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How to Survive Life on Call

How to Survive Life on Call 6

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.

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. 

 

How to Work as a Doula - Doula Outside the Box {5 in a 5 part series}

How to Work as a Doula - Doula Outside the Box {5 in a 5 part series} 2

The three most common ways to work as a doula are as an independent doula, as a member of an agency and with a doula collective.  However, there other ways to be a doula.  Many doulas have thought outside the box and created their own unique way that works for them. {For purposes of this blog I will be using the pronoun “she” as this fits the vast majority of doulas.  Males can be doulas too. Which is wonderful!}

There were four less common ways that appeared a few times in our survey about how you work as a doula which was completed by over 180 doulas.  These were: partnerships, volunteering, hospital based work and dedicated backup. 

How to be a doula

Partnerships

Doula partnerships seem to be gaining in popularity possibly due to the desire to have a more predictable schedule.  Doula partnerships are usually between two doulas.  The doulas often share everything from income to clients.  Many doulas in partnerships attend prenatal appointments for all clients.  The on call schedule is divided so that each doula has a known schedule for being on call.  When the client goes into labor the doula on call is the one that attends the birth.  The fees are usually split where the attending doula receives the major

The doulas in a partnership generally share the business responsibilities and make business decisions as a team.  Special consideration should be given to setting up contracts between the two parties so that the workings of the partnership are certain.  

Partnerships can be a great way to have more control over your business while preventing burnout of living life on constant call. 

Volunteer Doulas

Volunteering your time as a doula is another way to work as a doula.  Many doulas start their careers as volunteer doulas in order to get experience.  If volunteering with an organization or healthcare practice, doulas are often given set shifts and are not assigned particular clients.  They are available if needed during their assigned shift. Doula may also volunteer their services and follow the typical model of working with clients one on one.  Many doulas that work as volunteer doulas find the work very gratifying. However, volunteer work is not a necessity to being a doula.

Hospital Based Doulas

Hospital based doulas usually work as employees of the hospital.  They are assigned clients through the hospital program and can work with clients on a one on one basis or more commonly are assigned clients in labor.  Hospital based doulas can have the opportunity to work with a wider variety of clients than doulas in private practice.  Because hospital based program generally provide doulas for free, doulas are more accessible birthing women no matter what age or economic status.

While many doulas might enjoy working as a hospital based doula, the programs are not common.  One of the oldest program is at Lexington Medical Center in Lexington, South Carolina. In 2014, they reports to have provided doulas to over 8400 birthing families!

 

 Dedicated Backups

A dedicated backup is a doula that does not have her own clients, but rather only provides backup support for one or more doulas in her area.  Dedicated backup doulas are often paid a fee to provide backup support regardless of whether they attend the birth or not.  Having a dedicated backup doula in place can be a great asset to a busy doula.  Because dedicated backups do not take their own clients they are more likely to be available should they be needed. 

 Series Wrap-Up

It's the final blog in our "How to Work as a Doula" blog series. What did you think?  I'd love to hear your thoughts.  Please comment on an article.  If you liked the series share it with your doula network.  If you missed any blog read more here. 

How to Work as a Doula - Doula Collectives {4 in a 5 part series}

How to Work as a Doula - Doula Collectives {4 in a 5 part series} 1

Collectives that I describe in this section are independent doulas that work together under a shared group name, but handle all money and contracts on an individual basis.  Some groups use the word ‘collective’ in their names, but actually function more like an agency in that they handle matching of doulas to clients and handle contracts and payments.   For this blog, I looked at 12 areas of business and gave my thoughts on how the agency doula relates to each. {For purposes of this blog series I will be using the pronoun “she” as this fits the vast majority of doulas.  Males can be doulas too. Which is wonderful!}

  • Income – Most doulas in a collective do not share any portion of the fee for their services. They might however owe a due that is paid monthly or yearly to be part of the collective. 
  • Marketing Efforts – Marketing efforts are usually a combined effort between the group and the individual doula. Often doulas in a collective can share marketing efforts by listing their services on a central website and holding group meet the doula events.  The ability to share marketing efforts is often one of the top benefits that draw doulas into a collective.
  • Doula CollectiveBrand – The responsibility of managing , protecting and promoting the brand is usually the responsibility of all of the members of the collective.
  • Reputation – If the doula member represents herself as a member of the collective then she can impact the reputation of the brand. If she represents herself as an individual doula then she will impact her own personal company.
  • Backup Doula – One of the top benefits for joining a collective is to establish a solid backup network within the collective.
  • Input on How the Business is Managed - Each doula in the collective will manage their own business.  The management of the collective itself is usually done collectively by all of the group members.  In some cases, the collective will elect officers who will serve the role of collective manager(s) for their term of office. 
  • Doula Contracts – In most cases, contracts are handled by the individual doula in a collective.
  • Client Acquisition – The responsibility of finding clients is shared between the collective and the independent doula.
  • Client Fit – Some collectives have a matching process where a manager or volunteer processes inquiries and matches them with collective members. Other collectives are very open with the information that they provide about each doula in the collective and allow the client to contact the doula(s) that they are interested in.
  • Schedule Flexibility – Doulas that join collectives generally have complete control over their own schedule. She can book her calendar as full as she desires (or is able to). 
  • Job Security – A doula in a collective is her own boss. This means that she creates job security for herself.
  • Testimonials - All testimonials are owned by the independent doula. If she receives a positive testimonial it will always be a benefit to her business and won’t have to be used to grow a group.   She can grow her testimonials for her own business on her website and other sites like Yelp and DoulaMatch.net.

    Things to consider when joining a collective

    • Collective often have requirements for membership that include participation in both volunteer and marketing activities. It is important to know the requirements of the collective and to be able to fulfill the requirements.
    • Having a network of doulas to pull for backup is usually considered one of the top benefits for joining a collective; however I would make sure that you are comfortable with the backup that you are using before using any member of the collective. If the backup doesn’t not perform well it could be a reflection on your individual business and not the collective.
    • A collective can be a great fit if you want to run your own business, but would like the support system of a group.

     Read more about other ways to work as a doula.

     

     

    How to Work as a Doula - Agency Doulas {3 in a 5 part series}

    How to Work as a Doula - Agency Doulas {3 in a 5 part series} 1

    Agency doulas are doulas that work in one or more doula agencies. In some cases, they might also have their own businesses, but get client referrals from the agencies which they are members.  For this blog, I looked at 12 areas of business and gave my thoughts on how the agency doula relates to each. {For purposes of this blog series I will be using the pronoun “she” as this fits the vast majority of doulas.  Males can be doulas too. Which is wonderful!}

    • Income – The management of a doula group generally keeps a percentage of the fee that is collected for doula services. This fee varies between groups.  I have seen percentages of anywhere from 5% to 20%.  The payment process also varies between groups.  Groups may pay a percentage after the fee is collected from the client, hold off until the services are complete, make payments on a bi-monthly schedule or any variation of these.  Payments are generally made by the clients to the management of the group and then distributed to individual doulas, but sometimes payments are collected by individual doulas.   While the payment amount and strategy varies, the main point is that an individual doula does not keep the entire fee paid by the client.
    • Marketing Efforts – Marketing efforts are generally handled by the management of the doula group. Individual doula members usually do not incur their own marketing expenses.  Sometimes individual doulas are asked to participate in marketing events such as a meet and greet.
    Working for a Doula Agency - Part 3 in our How to Work as a Doula Blog Series
    • Brand and Reputation – Branding for a doula group is handled by the management of the group. This includes setting up the group name, logo, and website.  Maintaining the brand identity of the group is the responsibility of the management
    • Reputation - The reputation of the group is something that can be impacted both positively and negatively by all members of the group. A doula that stands out as a leader in the area and one that has developed a positive reputation in the community can impact the reputation of the entire group.  Conversely, a doula that creates a negative reputation in the community can create a negative reputation for her group.
    • Backup Doula – Most doula groups have a backup system within the membership. Each member is usually able to use one or more group members as their backup.
    • Input on How the Business is Managed – The amount of input that the individual doula can have on her group varies from group to group. The management of the group might allow for a lot of input from members, no input or some input.
    • Doula Contracts – Contracts are another factor that varies between groups. Many groups have a standard contract that each member must use.  Other groups allow the individual doulas to use their own contracts though this seems to be less common that a standard group contract.
    • Client Acquisition – The responsibility of finding clients in a doula group is usually is that of the management. Individual doulas might be required to attend client meet and greets, teas or speed dating events, but usually are not expected to organize these events.   Most doula groups have one point of contract for inquiry about services.  From that point the management either matches a client and a doula or distributes the client’s information out to the doulas in the group for them to decide whether to setup an interview.
    • Client Fit – In some doula groups, matching a doula with a client is done by the management of the group. In other groups that process of interviewing and deciding upon fit is left up to the individual doulas. 
    • Schedule Flexibility – Scheduling is another factor that varies from group to group. Usually an individual doula can express her scheduling preferences to the management which will be factored into the matching of clients.
    • Job Security – From what I have seen, most members of a doula group are contractors working for the group. They are not employees.  This means that usually doula group members can be released from the group at the will of the management.   The individual doula may or may not be asked to sign a contract to work with the group.
    • Testimonials – Like so many things, the ownership of client testimonials varies within a group. Some individual doulas keep testimonials for their work on sites like DoulaMatch.net and Yelp while other groups require testimonials to be stored on the group’s account at testimonials sites.

     

    Things to Consider Before Joining a Group:

    • Thoroughly review all contracts that you are asked to sign. Be especially aware of any type of non-compete language that is included in contracts that could prevent you from working as a doula if you leave the group.
    • Get all of your questions answered about payment. For example, if a client does not pay or disputes the payment with the doula group will the individual doula receive payment. 
    • Communicate your expectations for scheduling with group management. If you expect to have 2 clients a month, the group management needs to know.  The group might not be able to satisfy your goals or might want to book your calendar with more clients that you are comfortable taking.
    • Learn about the culture of the group and find out if it fits your personally and how you want to work as a doula.
    • Learn about any behavior standard that might exist in the group. Examples include how interviews are supposed to be done, how long after the birth labor doulas should stay and if a postpartum visit is routinely done by labor doulas.

    Wondering about working as an Independent Doula? Check out blog 2 in our series about working as a doula. 

    How to Work as a Doula - Independent Doulas {2 in a 5 part series}

    How to Work as a Doula - Independent Doulas {2 in a 5 part series} 2

    Independent doulas are doulas that work on their own.  They aren't part of a group, agency or collective.  For this blog, I looked at 12 areas of business and gave my thoughts on how the independent doula relates to each. {For purposes of this blog series I will be using the pronoun “she” as this fits the vast majority of doulas.  Males can be doulas too. Which is wonderful!}

  • Income - An independent doula keeps 100% of the income that is earned. 
  • Expenses – Independent doulas have to cover all of the costs associated with starting a business.  This could include legal fees, insurance, marketing costs, continuing education etc.
  • Marketing Efforts – Small business owners often incur marketing costs in order to build their brand and find clients. All of the costs associated with marketing will be the responsibility of the independent doula.  Marketing decisions will also be solely up to the independent doula.  This means that she will retain all creative control over this process.  She will be able to decide how to market her business and will have the flexibility to change her marketing plan as she sees fit.
  • How to work as a Doula - The Independent Doula

  • Brand – An independent doula has complete control over her brand. Every time she works as a doula she is representing her brand and her company
  • Reputation -  She does not have to share a reputation with all of the doulas in a group.  Independent doulas are able to develop relationships with clients, care providers and other professionals and growth their referral network which will benefit their own business. 
  • Backup Doula – Backup doulas sometimes can be a struggle for independent doulas. It is their responsibility to create relationships with other doulas and develop a relationship with one or more doulas to provide backup.  Usually, independent doulas use other independent doulas as their backup(s).
  • Input on How the Business is managed – The independent doula has complete control over how her business is managed. This is complete freedom to create the business that she wants.  A drawback to this freedom is the burden of being the only one with ideas for the business.   Doulas that work independently can feel overwhelmed with the day to day to-dos of business management.
  • Doula Contracts – Contracts are an important part of a doula's working relationship with both her clients and her backup doulas. The independent doula has total control over this process.  She can set up safeguards in her contracts to protect her business and define the working relationships in her business.  It is her responsibility to create these contracts and use them properly.
  • Client Acquisition – Finding clients and generating income is completely in the hands of the independent doula. It is her responsibility to develop methods for finding clients.  This includes marketing, social media, referral networks etc. If she is having a problem finding clients she is the only one who can fix this problem.
  • Client Fit – The independent doula has complete control over who she takes on as a client. She can be as discerning as she wants and decide on her own criteria for accepting a client.
  • Schedule Flexibility – An independent doula has complete control over her schedule. She can book her calendar as full as she desires (or is able to).  Doula’s that own their own businesses are able to schedule meetings to meet their own needs which include timing and location.
  • Job Security – Independent doulas are their own boss. This means that she creates job security for herself.
  • Testimonials – All testimonials are owned by the independent doula. If she receives a positive testimonial it will always be a benefit to her business and won’t have to be used to grow a group.   She can grow her testimonials for her own business on her website and other sites like Yelp and DoulaMatch.net.

  •  Things to consider before working as an independent doula

    • As an independent doula, you are responsible for all aspects of running a business. This requires a lot of determination, motivation, and drive.  I believe that to be a successful independent doula you must be a self-starter and passionate about running your own business.   Running your own business takes a good amount of organization and discipline. 
    • Many independent doulas often feel lonely. It is good to connect with other independent doulas for backup and support.
    • Working as an independent doula often requires a lot of effort up front in order to get a steady stream of doula inquiries and clients. If you can’t afford the extra time needed to establish your business it might not be the best choice for you.

     Read more about other ways to work as a doula.