I’ve learned a lot in the past three years. Birthwork feels like an extension of my nursing career. As a nurse, I’d say goodbye to patients & wonder what their lives looked like beyond those hospital doors. Now, I get to witness the rest of the story with my clients. That’s pretty special.

I’ve met doulas who’ve been doing this work for a decade & more, with over a thousand births under their belt. Their wisdom is unmatched. In the birth world I’m still considered a new-ish doula & I respect that.

So, I wanted to share some random thoughts & observations that live rent free in my head, along with a few lessons I’ve gathered over the last three years of being a birth doula.

Reality Is A Hell of a Drug

When I stepped into birthwork I had no idea where to start, what to do or how to do it. Doula training was great in that moment, but when the reality of building my own business from scratch came into play, I wanted to do nothing more than slide down the wall. I took a free webinar about starting a business & marketing to potential doula clients. We were given a step-by-step set of instructions & of course the first one was creating a social media space. Social media & I have a sordid past, but I created my Instagram business account & was immediately met by pregnancy content filled with fear mongering, false promises, misinformation, bros marketing-it was a sight to behold. The marketing strategies seemed pretty consistent across the board. One of the first reels I saw showed my girlies pop locking on Insta to promote their business. Nothing against them, I love that for them, I just knew that wasn’t for me. I already lived a life of service; in the beginning I found it difficult to translate that to marketing. Also, if you ever catch me dancing on social media, just know I finally won the lottery & it will be the last time you see me. When it comes to the business of birthwork, there’s room to take the path less traveled. Your definition of success might not look like anyone else’s. That definition will shape how you build & grow your practice.

Doulas Are Not the Last Airbender

As much as we wish we could (& as much as I adore Aang), we’re not here to save the world, it takes a lot of doulas time for that reality to sink in. I wanted to help every family who needed support, but I’m just one person. The guilt I carried when things didn’t go the way I hoped for my clients was heavy. And now, with birth doulas being seen as a solution to our nation’s maternal health crisis, the pressure has only grown. While our clients might benefit from our services, we need to make it clear that we cannot carry the world’s problems on our shoulders all the time & expect to not burn out like other health professionals have. We also need the healthcare system to know that even though we are here, they still have a lot of work to do to address the disparities they’ve created.

Divided We Stand

After completing my training, I followed the advice given to new doulas: get out there & meet other doulas. Say less. I was waiting for that moment. I joined online & in-person groups, connected with doulas locally & around the country. One day, a first-time mom posted a question within a doula forum about her scheduled induction. Simply asked about doula’s experiences. The responses were aggressive & unkind. The advice she was given was well beyond the role of a doula. Anyone that offered a different perspective got dragged. We’re here to support people through birth, not tear each other apart.

The division continues within the doulaverse-radical doulas, doulas who denounce medical care altogether, doulas who encourage strangers on social media to free birth. Our different vantage points shouldn’t cause friction. The judgment, the gatekeeping, the refusal to see the systemic disparities, are part of the problem, too. If we can’t come together, how can we expect the system we work within to come together?

This doesn’t just happen among doulas. Parent groups, too, can be divided. People judge each other harshly, from how someone gave birth, feeds their baby, stays home from work, returns to work, how they parent, whether they choose to have children or not. The judgment runs deep. Even with our shared history, our shared challenges, we struggle to show up for one another. That we doesn’t include me btw lol.

Fortunately, I’ve Met Doulas Who Get It

We’re not turning our heads away. We care deeply about reproductive health & reproductive justice. These terms aren’t trendy, they’re the framework for how we move. We show up for social, political & economic issues. We speak up when policies & laws fall short. That is another standard of a good doula. Any issue that affects our families, affects us. Privilege is not a shield of armor. If something affects one person, it has the power to affect us all. Our babies, their babies, our future. Unjust treatment should never be acceptable.

Whoever sows injustice will reap calamity, and the rod of their fury will be broken.
Proverbs 22:8

Doulas Are Woo-ish

Who started this rumor? Some families have been hesitant to work with me because I offer Reiki & sound therapy-flag on the play for many. I’m glad they felt comfortable enough to share that with me. Both modalities are used with patients for acute & chronic care management. Their benefits are documented. Some hospitals have even integrated Reiki as part of patient care.

Not every doula burns sage. Some of us are science nerds, some spiritually grounded, some religious, some holistic, many of us weave these together, fine-tuning our approach to meet the needs of our clients. The spectrum is expansive. What’s described as “woo” might actually be culturally or religious based traditions that doulas help families to tap into to celebrate birth & postpartum, traditions that are deeply personal & meaningful to them.

Doulas Are Undereducated & Worthless

This one really rings my bell. It’s sad to hear these words from the average person, it is especially sad when you hear these words come from the very people you share space with (nurses, doctors). Yes, some doula trainings are basic. A weekend course won’t cover the full scope of what it means to support birth. Many doulas leave training feeling ill-prepared, wondering what they missed. I pray that they’re giving themselves grace because it takes a lot to build a business & transition into a new field. But great doula trainings do exist. Each birth is continuing education. The amount of time doulas spend learning, attending workshops, studying, practicing, can rival degree programs. I see the same doulas show up, again & again, always seeking to grow & expand their practice, which speaks to their deep commitment to their clients.

Many of us came to birthwork by way of a career change. Leaving behind the familiar, downgrading the lives we’ve grown attached to, saying so long to lucrative salaries-that transition alone takes great courage. Our past experiences matter. Too many qualified new doulas are overlooked because people only focus on their doula experience, not the life skills they bring with them.

Our credibility is often dismissed when compared to nurses & doctors. Being non-medical doesn’t mean we lack knowledge. Birth doulas at bare minimum, specialize in the physical, emotional & educational aspects of birth. Medical care is essential, but it doesn’t replace the need or the power of emotional support.

Hospitals are starting to recognize our value. Behind the scenes, policies are shifting to include doulas as part of the care team. There’s a long history, strong research & countless lived experiences that speak to the efficacy of doulas.

Reimbursement Still Doesn’t Reflect the Work

When Medicaid began covering doulas services in New York, it was a big deal. The reimbursement rate for doulas increased, but compensation is still not set at a liveable wage. Doulas are supporting an array of high needs in NY state (and across the world) & are often unable to make ends meet for themselves. New York is one of the largest healthcare markets & major economic contributors in the nation. It also carries one of the highest costs of living. It is not a surprise when NY based doulas share that they receive public assistance. NYCDA has pushed hard for change & for them we are immensely grateful.

Other providers face similar issues. The system still undervalues essential care. But state by state, some doulas are being paid what they deserve. New York State, our turn is long overdue. Increased reimbursement should reflect the value of doula care, not hinge on unsustainable visit requirements. State by state let’s make it clear to decision makers that providers deserve a thriveable income because we’re going on vacation. A ton of vacations. We want to own a private island next to rest of the CEOs in the healthcare system. Stephen J. Hemsley would hate to see us coming.

In reality, we’re not asking to be multimillionaires, just like anyone else, we want to be able to support ourselves & our families.

The Biggest Surprise

Birthwork is the first professional space I’ve been in where tending to our own mental health isn’t an afterthought, it’s part of the work. Often, what draws us into this work is also something we might need to heal. Caregiver syndrome is real, I’m grateful for the spaces that recognize the value of putting ourselves first, because when we’re well, we can serve our families better.

My Clients Changed My Life

I love my clients. Truly. In the beginning, it was their reflections that helped me see my value. While agencies & peers tried to erase my past experiences, my clients saw the full picture. The relationships I’ve built in this short time speak to the ministry of presence.

I never shared all my experiences because I didn’t think it mattered. But it does. I encourage others to share their story in different ways, help people get to know us outside of those limited glimpses on social media.

Big thank you to my clients that have welcomed me into their lives, that send me pictures & updates of the beautiful families they’ve created. Watching their children grow, crawl, walk & eventually run really does something to me. You’ve been my tether & I’m forever grateful. Thank you from the bottom of my heart.