One of my biggest fears of attending births as a doula was the possibility of loss occurring. Learning that pregnancies ended, or babies were born sleeping was an unavoidable reality I struggled to accept. Knowing how and what ways to offer support for grieving families was intimidating and humbling all at the same time.
I’d been candid with myself about these kinds of trepidations; when I first started considering careers as an adolescent, I knew my personal history with grief and loss was a boundary I had yet tamed. Not wanting to put myself in a position to take on an emotional load I couldn’t handle was an active thought. Deciding to be a doula meant it would become something to anticipate.
In my current experience, I’ve never had a client who hired me experience a loss. I’ve been a part of a lot of rainbow families and even that space felt sacred. Always preparing for the worst for others, it never was something I had expected to experience in my own womb.
Already having a history of mental health disorders, like anxiety and depression, I thought myself prepared just for having the forethought. “I’d be okay”, “this too shall pass”, “it’s normal”, were all thoughts that rummaged through my body, not my mind. In my experience battling my mental health, I had a lot of numbing sensations that created dissociative experiences with my depression; my anxiety left me overstimulated and paralyzed from rapid thoughts and hypotheticals. This was nothing like either of those familiar grounds.
Although the pregnancy had been unplanned, realizing that the test read “Positive” was surreal. Being realistic about my current situation with my partner at the time, a decision was something that I wanted us to agree upon, together, whatever that decision would be. Even so, the loss happened prior to the choice being made, and it left me devastated when I realized what I wanted, a moment too late.
I found myself tangled in complicated emotions. Guilt overwhelmed me; was this a punishment for even considering other ‘options’? Was it all the stress and other unhealthy things I’d riddled my body with? Was it truly not meant to be or was it karmic for my past choices, or even past life?
Who was I to talk to about this? The partner who was unsure and apprehensive at the idea of starting a family with me? The one who shared hardly any emotional support because he truly didn’t know how or have any to share himself?
Or should I talk to my sisters or my mom? Ashamed to admit that I’d “slipped up” and wound up pregnant, now with nothing to truly show for it but crocodile tears?
All while still going to work, maintaining my stonewall face for my fellow clients and as well as my students on the daily. Even in returning to birthwork, I realized my heart had warped a bit. I saw pregnant bellies and newborn infants from a tinted black lens, almost like I was wearing sunglasses. I wore a smile on my lips, but the shaded melancholy didn’t really waiver. I recalled crying through the births of my babies with my clients out of joy, even after the first birth I ever attended; bearing witness to life coming earthside warmed my heart and gave me so much hope. Now I found myself weeping from a sense of longing, wondering if something as beautiful as that could ever happen to me.
I experienced a postpartum period; I bled for days afterwards, feeling cramping in and out of those times. Something about the physical pain felt as though it evoked more emotion out of me, knowing what the source was. I found myself sulking under a shroud, just waiting for it to pass over me. That had been my previous coping methods.
When I finally share what happened with a handful of individuals, I realized many had no words or really knew what to do to offer support. Sometimes, they felt embarrassed or awkward about being unprepared on what to do to help with my healing process. Others would offer the generic things that didn’t make me feel better at all; the things that came up as accidentally dismissive or accidentally judgmental.
Sporadically crying became a new norm and I felt parts of me were a bit obsessive over what happened; I still found myself trying to dissect why I felt so alone and isolated. My relationship didn’t survive the loss, and a lot of things fell through the cracks over the course of that year.
The sadness has since then evolved into other things that sting less. I’m still navigating the process and even this month, with October being Pregnancy and Infant Loss Awareness Month, the tears have returned and my heart aches out of the biggest maybe/what if of my life. More than anything, it’s humbled and opened me to a new level of empathy.
As a childless doula, a lot of my navigation through offering support has been from observation, recommendation, feedback and experience. However, this is an experience I’ve had to endure completely on my own, in silence. I’ve internalized this in hopes that I can be an advocate and support system for people who likely have had a similar one to mine.
People who know me, know I have a lot of pride. They also know that I’m a writer before I’m anything else. I needed express what I had experienced and stop hiding from myself. Although I see just how small I am in the grand scheme of life, I also can say that that’s even more reason to share. I just hope that in my sharing, someone else can feel a little less alone about their loss and know that it is complicated. It is hard to push through; you can, and you will.
My biggest advice to people who are looking to support loved ones who are dealing with pregnancy and infant loss: hold space. Be present. Sometimes words aren’t even necessary, being held is just enough. If you notice a rut of grief that they can’t seem to get out of, ask them what else you can provide. Even if they don’t know themselves, just do what you can. They won’t forget your kindness when they emerge from the shroud.
In the world of capitalism, we encourage people to take time to themselves and not chase the almighty dollar. Many doulas and birth workers work around the clock, but it’s not necessarily for capitalism, but the needs of families, clients, and the community. This experience, whether it’s pregnancy, birth, or postpartum, is going to be unique to each family; when we commit to being that line of support, we anticipate keeping that promise. But what happens when things shake our world?
This has been a battle near and dear to my heart lately. I experienced a lot of heavy hits in the last year. With each domino that has fallen, the weight only continued to get heavier, and heavier. Birth work is work that is scheduled or planned, so how do I navigate through it and still have the emotional energy or space to provide adequate care for my clients?
Fall of 2021, not only was I taking clients, but I was actively working a full-time job and being a full-time student; I started to feel like Atlas, carrying the world, MY world on my back. Punches directly to the gut had caught me off guard, but I tried to tighten my core to anticipate the next one. All so I could power through life and still be dependable and accountable for what my role was.
The first domino I experienced occurred in early October 2021. I had been knee-deep in my clinical hours for school, teaching full time, and prepping for my homebirth client. I had no intention or time to slow down all the things that were on my plate. I tried to swallow my pride and power through, with scheduled crying spells, getting a therapist, and trying to lean into other coping skills like paint pouring.
January 2022, I was hit with another boulder of loss. The conclusion of a relationship is something we all usually see coming, however, that hadn’t been my experience. I was stuck in a state of shock as well as a sense of abandonment. A huge piece of my support system was suddenly gone, and I had to reorganize my life to prepare for it all. My birth workload was increasing (3-6/month), I was going to need more clinical hours, prepping for the IBCLC exam was officially on my radar, and now I was being hit with a new kind of transitional grief.
February 2022, the icy weather resulted in my car sliding on the highway, in result, totaling my car.
March 2022, a majority of my births I ended up attending ended up being inductions turned C-sections.
April 2022, a looming bout of birthday depression.
May 2022, mentally and emotionally, I was so exhausted that I ended up missing my first birth based on a miscommunication and additional stressors in my life. So add on the sense of guilt and disappointment to the pot.
In June 2022, I experienced two losses in my family in a single week, one of which I was informed of while I was at birth that ended in a C-section. This was when and where I reached a breaking point and needed to take a step back. July has been a difficult month for me since 2004, and I already knew that that was going to ache.
My methods weren’t working, and they hadn’t been. I had been keeping my head down and trucking along, hoping that whenever I decided to look up, things would be brighter, better, and easier. But the cloud that had been looming over me only got darker and larger.
Self-isolation had been happening; I stopped interacting with people if it wasn’t work-related because of how dismal my mood was. I was aware I was depressed, but I kept telling myself it would pass. But how was it going to if I didn’t do more considering how much baggage I was carrying? How was I coping with these issues?
My biggest barrier was the idea of backing up and telling clients what I was dealing with. Professionally, this did not seem ideal. Even when I had uncontrollable bouts of quiet between me and my clients, I would apologetically overcompensate. In the same breath, that was draining my battery that much more. I was not well, and I hadn’t been well for a while.
Having anxiety about communicating what was going on in my life with my clients, I was concerned about it sounding like excuses. They paid for a service and were expecting it. Do I have wiggle room to be candid about what I was dealing with? How much do I share?
I think it truly depends on what’s going on and what your relationship is with your client(s). Some clients, I had the opportunity to be candid with. Others weren’t offering as much grace. I think the approach to this can fall in line with how to make sure that the clients you choose, as well as how many clients you work with within a month, is something to consider.
If you’re working with an agency, partner, or a collaborative, you can lean into your fellow doulas for support to pick up where you need to put things down. Whether that’s communicating to clients about what’s going on with you, or taking on a load of a client going into labor because you don’t have the emotional space to do so.
So for my fellow doulas reading this, you’re probably wondering… What do we do whenever we’re feeling overwhelmed by the unpredictable things that come with this thing called life?
With all this being said, being a doula doesn’t omit you from human emotions or experiences. There’s a reason why the average career length of a doula is 5 years. Burnout is real, especially when you add on all the other unpredictable factors of life that can hit us all at once and we feel like we don’t have anyone to lean into.
It can feel even harder when we feel like our clients don’t see our humanity unless we speak up. Although this relationship is business, we have to remember the service we provide is very intimate. We have emotional connections to these people and although the birthing experience isn’t ours, we’re still attached and bonded to it. Being a doula requires us all to have a space for emotional and mental maturity, but also growth.
So give yourself grace. When life comes at you fast, don't think for a moment you have to do it all on your own or that you can't step back. You can and deserve time and energy to troubleshoot, to pick up the pieces, or even just sit in your grief for a bit. That is okay. You deserve whatever you need to be your best self.
The first time I heard baby Noah cry when he arrived earthside, I felt my breath catch in my chest. His mother bawled and it began to spread; it felt like a burning sensation. Behind my eyes, in my throat, I was at a loss of words at the beginning of life. I struggled to blink away the adrenaline as it flooded my face in liquid form without any sense of control. The purity of the moment was something irreplaceable…
I knew I never wanted to do anything else again.
At least… that’s what I thought, for quite some time. I went home that night, energized and hormonal, having the epiphany in route back home; I found what I had been looking for, after all those years. Alas, this had only been one birth and I had no idea when my next would be. I wasn’t even formally trained just yet; I’d be attending that weekend.
It was 2019; I was working at a local gym in the small town about 15 minutes over from me, part-time, while also teaching a couple of physical education classes at a women’s college. My money situation was low and inconsistent; leaving my full-time job working in research was having its consequences, considering I took a pay cut to leave for my mental health. Now it was catching up with me and, I had to be candid with myself: I wasn’t going to be able to just do this full-time. At least, not yet…
I had the convenience of flexibility; even in arriving at that first birth, I had come off an early 5 am – 2 pm shift; baby ended up being born at 6 pm that afternoon. Realistically, being paid hourly didn’t provide much opportunity to not show up to work, even if I had been paid to support a client. But the cost of flexibility was the also the lack of stability. With no savings, debt and everything officially feeling like a whim, I really didn’t know what I was getting into.
So how did I transition/do I transition from being a doula part-time, to full-time?
Well first, I want to preface that by saying, I’m still not a doula “full-time”. In terms of my current career/income situation, I have two jobs, and they both provide me with income and work at about 50/50. So yes, practicing as a birth worker provides approximately 50% of my income.
Even with that 50%, I feel like it took a lot of planning and realism to get to where I am now. I had to learn from mistakes and take extra measures to make sure things could work, and when they didn’t, adapt. This post is for any of my fellow doulas who are trying to figure out how to transition into including more doula work in your life, here’s some tips.
1. Set yourself up to minimize heavy lifting on your end – I’m not going to pretend like word of mouth doesn’t get things done in the world of birth work! But in the era of social media, use these algorithms to your advantage.
If you decide that you want to be a doula and pay your bills with that income, you’re going to have to “play the game”. Having a social media presence may not seem fun or ideal. I’m not a fan of it myself, I find it very tiresome. What I find myself doing is making a plan.
Whether that’s picking a day out of the week to schedule posts for the next month, or setting up a weekly live on Instagram each week; you get to figure out how YOU want to draw people to your social media outlets.
These things are supposed to be easy for you to commit to that draw engagement; likes only get so far in the social media world now, create or share posts that get people talking; even if it’s not YOUR post, give the original poster credit, and even that in the world of the doula goes far just out of respect. This also allows you to gauge how much you can handle at once.
2. Be business oriented – if anyone would’ve told me that I would’ve ended up owning a business, I would’ve laughed in their face. I was in the mindset of, “I’m going to get a job and work for 30 years and retire”. No plans of entrepreneurship and now I’m here doing it full throttle.
In my doula training, we did have a business portion that covered how to start looking into business related ethics and good business practices (Side Note: Any doula training you TAKE should include a business portion with it). Even so, I had to come to terms with the fact that this is a different mindset and caliber of work ethic, that is new to me. It can easily become you turning into Wonder Woman, trying to do it all, whether it’s tax documents or liability insurance.
This may be where most people start to consider investing in an accountant or financial advisor where they are unsure about how to navigate these things. Fortunately, if you start slow and steady, you can find business workshops that to strengthen the foundation of your doula training. Reach out and network with fellow doulas and ask to pick their brains (respectfully… set up a meeting and be patient if you don’t hear back immediately).
3. Network with fellow doulas and potentially recruit a backup – ah the backup doula; some claim that she is a rare as a unicorn, and many claim they don’t exist outside of collaboratives or agencies, but they do!
There are a few things about backup doulas that makes them (seem) so hard to find. For one, there comes another person to be accountable for to represent under your business/name. If they’re just as busy as you are trying to take on your clients, what are the chances of them not being available when you aren’t available? And all those consequences fall back on your name.
Another thing that often isn’t discussed is compatibility. There are a lot of big, strong personalities in doula work, and it’s not a bad thing; it’s a beautiful thing that allows us all to learn and connect to one another. However, everyone may not have the same work style or approach to practicing as a doula like other people do. It can make supporting a client more difficult if you’re on two separate pages. You and your backup doula should have clear expectations and understanding of what will happen when a client is in and what kind of support will be provided.
4. Learn to say “No” and prioritize – now if you know you work full-time and this full-time job needs to remain a priority, why would you overbook yourself? Often the answer I hear: I didn’t know how to say “no”.
We gotta play the long game out here, and all I mean by that is slow and steady wins the race. There is no need to rush getting 10 births a month, I promise you (LOL).
Start with one or two clients a month to figure out your flow and perfect your practice as a doula. Learn from your mistakes, ask for feedback and reviews from your previous clients. This will build the longevity of your brand in the long run and you’ll notice the flow of clientele will slowly become a continuous stream.
Once its continuous, then you start plotting your exit strategy. How much money do you want to have saved before you walk away from your full-time job? If you have a spouse who is supportive, have you included them in the conversation? If you have children, this is an even bigger conversation that needs to include more people in your village and a plan.
All this to say, start flexing that “no” muscle and refer them to someone else. No doesn’t have to sound like “no”, either; it can sound like “I’m booked or unavailable during your birthing time.”
5. Be transparent with both clients and employers (this is hit/miss) – I lucked out to have employers who commend and understood the work I do and understand that I can adapt. The one time I didn’t have an understanding boss, I began to transition elsewhere.
I share this because I also know some jobs aren’t going to be understanding of this, and that’s okay. If you gotta keep this side hustle in the house for a bit longer, that’s perfectly fine. However, you should let clients who are signing you know if you are a part-time doula, or if you have other job obligations.
This doesn’t mean that they won’t sign you at all, this doesn’t mean they’ll feel put off by it. I think it provides a chance for candid expectations; For example, letting clients know that they could text me at any point in time during the day versus not being available for phone calls until later in the evenings. Establishing expectations to have those phone calls for check-ins so clients don’t feel like they’re not a priority, etc.
I say this because the last thing I want for anyone is to have a client in labor, calling and expecting you to join them, and you bluntly say, “I don’t get off until 7 pm, I’ll check in with you then.” Professionalism will be the key to this landing as a hit conversation.
6. Join an Agency/Collaborative – agencies and collaboratives have pros and cons; a big key to it is to be comfortable with the organization, their values, as well as their clientele populations. These are great spaces to work with other doulas closely and you have a bit more autonomy in terms of how you practice, and someone else is directing your clients to you.
For many new doulas, this can provide a lot of hands-on experience and put them in positions to absorb a lot of new information. On the back end, a common complaint may be related to the pay to be under the name of another organization. Working for yourself, you can pick the price and keep all the funds; organizations typically have a different system depending on how their support is set up for clients.
Many organizations don’t mind you practicing with private clients as long as they don’t come before theirs and there are no attempts to redirect clients to your private practice. These other options to be a better fit while they try to decide if they want to pursue birth work full-time; for others, it can be a key piece to getting out of their day job!
So what have we learned from what you’ve read? With every client and every birth, I’ve learned to figure out how I want my practice to look, specifically. I’ve also learned from mistakes and figured out what my true limits were when doing this kind of work. I want to share that these are some of the tips that have come in handy for my transitioning and creating my preferred schedule as a doula, especially from transitioning out of a regular day job.
The image I immortalized in my head when I decided I wanted to become a doula looked very different to where I’ve come now. It’s the perfect kind of job until you’re dealing with a hospital system that doesn’t respect you or your clients, a client who may not listen to you while making decisions or being sleep deprived due to having to go to births back-to-back. Like any career field, it’s going to have pros and cons. Add to both sides of those lists on your terms based on your experiences.
Don’t hold yourself to a standard based on social media or what you see other people doing around you. Find your own footing, your own pace, and gain some personal wisdom on this journey. Wouldn’t it feel a lot better to take a leap of faith and not have to swim back to shore to try again because the tide was too strong?
You’ll get there in time sis!
Or maybe you’re just thinking about becoming a doula?
My first question to you: why?
Don’t take offense to the question, just pause and ask yourself. Regardless of what your answer is, it doesn’t change the fact that we need more doulas, especially black doulas. I want you to ask yourself why you want to pursue this so you can be honest with yourself.
Many people start this journey into birthwork for many reasons: some have their own birth trauma that they’ve had to heal from. Some want others to have the same beautiful experience they had. Others, it’s a calling from the Divine.
Whatever your reasoning is, I want you to keep 2 things in mind:
1) Build it into your foundation
2) Keep it close for motivation
My journey started in research. I was a grad student in my last semester of school who wasn't completely sure about what my next steps were. Considering my home field is exercise science and physiology, I chose pregnant women as my specialty population. This project was an opportunity that felt as though it fell into my lap one semester before graduation.
One of the lead investigators on the project was a professor I highly respected, and there were physical activity components to the project. So I applied and went for the position of Recruitment Coordinator.
And I got it! The project was going to be studying pregnant women in their 3rd trimester to the child’s infancy at 2 years old, and observing certain lifestyle and developmental habits. I hadn’t realized the role was a desk job and that I wouldn't get a lot of frontline action to the exercise portion, but I was the one who went to the childbirth education, support groups and breastfeeding classes to recruit subjects for the study. It was in those classes where I was first exposed to birth at such a higher context.
If you're new here, know that I am childless, and no one in my friend's circle has had children. All of this information seemed so novel and new. It honestly felt like the twilight zone just off how fascinating it was to hear the knowledge.
And even then, I still hadn’t thought about being a doula. Hell, I still didn’t know what a doula was.
So, I had been working the job and another task as the "Recruitment Coordinator" was to call these families after their babies were born to ask them some general questions. More specifically, how long labor was and how it went.
As someone who has not experienced pregnancy and childbirth for myself, the horror stories I was hearing over the phone were stressful? I recall questioning the normalcy of it, and then began asking around. It seemed normal to fear and anticipate bad experiences with something that seemed a part of life.
At this rate, I had already started contemplating re-negging on my initial plan to give birth to 4 children like I’d been planning since I was 9. For women to have been giving birth for centuries, why did it sound like it had to be some kind of fearful shit to go through?
I vocalized these thoughts to a childbirth education teacher after class one evening that I had attended for a recruitment session. She smiled and just said briefly, “Sounds like you may be a great doula”.
My retort: What the hell is that?
That was how my journey began. I didn’t even know what a doula was before that conversation and she encouraged me to dive deeper with it. Even in researching what a doula is and what the role was, I felt drawn to it, but I wasn’t sure how or why. I’d done work in facilitation and social justice in undergrad; it aligned similarly with reproductive justice and birthing advocacy. But these two things couldn't be the same, could they?
I still had no idea what it would mean to get clients or what my role in a birth would actually look like in practice. But I had to decide when and why I wanted to commit to the role. I sat on it, meditated on it, and I couldn’t get away from it. I had the desire, the itch; even now looking back there was a lot of curiosity. After I left my research job and graduated, I still found myself coming back to this role: Doula.
I made a choice and took a leap. I began researching training organizations and figuring out what I needed to do to make things shake. I was fortunate enough to find a mentor who had a client willing to have an extra “observing doula” present for her birth. The ability to present for the experience and hold space without having to lead was helpful for me to see what really happened in the birthing room. I had secured a birth prior to training! I took it as a good sign.
I received a partial scholarship for my training and spent my last bit of my paycheck on it. The first birth I was able to witness was one that happened within 5 hours of leaving work, just in time to bear witness to life entering this world. I cried ugly, happy tears; hell, we all did. But that was the day that I realized I was right where I was meant to be.
This may sound like this happened over the course of two months, but it took a little over one year to be executed. Having so little experience with this work prior to entering it, I wanted to make my entrance humbly and respectfully. Although still a bit naïve, I didn’t want to walk into the space arrogant or unteachable.
Yes, I understood that the supportive care and work that brings life into this world is necessary and important. However, I needed to know why I wanted to be a part of it having never been here before this moment. In some ways, I believe I was one of the ones who felt called to the work by the Divine, especially with the path that was laid out for me to get there.
My why then: I wanted to be of service to birthing people. I wanted to help them pursue a birth that they could achieve. I wanted to motivate them, to assure them that they could have their baby, and what they are experiencing is normal.
My why now: All of the above AND has now evolved into: I want to provide accessible resources of information and education for expectant families to help them with the journey from pregnancy to parenthood. I also want to reduce harm and unnecessary interventions when it comes to hospital care.
I share my story and my why(s) so you can delve into your own.
Your "why" can be what some people call your “Doula Philosophy”. It can evolve, it can change, and that’s cool. But make sure at its core it’s solid, that it’s something you can stand firm in. As your foundation and your motivation.
It is not your job to save people. Sometimes it’s just your job to bear witness and to hold space. Sometimes there won’t be anything for you to actually do BUT show up and be present or wait.
If you enter this work, ensure that you have great support systems to help you give yourself grace. You’re still a human being who is flawed and you cannot control a birthing experience for anyone. Be their coach, their cheerleader, their confidant. And keep your morale high when it’s game time.
That way, when you’re in the Birthing Space and it’s Birthing Time, you don’t have to question why you are where you are; you’ll already know you’re exactly where you need to be.
What is your "why" to being a doula? Do you have a doula philosophy? Share below in the in comments! And remember:
About the Author: Angelica Knight, MS
Angelica has been writing since she was a kid, especially free-writing short stories and poetry. Now she hopes to expand her writing to provide insight and information to those interested in reading about the world of birth!