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How to Survive Life on Call

How to Survive Life on Call 0

Life on call is not easy. You always have to have your phone. You can’t have that second glass of wine. Every plan, every schedule, comes with a mental “but I’m on call” or “if my client goes into labor.” Real talk, I’m entering my 13th year of doula work, and I still have moments when I’m on call and missing out on something that I ask myself, “Why am I doing this job? This is crazy.” These are the moments that lead to doula burnout.

To battle burnout, I’ve put together three strategies and a few bonus tips that I’ve used over the years to make this crazy life on call happen. These ideas will not magically transform our work into a nine-to-five job, but they have made my life as a doula more doable and sustainable. There is no one size fits all approach, but, hopefully, you will find some ideas that will help you meet your professional and personal goals.

Block Time Off Call - Heavy Months and Light Months

When you’re on call for a client, it’s usually for a few weeks. Sure, you have their estimated due date, but you don’t really know when you’re going to be needed. When I started out, I thought I could probably only handle one or two clients a month and scheduled accordingly. Even though that’s not THAT many clients, I’d look at my calendar and realize that I would be on call for months at a time.

The strategy of blocking months is exactly what it sounds like. After assessing your schedule, goals and income, you choose a few months out of the year to be your heavy months. The rest of the year, you’re totally off call. For example, I have some doula friends who are preschool teachers and they are off call during the school year and on call during the summer. With this strategy when you’re on call, you’re ON, but the rest of the time you can chill, disconnect and do all those things you can’t do when you’re on call.

Create Blackout Days

Sometimes if you know you’re going to be out of town or have a big event like a birthday or anniversary, you feel like you can’t take a client during that time. Unfortunately, blocking off one day or weekend really amounts to blocking off a four week span because you don’t know when a client will deliver. I hate to hear about doulas missing out on potential work for fear of missing an event.

You’ve heard of blackout days with gift certificates. This idea works the same way. Tell your clients, “Yes I am available that month, but I want you know that I have a few blackout days on which I will have a great backup doula available for you.” Also, let them know that there are probably a couple days of the month that might have an unexpected conflict like a last minute trip or special event. In my experience, most clients are fine with the idea of blackout days as long as they know in advance.

Sometimes it feels uncomfortable to tell people you won’t always be available because you’re afraid you won’t get hired, but you can’t guarantee you will be at a birth. Life gets in the way, and it’s better to set your client’s expectations at the start.

Partner Up

Another strategy that has been on the rise is doula partnerships. Though there are formal permanent doula partnerships that require detailed business and legal planning, I’m focusing here on the idea of a temporary partnership used during those heavy months or months you know you’ll need more flexibility.

Make sure to partner with a doula who shares your style so as to make any transition as seamless as possible for your clients. You and your partner should attend prenatal meetings together. Tell your clients that when the time comes, it could be either you or your partner who will be on call.

The beauty of having a doula partner, as opposed to just a backup, is that your partner will be as familiar and prepared for the client as you are. However, If you choose to explore this option, I would recommend that you take it slow. Test the waters with a couple births to see how the partnership works. Make sure to get the money part of it ironed out in advance. Set up a breakdown where the partner that handles the delivery gets a larger portion of the fee, but the partner who attends the meetings still gets a percentage. I know it can be awkward to talk about money, but I’ve heard so many negative stories from doulas that revolve around compensation. Don’t fall into that trap.


Bonus Tips

  • Build a Village - Life on call requires a support network. When you have a family and you’re on call, you basically need somebody on call for you. Maybe that’s a relative, a family friend or a regular babysitter. I have four children and I have had to use all of these, including a whole network of moms that I pay back with babysitting.
  • Communicate your Limitations - Don’t miss out on your own life. If you have to turn off your phone for an hour a week for a yoga class, don’t stop going to yoga, just let your clients know. On the flip side, if you can’t bring yourself to make an appointment because you might have to cancel last minute, let them know you’re on call. Most service providers will be understanding of the rare cancellation. Chances are your client will not need you during these limited windows anyway.
  • Don’t Fatigue your Village - Can you please stop telling me that you’re on call?
    Your friends, your family, the people you interact with on a regular basis, they know what you do and what your life is like. If you’re constantly saying, “I’ll try to be there, but I’m on call”, the only thing you’re accomplishing is stressing them out. Once you’ve communicated your limitations just carry on. Again, the likelihood is you won’t have to cancel so live your life and let the doula work slot in. The birth will come when it comes. If you need to vent, find another doula.

Don’t Burn Out

You may think this advice is all good and well but be asking yourself what about the money? Every one of these strategies could mean turning away work, losing a client or sharing fees with another doula. My answer would be that burnout brings in zero income. If your current lifestyle is unsustainable, then you may very well burnout. We are not doula robots. We are actual people with lives and needs, and we should not feel guilty about that. Self care is not a myth. Taking care of ourselves, being kind to ourselves and our families will help with the sustainability of our passion and our profession.

Journey Back to Certification

Journey Back to Certification 2

Certifying for the First Time

In March of 2005 I began my journey to doula work by attending a DONA birth doula training in Atlanta with the amazing Rae Davies.  I was serious about this new career and began the road to certification immediately.  I completed all requirements, including attending 5 births in order to get the 3 qualifying births for certification. (2 of my first 5 births were C-section births and only 1 could count towards certification at the time)  

In late 2005, I received my DONA certification and began doula work in earnest.  I took about 2 -3 clients a month regularly until I became pregnant in late 2006.  After a few months, off in 2007, I started up again and continued with the work that I loved.   My DONA certification was up for re-certification in 2008 and I completed it as required without any issues. In 2009, I started YourDoulaBag.com and began selling products for doulas.  Also in 2009, another pregnancy and birth of my own (baby #4) took me out of doula work for about 4 months. Right about summer of 2010 I was enthusiastically back to a full client load and was busy building my doula products business.  At this time, I also created the doula data management program YourDoulaBiz.  Doula business was good.  I was "all in" as a doula.  This was my profession and I embraced it completely.  To be honest, I was juggling a lot of balls at this time in my life.  Four kids and a start up business was a lot for me to handle and things sometimes slipped through the cracks. 

What I didn't do was pay attention to my re-certification date.  

By the time, I realized that I had missed my re-certification deadline it was too late.  DONA International did not have a policy in place (which I believe they do now) that would allow you to re-certify after you miss your deadline.  I had lost my CD(DONA)!  You might be wondering how I could have ignored reminders from DONA.  Unfortunately, the organization had a few glitches with their notification system and reminder postcards weren’t sent.  An email might have gone out, but I didn’t see it. 

I wanted my certification back, but found out that the only choice that I had at that point was to go through the entire certification process again…from the very beginning!  So, I had to make a choice.  Continue to spend my very limited free time growing my business and working as a doula or start back at the beginning of the DONA certification process.  I decided to continue on with my work and revisit certification at a later date.

The Time Has Come

Six years and many doula clients later I have decided that now is the time to certify again.  I think there is value in certifying as a doula and I realized that there is no time like the present.   I ordered by DONA birth doula certification packet and started the certification journey…again.

Training in Louisville (aka #recertroadtrip)

January 15th and 16th I traveled to Louisville, Kentucky to take part in the DONA birth doula training taught by my friend and amazing DONA trainer, Robin Elise Weiss.  It was a great trip!  I recruited Kathleen Leathers, my doula buddy and SupportingHer collaborator, to join me for the trip.  It was a great weekend filled with lots of doula fun.  A highlight of the trip included Saturday night dinner with a group of awesome 100percentdoulas from the area.  We dinned in the capital city of Franklin, Kentucky and had a wonderful doula dinner.

 

 

The Learning Never Stops

While most of what was covered in doula training was very familiar to me, I did learn some new things and it was a nice way to refresh my skills.  Meeting the other members of the training was also a highlight of the trip.  I loved all the hands-on skills practice that Robin setup in the training and especially enjoyed pretending to be in labor over and over again.   

So, I’m one my way back to becoming certified again.  If you are a certified doula or planning to get your certification, heed my warning and don't let your certification lapse!  

 

  • Alice Turner
Doula Fees:  How to Get Paid for Services

Doula Fees: How to Get Paid for Services 5

How are you being paid for your services?  Doulas have been compensated in many ways ranging from barter to insurance payments.  The most common way to be paid for years has been cash and check, but payment options are growing.   In this blog post I’ll look at advantages and disadvantage of three of the most common payment options available.  {Note insurance coverage is not covered in this post as it deserves its own blog}

Cash and Check

Cash and check have long been the typical way that doulas are paid.  Have you ever found yourself with a stack of deposit checks sitting on your desk waiting to go to the bank?  Many doulas are still collecting payment via check, oftentimes asking clients to mail a deposit check or send a check to complete their payments.

Advantages

Getting paid by cash or check is the most lucrative way to be paid.  There are no fees associated with these traditional forms of payments.   For many doulas, checks are an easy way to collect payment.  There is no learning curve to getting paid by cash or check. 

Disadvantages

Cash and check isn’t easy for many of our millennial customers.  They aren’t used to paying for bills by check.  According to First Data Corporation, more than one fifth of all millennials haven’t paid a bill by writing a physical check.  Millennials are active online banking users.  Asking our customers to pay by check might cause making a payment a chore.  By requiring this method of payment, doulas could appear old fashioned and possibly even unprofessional.  We certainly don’t want our request for a check to delay our payment!

PayPal

PayPal is a payment option that is gaining in popularity among doulas.  You might find that most of your doula clients have a PayPal account and use this form of payment regularly when they buy items online or sell items on popular sites like eBay.  PayPal accounts are linked to a bank account and in order to get access to the funds the account holder has to transfer/withdrawn the funds from their PayPal account to their bank account.  This process usually takes 3-5 days, but can vary depending upon your country.

Advantages

PayPal is a popular way for paying for products and services online.   The payment site has tools to help businesses accept payments easily.  The PayPal account user can quickly create an invoice using the free templates and email clients through the PayPal site.  There is also a fun feature called PayPal.me where account holders can create a personal link that makes payment super simple.  I created one for my own business that you can see here http://paypal.me/alicethedoula.   There is also a very easy to use tool that you can use to add a payment button to your website.  This button can be customized in so many ways including adding a price and changing the size of the button.  This could be an option for collecting payment directly through your website.  Here is a button that I created in less than one minute.  It is for a 1 cent payment which goes directly to my PayPal page.  (if you find this blog post useful you can press the buy now button and send me a one US cent!) 

 

Disadvantages

When you hear complaints about PayPal they nearly always seem to be about their fees. PayPal charges the seller/service provider 2.9% of the amount paid and an additional 30 cents per transaction. This means is that if you charge $1000 for doula services, $29.30 will be held by PayPal for their fee.

Please take note that it is against the PayPal user agreement to request that your buyer use the “send money to a friend or family member” when they are paying you for services that you have provided. I researched this topic and contacted PayPal directly. The customer service representative confirmed that this is not the correct why to get paid for services using PayPal. You can find all of the details about this part of the user agreement here. Quoting PayPal “You may not use the ‘send money to a friend or family member’ feature in your PayPal account when you are paying for goods and services.” Violating the PayPal user agreement can put you and your buyer at risk for their account being shut down.

Online Payments

There are countless companies that provide a method for accepting online payments. Well known options include Square and Stripe which are the two that I researched for this blog post. Stripe fees are the same as PayPal which is 2.9% of the sales amount and 30 cents per transaction. Square fees are a bit less when you swipe a card than both Stripe and PayPal at 2.75% of the sales amount. If you type in the card number (through your website for example) the fee at Square is a bit higher at 3.5% and a 15 cent per transaction fee.

Advantages

Both Square and Stripe have mobile apps and allow you to easily swipe credit cards on your phone. In addition, adding a payment buttons to your website is almost as easy as adding a PayPal button. I created one below that links to my Stripe account. (feel free to test and send me another penny!) I think an advantage that Stripe has over PayPal is that customers aren’t required to have a PayPal account in order to make a payment. They can pay with debit/credit cards which could include debit cards that are setup for a healthcare flexible spending account.

 

 

Disadvantages

The fee is the biggest disadvantage of accepting online payments. Just like PayPal, the service provider is charged a fee for the convenience and protection of online payments.

What’s Next

The world of electronic payments seems to be changing daily. There are a few options in the future that look promising like Google Wallet and Venmo for Business. Until these become a bit easier to use and setup for business account, I think the best option is to look at adding PayPal and either Stripe, Square or a similar online payment processor to your business payment options. Moving beyond the typical cash and check payments will allow your clients to have options that are comfortable to them. The fees might be painful at first, but I think the advantages outweigh the fees. When it comes to tax time, there is a good chance that these fees can be categorized as business expenses. (perhaps this is the silver lining!)

  • Alice Turner
Doula Contracts: Electronic Signatures

Doula Contracts: Electronic Signatures 1



The purpose of a doula contract is to protect both the doula providing the service and the clients receiving the service.
  The contract should explain what is expected of both parties and what should be agreed upon and signed by everyone involved. Traditionally contracts were printed out and the physical copy was signed.  That physical copy was then filed and saved by the doula and/or scanned and saved electronically.  In recent years, electronic contracts have gained in popularity with many programs designed to make this process very easy.

Are electronic signatures valid?

In 2000, the E-SIGN Act (https://www.fdic.gov/regulations/compliance/manual/10/X-3.1.pdf) was passed into a US federal law.  This law grants legal recognition to electronic signatures if all parties choose to use electronic signatures.  All parties involved must also have access to the final signed version of the documents and the electronic record should be maintained.

The E-SIGN Act act also requires a paper alternative to be available if all parties do  not agree to using electronic signatures.  For this reason, I suggest that you include a sentence in an email to you client or during in person communication that states “I can provide a paper version of the contract if you would prefer.”

Review of Digital Signing Programs

There are dozens of programs that allow you to get your doula contracts signed.  We have selected three that seem the best fit for doula work.  These are SignNow, DocuSign and HelloSign.

SignNow

Available as an Android and iPhone app

Price: App is free and it is free to create an account.  The free account allows you to create 5 free documents per month on the app.  If you need more than that you can upgrade to a paid account which is $6.99/month or $59.99/year.  This is an in app purchase (through iTunes or Google Play).  The paid plan allows for unlimited documents. If you want to only create on the desktop version you have to upgrade to the paid plan.

Ease of Use: Very easy to use.  I had my contract document in email and saved it right into the SignNow app.  Inside the app the process for creating a template is super easy.  You go through and add any initial, signature and date fields to your contract document using the very straightforward interface. This process took me about 1 minute to complete.  Once the template has been created, you can create a document to send to your clients.  This requires that you enter email addresses which you can quickly pull from your phone contacts (if you have stored them there).  The contract is sent via email you your clients and you are notified when they have signed the document.

Client experience: Ability to download the contract before and after signing it. Ability to decline to  sign, easily see where to sign or initial, dates entered automatically, can draw or type signature, does not require that the client has the app on their phone, can be opened easily

Other interesting features: Login with touch id, create a team so that you can view any team members documents.

DocuSign

Web interface, Android, iPhone and Windows mobile apps

Price: There is a 30 day free trial that does not require a credit card.  After the 30 days the least expensive plan is $10/month when paid for the entire year and 14.99/month if paying monthly. 

Ease of use: You could login to DocuSign through Facebook, which was can make login very easy.  The app sser interface was similar to SignNow, but not quite as easy to use.  It was a little confusing as to add the fields for multiple signers (a client and a partner for example).  There was a phone notification that the contracts had been signed which some people might prefer over an email notification that the other programs had.

Client Experience: The client screen is a little misleading in that it at first it looks like the user must create an account with DocuSign in order to download the document, but there is a small download icon that could easily be overlooked.

Other interesting features: The company reports that in early 2017 they will integrate payments into there program.  If this works well it could be the go to choice.

HelloSign

Web Interface, Android and iPhone version

Price: 3 documents for free each month.  After that the smallest plan (pro plan) is $13/month when you pay annually.  The Pro Plan allows for unlimited documents per month.

Ease of use: Create an account or login with your Google account.  If you login through your Google account you can easily access your Google Drive an all documents stored there.  The desktop interface is very user friendly, but I found the app to be difficult to navigate.  If you don’t need to create the documents on your phone, then this could be a great choice. 

Client Experience: The client interface is very easy, but the process for the client to download a copy is a multi-step process.  They have to sign the document, wait for an email, click on a button to go to HelloSign and then from there download the document.  

Getting Started with Electronic Signatures

As you can see, integrating electronic signature can be super easy when you use a tool that has been created for this process.  If you are ready to update your business in this way

  • Get a contract finalized for each service/package that you offer. If you offer a few levels of service make sure that you have one contract for each service.
  • Pick a Program, Upload Your Contract and Setup the Signature, Initial and Date fields.
  • Test! Send a contract to yourself (via a different email) or a friend and get them to test it out. 
  • Determine where in your client lifecycle process you will send the contract. I like to send it for the client’s review after the interview. 

 

 

  • Alice Turner
Spinning Babies Workshop Review

Spinning Babies Workshop Review 3

If you are a birth doula, then it is very likely that you have heard about Spinning Babies. Most doulas have even visited the website or directed our clients to check out a page or two.  Spinning Babies is all about fetal positioning.  Founder, Gail Tully, has made Spinning Babies her life's work and has gained praise and respect for this important work in the field of birth.

If you have ever supported a client with a OP baby and felt the frustration of not really know what would help encourage the baby to rotate, then you probably would jump at the chance to learn something that would make a difference.  When Tammy Ryan planned to come to my area and teach a Spinning Babies Workshop I was thrilled and excited about learning. 

On Saturday August 20th, 2016, the fellowship hall of a church just north of Atlanta was filled with women gathered to learn Spinning Babies techniques.  Everyone was ready to go and ready to learn. 

Spinning Babies Workhop Review

Who was there? 

 

One of the things that I loved best about the class was the mix of attendees.  The class brought together all types of providers that work with pregnant women.  The majority of us were doulas, but there were also certified nurse midwives, certified professional midwives, labor and delivery nurses, chiropractors, massage therapist and childbirth educators.  I have never been in a training with such a variety of birth professionals and we were all in the same role that day.  We were all learners and this felt so good.  

 

 

What was covered?

The first half of the class was devoted to anatomy, fetal positioning and pregnancy.  We learned a lot about the pelvis, ligaments and muscles related to pregnancy.  It was a lot of information, but Tammy kept my attention.  Before our break for lunch we learned about belly mapping and about daily pregnancy that can be done to encourage optimal fetal positioning. 

We were up and moving around for the second half of the class.  This time was devoted to learning about fetal positioning in labor and birth.  We learned several different movement and positioning techniques along with when to use each.  We took turns practicing with each of us taking a turn playing the role of the pregnant women.    

Alice Turner and Tammy Ryan at Spinning Babies

 

Doula's Scope of Practice

Tammy did a nice job of covering the doula's scope of practice and how spinning babies techniques relates.  The room was filled with many birth doulas and this is a topic that I feel is very important to cover.  She reminded doulas how to determine if anything is out of scope. While this didn't apply to everyone there, it can't hurt for all providers to hear about the doula's scope.  

Summary

The opportunity to learn these skills in person and with my own hands was invaluable.  This type of information is so difficult to really understand unless you have someone show you in person.  I'll admit that in the past I have been frustrated with the Spinning Babies website. I knew there was so much good information on the site, but I just couldn't quite figure out how to reach it (or understand it well for that matter).  I think these techniques are difficult to learn in a virtual environment.  Now that I have completed the workshop, I feel great knowing that I have more 'tools' to bring to my doula practice. 

I recommend the Spinning Babies Workshop to all birth workers.  Attendees will come away with more knowledge about fetal positioning and some real practical ideas for working with your clients.  

Workshops are held all over the world!  Check out the site for a full schedule or bring one to your area.

Sneak a Peek into the Workshop

Tammy gave me permission to post some videos on Facebook Live during the workshop.  I think this is a nice way to take a sneak peek at the class. 

 

The Doula Interview: 3 Mistakes to Avoid

The Doula Interview: 3 Mistakes to Avoid 4

Doula interview mistakes to avoid
Mistake 1: Turn it into a mini prenatal  


Some clients are so hungry for information that they come to the interview with a copious amount of questions. They might ask you everything from your opinion about their care provider to what your thoughts are on circumcision. The potential Clients might even ask so many questions that before you realize it, hours have passed and you will have conducted a mini childbirth education class right there in the coffee shop. If you don't reign them in, their questions you might also have covered most of what you usually do during a prenatal. 

Being a source for quality information is great and I'm not suggesting that you should avoid answering all questions. What I do suggest is to limit your questions to those that are essential for helping with the hiring decision or help them with an immediate need.

Example of hiring decision questions: "What is your backup situation?" and "When do you meet us in labor?"

Examples of immediate need questions: "Is my hospital natural birth friendly?" or "Do you have a childbirth class that you recommend?"

Examples of questions that I suggest saving for he prenatal include: "How will I know when it is time to go to the hospital?" and "what positions would you suggest for back labor? "

The interview should be used to find out if you are a good match. It's the time to make sure that they know the great skills and qualities that make you unique. Use that limited time to ask them questions. You are interviewing them just as much as they are interviewing you!

Mistake 2: Bash their choice of care provider or birthing location

Many times I have received an inquiry from a potential client who was upset about a phone call or interview that they had with another potential doula. The other doula openly criticized the client’s choice of care provider and/or hospital and told the potential client that they would have a negative birth experience if they stayed with those choices. The first time I heard about this I was shocked and I thought it was a one-time occurrence. This actually is fairly common! Bashing someone else's choices isn't empowering. As doulas we need to honor their choices. If they ask opinion about their choices we can give input. If they aren't aware of challenges that come with their choices was can let them know, but not at the interview unless we are asked for our input. Doulas are there to support clients, not show our bias or force clients to birth with our favorite providers or favorite birthing locations. If you know that you don't like working with their choice of birthing location or care provider tell them that you aren't the best fit for them. Allow them to work with a doula that would feel comfortable supporting them where they are at. And please don't agree to be their doula with the intention of changing their mind during the prenatal.

Mistake 3: You don't interview them

When I first started out I was very eager to get clients. If they wanted to interview me, then I wanted to be their doula. I was ready to go and wanted to work with everyone. I would ignore red flags and not listen to my gut. This was a mistake that is one of my top 5 lessons learned in my first 10 years of doula work. Don't look past red flags during an interview. Doulas should be interviewing the potential clients just as much as the clients are interviewing doula. Make a list of questions for clients and bring them to the interview. This is an important step and also shows the potential clients that you are taking this relationship seriously.

doula interview coupon code