Doula Work Isn't About The Money...Except Doula Work IS About The Money

Nancy, administrator for Birth Boot Camp DOULA, applying counter pressure.

I have been a "birth worker" for a few years now. I started teaching childbirth education about seven years ago and it is an important part of my life. I am currently doing the coursework for Birth Boot Camp DOULA training, and I am learning so much. I am currently reading "Birth Ambassadors," as part of my doula training and I came across a most interesting paragraph.
"As much as doulas strive to be the 'latest addition to the maternity care team,' their limited presence at US births has not yet generated a strong enough moral agenda to stand alongside that of obstetricians, maternity nurses, and hospitals... Doulas struggle to sustain their practices, as individuals and in their multiple organizations, and have, as yet, been less effective in advocating for humanistic care during childbirth within a medical and institutional framework that does not put women's emotional needs, or perhaps even their emotional health, at the center."
What does this paragraph have to do with getting paid to be a doula? Well, let me explain my take on it.

Charging for birth work. Oh, this seems to be a hot button topic, doesn't it? At Birth Boot Camp DOULA, the co-creators, Amanda and Maria use the word "sustainability" a lot. Like all the time. It is very much a buzzword around these parts.

Amanda and Maria, co-creators, Birth Boot Camp DOULA
I am all for making a living doing birth work. For real. But I don't think I started to really understand what they were going on about until I read this paragraph in "Birth Ambassadors." I am sure I will learn a ton more from Amanda and Maria when I actually go to doula training in April, Eeeek!!

Why does having a sustainable practice as a birth worker or doula actually matter? First, I think it is important to decide what sustainable means. To me it means a profession that actually functions well within my life. That would mean that it works well for my family and myself. For me, something that is worth my time means that I am able to afford childcare, my husband doesn't hate it, and I can function and feel like it is worth what I am giving up to do it. (Because let's be real, you are always giving up something. Choosing one thing means not choosing another.)

Why does it have to be "sustainable"? Because if my work as a doula or childbirth educator is ruining my life then I am not going to last very long. I will quit because I just can't do it any more, because I am losing money, because I could make more doing something else, because my family is suffering, etc.

This really matters in birth work because birth matters. If, for example, a doula has a practice that is sustainable then she will be able to practice as a doula for an indefinite length of time, as long as her health permits it. A doula that practices for 20 years is going to  make a much larger impact on birth than one who burns out in two. She will help more couples and babies, she will make a bigger difference in her community, and hopefully, she will build respectful and trusted relationships with doctors, nurses, hospitals and midwives in her area. She will not just help more people, she will have a positive impact on the entire birth community as a whole.

And let's say we have hundreds, even thousands of these professional, sustainable, respected doulas in the country. Expand that influence out. We will see an exponential improvement in not just individual births but even in the attitudes and practices of birth professionals like doctors and nurses who work in hospitals. They will see the value of a woman who supports a woman, who listens to her, who recognizes the emotional impact of birth, who helps make breastfeeding more successful, and so on.

So, is doula work about the money? Well, yes and no. You may not make a million dollars as a doula, but for most of us, you will need to make SOME money working as a doula (or birth worker) or you will QUIT. I really care about birth. I mean, I deeply care about it on an emotional level. But if this work is ruining my life or my family and I am spending 20 hours with someone at their labor and losing money on it, then I am going to have to step aside and do something else.

Doula work is about the money. Not so much the money in itself, but the ability money has to make a profession sustainable. No matter how much someone loves and cares about something, if it doesn't pay the bills, it probably won't last for long.

In birth work this is even more important, not less. (And yes, there are too many birth workers who shame those doulas who are able to be profitable and successful in their business. Shame on the shamers, I say.) Why does it matter more for birth? Because change will come not when we hold a picket line, but when there are so many of us doing so much incredible and good work, that there is no other option but for people to take notice and improve birth.

I believe that sustainable doula practices (and other birth workers like educators) have the power to create positive change in the birth world, lower the cesarean section rate, improve birth outcomes and save lives.

But that won't happen if those doing the work can't pay their bills.

"Birth Ambassadors- Doulas and the re-Emergence of Woman-Supported Birth in America" is written by Christine H Morton, Ph.D. and Elayne G. Clift, MA
Join me at training and change the world!


Unknown said…
I am pregnant with my first child and have actually not heard very much about doulas. I realize that I need to do some research on my own to see if I want to hire a doula for my birth. I completely understand what you're saying when you say that being a doula is about the money and not about the money. We want to do what we love, but we also want to get paid to do what we love!