Challenging births? No need to panic!

Thinking about switching careers and becoming a birth doula? Unsure whether to take the leap? This four-part series asks seven awesome doulas to tell us how they switched careers to become a birth doula. They talk about the ins and outs of the job, and how they feel about working as a birth doula. In the final post of the series, they talk about some of the challenges with becoming a birth doula and how they manage these.

If you’ve already made the decision to become a birth doula, check out our Becoming a Birth Doula Guide. This FREE guide will walk you through the steps to start your new career.

What happens if you miss a birth?

Fortunately, this has only occurred a few times in my career. Only one was because I was too far away to make it in time. The others happened while I was en route to the hospital. I do my best to provide emotional support and if it is practical, physical support any way I can once I arrive.

Exie, Michigan USA

I meditate, I pray, and I follow up with the parent, and we make a plan for additional postpartum visits. The reason for missing the birth determines if any or all of the pre-paid funds are returned to the client.

Tintawi, New Mexico USA

I work with a team of other doulas so our clients understand that while I make every effort to attend their birth as their primary doula, life circumstances and overlap with other clients would impact this. They will have at least one opportunity to meet the rest of the team. So far all our clients have been attended. However, we also have a contract that offers them a refund if the reason I missed a birth is due to our error.

Feven, Bermuda

Depending on how it happens, I offer a refund.

I have missed four births to date. In three cases I arrived too late as they were precipitous labors (and both two hours away), but I still provided support in the immediate postpartum and in the following days. As my contract states, no refunds are given in this situation, and thankfully all my clients were very happy, although I did struggle as I felt I had failed them somehow.

The other one was more difficult for me to process as it was a virtual birth and my clients mostly needed help while at home, but by the time I saw the missed calls they were already at their chosen facility, where communication became very sporadic. I was glad to know they got very good support, but the fact that my help was no longer needed offered no relief from the guilt! I did provide extra postpartum hours and they were extremely gracious about the whole mishap, but I did send them a partial refund regardless. It took me a long time to get over the guilt and frustration — I had one job, and that was answering the phone, but I had forgotten to unmute it. Interestingly, I have never missed a call by a client in labor, but even if I had, in an in-person birth I would have still joined my clients with plenty of time. Virtual births are hard on the doula for that reason — we are often left to wait for hours, unaware of what’s going on, unable to help. Since then, I have been quite reluctant to take on virtual clients, although not many have contacted me anyway as I charge almost the same amount as an in-person birth.

Adele, South Korea

I do not currently do any birth doula work, but this is certainly something to be aligned with your clients prenatally. What some doulas agree with their clients is that as long as it was not the doula’s ‘fault’ for missing the birth (did not answer their phone, for instance), then they are paid in full for their work.

Xenia, Greece

I try to always arrange for a backup doula in the event that something comes up to prevent me from making it to a birth. However, this also depends a lot on why I miss the birth. If a client simply didn’t call me, unfortunately, that is their responsibility, and there is nothing that I could have done to change this. If something personal comes up such as an illness or a family matter, this is where a backup doula comes into play. These situations are clearly outlined in my contract so that clients know how to deal with things from the very beginning of our time working together.

Carmen, Michigan USA

You apologize and move on, for the most part! Generally, you’ll can miss rapid or precipitous births because they’re so speedy or you might miss a birth for inclement weather. On the rare occasion, maybe you miss a birth because your phone died or was off and you didn’t notice. The result is the same – we’re all human, and we can offer extra postpartum support or a refund if we’re at fault, alongside our apologies.

Johanna, Ontario Canada

What if something goes wrong during the birth?

If you do this work long enough, it will happen. During the crisis, it is important to stay focused on the client and their partner. Helping them feel safe and understand what is happening to the extent that they require is important. Staying calm and making myself helpful to the medical staff when possible has proven invaluable to how my clients process these experiences later. Debriefing with clients later if they are open to that can help them. Discussing what happened and my feelings with my spouse while protecting client confidentiality helps me process it. I also engage in extensive reflective practice in the days and weeks after.

Exie, Michigan USA

This is always a possibility. I do my best to see each part of the process as steps. If a step is misaligned, it can alter everything that attempts to ascend it. I would allow myself time to process and heal and create opportunities to listen deeply to my client.

Tintawi, New Mexico USA

I debrief with my colleagues, I also see a therapist every month.

Feven, Bermuda

If something goes wrong, I support my clients in any way that is possible and appropriate, then practice self-care if I suffer from vicarious trauma. I haven’t witnessed a stillbirth yet, but I did attend a couple of births where obstetric violence was used, and I have taken my time to process them with the help of other trusted professionals.

Adele, South Korea

Birth is amongst, if not the most, unpredictable event in a person’s life. And while we may be dedicated to supporting our clients towards having the birth they envision, what’s also important is preparing them (and ourselves) for alternative outcomes. As we do this planning work, it is equally important to align with our clients on the specific role that we will play. Supporting them on their journey is what we do, but support can be interpreted differently by different people. The clearer we become about what our clients expect, the more equipped we may be to adapt and respond to our clients’ needs should things not turn out as planned. What’s also important when things go wrong is having a support strategy for us and giving ourselves the time to process the feelings which may come up when things go wrong.

Xenia, Greece

As a doula, it is not my job to “fix” the problem. At the point that something does go wrong, I need to be ready to adapt and also help my client adapt and process what is going on. This may mean helping them create a new plan that fits within their new circumstances, helping them understand what is happening and why, simply being a source of emotional support for them, or it may mean helping them reflect and process what happened after the fact.

Carmen, Michigan USA

What-ifs are hard to work through and also infinite. Babies and bodies don’t read textbooks so there is always just a slew of things that could happen that aren’t “according to plan,” but not everything that can go wrong is a tragedy. If you’re doing this work long enough, things will go wrong, and it’s important to remember our role as support people. We can step up the emotional support during difficult/unexpected changes in the birth plan, and we can step back when the care team needs more space to manage the situation. In either opportunity, we want to take care of our client and their partner’s emotional needs while preparing to have someone take care of ours while we debrief afterwards.

Johanna, Ontario Canada

Do you get clients that you don’t like?

I try not to by using my consultations as a screening process as well.

Exie, Michigan USA

No. I have had clients with whom I don’t share their beliefs, but I think it’s important to care about the people I work with and I hope that we can work out our differences to create the healthiest relationship. If this is not the case, I offer other birth attendants to the clients and work to help them meet the attendant in question.

Tintawi, New Mexico USA

From time to time I work with clients whose personalities can be challenging, and I have learned over years to work hard to attract the ideal client as well as develop a system of debriefing and processing client experiences, which have been incredibly helpful

Feven, Bermuda

I can’t recall a birthing client I didn’t like (I’m very lucky in that way!), but there were definitely a couple of partners I found unhelpful, even disruptive. I hope and trust I was able to not let my true feelings transpire and focused on redirecting their attention when I sensed their attitude was negatively impacting the birthing person.

Adele, South Korea

Absolutely! There are clients with whom I connect and relate to and who I may enjoy supporting more than others, and this is ok. Every person is different and what enables a connection with my clients is not about whether I like them personally (or whether they like me) but rather depends on the extent to which they feel safe and comfortable enough to open up and accept help from me.

Xenia, Greece

I have honestly never had this happen! I think that for the most part what we put out there in our marketing is what determines the type of clients we tend to bring in. I think that this has meant that the clients that seek me out have been a good fit for me. That doesn’t mean I agree with every choice every one of my clients has ever made, but that is completely different. My client’s choices don’t impact the way that I see them as a person.

Carmen, Michigan USA

Rarely, as I’m in charge of deciding who I take on as a client and who I pass on as a referral. I’ve found that being explicit about my values as a birth professional, the work I do, and the kind of support I offer help to ensure my clients know what they’re going to get from me. I also ask clients to share their expectations of me, their other support people, their care providers, and themselves alongside their goals for their birth in our consultation meeting to see if we’ll be a good fit. I like to work with clients who want to learn and do some research on their own so I’m always clear in my marketing about that!

Johanna, Ontario Canada

How do you manage balancing your work as a birth doula and having a family?

When my kids were small, I tried on a strong support system that included my husband who took over my parenting duties and several friends who could help carpool or watch my kids.

Exie, Michigan USA

I schedule clients around my family. My family and loved ones come first.

Tintawi, New Mexico USA

I manage my client load depending on what is happening in our family. My spouse has a more flexible role at work and is able to pick up the load during my busy season.

Feven, Bermuda

It’s not easy since I have no backup and my main source of childcare is my husband, who is incredibly supportive and mostly available even with short notice, but sometimes simply cannot get out of work. As mentioned before, I am looking forward to being able to take on more clients as my daughters become more self-sufficient.

Adele, South Korea

What’s important for me is scheduling my work around the times when I can physically be present to perform it. I mainly work around my family’s schedule, which means meeting with clients and holding support groups in the day when my children are in school. When I need to visit clients in the evening or on weekends (which is rare), my husband is with our children and manages their activities and other household tasks.

Xenia, Greece

A lot of cooperation and communication! My partner and I have created a lot of different plans for childcare for the times I get called to a birth or when I have meetings with clients. This has sometimes meant finding help from other family or friends as well.

Carmen, Michigan USA

Very carefully! You need to make an intentional decision to be present with your family during family time, and the best way to do that is to set boundaries around when you will respond to calls, texts, and emails from your clients. Having set hours where you’ll respond to a call when you receive it, or a text within 1/2 an hour, or an email within two hours is important, so your clients know when to reach you for things other than “Baby is coming!” If we are clear with our clients about our boundaries and expectations of how they will interact with our boundaries, we can be successful in our business and present in our home life.

Johanna, Ontario Canada

Is the job as good as it looks?

Yes!

Exie, Michigan USA

It is as necessary and valuable as it seems.

Tintawi, New Mexico USA

It can be, and the challenging bits are valuable opportunities for learning:-)

Feven, Bermuda

I believe it is. I actually wish I could do more!

Adele, South Korea

It is an incredibly rewarding job, with highs and lows and an endless opportunity to learn as we connect with and support people in what is the most transformational time of their lives.

Xenia, Greece

Most of the time, absolutely! Sometimes, definitely not. Isn’t that true of any job though? Being a doula has its ups and downs for sure, but the ups have always outweighed the downs for me.

Carmen, Michigan USA

It’s so easy to look at this work with rose-tinted glasses and see all the sweet babies and want to snuggle them, but it is so much more than that. I rarely hold or cuddle my clients’ babies but being able to watch a family grow in love, trust, and support for each other through their pregnancy, labor, birth, and beyond is completely unmatched for “perks from a job” … you won’t find that kind of rush anywhere else.

Johanna, Ontario Canada

How do I know if this is the right job for me?

If you can work out the logistics for a good work/life balance and you love this season of life, it very well could be. It may take 1-5 births to really know if this is a good fit as far as the physical and emotional demands go.

Exie, Michigan USA

Ask yourself some deeper questions. Why are you considering this path? What do you hope to gain and share from doing this work? Is it profitable (if that is a concern)? Will I be able to make a difference in the lives of women and birthing people?

Tintawi, New Mexico USA

You will want to do it again and again, you will feel emotionally and intellectually invested.

Feven, Bermuda

The feeling you get after attending a birth. Knowing you made a difference in this family’s experience, no matter how much your back and feet hurt!

Adele, South Korea

My simple answer to this question is ‘by trying’, perhaps because I believe in taking chances and in the opportunities which arise when we try something new. I also believe that ‘what is right’ for one person will depend on so many factors including the stage we are in, the lifestyle we yearn for, the desire we have to connect and help others, and how much of ourselves we are willing to put out there at a given time.

Xenia, Greece

A lot of honest reflection! This is no different than any career move and that means really looking at what you want to do with your life.

Carmen, Michigan USA

You won’t know for sure until you try it but if you get excited about helping people, learning new things about communication, relationships, and physiology, and you really thrive when working with other people, that’s a great foundation to start with! The best thing about this work is you can make it into whatever excites you about birth and parenting.

Johanna, Ontario Canada

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