A Birth Doula's Breaking Point

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?

1. Communicate honestly: Be sure to communicate other things that you know are currently plaguing you that could directly affect your ability to show up and provide care/service. When my car got totaled, I let all my clients know immediately that I was out of commission for a few days and kept them posted as updates came in. I also communicated with a backup doula about the situation in case anyone went into labor. This is also applicable to a loss or death in the family, especially if you anticipate traveling for services/funerals around someone’s due date.
   
   
2. Determine your Capacity: Sometimes, there’s not much we can do but limit how many clients we take, especially if you're a full-time doula. I’ve had other doulas realize well in advance that they are not capable of supporting a client anymore. Be sincere and apologetic. Sometimes, offering a refund depending on when the client is due makes it easier to understand. Some of them transfer the funds to help them hire a new doula under short notice. There’s nothing wrong with taking leave as a doula and deciding not to attend a few births as long as it’s handled ethically.
   
   
3. Get help!: I’m still working on this piece myself. Therapy is a process, and it takes a lot of time. It also feels like it’s not working some days versus others. I’m looking for other ways to help myself process grief and stress, and a lot of why that’s a struggle appears to be rooted in unresolved trauma. It’s become more and more clear why this isn’t an “easy fix”. Reach out to family or fellow birth workers for support. The work that we do isn’t easy. Witnessing C-sections is something I now realize to be a trigger and traumatizing for me, as well as obstetric violence or other forms of abuse. Stillborn births and infant loss are other things to grieve. For some births, I’m recovering from more than just a lack of sleep.
   
   
4. Schedule breaks/Time Off: I decided to only attend births this summer and it was probably the best choice I’ve made. Although I’m not “working” full-time, I’ve managed to incorporate a nice chunk of time off. I didn’t realize how much of my life I’d centered around taking care of other people without even taking time to myself. There’s nothing wrong with saying “I’m not taking births for June and July/December and January”. The timing of all the things life has thrown at me and then to decide months in advance to take off time in July was Divine Timing. And I’m still grateful to myself thinking ahead.

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.