How to launch (or grow) your doula practice

How to launch (or grow) your doula practice

I’ve spent the past 6 months preparing a program to help doulas (and other birth workers) to grow their practice. After years of not making enough through my birth work, I decided to stop the excuses and just make it happen! And you know what? I did!

I’m so excited to be launching this program to help doulas learn the skills necessary to fulfill their dreams through this line of work. I’ve taken all the lessons learned from myself and others and brought it together in easy and simple lessons that don’t require an MBA to follow, and more importantly that are SPECIFIC to birth work.

The course is launching next week and I am SO excited. If you’re interested in learning more over the next two weeks please subscribe below!

How to end the doula-client relationship

How to end the doula client relationship

I’ll start by saying that I suspect if you asked 10 different people this question, you may get 10 different answers. But here are some thoughts for you to consider around setting appropriate boundaries and ending the doula-client relationship.

Setting appropriate boundaries

When doulas find themselves getting calls and text messages from clients 8 months after the birth, I always ask the question if they set appropriate boundaries from the beginning and the answer is inevitably ‘no’.

Having healthy boundaries is SO much easier when you set them at the BEGINNING before any awkward moments have come up. For example, here’s what I say “to help with my own life-balance I work regular business hours for non-urgent issues. So, feel free to email or text me your questions or concerns any time and I will get back to you when I can in normal hours. If ever you need me urgently be sure to call and I’ll always stop what I’m doing. If you happen to get my voicemail, it could just be that I’m on a call with someone else, so leave me a voicemail and I WILL get back to you soon.”

I am setting the boundary of how and when I’ll be available. We discuss this much more in-depth as well when we talk about early labour contact. For example, during the day I need notice that they’re in labour to reschedule appointments, cancel meetings, etc. But at night I don’t need a phone call to say that someone has felt two cramps. A text is fine for that and a call when they actually need me. I also explain that my phone is silent except for calls. That way I’ve made it clear that text isn’t for urgent things.

By setting these boundaries and making expectations clear, everyone will get what they need.

Reviewing what we offer

doula with pregnant clientBetween the first few phone or email interactions and the last postpartum visit, I suspect there are at least 10 moments to discuss how doulas support clients. In that time, I will have discussed what type of support I provide at each stage. For example, in our last prenatal visit we discuss the postpartum timeframe. I talk about what they might expect in general from their baby, their recovery, and from ME. I let them know that if at any point they feel they need extra support that it can be done at an hourly rate and that I’ve included some package options in their folder that I gave them in our original consultation.

How else could you be letting people know of how to support them? Jot down a couple of moments throughout the relationship that it would be appropriate and other ideas you might have. (eg. include extra postpartum in your packages? Offer add-ons at great rates for birth clients? Discuss who you refer to for postpartum services? Remind them of your resource list?)

Always anticipating

I’m a pretty assertive person but I still don’t like confrontation, awkward or uncomfortable moments, and I’ll admit a BIG part of how I now work as a doula comes from learning things ‘the hard way’. When a client calls you over for a third postpartum visit and your package only includes 1, it may feel awkward to charge them for it. But if you’d mentioned all along that you can offer more than 1 visit if they need for an extra fee, then they won’t take advantage or it won’t feel weird for you to say “have you had a chance to look over my postpartum packages to see which one might make the most sense for what you need?”

Becoming friends with our clients

Once in a while you will worsmiling friendsk with a client that you can imagine being friends with. I once had a doula on my team call me to sheepishly ask “that client and I have so much in common and our kids are the same age, do you think it would be ok if we continued to hang out?”. Of course! If you have made your boundaries clear and following the end of the doula-client relationship, you both have a desire to see each other, why not continue!? As we age, it can become tougher to make new friends. I think we should take every opportunity we have. If the boundaries have been clear all along and the relationship has indeed ended (no longer a power dynamic of one person being seen as the ‘expert’) then two people who mutually want to be friends can do so.

If a client wants to be your friend and you don’t want that, then perhaps the boundaries weren’t set early on or the client is misunderstanding your kindness? Using words that set your expectation can be helpful “it was so nice working with you and watching your little one grow these past months. I’d be happy to get a pic and hear from you every few months if you think of me”. They will likely pick-up on the subtlety of what you’re communicating.

Social media

Some doulas ask if they should accept friend requests from clients. I encourage you to consider how you use social media and how you feel about your privacy. Some doulas create a work profile to connect with clients and colleagues, and a separate one that is private. Only you can answer this question for yourself, but I do encourage you to think about it and be deliberate and thoughtful in your decision.

Good luck my lovely doulas.

#WorldDoulaDomination #DoulaClients

Sign-up for our newsletter to hear more- click here

 

About the Author

Stefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it isStefanie Antunes to be prepared for birth and to have good support around you.

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula membe

How to provide great postpartum support

How to provide great postpartum support

As birth doulas we provide two types of postpartum support. That immediate support right after the delivery and most of us also provide10th day of Doula School at least one in-home visit as part of our package. We’re going to discuss the in-home support we provide as birth doulas, but I’d also like to share some thoughts around continued postpartum support for those of us who offer bigger postpartum packages, and for postpartum doulas specifically.

Processing the birth

As a birth doula, one of the main goals of our postpartum visit is to process the birth. Depending on how things went and how soon after birth our visit takes place, our client may have varying degrees of ability to really discuss and process the birth experience. Regardless, we can review our client’s memories of the birth and take the opportunity to plant seeds of accomplishment and show their strength and resilience in dealing with whatever took place. This is an opportunity to share some notes so we can be sure our client’s memory is both accurate and positive. Remember our goal is always to ensure that they have as positive a memory as possible, so all of our feedback should be with that in mind.

Depending on how things went, clients may need therapy from a professional at a later time, when they’re better able to deal with their feelings around their experience.

Answering questions and providing resources

Of course, part of our visit will revolve around some baby care/behaviour questions and perhaps around our clients’ physical recovery. Do your best with that based on your own knowledge and scope and always defer back to the care provider when in doubt. Another thing that is helpful is to keep a list for yourself of things you can send in a follow-up email. Providing resources and referrals is a great way to ensure our clients have continued support and the help they need (it takes a village).

Postpartum visits of longer duration

If you’re a postpartum doula or a birth doula who provides a bit more postpartum support, here’s my list of goals for every shift:

Always ASSESS (questions and observations) before you ASSIST (do, say, suggest)

  • Start with a check-in: I like to start by seeing how things have been going and asking my client how I can help them best that day
  • Prioritize: asking clients to prioritize what matters most to them. I’ve realized by working with hundreds of clients over the years that one client may need their dishes done but doesn’t care about the general chaos going on in the rest of the house, while some people need clean floors but don’t stress about dishes.
  • Always bring a wrap. I always bring a wrap so if my client is needing a nap, I can put baby in the wrap and still do everything else to help get chores done
  • Goals: my typical goals for a day shift include dishes and kitchen (put away clean dishes, wash dirty dishes), sweep the floor, do a couple loads of laundry, and make a meal. I find I can almost always get that done in a 4-5 hour shift, even with twins!

Cooking meals

Cooking can be tricky whether or not you cook in general. If you do, you may find clients have different spices than what you’re used to, and if you don’t cook, you may feel intimidated about what to make.

It’s always best to ask your client what they’d like you to do. Sometimes they have very specific things their families like and will be very clear about how they’d like you to cook. Some clients just ask for help with meal prep so they can do it themselves more easily later. I have a few recipes that almost everyone likes that I will often make if my client doesn’t specify what they want me to do. If you don’t cook often, try a few things at home so you become comfortable with what to do and how to get it done. In today’s day and age there are so many great recipe websites that can help guide you as well. Most people are just happy to not have to make it themselves! If you have a great recipe that is easy and nutrition, feel free to link to it in the comments below!

In the doula spiritFamily supporting new family

One of the most important parts of supporting families postpartum is to remember the doula spirit of non-judgment and compassionate care. Remember a tired person can be a grumpy person. As Penny and Phyllis always say “you won’t always understand why a woman behaves the way she does, but she has a darn good reason”. Remember that just like we support whatever our clients plan for their birth, so do we support however they choose to parent their babies. If ever you see behaviour or parenting decisions you don’t agree with, it’s not your place to try and ‘sway’ a client to another behaviour. Instead, offer education and support WHEN REQUESTED, but then simply provide support in whatever way will help them best in their transition to parenthood.

Good luck my lovely doulas.

#WorldDoulaDomination #PostpartumDoulas #DoulaGoals

Sign-up for our newsletter to hear more- click here

 

About the Author

Stefanie Antunes and familyStefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

How to live on call

How to live “on-call”

When I was a new doula I was stressed to the max the first few times I was on-call. It was like at any moment of the day or night the phone would ring and I would have to go screeching out to tend to my client in labour. Then reality set-in and I realized that being on-call was really not what I’d imagined. Most of the time it turned into several days of contact between my client and I as they experienced pre-labour signs.

So how can we be ready when needed?

I realized that the on-call lifestyle was better handled by being PREPARED like I might get the frantic call, but to live (for the most part) like I wasn’t on-call. Life like that was so much more tolerable and enjoyable.

Here’s a great exercise: for the next two weeks ask yourself at the beginning of each day “what would I do if I got called now?” and think about how you’d handle your day. Would you need to call the babysitter to pick-up your child from school? Would you need to call a friend or family member for help? Would you need to reschedule a dentist appointment? Just do it for pretend to see how you’d handle it. One of two things will happen: you will either have a solution for everything you need to adjust (and can stop worrying), or you’d realize there are gaps in your ability to rearrange your life, and this will give you the opportunity to find a solution (so you can stop worrying).

But what if…..?

What if your client calls you while you’re doing yoga and your phone is off? What if your child is sick? What if your childcare cancels? What if your phone gets accidentally turned off? What if you’re in the grocery store with a cart full of groceries? Honestly, we could play the ‘what-if’ game ALL day. Don’t do that to yourself. It will kinda drive you mad. Instead just be prepared for whatever might come by having lots of options. There is a solution for EVERYTHING. Promise.

Preparing our clients

doula with pregnant clientOne of the best things you can do is spend some time prenatally with your client to help them understand how and when to contact you. Because I was a very busy doula when my children were young and my husband often worked out of town, I made sure my clients gave me lots of lead time when they thought they were in early labour. This gave me the time to get childcare in place so when they actually needed me, I was ready. I used to say “I’d rather you call me because you’re feeling something and then call me back two hours later to say it stopped, then to call me frantically to meet you at the hospital asap”. Remember most labours are long. I’ve never missed a birth waiting for my babysitter to arrive. Well there was this one time…. but it doesn’t count cause the midwife missed it too 😊

So what DO I need to adjust?

There are three things I do when on call. I always have my labour bag packed so it’s ready at any time, I don’t drink alcohol to the point of not being able to drive, and I ALWAYS ALWAYS have a charged cell phone. Otherwise I live life. I tell my clients to leave a message or text me if they don’t catch me on the first try and I’ll always get to them within an hour at most, usually much much sooner. But remember…they’re usually calling me in early labour to let me know that things MAY have begun. Once I know someone’s in early labour then I’m glued to my phone and I don’t do things that I may have to leave ie grocery shopping (gosh that would suck to leave a full cart), bringing my kids to a long activity, go out for dinner, etc.

How do I book things if I may have to cancel?

massage

You may need to work with people who understand your lifestyle and who can accommodate a last-minute cancellation without a charge. If they won’t, then find someone who will, or just book an appointment when you know you won’t get called. I remember one two-year period where I must have seen about a dozen different massage therapists and hair stylists because I always just booked whoever was available last minute. But really there are worse things right? 😊 My friends all knew my lifestyle and we’d still host dinner parties. I once had to leave my own dinner party but my company was gracious enough to clean before they left!

So again, my best piece of advice: be prepared for the call, but live like you’re not on call.

Good luck my lovely doulas.

#WorldDoulaDomination #On-CallLife #DoulaLife

Sign-up for our newsletter to hear more- click here

 

About the Author

Stefanie Antunes and familyStefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

How do I know I was helpful?

How do I know I was helpful at a birth?

Sometimes a doula will call me to discuss a birth. There’s a feeling that something feels “off” but they can’t pinpoint it. This is usually the time when you need to process a birth. “Processing” can mean different things to different people. What I’m discussing in this blog post is fairly straightforward births and how to know if you were helpful. For more info about more overarching feelings of helplessness or even feelings that resemble PTSD or Vicarious Trauma, please read my other post entitled the Three Year Itch.

What does ‘helpful’ mean?

I think when we’re sitting in our doula training and hearing all the statistics about how helpful doulas are, how they reduce intervention and increase birth satisfaction, we picture every client just gushing about how awesome we were. But the reality is stats are just stats, and the client who had a wonderful birth that met her expectations may be thinking “well of course I did, that’s why I hired you”. Now I promise you will have your fair share of clients who say “I couldn’t have done this without you!” and your inner ego goddess will roar in delight. But what about when a client doesn’t seem super fussed about our help?

Talk to another doula

Anytime I have felt unsure about my role at a birth, I’ve always found it helpful to discuss it (process it) with another doula (in keeping with confidentiality). Sometimes we need to hear another doula say “yeah, that’s exactly what I would have done in that situation”. Our inner egos need validation. That’s the plain truth. Many of us doulas are also highly emotional and right brain people who ‘feel’ so much from/in the work we do. That can be a tricky combination when we don’t feel validated for our work.

Confidence

person with confidenceAt the beginning of every training I ask doula students to complete the sentence “This workshop will be a success for me if…” and about 50% of responses have the word ‘confidence’ in their answer. “…if I leave feeling confident about my role as a doula”, “…if I feel confident knowing how to support parents”. I always spend time discussing how confidence comes from inside. I can provide information, support, training, but I can’t provide confidence. Just like we can’t ‘make’ our clients feel more confident.

I encourage you to grab a piece of paper right now and list things you’re good at that relate to being a doula. Are you a good listener? Are you great at finding resources online? Do rock the Rebozo? Are you a comfort measures master? What would your closest friends say about your best qualities? Not sure? Ask them!!! (yes this is hard to do)

Check your ego

Just like we need to ‘check’ our own personal worries at the door when we enter a birth space, so must we regularly check our egos in this line of work. Go forward always assuming you’re doing the very best you can in the moment, with what you know and have available to you. And leave the other shitty feelings behind, because they add very little value to the love you bring forth in your doula work.

But HOW do I know?

It’s a great idea to review/process the birth with a doula colleague or mentor to see if there’s anything you could have done differently. Just be sure to let people know if you just need to talk about it, or if you actually want suggestions and feedback. Telling the person we’re chatting with will help us to get the help we need in the moment.

I also ask my clients in our postpartum visit “is there anything else I could have done that you may have found helpful, so that I can use that next time?”

Take in the doula mentor and client feedback without the chatter of our ego, putting its nose where it doesn’t belong. The more we can ‘check our egos’ in our work, the better we’ll become as doulas over time.

What else can I do?

If you’re struggling with ‘checking your ego’ or with confidence in general, I’d like to suggest you listen to positive and empowering podcasts. The more you surround yourself with the right messages, the better you’ll feel. I adore Marie Forleo. Check out her video blog here.

I could speak about this for hours, but this will have to do for now. Please share YOUR ideas on this topic in the comments below! I’d love to hear your ideas and anything else that works for you.

Good luck my lovely doulas.

#WorldDoulaDomination #DoulasRock #DoulaConfidence

Sign-up for our newsletter to hear more- click here

 

About the Author

Stefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.Stefanie Antunes and family

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

Supporting Partners Who Aren’t Hands ON

What to do when a partner doesn’t want to be involved

I got a call from a new doula recently after one of her first few births (story used with permission). She mentioned she’d done two births so far and both had been quite different from each other and wanted to debrief them. In one she mentioned how the partner didn’t want to be involved and wondered what the best way to handle that would be and if she’d done the right thing.

Relationships

I love doula work because it’s so REAL. Social masks disappear in birth and it’s like seeing a whole other level of humanity. I remember once at a birth thinking “this has got to be as close to a godlike presence as I’ve ever been”. There is something ethereal about it at times.

When social masks come off we see the ‘real’ people behind the social pretenses. Which can be beautiful….or not. You will see deep into people’s lives, how their relationships are structured, and how they each behave within that structure.

Good or bad?

I used to find myself defining relationships I saw as ‘good’ or ‘bad’. Over the years and with maturity I realized that there is no good or bad, there’s just what my social upbringing and culture have programmed me to believe is ‘good or bad’. I now find myself instead ‘noticing’ instead of judging my clients’ relationships. This non-judgmental noticing will help me to better understand how to serve them and it begins in the consultation.

In the consultation I find myself watching how they sit. Are they side by side or across the table? How close to each other? Are they touching? Is one busy doing something else? When one speaks, does the other partner watch intently and nod, hanging on every word, or are they on their phone or off in their own mind?

This is my first opportunity to get a sense for what the relationship might be like. Within the first 5 minutes I have turned to ask the partner what they envision for themselves for this role. We say we involve partners, but if you spend an entire consult ONLY speaking with the pregnant person then you’re not really showing that are you?

It takes all kinds of kinds

pregnant couple - doula clientsWhat seeing hundreds of couples has taught me is that there is no one way to be in a relationship, just like there is no one way to birth or parent.

You’ll see relationships that make your heart feel warm and fuzzy and others that make you cringe. Have you ever wondered why that is? Did you think it was because the relationship was ‘good or bad’? It’s really simply because of your own biases towards what constitutes a good relationship. Of course our egos would like to see everyone in ‘good’ relationships, but because we’re all so different, that will never happen.

How do I work with difficult partners?

Working with partners that you perceive as difficult can be tricky! One thing I’d always like you to keep in mind is that if this couple has been together for a while, it’s very likely that the partner’s behaviour isn’t new to the pregnant person. So while it may at times seems ‘strange’ or even ‘unacceptable’ to you, it may be very expected to the pregnant person. Also keep in mind that may be precisely WHY THEY HIRED YOU!!

We’re not marriage counsellors and that’s not our job! Just support them both in the way that works for each of them.

Side note: If you perceive a threat of violence try to find a time with the pregnant person alone and offer your support. Sending them info or text messages is ill-advised because the abusive partner may intercept them and it could cause more problems. An abused person needs to know there are others who care, but they need to be willing to get help to get away from the situation.

Cultural considerations

In many cultures it’s inappropriate for a partner to touch a labouring person. They may want to, or they may really not want to. But if their culture tells them not to, then find ways of allowing them to be present (if desired) without encouraging touch. Also, please don’t assume because someone is from a certain religion or culture that they aren’t allowed to touch. The question I always ask is “are there any religious or cultural customs that I should know about that may impact how to best support you at your birth”?

Partners who step back

Sometimes you might have a partner who thought they wanted to be involved but once labour comes, thpregnant coupleey take a step back. Labour can be so overwhelming for a partner! Give them specific ways to be involved. Show them a technique and step back to let them try it. But if they keep stepping back repeatedly there comes a point where you need to recognize their emotional or physical struggle. Think of other ways to involve them. Here are a few ideas:

  • Bring a chair close to the labouring person for the partner to sit on
  • Ask them to be in charge of the music playlist
  • Have them prepare the bath or shower
  • Ask them to pull out all the labour items and put on the window sill
  • Do a hand/foot massage and see if they want to do the other hand (foot)
  • Ask them to get ice
  • Ask them to grab a warm blanket
  • Ask them to take notes for the birth story (or for your certification records, lol)
  • Encourage them to get a snack and maybe coffees for all
  • Give them permission to just sit and do nothing (don’t we all forget the value of just BEing?)

When to stop

If a partner repeatedly says no to your suggestions just let them BE. The experience may be more than they can handle and the pressure we sometimes put on partners to be “coaching” is really tough. Another doula trainer once said “for a partner to be at a birth for the first time is like watching football and then showing up to coach the Super Bowl” (wish I could give proper attribution for this, but not sure who originally said it).

Consider also that people who don’t have a very emotionally close relationship will BOTH feel awkward by your repeated attempts to bring them together!

Check-in once in a while to make sure they’re doing alright and ask if there’s anything you can do for them. I know we spend so much time in doula training being taught how to involve the partner, but there are times when the best thing we can do is let them keep the bench warm. Doula work is all about reading the situation and providing the best type of support for that situation.

I feel like there are a hundred other things I want to say, but I hope it gives you some ideas and considerations on how to support partners who aren’t as hands-on!

I’d love to hear your ideas and anything else that works for you.

Good luck my lovely doulas.

#WorldDoulaDomination #DoulaAreForPartnersToo #PartnerSupport

Sign-up for our newsletter to hear more- click here

 

About the Author

Stefanie AntunesStefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

Doula Prenatal Visits

What to cover in Prenatal Visits

When I first started as a doula, all of my clients came from the prenatal classes I taught. Back tHow to conduct prental visitshen we needed a captive audience to discuss what doulas were and how they helped 😊  I loved that I got to spent 6 weeks with people and then have another visit to recap how they were feeling. So all in all I spent about over 15 hours with clients by the time I was at their birth as their doula. The doula profession is different now in many areas. In our area doulas typically spend more like 4 hours with clients in prenatal visits. In adapting to this new way of doing things, I’ve realized that our prenatal visit time together has to be very effective and the time must be well spent. When I speak with new doulas after their first few prenatal visits, I often hear one of two things: either they went on for 3 hours, or they were done in 45 minutes. I’ve put together a few thoughts here to help guide you in your visits with clients so everyone’s time is well spent! (On a side note, I think the perfect timing is 90 minutes to 2 hours).

Goal of visits

The goal of our visits is always to deepen our connection with our clients, establish trust, and build rapport. We do this through active listening and good communication skills. I can’t teach you that here, but I encourage you to NEVER stop learning how to be a better communicator. Here’s an article that might give you some tips.

What should I cover?

So really it comes down to what to cover and how. If we look at adult learning theories, we know that people are going to retain more if they ‘do’ something with it versus just being lectured to. We’ll want to keep that in mind during these visits. Of course I begin each visit with a check-in to see what’s been happening, how they’re feeling, what worries have come up, questions, etc. This will help guide my visit, but many of the activities I have set are activities that will help answer all of these points. Here are some of the topics you may want to cover (as they come up):

  • Discomforts of pregnancy
  • Nutrition in 3rd trimester
  • Body mechanics, posture, pelvic tilts, Kegels
  • Stages of labour review
  • Body’s normal physiological response to pain: Fear-Tension-Pain Cycle
  • Physiological benefits of relaxation
  • Various breathing techniques
  • The doctor-patient relationship and assertive communication strategies
  • Development of birth preference docs (aka birth plans)
  • Negotiating with medical staff
  • Signs of pre-labour and labour
  • Emotional and physical response of birthing person to labour
  • Back labour
  • Pushing
  • Hospital procedures: admission, labour & delivery, postpartum, discharge
  • Ways of handling pain and comfort measures
  • You may want to discuss how they FEEL about (though teaching it may be outside of your scope of practice)
    • Intrapartum concerns (not-so-positive things that can occur during labour and birth)
    • Medical interventions:
      • EFM
      • Forceps and vacuum extraction
      • Amniotomy (breaking your water)
      • Episiotomy – research, how to prevent
      • Induction/augmentation: natural ways and medical ways
    • Medical pain management: epidurals, narcotics, other
    • Cesarean: indications, procedures, emotional response, pain management, how to avoid
    • VBAC
  • Postpartum: in hospital, at home
  • Adaptation to parenthood
  • Breastfeeding
  • Newborn

How do I cover it?

As you look at the list you can imagine that there’s just NO way to cover all of that if you’re only seeing your client once or twice. I’d love to see doulas recommending their clients take a good childbirth education/prenatal class. Education is SO worth it. But I recognize that’s not always possible. Be sure not to fall into the trap of “I hired a doula so she’ll teach me everything I need to know”. That’s just not possible unless you’re spending 10-15 hours with each client AND you’re a childbirth educator!! (scope!!)

So here are some ways to cover those topics above in ways that increase learning retention and that are FUN. Please, let’s all commit to STOP BORING PRENATAL VISITS!!

  • Labour positions: having printed labour stations that describe a position and then guide clients through a ‘pretend contraction’ with breathing and partner support (if applicable)
  • Role play of difficult topics (things that really matter to them)
  • Conduct a guided visualization
  • Massage: teach support people how to perform a hand massage
  • Show: touch relaxation, a couple of acupressure techniques (watch for scope here)
  • Comfort measures grab bag: pull items out of your labour bag and ask people how it could be used, then try it out!
  • Comfort measures pie chart: keep the chart going every time they express something they’ll use to cope, fill in one of the pie pieces
  • Ice cube activity: to show the length of contraction and the difference between doing nothing and using comfort measures during a contraction
  • Birth preference cards: most doula trainers teach this activity of 15 cards with opposites on either side of the card. Clients discuss why they chose each side as they go through. This is a great opportunity for you to make a list of any info you can send them (if they’re unsure of what they prefer). Then you ask them to flip 5 cards over (which 5 do they choose first, they’re now getting the opposite of their preference), and then 5 more. Watch how they prioritize things. What really matters to them? Then role play the top 5 left. How would they negotiate their wishes? What questions would they ask? If you’d like to get the activity, I’ve put it here to share with you. Print it on labels that are 5160/8160 size.
  • Birth plan review: go over each point validating it but suggesting to remove anything nurses and docs don’t need to see (ie turning lights down, walking around, etc). Anything that can easily be discussed should be taken off to keep it short and sweet. Lead the activity in a way that asks “how could we make that happen?” so they see how much is in their control.
  • Pain Management Preference Scale: this activity is great. I give each person a sticky note and ask the pregnant person to write what number they are on the scale, and their support people to jot down what number they expect was chosen. Then compare to see if they’re both on the same page. Then discuss how we’ll all support that preference. You can buy this and other tear pads on Penny’s site here
  • Of course discussing “when to call the doula”, having general discussions around boundaries (when it’s ok to call for various types of inquiries, etc)
  • Postpartum planning (lots of activities you can do here). I like to use a postpartum bag which includes things like: condoms, Epsom salts, plastic housecleaning glove, a dice (never know what we’re gonna get), a candle, watch, cell phone, pads, breast pads, peri bottle, etc. You can pull out an item and ask them what thoughts or questions it generates. Have a chat about each point.

This list certainly isn’t exhaustive, but I hope it gives you some ideas on how to have fun and be effective in a prenatal visit!

I’d love to hear your ideas and anything else that works for you.

Good luck my lovely doulas.

#WorldDoulaDomination #DoulaPrenatal #Connecting

Sign-up for our newsletter to hear more- click here

About the Author

Stefanie AntunesStefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

Identifying our Ideal Doula Client

Identifying our Ideal Doula Client

It probably isn’t the first time you’ve heard the term “ideal client” or “target market”. It’s something ALL businesses talk about, a big part Identifying our Ideal Doula Clientof every business plan, and has been discussed a lot recently in the doula community.

Defining

Your ‘target market’ is a precise description of the people who are most likely to become your clientele. I like this article that gives 5 steps to defining it and may be helpful to you.

Who IS our ideal customer?

I can’t tell you exactly who YOUR ideal customer is, but I can tell you what it ISN’T. It’s NOT every pregnant person you see in the mall. Why not? Because not every pregnant person wants a doula.

Yes, yes, I know….if they knew more about doulas maybe they’d want one. But that’s not the current reality and that’s maybe a discussion for how to advance our profession….perhaps another blog post some day.

When I ask new doulas who their ideal target market is they always start with “pregnant people”! Then I explain as above and they still persist in saying “but I’d work with ANY pregnant person”. It may be true that you’re WILLING to work with anyone, but you won’t be the right doula for everyone. That’s sometimes a bit tough for our egos to accept, but it’s a really important part of establishing who our ideal target market is. I tell myself regularly “There’s a right doula for everyone, but I’M not the right doula for everyone”

Identifying our ideal client

Pregnant doula clientOne of my favourite business gurus is Marie Forleo (check out her blog linked here). She has such a wonderful spirit and is a great business coach who targets a very specific type of business owner. She calls it the “customer avatar”. An avatar is that little icon that represents a character in video games. Imagine if you had one of those that represented your ideal customer?

Grab a piece of paper and draw out your ideal customer. Give them a name, write down everything they like. Not just relating to being pregnant or a new parent. I mean EVERYTHING. What’s their favourite colour, what radio station do they listen to, what shows do they watch, what are their hobbies, what is their hair colour, eye colour, etc. Go on and on and on.

What if I don’t know?

If you’re not sure what the answers are, then you might need to take a different approach. Maybe instead think about someone you know that you would LOVE to work with as a doula. What is it about them that makes you want to work with them? Sometimes if we flip the task it becomes easier. Maybe you could ask that person for a coffee and actually ask them the questions to create your avatar. Tell them you’re just starting/growing your business and you’re interviewing some people and you’d be honoured if they’d give you 15 minutes of their time.

But what if that isn’t the only person I want to work with?

Of course that’s not the ONLY person you want to work with, and surely you’re capable of working with many more, but when we define it, we can use the information to help build and grow our business effectively. When you’re targeting Sarah, it doesn’t mean you won’t work with Gabrielle. But if Sarah is your IDEAL client, then you want to find more Sarahs.

What do I do with my avatar?

Once your avatar is complete you will use it to guide ALL of your planning and marketing activities. From what colours to use on your site,doula business planning to what pictures you choose, to the wording in your copy. Remember you’re NOT creating a website that YOU love. Your goal should be to create a website that will catch Sarah’s attention and get her to call you.

Having an avatar will make SO many of your decisions easier. Because you won’t be conflicted about what to choose, your avatar profile will guide you.

Hope some of these ideas will help you to define your ‘ideal client’. I’d love to hear your ideas and anything else that worked for you.

Good luck my lovely doulas. I would love to hear what has worked for you and any other ideas I’ve missed here. There are surely a hundred more.

#WorldDoulaDomination #DoulaClient #IdealClient #TargetMarket

Sign-up for our newsletter to hear more- click here

 

About the Author

Stefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.Stefanie Antunes

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

Creating Doula Packages

Pricing our Doula Packages

One of the most common questions I get asked in doula training is how Creating Doula Packagesmuch to charge and how to create doula packages.

Like a lot of life’s big questions, there isn’t really one simple answer, but I’ve put together some thoughts for you to consider here.

The Going Rate

When I was the Direct or Public Relations for DONA International I had the unique opportunity to speak with doulas from all over the world, though most commonly across North America. I have a funny habit of noticing trends and I realized that despite the wide range of prices people charged for doula services, that the average rate for a doula service package was about the cost of a month’s worth of daycare in that area. So, of course, in small towns it was lower, and in large urban centres it was higher.

Value

Doesn’t that kinda makes you wonder about how often you’ll hear people say they can’t afford doula services, but almost everyone you know is paying for daycare for their little ones each month? Sure, sometimes people can’t afford that and they have family help them, or they work opposite shifts so they don’t have to pay for childcare, or one simply stays home because it’s not worth it. All of that is totally legitimate. I’m just saying that paying for daycare is very common because people see the ‘need’ for that service, even though it can take up a large chunk of their after tax dollars.

People will pay for what they value

doula vale

Ultimately, people will always pay for what they value. Just about everyone has a smart phone these days. But I promise if you go to a cell phone company and ask for the deluxe package, but tell them you can’t really afford it and want it for cheaper (or nothing), they would laugh in your face. And yet, we see this constantly in the doula world. People saying they really want a doula but can’t afford one. Every time you hear that I’d like you to imagine someone saying that to the cell phone company “but I really need/want this phone….please…can you give me this phone”. If anything, it will likely make you smile as you imagine it. So here’s the thing….when people really want something because they VALUE it, they FIND A WAY to pay for it.

Where there’s a will there’s a way

I’ve had many lower income clients over the years hire doulas. They’ve hired them because they realize the amazing service it is, how much goes into providing that service, and they recognize that paying for this great service is expected. They’ve done payment plans, or asked family and friends to help out, but they’ve made it work.

Do you value YOU?

The real question is do YOU value YOU? Do you believe that doulas are worth it? Do you respect yourself to charge a livable wage for your area? I grew my business over 1000% in the past 5 years and it’s because I changed my mindset (no that’s not an extra zero by accident). What beliefs are holding you back from charging what you are worth?

Packages

Some of the things doulas might include in their packages is a varying number of prenatal and postpartum visits. That’s one way to have a basic package for people who have smaller budgets. Think back to our cell phone analogy and think of it as “pay as you go” and ‘using wifi instead of data’ on your phone. Then have packages with more prenatal and postpartum visits for people who can afford more and value the extra time. Of course I wish everyone could pay for 4-5 visits with me! I’d love to spend more time getting to know my clients, but I have a practice to run and they have budgets to manage so we find what works for each client.

Other things to consider are what other services you offer that fit with your doula work. Are you also a childbirth educator and maybe one package can include your classes? Are you a postpartum doula and can offer an extended postpartum package? Sky’s the limit on how to structure your package to give you an idea (in the back end from a value perspective. Note: you wouldn’t show this pricing on your website). Here’s a sample below:

  • Prenatal visit 1: value $100
  • Prenatal visit 2: value $100
  • Birth: value $500
  • Postpartum visit: value $100
  • Being on-call, text and email support, etc: value $200
  • TOTAL value: $1000

Offering payment options

One of the best ways you can be flexible for clients is to offer a variety of ways for them to pay. We accept Visa/MC/Amex, bank transfers (common in Canada), cash or cheque. We’re also happy to accept gifts from family members who can call-in a payment and we can put it to the client’s account to reduce their bill. We do everything electronically as much as possible so it’s easy and convenient for people. I rarely accept cheques or cash anymore!

We’re also happy to split things up into monthly payments or a 50% deposit and 50% due at 37 weeks. All of our payment plans are always paid up by 37 weeks however to make sure we don’t have to stress and worry about that later.

Hope some of these ideas will help you to form some of your own thoughts. Grab a piece of paper and write down which ones might be a fit for you.

Good luck my lovely doulas. I would love to hear what has worked for you and any other ideas I’ve missed here. There are surely a hundred more.

#WorldDoulaDomination #DoulaValue #SelfWorth #DoulaPackages

Sign-up for our newsletter to hear more- click here

About the Author

Stefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.Stefanie Antunes

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.

Client Follow-Up

How to follow-up with clients

As an agency owner I have the privilege of hearing the odd customer complaint. Admittedly we don’t get very many (thankfully!), but when we do one of the comments I hear is that the doula didn’t follow-up as promised.

Types of follow-up

In our last post we discussed the consultation and how important it is to follow-up within a couple of days of meeting a client. If you’ve gone to all the trouble to market yourself, then interact by phone or email and then meet with a client, why stop the great service once you’ve met with a potential client? Be sure to follow-up. If you’re wondering what you should follow-up with, read our last post for a reminder.

Once hired

When a client calls or emails you to let you know they want to hire you as their doula (congrats!) be sure to follow-up promptly with your contract and/or next steps for how to finalize the booking. If you haven’t received a signed contract and deposit, you’re not really booked yet.

This is one of your first opportunities to show them that you’re responsive and it will reinforce for them that they made a good choice in choosing you.

Booking confirmation

It’s also a nice doula touch to thank your clients for booking you (once you’ve received the contract and deposit). Some doulas like to give a little gift. Think about other great practitioners in your community that might like to offer a free service to your clients (usually in the hopes of the client rebooking for extras). If you take the time to get to know these

practitioners it may make a great gift to your clients. In the past I’ve done this with photographers, therapists, acupuncturists, etc. The clients aren’t obligated of course, but it’s a nice touch. I’m sure you can come up with many other ideas! Let us know what they are so we can share among each other!

Prenatal visits

One of the most common times to need to send a follow-up to a client is after a prenatal visit. Because so many things come up in a visit, it’s a good idea to keep a piece of paper, notebook, or sticky note near you to jot down the things you’re going to send more info on after your visit. I like the sticky note because I put it on my phone so I get to it very soon after our visit. Be sure to follow-up promptly with anything you promised. The most common items are websites, links, more info, etc. Please know that if you’re a new doula who’s worried that clients expect you to know everything, they DON’T! No one knows everything and some things are outside of our scope to provide. So it’s totally normal and natural to have a list of things you’re going to research for yourself or send to your clients as a follow-up.

Touching base near the due date

We definitely want our clients to feel like we’re there for them and thinking about them, but some clients feel overwhelmed at how many people call or text to “see how things are going” near the end of their pregnancy.

Maybe instead ask your client what they’d like from you. Do they want you to call or text? Do they want to be the one who reaches out to you? Will they feel cherished by a warm message with some info? Will they enjoy a short check-in visit while you’re in their neighbourhood? Be sure to inquire so you can provide the right and best type of support.

During early labour

Early labour can be another challenging time. How often and when people might want to be in touch varies from client to client. Again, the best course of action is to ask your client during a prenatal visit what they feel might be most helpful. Each time you chat with a client in early labour make a plan for what the next ‘check-in’ will be. Will they call you (my recommendation), or will you reach out to them? Get a clear understanding so you can meet your clients’ expectations.

Postpartum

Doula trainingOne of the most common times to send further info, links, and resources is following your final visit. This helps to set your clients up for success as they venture out without you.

It’s also nice to leave a parting gift. This could be something you make (if you’re crafty), or maybe a birth story if you like to write. My suggestion is that it be something thoughtful and something that you’d enjoy making or doing, so it doesn’t feel like a chore to you.

In conclusion…

As you can see there are TONS of opportunities to connect with our clients outside of our in-person time together. It’s a big part of what we do and what makes us great. On a side note, it’s also part of the value we bring, and the hours we spend supporting our clients outside of the ‘traditional’ hours we think about. I’d love to hear your ideas too and if you’ve found other things that work well for you.

Happy doula-ing

#WorldDoulaDomination #ClientFollowUp #DoulaSchool

Sign-up for our newsletter to hear more- click here

About the Author

Stefanie Antunes has been a Lamaze® Educator and doula since 2002, after the birth of her second son showed her just how valuable it is to be prepared for birth and to have good support around you.Stefanie Antunes

Stefanie is a visionary in the childbirth field. She leads the Discover Birth organization providing a variety of services to expectant parents and training for those wishing to pursue work in the childbirth field. Stefanie is a board member with the Association of Ontario Doulas, former Public Relations Director for DONA International, and sits on many local boards and coalitions to improve our communities. She is a DONA-approved Birth Doula Trainer, runs an Approved Program for Lamaze International and runs two doula agencies Discover Birth and The Nesting Place.

Stefanie is the founder of The Birth Doula Program at the Scarborough Hospital.

Stefanie is a contributing author in the best selling Power of Women United and the book Bearing Witness: Childbirth Stories Told by Doulas. She is a regular contributing writer and blogger, and has done many interviews online and for TV/radio.

Before becoming a doula, Stefanie worked in corporate intelligence, helping large companies keep abreast of their markets and competitors. She now works to bring some of those same skills to the doula profession, helping it grow and prosper, along with its many doula members.