Boundaries are absolutely crucial in maintaining a healthy relationship with anyone – family, friends, and doula clients. We teach people how to treat us.
WE TEACH PEOPLE HOW TO TREAT US.
This applies to our children, our partners, our extended family, and our professional relationships. If someone is trying to take advantage of us or not respecting our boundaries then we can (a) let them (b) teach them better. From the first interaction we have with a client we are establishing what our boundaries are, which means it’s necessary for US to know what our boundaries are!
Doulas are giving – by definition we are choosing to be a servant to a laboring mother. So often I see doulas wanting to give, give, give – which can be wonderful, but it’s also a problem if we’re not establishing healthy boundaries. We cannot serve and help and energize a mother in labor if we’ve depleted our own reserves already. We MUST take care of ourselves in order to better serve those we love, be it family or clients or friends. At some point we will drain ourselves and not only will we suffer for it, but everyone around us will suffer. This applies emotionally & physically – with our patience, our energy, our enthusiasm, our loving attention, and our time. Doulas can become so physically and emotionally exhausted during a birth that they can not drive home safely! And once home they can be so drained that they aren’t able to give their family the attention and love they need.
What’s the solution? I don’t know, but I can tell you what I’m trying!
Establish your boundaries – financial, physical, and emotional. What are your limits as far as doula work?
What’s your fee? What’s the lowest you are willing to go? For what cases?
What are your financial guidelines for deposit, contract, and balance paid by? What if someone doesn’t respect them? Are you willing to attend a birth for free if a client has neglected to pay you? What steps are you willing to take – or not take – to enforce being paid? Will you keep a deposit if they break the contract? What if they don’t pay you the balance due on time – will you still go on call for them? Do you charge a bounced check fee (does your bank charge YOU one?)
How long will you hold a spot for someone without receiving a contract & deposit? What if they say they want to hire you but haven’t paid within a set time period?
Where are you comfortable meeting for a consultation – their home, a public location, doctor/midwife’s office?
Are you willing to be hired over the phone/email without meeting the client in person first? What if YOU don’t feel good about working with the couple – how will you tell them no?
What’s your travel area? How far are you willing to go and will you charge a travel fee outside that area?
How many clients within any given time period? Under what circumstances would you make an exception?
What if clients go at the same time? Do you have back up? How will you handle paying your back up? What if it’s a free/discounted birth?
What’s your plan for overlapping births or births very close together? Would you go home for rest in between or go straight from one to the next? How long are you comfortable being away from your family?
How long are you willing to go without sleep? What’s your safety plan for returning home with no sleep? Does your contract include the option to leave a birth (with a back up to “labor sit”) if you’ve been awake ____ number of hours?
What if mom is being induced – will you go right away or wait for active labor? What if mom says she needs you right now? What if mom’s water breaks but she’s not in labor – when will you go?
What situations are you NOT comfortable working in? Under what circumstances would you turn down a client? Financial, care provider, birthing location, birthing choices? What would make you say no? Are there any hospitals or care providers you will NOT work with?
What situations are you willing to do for free (or low cost) – adoption placement, deployed spouse, infant loss, teenage mother, premature?
What limits do you set on clients as far as how often they can call/email you? Before being paid? Once paid? What if they call you every day for at least an hour? What if they call after midnight to talk? In what situations would you set a boundary with a client about contacting you and how would you enforce it?
If an extended family member, partner, or client becomes verbally abusive to you how would you handle it? What if a staff member at the birthing facility becomes verbally abusive?
What family events are YOU not willing to miss? Birthdays, school events, holidays, reunions, weddings, etc? Do you tell clients these are times you are unavailable and are you comfortable calling in your back up in these cases?
What events are important to your family that they do not want you to miss? Are there any situations in which you would be willing to miss them? How would your family respond to you being gone, and how would you handle that?
How can you support your partner while you are gone for a birth? What concerns do they have about your doula work and how can you address those?
What childcare arrangements do you have for daytime? Nighttime? Weekends? Holidays? When your child is sick?
What concerns do your children have about you being gone and how can you address those? What can you do to ensure you focus on family time during family time, and not let doula work intrude?
Do you have times you will NOT answer your phone (except for births) or times you will not be checking email?
Are there times you are not available for consultations or prenatal/postpartum visits? Do you let your clients choose any time for your meetings or do you set certain parameters for when you’re available? Weekends, evenings, daytime, etc?
Will you friend clients online? Will you accept friends requests from clients? Accept play date requests during their pregnancy or after the birth? What are you comfortable with as far as friendships with your clients during/after their pregnancy?
Will you work with friends as clients? Family? Acquaintances? Members at your church, parents from our child’s school, mom’s group, etc? Will you charge them? Discounted or full fee?
There are many more questions that arise as a doula, and it’s important to consider these scenarios. Rather than being in an unanticipated position and unsure of what you feel is best you can ponder in advance what your feelings are and how you would like to proceed. Just as in birth, there are always surprises in doula work and considering your boundaries now helps you better handle the twists when they pop up. I’m fortunate that all of my clients have been wonderful to work with, kind, respectful, and fun! There are situations in which doulas work with clients who are not appreciative of their work or worse. It’s important as doulas that we have healthy boundaries and we teach others to respect those boundaries – this truly does help us to better serve.
(Image is me with my doula and the two babies whose births she attended – I am fortunate to now call my doula my friend and doula mentor!)
Hi appreciate you writing this. One question for you and your practice is how do you set boundries postpartum after a traumatic birth. I have a mama who has absolutely no support network and is clinging to me as life support. I of course feel for her and her sitiuation, but it is draining me and my family. I hate to say this, but I really want to just walk away from her but I KNOW that is not the right thing to do.
Kate, thanks for visiting!
That’s a hard situation for everyone involved. When supporting a mom after a traumatic birth I think it’s really important to know your limits and have resources in place for referrals. Are there support groups in your area for whatever her particular situation may be, such as postpartum depression, cesarean support, single parenting groups, etc? Do you have a list of counselors who specialize in PPD, PTSD, and birth trauma? If she birthed in the hospital does the staff social worker have support group or therapist resources? Is there a new mom group in your community which could provide social support? Has she spoken with her OB/midwife to process the birth and do they have referral ideas? Sometimes there are unanswered medical questions and talking with the medical provider and reviewing records may be helpful – but that may need to wait depending on how recently the birth was/how fragile she may be feeling.
And do YOU have support in place? Do you have other doulas or birth professionals you can process without breaching confidentiality? Are you also feeling traumatized by the birth experience and could you benefit from talking it through with someone? Do you have peers you can debrief with and gather ideas from?
For both of you be mindful also of self care – eating well, sleep, sunshine, exercise! If it’s financially an option then a massage is a nice way to decompress.
As far as boundaries – if her need for support is beyond what you can provide, and it’s impeding your ability to care for your family, then it’s absolutely appropriate and important that you set boundaries. Presuming your doula contract with her has been fulfilled and all visits are complete then I would probably say something along the lines of, “I realize you are working through a very hard experience, but I’m concerned that I’m not able to best provide the level of support you need. I wanted to get you some information for local resources who can better get you the care you need.” Then I would set whatever boundaries you need for your own sake – whether it’s letting the phone go to voice mail, only taking calls at certain times, setting a scheduled time for answering emails, not having future visits, or limiting contacting in whatever way you feel is best.
I’m sorry, that’s a tough situation!
Hi~ what a great article. There are definitely a huge number of factors to consider when taking on the role of doula. Up until now, I thought I had this down but now I am looking for advice! I have a client who is having pre-term labor contractions at 32 weeks. They are frequent and some days last up to 8 hours with contractions that are 3 min. apart (but with no cervical change). I know she is exhausted. I have suggested seeking a nutritionist, homeopath and trying different relaxation techniques but as we hit our 3rd week with her as my client I am having a hard time with the expectation of putting my life on hold for 8 weeks! I usually put a 3-4 week window around a due date where I won’t leave town but I have been getting a call every other night with her thinking, “this is it” every time. What kind of time frame do you give yourself when you take on a client. I usually do not take clients around the holidays because I have small children, but took this one knowing that her due date fell well after Thanksgiving. (I told her we are always out of town for 5 days at this time) but am feeling like I would be letting her down if I left. Any advice would be greatly appreciated!
That is a hard situation! My contract states on I am on call from 38 to 42 weeks, meaning I will not leave town, and ideally I am within an hours drive or less of their birth location during that window. I explain that if they were to deliver before that point I would do my very best to get there but that I cannot guarantee I will be able to attend their birth and they would get my back up doula instead (presuming she is available.)
So if your contract has a set time frame for being on call then don’t change travel plans outside that window. You could speak with her about the situation, as it sounds like she may be birthing long before 42 weeks and you may want to bump your time frame informally (or officially) to 36 through 40 weeks instead. If she’s already aware of your holiday plans then I wouldn’t change anything, and I would let her know you’ll be there if possible but there’s a higher than normal chance she’ll get your back up. And make sure you have good back ups in place and aware of the circumstances!
I personally start contracting in my first trimester due to irritable uterus, which it sounds like your client may have. Hydration and relaxation can help somewhat, and anxiety certainly makes them worse! If her care provider isn’t putting her on any type of bedrest/restrictions then I would offer emotional support as you can, but don’t assume she’s going to birth soon. Even with my frequent contractions (every few minutes sometimes for hours on end) I still managed to get to term with 5 of my 6 babies! Hopefully she’ll make it past Thanksgiving. I know it’s hard to feel like you’re on call for weeks and weeks, so I would do your best to keep living life as normal to include making your holiday & travel plans until that on call window.
I hope that helps!