When I had a doula at my first son's birth 13 years ago, people were like, "A who? A what? ... When did you get so crunchy?" In those days, you had to be pretty hardcore to hire a doula!
When I trained to be a doula eight years ago, all of us students were advised that you could not earn a living as a doula -- that any money earned might only serve as ancillary income. On the other hand, there were a couple women in my area who actually did support themselves with doula work. I confess that most of us birth workers were pretty sniffy about them, sure that they were doing something wrong.
These days I feel differently and think it's terrific that more women are creating a sustainable business out of doula work -- this work is so important (and so much fun!) that it shouldn't only be available to those who are relatively well-off and/or partnered with a primary breadwinner. For my own self, I've created my own business to help put my kids through school and keep me busy (and solvent and doing the work that I love) until retirement.
Doula work is immensely rewarding -- but it is also so challenging, both physically and emotionally, that I feel pretty sure that no one is in this line of work just for the money. Perhaps because no one else could really understand the nature of the business, traditionally birth workers viewed each other as colleagues who were all on the same team. For example, at least once I got a call from a doula I barely knew asking if I could provide emergency backup for her (and I did, and we worked out the money later).
Now that more doulas are taking their business (and their income) more seriously, there is definitely a greater feeling that other doulas are the competition. We all strive to catch the eye and the pocketbook of the relatively small pool of pregnant ladies who are both interested in and can afford professional doula help. At the same time, service fees are increasing as more doulas (rightly) insist on earning a living wage.
So, where do we go from here? Can we continue to split a pretty small pie? (Only 3% of women said they used a doula for their birth in 2006.)
I think a more unified doula voice might serve to spread the word about the many benefits of hiring a doula. Outside of a small circle of birth enthusiasts, "a what?" is still a common question when I explain my job. And creating more of a demand for postpartum services would be a great goal! Just about every seasoned mother who hears about the service provided by a postpartum doula says, "Oh, I wish I had one of those!"
It's now well-documented that using a labor doula improves birth outcomes and satisfaction levels, and postpartum doula care helps with improved breastfeeding, physical recovery and mood. Yet at a time when parents spend anywhere from $3,900 to $27,500 on a new baby, relatively few women choose to invest in their birth and postpartum experience.
It's good for business and good for women if more new moms are convinced of the need for and value of doula work. How can we all work together to promote a new doula movement that focuses on education and "good press" to all women of child-bearing age? And to make sure that our health professionals are aware of the many benefits of doula care? Is it possible to be both business-minded and united towards a common goal? I'm excited about the future of doula work -- and hoping that many more families can enjoy the benefits of professional support during the huge transitions that take place with each new baby.