Building my SUSTAINABLE doula practice

I wrote an article when I first started doula work called How I’m Building My Doula Practice as a guest post on a marketing blog. Now, 3.5 years into my work as a birth doula, I run a successful, well-known and full doula practice. Along with taking 4 clients per month, I also teach a doula training program called Wise Woman Way of Birth and Birth at Home prenatal classes for expecting parents. Things are thriving, and getting better and better every month.

Being on call, juggling the free initial interviews, prenatal visits, teaching classes with running off to a birth at any moment is a very specific lifestyle. I put in full-time days on the marketing/admin/development side of my business, plus drop everything to go be with a family when their baby decides it’s time to come out.

The good news is, the busier and more experienced I get, the better I am at clearly laying out my role to my clients and at setting boundaries to allow for self care to make sure I can serve my clients at 100% of my ability, as well as to ensure that I don’t  burn out from the birth work lifestyle and need to quit as I get better and better with experience!

If you haven’t already read How I’m Building My Doula Practice, go check it out! As a follow up, here’s how I’m moving more and more towards building a SUSTAINABLE doula practice:


1. Being organized

If there’s anything I can recommend to new doulas, it’s to get good systems in place from the get go. A while go, my colleague recommended I start using Wave Accounting. It’s a free web app that tracks income and expenses and generates receipts, and I truly love it. It changed my life in terms of tracking income and expenses!

Another way I stay organized is by using Acuity Scheduling, an online scheduling system that takes out a lot of the back-and-forth emailing involved with scheduling and re-scheduling client visits. This is extremely important in a job that requires a lot of shuffling visits around births! It also saves client files, intake forms, and visit notes to help keep track of my clients.


2. Having a good team of other doulas for on-call coverage.

Speaking of back-ups, if you’re going to run a doula business, you need to have a good back-up doula system. Whether you take 2 clients a year or 6 a month, birth is unpredictable and it’s only responsible to have a good back-up plan  for potential birth overlaps, or in case of illness, etc.

When I was a new doula, I would only take one client every two months because I was terrified of overlap. Now, as an experienced doula, I often wish I could find 5 clients a month with the exact same EDD, because then I feel like I would know with almost certainty that they wouldn’t birth on the same day! The first time I ever had an actual overlap of births, the client’s due dates were almost 6 weeks apart. You just can’t plan these things!

In addition, having a good back-up team means that if I’m at a birth with a client, and another client needs support for an urgent question, I can have them call one of my back-ups. This way, they have access to support for an urgent question if one comes up, and the birthing client I am with at the time still gets 100% of my attention.

3. Sleeping

My university-era insomnia trained me well for birth work. I’ve never been a very good sleeper, and even when I’m not at births, I usually only sleep for a few hours at a time. I can go for quite long stretches without sleep and feel 100% fine.  However, I AM human and occasionally even my eccentric, non-sleeping self requires a bit of catch-up shut-eye.  Often, it’s enough for the birthing woman’s partner and doula to spell each other off for sleep breaks (and that’s one of the reasons people hire doulas in the first place!). However, sometimes I might need a sleep break during a time where the family also is needing focused doula-support, and in that case, back-ups I can call for help are a must-have.

When I was a new doula, I would have felt extremely guilty calling in a back up to relieve me for a sleep break. It is always a balance between using a back-up in these situations so the primary doula can rest, and in limiting the coming and going of new people, which can also impact a birth. Sometimes it’s more appropriate to just take a break if it’s at a time when the clients don’t really need me there full-on, but sometimes reinforcements are necessary.  So if I’m tired, I ask for help from my colleagues.

4. Setting boundaries for work-time and down-time

I do my very best to get back to my clients ASAP when they email or text me questions looking for information or resources prenatally. But I’ve been training myself to practice knowing that, while I absolutely am available for urgent questions or birth support, I don’t need to be answering emails around the clock. Not only that, I of course can’t be juggling answering emails while I’m at a birth with another client who needs 100% of my attention.

I let my clients know that, due to the nature of birth doula work, I am occasionally am away from my home office for several days at a time, and may not always be able to respond to emails quickly. I make sure they know that I am only able to respond to non-urgent calls and emails during daytime hours on weekdays, and that it may occasionally take me a few days to return a non-urgent call or email if I’m at a birth with another client. I also make sure they know, of course, that for URGENT questions (or if they’re having their baby!), I’m available around the clock.

5. Taking days off-call

A hike in the mountains, a snowboarding trip, having a glass of wine with girlfriends are all activities that are complicated by being on call full-time! For birth doula work to be sustainable, we need days off just like any other professional. I now have as part of my service agreement that I take up to  6 days off-call per month, where I have my practice partner cover client calls.  Keep in mind, most working folk get at least 8 days off per month, but I love my job and feel 6 days a month where I can turn off and enjoy my personal life is all I want right now to keep me energized and refreshed and excited to get back and give my clients 100% of my energy for the rest of the month.

To maximize client care, I now work in a partnership with my colleague, Kaz Hiroe, who covers for me for a few off-call days each month, in order to ensure clients get access to a doula who is rested! She also is my primary back-up in the event of needing coverage for birth overlap or sleep breaks, as noted above. You can learn about how we work together here.

This is all clearly laid out in my service agreement, and most of my clients react in shock when they realize I only get 6 real days off per month!

Although the on-call nature of birth work demands a very specific lifestyle, most of us wouldn’t trade it for anything! If I don’t go to a birth for more than 2 weeks, I start going through withdrawal… I catch myself staring at pregnant women in grocery store line-ups wondering, “Maybe she’d let me come to her birth?!”. Still, it’s important for this work to be sustainable so that I continue offering care to clients for a long time in the future!



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