Comparing Births: a Real Mistake

We have a previous client who had a precipitous – very fast- birth with her first child. Her doula arrived just after the baby was born and helped her come down from the adrenaline rush and settle in with the new baby. The doula provided weeks of on call and even more weeks of being available for contact and assisting her along the way. She is pregnant again and is fearful that this birth may be fast again. But she is concerned about whether to hire a doula if it does.  The fact that she called her doula again this time, tells me that she saw value in having the doula the first time. She asked the doula if she would offer a refund if she had the baby in the car on the way this time.

Those of us in the birth business know that each birth is a stand alone and may not be anything like the last one.  I reminded the doula that there is value in her work prior to the birth and this mom knew it. That is why she wanted her again. But I also offered a different thought approach. What if the doula charged the way other professionals did- by the hour.  I used to work a job where we billed by the quarter hour- so I wonder  if this client were charged for each phone call, text and email, what would that actually cost a client? I wondered if she wanted that prior support and then if she had a longer labor, would she still want an hourly rate? (I realize there are doulas in this town who charge for the interviews, limit the labor support to a certain amount of hours and charge  for teleconsults. We do not do this. Our fee is the same whether it is a fast labor or a long labor.)

Recently I had a client who during her labor kept comparing her first labor with her current one. But there were lots of different variables at play that she kept having to be reminded  of. This pregnancy was almost a month longer, thus the baby would most likely be larger. Her water broke the first time and was intact up until nearly the end of this labor. But I feel like this mom struggled with the comparisons all through her labor and birth. I was with her twice as long this time – her labor was three times longer than her first. Each labor is a stand alone labor. You never know.

apples to oranges

We recently were contacted by a mom who had a gentle birth with her first baby without a doula. She then found out late in this pregnancy that she had placenta previa. This means she will have to have a planned cesarean. The news was devastating. She has contacted us to see if we can provide guidance regarding her planning a gentle birth albeit a cesarean. She and I had an hour long conversation regarding her options. I did not charge her for this time as I saw it as helping her change her birth experience and time I can offer her. She is meeting with one of our doulas who is available during that time to consider having a meeting with a doula  prior to the date of her surgery and have adoula prior to her going to the OR. She is not going where a doula is usually allowed. But she wants the doula to stay to help her afterwards if the baby is able to be with her afterwards. She feels there is value in helping her prepare and be ready for her surgery. There is value in having a doula along the journey.

I had my fastest labor with my first daughter. I had my longest labor with my second child, my son. My third child fell in between the two in length. I have doula’d for moms who had such a fast labor the first time with having a baby as soon as she walked in the hospital door. She was convinced by her doctor to be induced so that would not happen again. Her induction was long and difficult. She said later it would have been easier to have a baby in the car! I had a similar situation with a mom who was due during the Olympics here in Atlanta years ago. The doctors convinced her to have an induction so she would not be stuck in traffic. Her labor was made more difficult than her prior labors and births due to a fear of inconvenience.

I am not sure what that previous client will do this time around. I do know that often much of the work of a doula is prior to labor beginning. I also know being hired last minute without a time to establish that early relationship is sometimes difficult as well.  I understand that there are a lot of doulas who charge for consultations if someone is not a paid doula client. I am often on the phone with women and couples who want to understand their options.  I currently do not charge for phone calls where I feel like I am helping to guide them in a gentle birth but I am also being a birth change agent. Often if I am available, these conversations will lead to them hiring me. More often I am no longer available to them and they may hire one of the doulas in our company. Occasionally they will hire a doula elsewhere or not at all.