Fees must be paid in full and all requirements for participation completed by the August deadline. Doulas may use this benefit to meet initial requirements to join the registry or as fulfillment of continuing education requirements.

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Comforting Closure—Conversations with a Death Doula is a series of podcasts by end-of-life doula Traci Arieli. Recently, Traci interviewed Patty Brennan for a conversation about her book, Into the Fog: Navigating My Mother’s Journey through Dementia. The book is both a memoir and a guide for families in which the author recounts lessons learned the hard way.

Watch Podcast: Interview with author Patty Brennan: Inside the Dementia Journey. And be sure to check out Traci’s other podcasts. She brings an engaging and gracious energy to her podcasts.

The post Inside the Dementia Journey: What Caregivers Wish Someone Had Told Them (Podcast) appeared first on Lifespan Doulas.

Your homepage is often the first (and sometimes only) page a potential client will visit before deciding whether to reach out. In the world of end-of-life care, your site isn’t just selling a service — it’s offering comfort, clarity, and trust at an emotional and vulnerable moment.

So, what exactly should you make sure to include on your homepage to be sure it is both inviting and effective? Here are my top five must-haves.

1. A clear, compassionate introduction of who you are, what you do, and who you help as an end of life doula.

When someone lands on your site, they should immediately understand who you are, where you are, what you do, and who you help. This isn’t the place for vague statements or industry jargon. Instead, speak directly to your visitors in a warm, human tone.

Example: “As an end-of-life doula in Chattanooga, TN, I support individuals and families through the final stages of life with compassion, practical guidance, and presence.”

Within the first few seconds, your site visitor should feel like they’ve found someone who understands what they’re going through. Avoid burying this in a long narrative paragraph all about your calling to the work, your background and training and every one of your services….  Including where you are goes a long way to showing up in search.

Keep it short, heartfelt, and easy to read.

2. Share an overview of your end of life doula services (NOT ALL THE DETAILS!)

A homepage isn’t where you list all the details about every single service or package you offer end of life care — that belongs on your Services page. 

Here, your goal is to give visitors a quick snapshot of how you can help. You want them to be able to scan and get an instant sense of how you can make a difference in their lives.

On your home page, you can include 3–5 short blurbs that cover your main offerings, like:

• Vigil Support – Presence and comfort during the final days and hours.
• Advance Care Planning – Help with paperwork, wishes, and conversations.
• Family Support – Guidance for loved ones during illness, death, and after.

Each blurb should link to the full Services page for more details. This way, someone scanning your homepage gets a sense of the scope of your work without feeling overwhelmed.

NOTE: At the start of your end of life business, it’s fine to just have a single services page. Down the road as you grow, however, I do recommend expanding your site to include individual pages for each of your core services. This will help you to show up in searches for specialized terms such as legacy projects and vigil support.

3. A warm, inviting photo (yes, of you!)

In end-of-life work, trust is everything — and trust starts with connection. People want to see the human being they’ll be inviting into such a personal and emotional space. That means at least one authentic, friendly photo of you belongs on your homepage.

This doesn’t have to be a stiff “professional” headshot. In fact, photos that show you in a natural, approachable setting often work better. Think soft lighting and eye contact. 

Do NOT take a family photo and crop everyone else out of it, or reuse your professional photo from back when you were a lawyer, or take a quick selfie sitting on the couch.

A good quality image here makes a HUGE difference in terms of relationship and trust building. Grab a friend with a good phone camera or DSLR camera and take 50 photos of you until you get one that feels good! And yes — smile. You can be both professional and compassionate at the same time.

If you have any images of you in conversation with a client, or even a friend or family member posing as a client (with consent, of course), that is even better.

4. A clear call to action (CTA)

The biggest mistake I see on doula homepages? No clear next step. If someone connects with your words and feels ready to learn more, you need to make it very obvious what they should do next.

You should have at least one if not several call to action buttons on your home page – and the first one needs to be visible at the very top of your site before people have to scroll. Make it a button, not just a link, so it stands out visually.

Examples of strong CTAs:

• “Schedule a Consultation”
• “Book a Free 20-Minute Call”
• “Send Me a Message”

5. Build trust & connection with site visitors

Your homepage isn’t just about services — it’s about connection. End-of-life care is deeply personal, and families want to know the person they’ll be working with. A short About Me section on the homepage builds that bridge.

Keep it brief here — just a few sentences about why you do this work, your approach, your training and experience, and maybe a personal detail or two that humanizes you.

This personal touch can be the deciding factor for someone choosing between you and another doula.

Including a few short testimonials from past clients will instantly build trust with your site visitors.

Bonus Tips for an Effective Homepage

While the five items above are non-negotiables, a few extra touches can make your homepage even more effective:

Soft, Calming Visuals: Use colors, fonts, and images that match the tone of your work — avoid anything too harsh or clinical.

Simple Navigation: Don’t make people hunt for your Services, About, or Contact pages.

Readable Design: Keep paragraphs short, use headings, and make sure your text is easy to read on both desktop and mobile.

Final Thoughts

Your homepage is your way to meet clients where they are — at 2am, wondering how on earth they will manage with all the stress and overwhelm of their situation, searching online for a solution. 

It’s the place where first impressions are made and where someone decides if they feel safe enough to take the next step with you. 

By focusing on a clear introduction, a snapshot of your services, a warm photo, a clear call to action, and a brief about section with testimonials, you’re giving visitors exactly what they need to feel confident reaching out.

If you’re wondering whether your current end of life doula website’s homepage checks all these boxes, take a few minutes to review it with fresh eyes — or ask a trusted friend to give honest feedback. Sometimes a few small changes are all it takes to make your site not just beautiful, but truly effective.

Interested in learning more about your options for an effective website? My end of life doula website templates are designed especially for your needs. Clear, easy to navigate, and warm, you can be assured you have an affordable website that can instantly build trust and connection with the people who need your care. You can explore website templates and pricing packages here. Save $50 with your LifeSpan coupon: LIFESPAN!

Sarah Juliusson is the founder of TheWebsiteDoula.com and DeathDoulaWebsites.com and one of the most trusted names in web strategy for doulas and end-of-life professionals. Since 2011, she’s launched over 350 websites that don’t just look beautiful—they show up in search and turn visitors into clients. Sarah is known for her warm, patient approach and her gift for making tech feel human and approachable, guiding small business owners to feel genuinely confident in their online presence.

The post Your End-of-Life Doula Website: 5 Home Page Must-Haves appeared first on Lifespan Doulas.

How does your facility support residents and loved ones who are dying?

• How does your care change once residents are on hospice?
• How do staff members know which residents are on hospice?
• Do you educate residents and their families about end-of-life issues and the dying process? Who is responsible for this?
• How do you support grieving staff members? Who does this?
• How do you support residents after a death?
• Do you offer a send-off ritual after a resident’s death?
• Do you maintain a public memorial space?
• Do you educate residents and families on the realities of CPR for people with their health status? How many of your residents are “full code”?
• Do physicians and nurses routinely check POLST orders before doing CPR, tracheal tubes, feeding tubes, hospitalization, or other medical interventions? (NOTE: Medical caregivers are mandated to check orders by state regulations. Further, any changes in the patient’s condition may trigger a mandatory review and update of their POLST.)
• For patients on hospice, are staff members encouraged to call the hospice team when medical questions arise?
• Have you checked in with your hospice teams to learn what problems they typically encounter when coordinating with staff at your facility?
• Are comfort medications administered on schedule, PRN, or both?

How does the facility help healthy residents prepare for death?

• Do you have a “Living Well, Dying Well” discussion group for residents?
• Do you support residents in preparing Advance Directives?

How does the facility work with end-of-life doulas?

• Have you ever had an end-of-life doula on staff? What were the positives and negatives in the opinion of staff members?
• Did the board invite staff leaders’ thoughts about the need for an end-of-life doula?
• Do staff members support having an end-of-life doula on board?
• Are end-of-life doulas expected or encouraged to chart, work specific hours, or visit a certain number of residents per day?
• To what extent is the doula expected to be available outside of their regular hours?
• To what extent may the doula set their own work schedule and tasks?
• Are patients’ pain management orders shared with the doula?
• May the doula contact hospice directly if the patient shows symptoms of distress?
• May the doula communicate patient care needs with the patient’s nurse directly?

Download this tool as PDF.

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I found myself grabbing the yellow highlighter repeatedly as I read Jane Callahan’s new gem of a guidebook. The author weaves together her own life experience and client stories while synthesizing an overview of end-of-life issues, decision points, and resources. It makes for an informative and engaging read that brings the nitty-gritty of end-of-life doula work to life.

A repeated theme throughout the book is that we don’t know what we don’t know or need to know. This idea resonates with my decades-long perception that, when it comes to navigating our choices in the face of a major life transition, it is not possible to know all the answers, but there is power in learning to ask the right questions. Doulas can help clients identify the questions they should be asking if they want to make informed decisions, prevent trauma, and have agency over their experience. This is what empowerment looks like.

Communication and advocacy are a big part of the doula’s role and a section on end-of-life conversations from the doctor’s perspective was especially helpful, highlighting the work of Dr. Matthew Tyler (HowToTrainYourDoctor.com). His model uses the following framework: helping the person understand their disease and how it will play out, explaining what their options are, asking what matters most to them, and building a plan around that. Jane then outlines a series of essential questions for the person’s care team to create the plan. I believe these questions will provide the structure needed to guide difficult conversations, for both doulas and families.

A section on legacy planning includes a wide range of legacy project ideas and related resources that doulas can use to support clients in the creative process. Legacy work is the outward manifestation of the life review process, answering the questions, Why was I put here? What am I leaving behind? What did I learn? How did I matter? What have I left unresolved?

Here are just a couple of the resources Jane shares:

• Share the Care: How to organize a group to care for someone who is seriously ill, by Cappy Capossela and Sheila Warnock
• Death Nesting, by Anne-Marie Keppel and Dr. Karen Wyatt

The post A Death Doula’s Guide to a Meaningful End by Jane Callahan (Book Review) appeared first on Lifespan Doulas.

Tips for Getting Clients Comfortable in Bed at the End of Life

Palliative positioning has the power to reduce a pain score dramatically, and it’s a skill that anyone can learn. As a massage therapist working in hospice care, I’ve learned that most of what I do to help people is very simple. It starts with taking the work out of lying down.

Tip #1. Start by noticing whether your client looks comfortable. If a client is verbal, of course, we can ask about their comfort, though people will often say they are “fine” when observation suggests otherwise. My assessment of comfort includes nonverbal signs of effort or strain, including facial expression, respirations faster than 20 per minute, and fidgeting.

Tip #2. Check the hips. Clients often slip toward the foot of the bed, causing the bend of the bed to occur in the middle of the spine. If this is the case, have the client scoot toward the head of the bed if they’re able, so that the hips are aligned with the bend. Seek help from family or care staff as needed.

Tip #3. If you suspect the client is still not comfortable, invite them to try something different. My script for this: “I’m noticing X, would you be willing to try Y to see if we can get you more comfortable?” The X might be “I’m noticing that your arms don’t have a place to rest,” and the Y might be “Would you be willing to try pillows under your arms to see if you like that better?”

I place the items, and then I ask, “Is this better or worse?” Keeping our language neutral allows each client to be the expert in his or her own comfort. If the client is nonverbal, I use this same script, watching for nonverbal indications of improvement (softening of the face, slowed respirations, stillness of the body).

Tip #4. Use available materials to fill empty space. Every body part should have a soft surface to rest on. Dangling arms are often more comfortable with a pillow under each elbow. The knees, ankles and low back may feel better with a pillow under each leg.

I use pillows of different sizes, borrowing small decorative pillows when needed (these can be covered in a pillowcase for protection). Towels can be folded or rolled to create padding that is customized to size, and rolled washcloths can fill tiny spaces such as the back of the neck or curve of the fingers.

Tip #5. Stay open to learning as you improve your palliative positioning skills. I am constantly learning new tricks from clients, family caregivers, home health aides, restorative yoga teachers, and other massage therapists. Chapter 4 of Palliative Touch: Massage for People at the End of Life describes palliative positioning for people in recliners, wheelchairs, hospital beds, and other furniture. Visit www.finaltouchtraining.com for more information.

Author

Cindy Spence and Susan Gee teach Palliative Massage for People at the End of Life, a three-day course for massage therapists, end-of-life doulas, and other healthcare professionals. Last year, Cindy conducted a very informative webinar for Lifespan Doulas on Comfort Massage at End of Life. Check it out to get a flavor of her teaching.

Photo copyright Final Touch Training © 2024

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Recently, I was conducting a webinar for end-of-life doulas (EOLDs) when someone in the audience shared that Medical Aid in Dying (MAiD) clients were her specialty and that she travels to other states to “do it.” As MAiD was not the theme of our webinar, I did not pursue questioning her as to whether she personally handles the life-ending pharmaceuticals and what exactly it is that she does. Coincidentally, within days, Karen Reppen, a seasoned community deathcare advocate, EOLD, and National End-of-Life Alliance (NEDA) board member, reached out to me voicing her concern about language related to MAiD in the doula scope of practice. As more states get on board with legalizing MAiD, I expect that the doula’s role in relation to the practice will become increasingly controversial.

Are doulas clinicians?

The American Clinicians Academy of Medical Aid in Dying (ACAMAiD) offers abundant resources on the practice of MAiD and a free online MAiD training for doulas. They believe that:

“The preparations and procedures around aid in dying can be complex and more easily managed by a knowledgeable clinician, rather than a stressed-out but well-intentioned loved one.”

This makes sense. The problem is doulas are not (and should not become) clinicians. Doulas who choose to support clients through this decision and process should become knowledgeable about the logistics and best practices involved and the thorough ACAMAiD training will prepare you to do so. However, in the recorded webinar re-enactment of a medically assisted death, the doula is shown taking the lead in the process. She mixes the deadly drugs, brings them to her client’s bedside, coaches her how to drink the solution, and puts the glass into the person’s hands. Later, the doula observes the person has stopped breathing, checks for a pulse, listens for a heartbeat with a stethoscope, and informs the two daughters that their mother has died. (There is no mention of calling in hospice or the medical examiner/coroner who would be legally able to pronounce a death.) She states, “Doulas are in the perfect position to do this—this is what we do—we do death, and we do it pretty well.” In the event something goes wrong (e.g., awakening, or failure to fall asleep within thirty minutes or die within four hours of ingesting the drugs), doulas are further instructed to be prepared to help sedate the patient by administering phenobarbital via rectal suppository. Does anyone really think these actions are consistent with the doula model of care?

Proposed amendments to the doula scope of practice

The founders of NEDA tried to get out ahead of this issue back in 2017 when NEDA was formed. We intended to proactively address the misperception that “death doulas” are somehow bringers of death or inextricably linked to the practice of MAiD. There was concern that we would face pushback on our emerging profession if the two were linked in people’s minds. I believe this concern remains valid. In 2016, with the founding of Lifespan Doulas, I adapted and rewrote the established scope of practice governing birth and postpartum doulas to include issues specific to EOLDs. Two tenets of the scope are relevant to this discussion:

1. As non-medical care providers, doulas do not perform clinical tasks (e.g., monitor vital signs, administer medication, prescribe treatments).
2. Doulas do not facilitate medical aid-in-dying but may be present per client request.

It is imperative for EOLDs to understand that in states where MAiD is legal, there is a requirement that the individual must self-administer or self-ingest the prescribed drugs through the gastro-intestinal tract. This means that the person seeking to end their life through MAiD must be capable of physically taking the medication themselves. There can be no question that doulas should not administer the meds. What is in question is whether the language in the scope of practice is sufficiently clear on the issue of MAiD. For example, Karen asks, “How do ‘presence’ and ‘facilitation’ differ?” and “Isn’t facilitation really something doulas try to accomplish in all they do?”

Upon reflection, I agree with Karen that the word “facilitation” in this context is too broad and leaves room for misinterpretation. Accordingly, I propose amending the doula scope of practice as follows:

1. As non-medical care providers, doulas do not perform clinical tasks such as prescribing treatments, monitoring vital signs, administering medication, or pronouncing a death.
2. Medical Aid in Dying (MAiD). When supporting individuals who have chosen MAiD, it is imperative that doulas maintain their non-clinical, non-medicalized role. Doulas may provide guidance, education, and planning for the MAiD process and be present as a witness and guide. Doulas are prohibited under the scope of practice from handling medications that will result in a person’s death.

Download the updated Doula Scope of Practice.

MAiD increases risk for the doula.

The doula scope of practice is intended to protect both the consumer and the doula. I believe that when doulas cross the line to provide clinical or medicalized care (which MAiD clearly is), they increase their liability exposure significantly while at the same time creating confusion for both consumers and care providers about the role of the doula. Consider the risk for the doula when family members may not all support a person’s choice to end their life. (Do you want to be in the middle of that scenario?) And ask yourself why some hospices, in states where MAiD is legal, bar their personnel from being involved or even present in the same location for a medically assisted death.

Summary

I look forward to constructive feedback from the doula community and am open to further amending this statement as the conversation develops. Hopefully, the training organizations and leaders of the EOLD movement can be unified in our understanding of the doula scope of practice. I don’t see how we take on a clinical role and still be true to the doula model of care. One simply cannot be a doula and “specialize” in a medical role. As always, doulas can be resourceful, gather information, support informed decision making, and be present at the death for comfort and guidance. Information, support, resources (aka “facilitation”) are always in the doula’s wheelhouse. Handling medications is a hard “no.” Call yourself something else (please).

A debate regarding the pros and cons of legalizing MAiD, as well as ethical concerns related to the practice, is a completely different (and worthy) conversation. Each doula is encouraged to set her/his own boundaries around the practice based on whether they can provide nonjudgmental support to an individual who is making this choice. No doula is required to facilitate an action that contradicts her/his own deeply held beliefs.

—With thanks to Karen Reppen for her edits, insights, and willingness to engage.

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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.

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While mentoring for doulas may be desirable, is it available?

The short answer is “No,” but there may be exceptions. Most practicing doulas are uncomfortable inviting an inexperienced doula whom they don’t know to their clients’ intimate family moments. They may assume that to do so would be a violation of the client’s privacy. They might rightfully question the added value that the “shadow doula” brings from the client’s perspective. For this reason, it really isn’t done, though some doulas may feel comfortable incorporating an unpaid helper into their practices. It might be a bit easier to find a postpartum doula whose client would benefit from yet another pair of hands in the home (e.g., to help with multiples).

New doulas can always ask, but be aware that agreeing to mentor someone is more work, not less, for the doula mentor and there is little incentive for her/him to do so. Presuming that mentoring should be provided free to new doulas is not likely to meet with a positive reception. Humility rather than entitlement will work better. And think about how you might bring added value as a doula mentee to your mentor.

What is a new doula to do then?

If you are not successful in finding a doula mentor, I encourage new doulas to trust themselves, summon their courage, and jump in the deep end after training. You will find a way to be a comfort to the family you are serving even (especially?) if it is your first client. Here are some additional tips:

• Develop (or join) a doula network in your community or online. A lot of informal mentoring is available—doulas helping each other—especially in doula Facebook groups. There are local forums and theme-based groups (e.g., groups with a focus on business topics).
• Consider starting out as a volunteer to get some experience presenting yourself as a doula and grow your confidence. I have noted that after serving even as few as three clients/families, newly trained doulas start owning their title “doula” as they witness the positive effect of their efforts for the folks being served.
• Search for training that incorporates formal mentoring. While not common, there are a growing number of community-based doula programs—often aimed at serving targeted under-served or “at risk” communities. These programs typically offer subsidized training, mentoring, and jobs to community doulas.

Bottom Line: Be your authentic self and don’t promise more than you can deliver. That will take the pressure off. You and your business will always be a work in progress and your clients will always be your greatest teachers.

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Just as no one doula can be the right fit for every family, no one doula training can be the best fit for every prospective doula. Before you get lost in the Sea of Choices and are tempted to give up before you start, let’s establish some criteria for your decision-making. In this article, I will provide a framework for spotting key differences among the myriad of offerings.

Is the doula training in person or online? Consider how you learn best before choosing a doula training.

In-person training has become less common since COVID-19 began to affect every aspect of our lives in March 2020. The social aspect of a live workshop is, no doubt, a significant feature and may be important to you. For birth doulas in particular, there is greater opportunity to practice hands-on techniques, which is a benefit. Downsides can include the need to travel, take time off work, be away from home and family, and pay related travel expenses. Workshops are a very concentrated form of learning, often involving 2–4 long days.

Online training can take different forms, as follows

• Self-paced learning. The student gains access to an online learning platform where the course is hosted, and then moves through the study materials at their own pace. This ensures time to digest the content and follow up on linked resources for a deeper dive. Check whether you have unlimited access, in case you want to review materials in the future. Self-paced learning works well for students who are goal-oriented and self-motivated.
• Live online workshops (on Zoom or similar platform). This option involves sitting at your computer in real time. It can be a convenient choice with a surprising overlap of benefits similar to in-person training including sharing, learning, and connecting with others. For example, breakout rooms on Zoom allow for small group exercises and processing sessions. Hands-on skills can be taught as demonstrations with students arranging to have a “practice partner” available at their location for counter-demonstration and Q&A. Some trainers/organizations will offer online workshops over a weekend, while others might offer a weekly course over a longer period.
• Hybrid courses may offer a blend of both self-paced learning and live, interactive meetings or workshops.

Is professional doula certification offered?

Most training organizations offer certification, but there are exceptions, so be sure and check. Many folks considering becoming a doula are confused about the meaning and value of certification. The main factors to consider are:

• Cost. Is the certification included in the training fee or is there a separate fee? If so, how much?
• Requirements. What are the requirements to become certified? If you are required to get hands-on experience serving families, how do you find the families? How long does the process typically take to complete? Can you even get into your local hospitals as an uncertified doula in order to gain the hands-on experience to become certified, if required (my not-so-favorite Catch-22 since COVID)?
• Is re-certification required? If so, what is involved (requirements, fees)? Many organizations require an annual membership fee for certified doulas, continuing education, and so on.

What are the qualifications of the trainer?

The background and expertise of the trainer you are considering are important. How broad is their knowledge? How deep their experience? What strengths do they claim? What is their reputation? What do others say about them (e.g., testimonials on their website)?

For end-of-life doulas, I have noticed that many training programs have not been developed by experienced doulas, steeped in the doula world and the doula model of care. Rather, they have been created by hospice professionals who are often coming from a clinical perspective and then adapting the training to the doula model. Can a trainer who has never had a doula business authentically teach you to create a doula business?

What is the cost of the training?

Most doula trainings are in the same ballpark in terms of cost, but there are a few outliers. Consider whether the organizations on the higher end are truly offering more value or do they just appear to be savvy marketers? A handful of trainers may offer a significant degree of hand holding post-training, mentoring, or even internships, though this is not the norm. A strict cost comparison, searching for the cheapest doula training available, will likely not serve you well. Plus, there can be hidden costs to doula training, as mentioned above under certification. Make note of the fees, whether payment plans are available, and what you get for your money. Some trainers may offer scholarships or reduced fees for low-income trainees, especially nonprofits who can offset these losses with grant funding.

Does the trainer/organization have a niche/specialty?

We all have our strengths. Most trainers will highlight their strengths and areas of interest or expertise. They may focus on an aspect of doula work they are passionate about or a particular skill set. If their niche resonates with you, then perhaps you have found your match. Does the website you are browsing have some personality? Does it jive with you, your interests, motivations around engaging doula work, and goals for training?

Does the trainer/organization promote a political agenda?

In today’s highly polarized political climate, I have noticed that many doula trainers and organizations are promoting a political agenda. Are their values, as reflected in topics covered and language used on their website aligned with yours? Are you a good fit for their brand? If you are not in alignment, consider whether you want to engage on these topics in doula training, for example, Critical Race Theory. Prospective birth doulas may want to consider your comfort level with the elimination of the words “mother” or “woman” when speaking about birth, in favor of terms such as “person in labor” or “pregnant person.” On the flip side, if your trainer is using gendered language, will that put you off? An organization’s website will provide clues regarding what you can expect.

How is their customer service?

Are your emails promptly acknowledged? Your phone calls returned? Do you have the sense that this person/organization cares about your experience and will endeavor to ensure you are a satisfied customer? If they take days to respond to your questions up front, consider what happens once you have paid XX dollars and experience technical glitches or other issues down the road?

In Summary: What does your gut say?

In this article, we have discussed how to choose a doula training and have given you different parameters on which to base your selection. Start with considering your goals for doula work. As you are searching, makes a few notes about each of the websites, based on these parameters. You may think you will remember, but without some structure to your search, I guarantee your session will end in a cross-eyed blur! Once you have vetted the top contenders, narrow down your choice to the top two or three. You are seeking the right match for your goals, learning style, personality, and pocketbook. In the end, choose the doula training that is right for you—go with your gut!

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