Announcing The BabyLove Alliance’s Doula Program

As the Executive Director of The BabyLove Alliance, Ltd., I’m proud of many things. I’m proud of our 501(c)3 status. I’m proud of the little organization we’ve built. I don’t think building this or any non-profit is as hard as anyone likes to think it is, but it’s still an impressive little accomplishment. We’re working on creating a program that integrates prenatal education and birth doula support with mental health and medical risk counseling, and I’m working on raising money to open our very own Baby Cafe to provide breastfeeding help and support to families free of charge. Today, I want to tell you about our doula program.

First, a little background: I’ve been a doula for 9 years. I started my career in Southeast Minnesota. Things there 9 years ago were very different than they are in the Twin Cities now. First of all, there were (and still are) only a handful of doulas in the area; however, those doulas were some of the kindest, most caring doulas I’ve ever had the pleasure of working with and I miss seeing them on a regular basis. Second of all– do you know how much doulas cost? I charged $350 for the first two years I was a doula. That was a totally normal fee. By the time I started taking clients again after my son was born (7 years ago), I think I was charging $550. Third, many of the doulas that started as doulas the same time I did are no longer doulas. Why? Being a doula in a solo practice is brutal to maintain over any length of time. It’s hardly steady income, it’s almost impossible to balance with any other job, and if you have kids it requires many sets of extra hands to be willing and able at any given time to pitch in when a doula is called to a birth. It makes it exceptionally difficult for doulas who don’t have family at the ready. It also means almost any doula ends up having to be a stay at home mom.

As my doula fee for private clients crept up, I’ve become acutely aware that, in all likelihood, that fee was out of line with my own family could afford if we had to hire a doula today. Paying what amounts to a mortgage payment or a month’s rent on a doula? Whoa. Now, it would take a book to explain how doula costs got this high, but if you believe in market forces (and, yes, I actually do), then it’s easy to tell it was time for something to change.

So, if you’re keeping track, there are a couple of issues at play: It’s hard for anyone who needs to work a regular job to pay the bills to work as a doula in private practice (how 99%* of doulas in the US operate). It’s hard to be a doula in private practice unless you have a ton of flexible social and family support to help with childcare. It’s hard for families to pay for doulas out of pocket (and no–I’m not going to tell parents to go to extreme measures to pay for doula care). Over 40 studies have found that doula care improves birth outcomes for mothers, partners, and their babies. No study has ever found negatives to doula care. Having access to doula care is a critical part of providing evidence-based maternity care. That’s why The BabyLove Alliance, Ltd. is doing doula care differently than anywhere else. So, here’s what we’ve come up with:

TBLA Doulas (800x800)

The BabyLove Alliance, Ltd.’s doula care is different. The fee for doula care is determined by a family’s income level, and our doulas and providers work as a group to ensure complete collaborative care.

  • Fees range from $150-$800 based on a family’s income (more here).
  • Families are matched with 2-3 of The BabyLove Alliance, Ltd.’s doulas, whom they will work with during pregnancy, birth, and postpartum. We call this a “pod”. They work together as a team to help families throughout their pregnancies and attend births based on a rotating call schedule. This way, the doulas can balance jobs, kids, life, all while being paid a fair wage for their time spent with clients.
  • The program starts with a comprehensive intake to make sure we can do our best job of supporting our clients. If necessary, we may have them work with other professionals in our organization.
  • Our doulas are accountable to the organization and to each other. They are trustworthy, professional, and kind– a must for any birth professional you’d hire!

I really, really, really believe in this model. It’s sustainable. It’s the most fair to everyone. Yes, others are doing similar things in the US (maybe?), but I think it’s enough of a difference that doulas and families looking for doulas should take a look.

To find out more, shoot me an email at info@thebabylovealliance.org or call me at 651-200-3343.

Or, attend one of our upcoming Doula Information Nights to meet our doulas, have a chance to ask questions, and to start the process of working with our program. They are: 

  • February 26th, 7PM
  • March 25th, 7PM
  • April 22nd, 7PM

At BabyLove– 4590 Scott Trail, Suite #102, Eagan, MN 55122

Having a doula is more within your reach than you think. Being a doula is something you can actually do. Hooray!

Warmly,

Veronica

*I’m totally guessing there. 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Is there a problem with doula care?

Last week Choices in Childbirth released a report on doula care and insurance coverage. As someone who is deeply interested in the subject (and very opinionated on the specific barriers and possible solutions), I found it very interesting and even useful. Unsurprisingly, the report also became fodder for an anti-doula option piece. On Slate, Elissa Strauss wrote the very click-baity titled piece “More Doulas Can Lower the Cost of Childbirth. There’s Just One Problem.” My mom actually ended up sending my the link, asking me if I could believe what she wrote. I read it. I yawned a little. It was nothing I hadn’t heard before, but I think it’s still a good idea to address her article point by point.

Point #1:  Doulas aren’t regulated or licensed

Yep, this is totally true, and realistically, it is creating a major issue in many ways. In fact, Strauss writes,

Anyone can call themselves a doula without any training, certification, or practice. I could declare myself a doula right now. So could you.

Some doula trainers that I totally respect and admire have pointed out the number of certifying organizations has increased exponentially in the last couple of years. Every program is a little different, some requiring more documentation than others, some having in-person trainings while others are mostly done online. Not every organization promotes certification, either. Certification can protect families by knowing that, absent any other regulations, the doula can be sanctioned by her certifying organization. I am a birth doula who was trained to be a doula in November of 2006 and have been certified through DONA International since August 2007. Currently, no doula organization is accredited, either; however, Lamaze International IS an accredited childbirth education program.

I have more opinions about this specific subject than can fit in this post, but parents can still find doulas who are held responsible in some way, shape or form. Which brings me to her next point:

Point #2: Some doulas resent certain protocols

OK, so this is a really sweeping generalization, and I’m not sure if it makes for a good argument about why doulas are in of themselves bad. However, yes, my experience in the last 9 years is that there are doulas who can push the limits of what a non-licensed professional can and should do. However, in the absence of a standardized Scope of Practice (I follow the scope and standard of practice as set forth by each certifying organization depending on which hat I’m wearing), it’s up to the hiring party to figure out what that needs to look like.

Point #3: They are biased!

This is a tricky as heck little paragraph. Strauss states,

With standardization, women, as well as insurers, could feel confident that the doula they hired would be providing them with sound advice. This means providing information that is accurate as well as unbiased. Doulas currently have a reputation as being advocates for intervention-free childbirth; for many of them, having an epidural is a sign of personal weakness and/or capitulation to the medical industry and maybe just a big, fat failure. (Note how the report mentioned above doesn’t distinguish between C-sections and epidurals in terms of their potential value to mothers.) There are some good—if often overstated—reasons to avoid epidurals, but there are also manygoodreasons to get one. It would be unfair to women to populate our labor and delivery units with doulas who insist that childbirth will not hurt too much if the mother just remains calm and breathes.

First of all, as I’ve stated before here, too often the discussion of pros and cons is labeled as being biased. As far as I know, at no point was the CiC report meant to be a comprehensive report on the use or overuse of maternity care interventions. If Strauss needs to be enlightened on evidenced based maternity practice, I’d suggest she start by looking at the groundbreaking Obstetric Care Consensus “Safe Prevention of the Primary Cesarean Delivery” released by AGOC and SMFM. Maternity care in the US needs to be be improved in all metrics, including cost.

Second, all humans are biased. All professionals are biased. However, some are better at recognizing their biases and at removing those biases from their day to day professional interactions. As a doula, I would never, ever talk a mom out of an epidural. Now, that’s different than telling a mom who has a baby’s head halfway out that the epidural might take longer than the one push needed to finish giving birth. No care providers, be they doulas, nurses, midwives, or doctors, should ever, ever, EVER disrespect or manipulate patients. Period.

Point #4: I didn’t have one

Whenever I read or hear discussions about public health policy, it’s really silly to bring any one person’s experience into the larger discussion. Really, it’s not how anything scientific ever gets done. Since Strauss didn’t have one, it’s a great reason to ignore a really well-done report, I guess. Or it’s not. Let’s go with this being a bad reason to ignore the report, ok?

Overall, the piece points out nothing that those of us who are working on doula care access don’t already know, namely that we have a lot of work to do on standardization and definitions before we can even talk about reimbursement. And on it’s face value, it’s possible that Strauss could have written a more thoughtful piece on the other issues that exist in doula care being covered health services. Instead, it comes across as a piece to justify her own rejection of doula care under the guise of commenting on the Choices in Childbirth/ Childbirth Connection report.

Interestingly enough, the use of doulas to improve a medicalized life experience have popped up in conversation about health care on the other side of the life continuum: Death. PBS’s Next Avenue brought up the topic this week. My ideal solution to gain access to doula care as a covered service recognizes that there is a need for emotional and physical support for patients in many different health care scenarios. A proper doula serves as a conduit, a guide, a translator, and a constant companion who is wholly invested in the emotional support of the patient and his or her family. Doulas fill the gaps.

My post is by no means meant to be a comprehensive discussion on the state or future of doula care. I do have very practical, actionable ideas on insurance coverage of doula services that I’d be happy to talk about with people in person. But just because a writer on the XX Blog thinks doulas are terrible, it’s no reason you should too.

Speaking of doulas, the non-profit I run, The BabyLove Alliance, Ltd, offers doula services on a sliding scale. Our very first Doula Information night is coming up on January 29th at 7pm at BabyLove at 4590 Scott Trail, Suite 102, Eagan, MN. Come meet our doulas (who aren’t pushy, btw), find out what makes our doula services more complete than anywhere else, and ask any questions you have about having a doula at the birth of your baby. Email info@thebabylovealliance.org or call Veronica at 651-200-3343 for more information. Spread the word!

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.