy and birth.

I do my best to mirror the language of the people I’m working with. If they call it a baby, I’ll call it a baby. If they call it a pregnancy, or a fetus, or a itty-bitty bundle of joy, I’ll do the same. Nothing about these language choices denotes anything about what choices should be available to pregnant people—it simply denotes how that individual person sees themselves and their pregnancy.

Read the full piece here.