Read as Jess Buell talks about her career as a Birth Doula. Find her at www.birthbabybreastfeeding.com.
What do you do for a living?
How would you describe what you do?
I offer emotional and physical support, education, resources, and advocacy for women during labor and childbirth.
What does your work entail?
I offer consultations prenatally where I discuss the birth process and educate about birth options and interventions. At a specific point in a woman’s pregnancy, I go on-call, which means being accessible by phone 24 hours a day, 7 days per week until she goes into labor. When she is in labor, I go to her home or meet her at the hospital and offer her support (massage, verbal guidance, advocacy, suggest good labor positions, etc.) to help her progress through labor and birth her baby.
What’s a typical work week like?
I have prenatal consultations 2 days per week, 10 hours per day. I also have a second and third job that fills up the other 3 “work” days. However, if I have a client in labor (which can happen on weekends too!), I rearrange my schedule in whatever way I need to so that I am available to the laboring woman because at any given point she may need me to come to her. In birth work, there really is no such thing as a typical work week.
How did you get started?
I had a baby. Actually, it took me a couple of years after my daughter’s birth before I decided that this was something I wanted to get into. My ultimate goal is to become a home birth midwife, but part of that education is to become a Doula first. Being a Doula gives you an idea of how birth works, what it is like to be on-call and have to schedule your life 9 months out, and what birth looks like in the hospital. So, once my mentors told me that I needed to become a Doula, I did some research to find different trainings. I went through a training, did the required reading and other certifying requirements, and then started taking clients.
What do you like about what you do?
I love supporting women and watching them transform into mothers. I love educating women about their bodies and the birth process. I love giving support to a woman so that she feels empowered in her decisions and birth, instead of traumatized. I love that there is always something new to learn, no matter how many births you have been to. Birth is unpredictable, so it’s different every time, which keeps you on your toes. And, I’d be lying if I said I didn’t love watching a new human come into the world!
What do you dislike?
Sometimes, the hours. Some births take a very long time and you might be with a woman for 24+ hours. Mostly, I dislike when I give tons of great support and a baby still won’t come out so a mom has to have surgery. That is rough. It’s hard on everyone, even me, because I put a lot of emotional energy into my clients and I hate when we have a bad outcome like a cesarean.
How do you make money/or how are you compensated?
My clients pay me directly. My services are not covered by insurance, so it is self-pay. However, some insurance companies reimburse for my services, which is nice for those clients to get some of that money back, especially because my services can make a huge difference in the cost of someone’s overall hospital stay.
How much do people in your career/field make?
In Columbus, where I live, Doula services are about $600 per birth. This is a flat rate. For me, I can take a maximum of 4 clients per month, due to my schedule and my ability to truly give good support without getting burnt out, so that’s a total of $2400/month. However, I give $100 from every birth to my office to pay for rent and our office manager’s salary. So my take home salary could be $2000/month. If you divide that by the number of prenatal appointments you do per month, the number of hours you spend with any given client, wear and tear to your car (and you might go to a client’s home 2 or more times, plus driving to the hospital), and any tools you might want to have for physical support, it sometimes can break down to about $10/hour or less (based on a 40-hour work week). It really depends on the month and how the births go. Sometimes, it is more like $25/hour. I’ve been to births where I am there for longer than 24 hours and I’ve already put in 24 hours at my other jobs, plus 20 hours on the 2 prenatal days. So, it really depends on the month and the birth. If you want to make a lot of money, you do not get into birth work. This is truly a calling.
How much money did/do you make starting out?
In my first year, I had maybe 6 clients total, so I made about $3000.00. I had a part-time job working somewhere else for $10 an hour. It was the only way that I could continue to make ends meet while I built up my clientele. This is not a field of lots of repeat customers. You might have repeat clients, but only once every few years because you can only have a baby so often. It takes a while to get your name out there and get referrals from other professionals and from your own satisfied clients. It all depends on how well you market yourself too.
What education, schooling, or skills are needed to do this?
You don’t have to go to school to be a Doula. You do need to be familiar with the birth process, so that you know what is normal and what is not. There are various training programs that teach you the basic skills, but the real learning comes from going out there and doing it. I do suggest reading a lot about birth so that you can speak intelligently about birth and really educate your clients prenatally. This provides a good foundation so that when they are in labor, they are much more likely to be successful in attaining their birth goals. I did complete midwifery school as part of my training to become a home birth midwife, but I think it has helped in my role as a Doula too.
What is most challenging about what you do?
Becoming invested in a client and the outcome of their birth and not having it turn out the way they planned. Having a client go back to the OR for a cesarean, when their goal is to have an unmedicated vaginal birth, can be heartbreaking.
What is most rewarding?
Watching a woman have her second baby, unmedicated, after a traumatic first birth that was full of interventions. It is pretty awesome to watch a woman face her fears head on and accomplish a major goal. Plus, who doesn’t love to see a squishy new baby?!
What advice would you offer someone considering this career?
Get into this job if you feel called to do it. It is emotional, it is physical, it is rewarding, and it is hard. If you feel called to this line of work, find a good mentor and shadow a few births so that you know what you are getting into before you start taking your own clients. Don’t get into this job if you like to know exactly when you have to be at work. Don’t get into this job if you don’t like unpredictability. Don’t get into this job if you want to make a lot of money and have benefits like health insurance and a 401K.
How much time off do you get/take?
I take July off, to attend a conference. Otherwise, I work the rest of the year. This year, I took half of July and am taking all of December, because I felt like I needed an extra break. In order to take an entire month off, I have to save during the rest of the year to meet my expenses of that month off. If you don’t work, you don’t get paid-there is no built-in salary in this job. Also, in birth work, because of the large window that a woman can have her baby, if you want to take a week off, you have to plan to take more like 3-4 weeks off or have really good back up coverage because your client might deliver while you are off that week. Most of us plan our vacations 9-12 months in advance so that we have time to save money, as well as making sure that we don’t take clients during the time that we want to be on vacation.
What is a common misconception people have about what you do?
I hate to sound so negative, but the common misconception about what I do is that it is all glamorous. The reality is that this is an amazing job and very rewarding. But it also is hard work. Even when I am with a client for only a few hours, I am exhausted when I come home because of the energy that I have put into supporting a family.
What are your goals/dreams for the future?
I am continuing on my path to becoming a home birth midwife. I am also training to be an International Board Certified Lactation Consultant so that I can offer true continuity of care to my clients, no matter where they choose to give birth. My overall dreams, though, are a future in which all women have good support and freedom to birth where they feel safest, whether at home or in the hospital, and they don’t have to fight to have the birth that they desire.
What else would you like people to know about your job/career?
I was a lost soul before I found my job as a Doula. I had no idea what I wanted to be when I “grew up” and I was constantly itching to run away to somewhere where the grass is greener because I knew that I wanted to do something meaningful but didn’t think I could do that here. Being a Doula has grounded me. It has given me roots. It has provided me with an outlet to truly make a difference in other people’s lives. It is truly an amazing experience!