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

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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

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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

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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

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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

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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.

 

 

 

 

Rocking the consultation

How to rock a consultation (interview)

When I train a new group of doulas we always spend a fair bit of time on discussing consulations (many people call them interviews). This is where a potential client has expressed an interest in having you as a doula and you go meet with them to “sell” yourself…I mean… to see if you’re a good fit.

Selling yourself

And THIS is exactly when I see a look of DREAD cross most people’s faces in training. They’re thinking “ew, sell myself? Gross!”  I’m not quite sure when sales became so gross to us socially. Was it the door to door stuff our parents/grandparents experienced when people would come and use high pressure sales tactics and basically not leave until you purchased? Is it the idea of the greasy sales person who won’t take no for an answer and who does things like tell us the product “sells itself” and who pull out their calculator to tell how they’ll give ONLY US a special price? I’m not sure what it is exactly, but for some reason many people in the helping field dislike the idea of selling themselves and their services. But here’s the plan ol’ fact people…if you can’t use effective strategies to sell your services, it’s gonna be super tough to actually do doula work. So here are my thoughts on how to sell in a way that doesn’t feel ‘sales-y’.

Initial Interaction

The intention of the initial phone call or email is not to fit everything about your services into this short exchange, but rather to create a connection with parents so that they want to hear more about you and book you for a more in-depth consultation.

Goal of the consult

I always say there are really only two main goals to a consultation: Connecting and evoking emotion. You can skip a LOT of things, but not those two.

Meeting potential clients

doula schoolTypically, a person will decide within the first few moments of meeting or speaking with you whether they connect with you or not.

Marketing research suggests that the decision to hire or not to hire is primarily subconscious and has more to do with the feeling someone gets from you than the things you say. Think about what feelings are most important for you to bring out in your interviews and HOW to bring them out.

How do parents feel with you?

What do you say when someone asks “What do you do?” or “Tell me about doulas?” Do you give them the general definition, tell them what you’re not, or list the tasks you typically do at a birth? How much time do you spend answering this question?

A common mistake for people to make when answering this question is to go into the tasks of their profession as opposed to stating the purpose or difference that they make in their practice. The tasks of birth support are harder for people to relate to than the difference that you’ll make for them.  When you are asked “What do you do?” think of it as someone asking “How would I feel differently about my experience with your services?” How will they experience pregnancy, birth and postpartum differently with your support? How might they see themselves or each other differently with your care?

Grab a piece of paper and write down your thoughts on the following questions:

  • How do your clients feel differently in your care?
  • How do your clients relate to birth differently in your care?
  • Now you tell them how you make that difference:
  • What is it you do to make that difference for parents?

Parents are more likely to hire you if they feel the difference you’d make for them while they’re getting to know you. Instead of simply telling them about how you’d make them feel, practice phrasing your answers in a way that invokes feeling in the parents.

Example A (Listing): “As a doula I don’t do anything medical, but rather support you emotionally, physically and informationally during labour by helping with positions, pain coping and advocating for your preferences.” (this isn’t wrong but it doesn’t make me feel warm and fuzzy)

Example 2 (Invoking a feeling): “You’ll feel more confident in your ability to maintain a coping mindset throughout your labour because I’m able to stay at your side for the entire birth to help you if you’re scared or caught off guard by the sensation of labour.” (Yes, exactly! Love love love this)

Do you feel a difference when you read the two statements?

Client Centered Conversation

Another misdirected approach that some take when speaking with parents is that they focus the direction or subject of the conversation on themselves. As a result, the parents can get a feeling of being ‘sold to’ instead of feeling a connection with you. If you can talk about your services and experience in way that appeals to the parents’ interests and personal experience, you’ll more likely build a connection with them receive a call back.

Pay attention to the next few commercials or ads you see/hear on TV or radio. What’s the focus?

Consult topics

There are a lot of things I cover in a consultation, but I ALWAYS begin by asking the client about them and what they envision for their experience. The ENTIRE rest of the consultation, how you describe your role, the words and tone you use, and what you focus on should be based on what the client has shared with you. It’s not that you’re not telling the truth, it’s that you’re focusing it appropriately. Just like we do our doula services!

It’s not important that you tell them all the details about your background, doula package and other services right away. Instead, focus on building a connection with what you have to talk about and make them want to hear more!

In my trainings I describe two clients:

Shelley and John are having their first baby. Shelley shares that she struggles with anxiety, is not interested in feeling a lot of

doula training class dates

Pregnant Woman with doula

pain in labour, and is always thinking that there’s something wrong with her pregnancy and that birth will be horrible. It took them 3 years to conceive and they are pregnant from IVF.

Desirée and Charles are also expecting their first baby. Desirée was at her youngest brother’s birth – a home birth. They have a hobby farm and are planning a home birth with midwives. They have a very natural approach to life and birth. They are super excited about this birth and very confident about it all. They are looking to hire a doula to have an extra set of hands for the logistics of setting up the birth tub and just to have an extra person who can focus only on the non-medical aspects of their birth.

If your consult sounds the same for BOTH of those people, you definitely need to reconsider your strategy. Get together with another doula and brainstorm how you’d describe the role of the doula to each of those clients. It should be pretty different in terms of what aspects of care you focus on.

Talking about fees without feeling icky

Similar to your relationship to speaking about your approach to doula care, the messages you carry about your fee influence they way people will respond to your conversation about payment.

What beliefs do you have about charging for doula care?

Do these beliefs positively influence your ability to communicate with clients about your fee or are they limiting?

Think back to the list of experiences that influence your doula care and they way that you’ve made a difference to clients. When you speak about your fee, call on the more positive associations you have with the value of your doula care – speak from a place of self love instead of a place of fear (abundance versus scarcity). Avoid explanations – just re-cap what is included in the package and the payment options.

Memorable Goodbyes

Although some clients will be ready to book you during your interview, many parents want to take some time to think about it or interview another doula before they make their decision. Even on your way out the door, we can continue to deepen their connection with us and make ourselves stand out in their minds.

How would you say goodbye to a client while taking into account what you’ve learned about building connections with the way you speak?

Example A: “It was really great to meet you. Is it alright for me to follow up with you in a few days?”

Example B(Parent-Centered): “You mentioned that you were worried about postpartum support. I have an article that goes over basic things to think about to prepare for postpartum. Is it ok for me to get your email to send it to you?”

Your Tone, Your Eye Contact, Your Pace

Doula trainingEye contact goes a long way in terms of building a relationship and often tells someone how present you are to the conversation at hand. Similarly, if you’re speeding through information, parents may feel that you’re rushing them and consequently, they may feel an urgency to get your attention or simply end the conversation.

Practice speaking comfortably and concisely about your work before you attend the consult and take note of your tone, pacing and eye contact. Do you have a tendency of looking around the room? Do you speak faster when you know your time is almost up? You may also want to record yourself with a video camera so you can observe yourself and listen as if you were the parent at the interview.

How do your pacing and your tone influence your feelings as the listening ‘parent’? Are you remembering to check in? As the listener are you captivated by the recording or does your mind drift?

Follow-up

The timing with which clients are followed up with is an essential ingredient in representing ourselves as available and accessible doulas. The content and timing of the follow up call or email can be the turning point for a client when deciding between two doulas. I’d suggest following-up within a couple of days.

Timing/length of the consultation

I feel fairly strongly that a consult under 45 minutes is likely missing out on some opportunities to connect. I feel equally as strongly that if it’s lasting a lot more than an hour, you’re probably discussing things that are better suited for a prenatal visit once you’re hired. Also, it may seem ok to spend 2 hours with someone in a consult when you’re a new doula, but once you’re doing 2-3 per week you will probably begin to see that you can be effective in about an hour and spend the time saved on yourself, your family, or your other clients.

In conclusion…

I know that’s a LOT to think about. Try breaking these ideas down into chunks and thinking about them a little at a time. I’d love to hear your ideas too and if you’ve found other things that work well for you.

Happy doula-ing!

#WorldDoulaDomination #RockingTheConsult #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.

Getting our first few doula clients

Getting our first few doula clients

Over the past few years there has been so much talk about whether to charge for our first few clients after we’ve completed our training.Getting our first doula clients

My personal views see both sides of this argument. I say if you can charge for your first few clients, please DO! BUT I see a lot of new doulas who just don’t feel comfortable doing that and to tell them to charge is a disservice to them because they just won’t do anything. It’s like when we’re worried or anxious and someone tells us not to worry. It doesn’t usually work does it? Sooooooo….here’s what I have to say to those of you who are struggling to find your first few clients. My answers might surprise you.

The doula in you

First, I want you to grab a piece of paper. I want you to write down 5 reasons doulas provide a wonderful and worthwhile service.

Now I want you to write down 5 reasons YOU’RE wonderful. What are those nice characteristics people always say you possess? Don’t be shy. Be confident and honest about your skill set.

Now I’d like you to list your previous education, work and life experiences that have led you to becoming a doula and that will make you a good doula.

No experience

Consider the new doula who says “I have never been to a birth and I don’t have a child of my own. How on earth am I going to be a doula for someone for the first time?” As I dig a little deeper I’ll ask about their educational background and life experience. The new doula says “I have been interested in birth since my younger brother was born a few years ago. I wasn’t in the room but went to all my mom’s prenatal visits with her and was SO fascinated by my newborn brother. I took women’s studies in university and I’m considering becoming a midwife at some point. I’m always the friend people come to when they’re struggling with life situations”. EVERY single one of those points has led this person to becoming a great doula even before she has attended her first birth. Keep in mind that what makes us a competent doula is our ability to be committed, unbiased, supportive, a good listener and a good communicator. Odds are, you possessed those qualities LONG before you’ve attended a birth.

So you’re probably wondering when I’m going to “tell” you how to get your first few clients, but the truth is that’s the easy part. What isn’t easy is YOU being aware of how awesome you are and being confident about your ability to get these clients and doula your first few clients.

IF you feel confident charging for your first birth, then I’d encourage you to charge a fee in the range of rates for your area. When we start off charging a low fee because we’re “new” we devalue the service in our area. Personally, I’d rather see people do probono work for agencies who support under-served populations than charge a low fee to a client who can afford a typical doula fee. But that’s just a personal opinion and I would always encourage people to do what’s right for themselves.😊

IF you would rather do probono support for your first client(s) then here are some ways to find those clients in a way that doesn’t devalue doula support in your area (as much):

  • Go visit a pregnancy help centre
  • Go to your local health department and see what programs exist focused on under-served prenatal populations
  • Go to a local homeless shelter and discuss with a worker if there is anyone expecting who may need support
  • Chat with local midwives or OBs about single parents who are unsupported and low-income and who would benefit from a doula’s support
  • Find all the agencies in your area who support vulnerable populations and who might benefit from you coming in to do a short chat about comfort measures or doulas (or other in-scope topics). More education for these expecting people is so valuable whether or not they ask you to be their doula. Furthermore, the experience of going and presenting about doula services or labour is helpful in building your confidence.
  • Check with local doula associations that may have programs to support new doulas
  • Connect with your local State or Provincial rep at your training organization to see if they have some good local recommendations

I’ve seen a lot of new doulas post on Kijiji or Craigslist, but I don’t encourage that. In those situations, you may find yourself supporting someone who could afford to pay for a doula. My experience is that when doulas provide probono support to families who could actually afford doulas, they are often resentful of the amount of work they do. This rarely happens when you support someone who can’t even afford basic baby supplies.

You may also find comfort in supporting friends or family members to start. It may feel less intimidating, though your role will be different from supporting a stranger. In addition, be sure you can stay within your scope if it’s a close friend or family member! Part of being a good doula is not being emotionally involved 😊 If you’re open to this idea then post to your Facebook family.

Your Salesforce

Remember that you are not a salesforce of 1. Every single person who loves and cares for you and knows why you’d make a wonderful doula is on your sales team. Make sure they have a nice little postcard (my preference) or business card (less preferred) to give to pregnant people in their lives (which we ALL have) to help promote you.

Getting clients

If you do even a small handful of these things you will have more clients than you could even handle!

I’d encourage daily meditation and journaling about how you’re feeling about your new journey along the way. Much of our success is around confidence and having the right mindset.

“Smile, Strength, Reflection. I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear” Nelson Mandela

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 #DoulaBusiness #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 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 members.

 

 

The Three-Year Itch

Overcoming the Three-Year-Itch

Written by Stefanie Antunes, originally published as a Featured Story in the International Doula, Volume 17, Issue 2 (2010)

Every year, thousands of doulas, childbirth educators and midwives leave the profession.  While many may leave for family or financial reasons, a great number leave due to a feeling of unease. Some describe it as feeling overwhelmed, while others call it feeling frustrated. I have come to call it the Three-Year Itch.

Many of us come to the birth profession with a great sense of excitement in a great new career journey that will allow us to touch other people at such a special time in their lives. It often begins in a very magical way — a birth that leaves a mother feeling exhilarated and a
partner feeling proud of his involvement and thankful for our impact. Over the years, perhaps some negative experiences occur — the ones where women’s choices fall on deaf ears or where a mother or baby may have been harmed, even though there were options to avoid
it. We may find ourselves supporting the mother whose birth experience went very wrong and who is feeling like her life is falling apart.

For many, what begins to happen is the formation of a gloomy cloud overhead; which may bring about a feeling of unease, a feeling that something just isn’t right, speaking in an “us versus them” tone, a feeling that there is no need for these things to happen and believing it’s not fair. What they may be experiencing is called Vicarious Trauma (VT). The technical definition of VT is: “A permanent transformation in the helper’s inner experience resulting from empathetic engagement with the client’s traumatic material” (Pearlman & Saakvitne, 1995).

Most people do not realize they are suffering from VT. They may simply think it is time for a career change; that perhaps they were not meant to be in the field after all. Signs and symptoms can include intrusive imagery, cynicism, poor memory, volatile moods, lack of spiritedness and/or physical problems. Basically VT is a set of cognitive, emotional, physical and spiritual disturbances that result from helping trauma survivors. So, what does birth have to do with trauma? Although we all wish every birth was an amazing transformative
experience, the truth is current systems do not always support this possibility. Sometimes women’s choices and preferences are not respected. Sometimes women make choices that are not informed, which may ultimately lead to interventions they had hoped they could
avoid. Trauma is really stress gone haywire. It is not the event itself that determines whether something is traumatic to an individual but the perception of the event. What this means is that one person’s happy birth story can be another’s traumatic event. The issue for those of us in the birth profession is what we witness or hear. When a helping person is listening to shocking, sad or awful stories, it may look like s/he is calmly listening, but the activity going on in the brain is not calm. The helper is using something called “controlled empathy.” Not only is the helper absorbing the shocking story, but s/he must respond to the content in a constrained manner. Controlled empathy
is a vigorous neurological activity, which can actually cause damage to one’s brain.

Dr. Ellie Izzo and Vicki Carpel Miller, authors of Day After Day The Price You Pay: Managing Your Second-Hand Shock™ estimate there are over 100,000,000 helping professionals worldwide. They describe in remarkable detail the toll of VT and what can be done to help resolve it. They also discuss how hard work and dedication can take a heavy toll on the helper. Since this heavy toll cannot be seen by the naked eye, it may explain why so little has been written about it. The toll for many can be high and the recovery resources low. According to a study by Pearlman and Saakvitne (1995), at least 53 percent of those in helping fi elds are trauma/abuse survivors. The estimated percentage is actually higher to account for those who have blocked their trauma from memory and those unwilling or unable to discuss it.

The toll of VT

These feelings begin to cloud our judgment. They may impact the kinds of clients we accept. They may create a strong dislike for a particular hospital or care provider in our area. We begin to feel, act and speak in a very jaded way. Voilà, we are officially in the Three-Year Itch. It can also be described as “compassion fatigue.” Whatever the term, when we are in it, it feels awful. It can change the way
we look at the world, the way we sleep, the way we interact in our community and with our family. This may cause many of us to leave
the profession within a couple of years (generally years four or fi ve); but for those of us who want to stay the course, there are some very important things to help us work through this treacherous period.

The Three As

Awareness. Think of how helpful it would be if you knew heading into your career that you may hit a point where things felt overwhelming, but that you could move past it with some strategies. You might even be able to avoid it with some pre-planning.
• Know that VT and Second Hand Shock™ are very real.
• Each person will perceive and react differently to VT.
• Be aware that these feelings of frustration are common.
• Symptoms will not always be associated with the precipitating trauma.
• These feelings do not mean you chose the wrong fi eld of work.
• Be prepared that your clients’ birth experiences won’t always be great.
• Know that at some point you will face a bad situation that you just may not know how to deal with.
• You can get past this.

Never forget that these feelings can affect your relationships (both personal and professional), impact your credibility in your field and community, lead to lost wages and/or affect your clients who are caught in the middle.

Acceptance. If you identify yourself with the description above, you are already halfway to the resolution. Acknowledging and accepting this stage of your journey is a large step toward moving past this phase. The biggest danger for most of us is when we have entered this field to relive our own great birth experience or to help other women avoid the negative. When we are in it, it feels terrible experience we may have had. These reasons are almost certain to have us dealing with VT and to feel defeated when what we are striving for does not
materialize. We must remember to accept the good work that we do, even if the outcome is not good. Otherwise we are at risk for only feeling good when we perceive ourselves as miracle workers making huge impacts all the time.

Here are some things to do to move forward:
• Create realistic expectations for yourself. We can all change the world but only one family at a time. Focus on small goals not fixing the system. Keep in mind that much advancement has been made in maternity services and together we will continue making them.
• Plan a period of readjustment and development. Ask yourself what help you need. How can you benefit from someone in your community with years of experience who has weathered these storms? What further education might help you feel more confident in advocating for change?
• Surround yourself with the right support network. Do not try to do it alone. It is absolutely imperative that you have someone to debrief with. Within the confines of confidentiality, speak with someone about negative situations that have impacted you emotionally. Discuss
what happened, what was involved, what you can take and learn from this experience. At a later date, you can consider advocacy work to remedy situations that repeat themselves.
• Create a plan. Once you can begin to accept things for what they are (a complicated system of interrelated people, processes, procedures, organizations) you can begin to formulate how you might affect change at the level intended — personal, local, regional, national, international.
• Rejuvenate. Keep yourself at the top of your priority list. It is not just a cliché. If you are to be an effective professional in this fi eld, you must be able to keep yourself healthy, both physically and emotionally. Take time for yourself on a regular basis.

Action. When we describe the phase of transition in labor, we often say things like, “It’s the toughest but the shortest,” “It’s right before you get to meet your baby,” “It will be over before you know it.” The Three-Year Itch is something of a transition phase and it can become a thing of the past for you, steering you towards a fulfilling and rewarding career as a doula/childbirth educator/midwife if you can just make it over the hump in order to see the rainbow following the storm.

Those who can overcome these feelings  will feel invigorated and reenergized in their roles, create action items allowing them to continue working at affecting change in their community, see their accomplishments rather than what is still left to do, see gaps in maternity care as areas for improvement and will be able to take action. The only difference between those who accomplish a lot and those who accomplish little is tenacity and determination.

There is no better world than one where we work to help others. The doula profession is a noble one. We all have a collective goal to see a world with peaceful birth, an experience that is empowering and transformative for the new family. We will only see this future if we can learn from our experiences, stay the course and help others on their paths. Leaving the fi eld due to burnout will serve no one. Even those
who leave often feel forever drawn to what could have been. Let us work together to get past our Three-Year Itch, whether it truly happens for us in that three to five year mark, or before or after.