Should Doulas Volunteer Their Services?

Part 1

Volunteer doulas and volunteer doula programs have fallen out of favor with an outspoken segment of the doula community who view them as devaluing the role of the doula. The word “demonization” comes to mind as the tone of the criticisms and pushback on social media has become increasingly polarizing. One doula Facebook group bans anyone from participation who even suggests that doulas volunteer or discount their services. It is forbidden.

I think there are a few different doula groups, motivations, and themes at play that I intend to explore in this three-part blog series. Here is a summary of the groups/viewpoints as I see them.

Professional doulas who charge fees for their services. The complaint from this group is that volunteer doulas undervalue the profession and compromise the professional’s ability to earn. They argue that volunteering or low-balling doula fees sets a cultural expectation that doulas aren’t worth much, adversely impacting other doulas’ ability to make a living. In other words, why would people pay for services they might procure for free?

Inexperienced doulas who lack the self-confidence to charge fees. This group prefers to gain experience through pro bono doula work before presenting themselves as professionals and launching their doula businesses. The counter viewpoint claims that doulas should charge top dollar out of the gate (immediately after doula training) because they are worth it.

Doulas who feel called to work they love. The claim from this group is that they love the work so much that they would do it for free. Therefore, it feels wrong to charge for their services. 

Doulas who believe that every family who wants one deserves a doula. Many doulas living in low-income communities have a strong desire to serve people who could benefit from services but are unable to pay. The flip side of this argument is that doulas provide a luxury service for which clients ought to pay market price.

Should doulas volunteer their services? Part 2

First, a disclaimer . . .

I was the founder/executive director of two nonprofit community-based volunteer doula programs in Michigan from 1998 through 2014. Both programs served a dual purpose:

1. Improve birth outcomes by providing free birth and postpartum doula support to low-income families during pregnancy, birth, and the early weeks postpartum; and
2. Provide a venue for newly trained doulas to gain firsthand experience with clients and complete professional certification requirements. As a doula trainer, I repeatedly witnessed the “fire in the belly” of student doulas at the close of a training weekend only to see the fire go out when, months later, many had failed to find an opportunity to put their new skills to use. Our Doulas Care Program provided that opportunity.

Thus, in the past, I have promoted the role of volunteer doulas. At the same time, I have always taught business skills to doulas and championed an entrepreneurial mindset for those who want to earn their living doing doula work. I don’t believe these two positions are fundamentally incompatible. Some doulas feel “a calling to serve” while also enjoying the personal freedom of not needing to generate an income from their work. Others simply can’t afford to take unpaid time away from family and other commitments while still needing to generate an income, but if someone else can and wants to, isn’t that a win/win? Isn’t there room for all of us?

Do volunteer doulas lower the value of the professional doula in the marketplace?

As a professional in the doula world for 40+ years, I have noticed I am most likely to complain about my competitors and get wrapped up in what others are doing when I am struggling, when I am worried that I don’t have enough (clients, money, etc.). Or when I’m feeling lost and unsure what my next move should be. In other words, when I am in scarcity mode. My husband used to say to me, “There’s always room at the top” (so true, as excellence is always in short supply). Also, “competition is moot.” The message was to stop worrying about what others are doing and focus on myself and my business, my clients, and the opportunities at hand. This shift in mindset is key to success.

Our challenge is to effectively articulate the services we offer and the value we bring to families as an ally for the challenges they are facing. When we concentrate on what others are doing—for example, seeking to blame those who volunteer their services for our own lack of success—we become hopelessly mired in scarcity. When we focus on our strengths, the value we bring, we move ourselves from scarcity to abundance. Henry Ford famously said, “One man thinks he can, and one man thinks he can’t. They’re both right.” In other words, my answer to the question “Do volunteer doulas lower the value of the professional doula in the marketplace?” is “Yes, but only if you believe it to be true.”

One of the great benefits of self-employment (and there are definitely a few drawbacks) is the freedom to choose your own gig, set your own rules and rate of pay, and work with whomever you choose. You get to decide if you want to offer “a luxury service” for people of means, set your fees at or below market rate, or simply volunteer. It’s really no one else’s business.

Getting Your “Sea Legs” as a Doula Volunteer

Many (most?) newly trained doulas desire mentoring. Ideally, they would like to be a “fly on the wall” for a handful of doula intake interviews, observe the doula in action, and perhaps debrief the experience after the fact before flying solo. While a volunteer program can raise funds to cover on-the-job mentoring, it is a rare doula or doula trainer who can regularly accommodate this need. The lack of hands-on mentoring opportunities for “newbie” doulas may reflect a reluctance on the part of seasoned doulas to introduce a stranger into what is, ultimately, the very private experience of her clients. So, in the doula world, the way it works is, we dive in the deep end after training, endeavor to do our best, and learn on the job. And it does work (for the most part)!

Some folks come to doula training with a great deal of professional experience in a related field. Some are already business owners. Others are young adults, with little professional exposure and limited life experience. I believe that volunteering services for a handful of clients after training is a reasonable way for doulas to address any qualms they may have around presenting themselves as professional caregivers. Volunteering is a way to dial down the pressure and performance anxiety. As doula volunteers move outside their comfort zone to engage the work, their clients affirm and appreciate their efforts. And sooner than you may imagine, the doulas feel ready to start charging fees for their services.

Doula Work as a Mission or Sacred Calling

There are still others who feel a strong calling to use their doula heart and skills to relieve suffering in their community, serving lower income families who could benefit from support but cannot afford it. These folks are not entrepreneurial in nature, nor do they aspire to be. They cannot imagine charging money for their services and feel a sense of joy and fulfillment in their work. I, for one, am grateful. When a busy professional doula must turn someone away for inability to pay for her time, isn’t it a comfort to know that there are others out there who are willing to step up to help?

Should doulas volunteer their services? Part 3

The notion that heart-centered work and making money are fundamentally incompatible is a false dichotomy. It is possible for doulas to do both—choose a path of service to others and thrive financially!

Let’s not . . .

• Promote the idea that one is forced to volunteer because families can’t afford our services.
• Convince ourselves that because we would do it for free, we should do it for free.
• Make excuses and blame others for our own lack of success in creating a doula business.

What if they can’t afford the doula’s fees?

There are many variations on this theme and not all of them stand up to examination. Following are some considerations.

“Can’t afford” is relative. People are weird about money. One person’s “can’t afford” might translate to assets are not liquid, or they don’t want to cut into their children’s inheritance, or they are cash poor because they just bought a new vehicle, while another person’s “can’t afford” means they are choosing between which overdue bill gets paid or how much they will have left to pay for gas and groceries. Clearly one scenario draws more sympathy than the other. However, my intention is not to minimize the real anxiety someone might experience about dipping into their savings to pay for the doula’s fee. We can acknowledge their anxiety is real without judgment and without feeling compelled to rescue. They will figure it out.

Require some skin in the game. Being a doula does not mean that we are all-giving all the time. It is better for both parties to expect and give something in return, to both appreciate and feel appreciated. You can get creative here and keep it simple so that it doesn’t add to their burden. I was often asked to waive childbirth class fees for expectant parents on Medicaid. My counteroffer included asking whether there was a portion of the fee they could cover, or suggesting they provide a snack and beverage for one of the group sessions. One couple was proud to bring popcorn, apple slices, and iced tea as their contribution. Not going to break the bank, but it was something, and they knew I was counting on them. An exchange of energy.

As a volunteer doula, you might ask that clients reimburse your out-of-pocket expenses, for example, gas, parking fees, childcare. Or you could share a “wish list” of doula supplies (with different price points) to which they might contribute, to help you on your doula journey. Or you could request that they give permission for photographs to be taken of you in action for your website along with a testimonial. These are just a few ideas.

Focus on what you are willing to do without compensation (if anything). In the face of dire need, doulas can easily become overwhelmed. I have faced, on more than occasion, a black hole of need threatening to suck me in. Doulas need to be careful in these situations or we will become burned out well before our time. Rather than focusing on the fact that I may not be positioned to take on the super needy, super under-resourced client, I have found it helpful to think carefully about what I can do. This positive reframing puts me on a track of setting strict boundaries, while identifying measured ways to help. Clients will follow our lead, especially if our messaging is consistent and our actions are congruent. If the arrangement is open-ended and unspecific, then the doula can expect to get sucked into doing more than she/he may find manageable.

Examples of “measured support” include:

• Offer to do a one-time consultation with the family to assess their needs, share resources, and begin to create a “circle of support.” Set an expectation regarding how long the consultation will last.
• Set up a Meal Train or similar online support calendar. Encourage them to identify a helper who can keep the calendar updated (not you).
• Commit to limited ongoing doula support in the form of a visit or shift at a frequency that is sustainable for you.
• Help them think outside of the box regarding community support that may be available to them (e.g., their faith community, veterans group, fellow yoga class members, extended family, neighbors, local Facebook groups, etc.).
• Make a decision regarding how many (if any) pro bono doula clients you can serve per year.

Remember, it’s okay to say “no.” No one is entitled to your time and energy. When folks seek free services, request a discount, or express dismay at your fees, that’s not a big deal. They are just trying to get their needs met. We don’t need to judge them or even feel put upon. Nor do we need to feel guilty. We are not obliged to be their solution. It’s okay, necessary even, to have a clear sense of what you can do as a doula and what you cannot. Having a robust set of community resources and referrals for lower-income families at hand, including referrals to the volunteer doulas and doula programs in your community, will help you to honor your boundaries in the face of overwhelming need.