Wednesday, November 08, 2006

Earning one's fee

Whenever I attend a fast, uncomplicated birth (which, you may remember, rarely happens for me), I feel guilty about my fee. On a few occasions, I have even given some money back to the clients.

At these times my spouse gently but firmly reminds me that I do not charge extra for protracted births. From his perspective, the person who loses a partner for hours/days at a time, it all evens out. I have learned to joke with clients that if they end up feeling like they overpaid for my services, they can be happy that their birth was so easy -- they'd probably prefer that than having the kind of labor that wrings every last cent's worth out of their doula investment!

But focusing on the birth itself is only part of the story. As Vancouver Doula illustrates so well in yesterday's post, labor and deliver is just the tip of the iceberg.

Independent of her post, I'd been thinking about this issue recently. A few nights ago I was on the phone for 45 minutes with a recent client who has breast yeast. Some of our conversation was technical breastfeeding discussion but most of it was commiseration. At the end she said it was so good to vent.

This is a client whose birth went so well I was afraid she'd think I was a waste of money. Since that time she has said repeatedly how she and her partner felt so much more calm heading into the birth and during it because they had a doula. That calm came from our hours of conversations and e-mails, and from their knowledge that the doula would be a familiar face and constant presence.

I have heard this many times before.

Not everyone is anxious heading into birth or faces breastfeeding issues postpartum. But it is part of the birth doula's role to provide support before and after birth. The impact this has on the birth itself and on families' general satisfaction with the birth/postpartum experience is hard to measure. Yet it certainly factors into my ability to feel reasonably comfortable about the fees I charge.



Blogger I am a Milliner's Dream, a woman of many "hats"... said...

I often think that births that "go well" do because the doula is there. I have never had anyone think I was a waste at a birth like that. I HAVE wondered if someone thought I was a waste when things didn't go "as well" when the birth was long and drawn out or ended in a way the family wouldn't have chosen. We all do it; don't take credit, but take unwarranted blame.

I keep telling myself (still!) that outcomes--"good" or "bad" are not up to me.


P.S. Have you seen the "Economics of a Doula's Fee" document?

3:17 PM  
Anonymous HollyRhea said...

I'm interested in this "Economics of a Doula's Fee" document.

I'm a new doula. I attended a homebirth this past weekend, in which I arrived thirty minutes before baby was born. (Luckily, midwife was two minutes behind me). I felt a little useless, too, but the mother said my breathing with her was what she needed - I arrived just in time for her. My own doula for my daughter's birth arrived 45 minutes before she was born. It just happens. She drove us to the hospital, which is something neither I nor my husband could have done (I couldn't face contractions without squeezing the life out of him).

Even having experienced a labor with a scant amount of doula-presence, it was worth it to me to have the same peace of mind you speak of. Enough, in fact, that I'm now doing it for a living.

12:16 PM  
Blogger doulicia said...

I, too, would like the "Economics" link.

HollyRhea, good for you! I thought douladom was on hold for a while.

12:47 PM  
Blogger marrie said...

I just gave birth to my third child in May, and I never had a doula, although I considered the option, I couldn't afford the extra expense.

I saw an OB for my pregnancy, but ended up with a midwife for my labor and delivery. I planned a water birth in a birthing suite at the hospital, but I ended up getting out of the tub and asking for an epidural, just after my husband left the room because I asked him to get me something to drink. I found myself alone in the room, with suddenly much more intense contractions. I wish I had a doula at that moment, because I ended up begging for an epidural, and the only thing that got me through transition was the midwife breathing through the contractions with me. She tried to talk me out of the epidural, without talking me out of it, if you know what I mean. I ended up pushing instinctivly right after the anesthesiologist inserted the catheter in my back, but before he gave me the pain medication. He took it out and my son was born 4 pushes later! In retrospect, I should have stayed in the tub. Maybe if someone had been with me I would have.

Still, it was by far my best birth experience, the first time I had no pitocin and no drugs other than the novacaine stuff for the epidural that I didn't get. Thank goodness for that midwife, I thought I'd go crazy waiting for the anesthesiologist, but she got me through it.

I found your blog googling breast yeast, and read some more.

10:06 PM  
Blogger marrie said...

OH, and the point of that long comment was, although we got to the hospital at midnight, and I gave birth at 7:11 am, my husband and I were alone for probably 6 hours of the experience, but the midwife was there for that hard half hour or so of transition, and it made all the difference in the world. So I'm sure that you really help your clients, even if it is fast and "easy" for them.

10:09 PM  
Blogger doulicia said...

Marrie, I'm glad you feel good about your last birth. Your midwife sounds like a good person to have had on hand. Sometimes, just a person encouraging you through that last little bit can be all it takes.

1:17 PM  

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