This week I saw this meme.

It made me want to write about what you get when you hire a doula.

The birth/wedding spending is a very well known analogy in the birth world. Most people spend A LOT more time and money planning for their wedding day than they do for their birth.

I’ve written about this before here.

So why do I feel compelled to write about why doulas are worth the money?

Because I keep hearing/reading stuff about the fact that doulas are expensive.

This simply isn’t true.

The fact that people are reluctant to invest much time and/or money is preparing for their birth is a reflection of the low value our culture places on motherhood, and of a lack of understanding of the impact that birth has on women, and on society as a whole, but this is a topic that deserves its own blog post.

I’ve written recently about the value of a doula, but this time I’d like to explore and explain what you really get when you hire one and why it’s worth every penny.

My friend Maddie McMahon also wrote a brilliant blog about doulas and money this week.

And doula SallyAnn Beresford also wrote about budgeting for your birth.

I’d like to correct some misconceptions about doula work and its worth.

I think the biggest misconception is that you hire a doula to support you through the birth of your baby and that’s all that matters.

Recently a colleague was asked how much she’d charge to only come to the birth, and do no antenatals.

This has happened to me too and I had to explain it just doesn’t work like that.

Much of the work we do is in the preparation, the getting to know you and the support and information we give prior to the birth.

I saw another meme last week that summed it up very well “the power of a birth plan isn’t the actual plan. It’s the process of becoming educated about all your options”.

It’s a big myth that there is no point writing a birth plan because birth is unpredictable (and I encourage all my clients to write 3 births plans (Read about this here)

So back to what you get from your doula, and I’m in the thick of it at the moment as I’m supporting a woman pregnant with twins and one planning a VBAC , one having her first baby, one having her 2nd baby and one having her 3rd (they are not all due at the same time!).

The minute you hire a doula, she’s completely dedicated to you.

Whilst most of us have letters of agreement that cover a certain number of antenatal appointments, we also state that you get unlimited phone and email support from us.

These days I’m in contact with my clients via email, text, phone and whatsapp groups.

All this work can seem invisible because it’s not face to face, but I spend hours for each client beside the face to face meetings, researching information for them, on whichever topic they need information about.

I send them various signposts, from online articles, examples of birth plans I’ve collected through the years, books etc. I contact other people for information when I’m facing a situation that is new to me (this happens all the time by the way as everybody is unique).

I help them write their birth plans, reading through and making suggestions about things they haven’t thought about.

I send them up to date hospital policies that I’ve managed to collect through my knowing of the right person to contact at the hospital.

I lend them books and DVDs, slings and other pieces of equipment.

I signpost them to the huge network of midwives, doctors, osteopaths, massage therapists, and other complementary practitioners that I trust and with whom I’ve built links over the years in my community.

I suggest they meet with a different consultant or with the consultant midwife, and I often accompany them to the appointment.

I’m truly passionate about this (and all the doulas I know are too), so I put absolutely no limit on the time I spend doing this.

With more complex pregnancies,  it can mean an incredibly high number of hours.

And of course I meet face to face with my clients at least twice antenatally (not including the first time we meet for an interview).

I prepare extensively for these appointments, discussing what they want ahead of time and preparing the right props to take with me.

I listen deeply to their wishes, their concerns and worries, and I try to provide the information that maximises the chances of them achieving these wishes.

This is the antenatal prep.

Then there is the on call period. Most of the time we go on call from 38 to 42 weeks pregnancy, or until the baby is born which can be longer than 42 weeks.

This means that for up to a month (it’s pretty rate that it’s shorter than 2/3 weeks especially for first time mums, and I’ve been on call for 5 weeks in the past), we are on standby 24/7.

We literally put our life on hold. We don’t go away more than an hour from our house. Most of us have young children ourselves so we have to make very complex childcare arrangements to be able to drop everything and come to your whenever labour starts (including at night). We can’t drink alcohol, even at a party. We can’t let our hair down. We tell all our other professional engagements that we’re on call and may need to cancel at short notice (“unless I’m at a birth” becomes a recurrent sentence).

We pack clothes ready for the next day so we are ready to disappear in the middle of the night when needed. We need to be careful what we wear in case we have to hot foot it to the birth. We repack our doula bag, making sure everything we need is in there, and replenishing supplies.

Our phones are glued to us 24/7, and placed on the bedside table at night (And we’re always making sure the battery is charged).

We sleep less well (we experience a level of heightened alertness and often wake up at night to check our phone in case we missed a text/call from you). We always make sure we are reachable, are paranoid about phone reception which something means giving someone else’s landline just in case (some clients live in areas with poor mobile reception).

Our clients are always on our mind. We care deeply for you at this vulnerable time.

We know that we might need to come to you very quickly when labour starts. We never know when.

We have to remind our partners of the fact that we may disappear in the night or day, and make sure they know what’s happening with the kids etc.

Our partners and children find the unpredictability difficult to handle ,especially as they don’t know how long we’ll be gone for.

We keep telling our friends and family : if my client calls I’ll need to go. I choose to take the car instead of the bus when going to town, incurring extra parking charges, because I want to be as quick as possible in case I get called, plus my doula bag is usually in the car and it’s really big. I have to remind my kids when we go to the park or the cinema, remind my husband when we go for a rare meal out. Several times I have had to tell my choir leader at the beginning of a concert that if I may need to disappear.

We miss study days and conferences we have paid for because we don’t feel safe going that little bit further away in case labour happens during that time.

It takes a very special kind of person to cope with this level of unpredictability and low level tension on a constant basis. It gets easier as you become more experienced but it never quite get to the state when you feel completely relaxed.

The on call period is up to 30 days, 24h a day. This can mean a total of 730h or more. So if you think that my birth package starts at  £950, one third of which is for the on call period, that’s 316 divided by 730, which amounts to 43p per hour. Not exactly minimum wage hey?

Then there is the birth itself.

I’ve been a doula for 6 years and the shortest birth I attended was about 3h long (I always stay a few hours after the birth to make sure mother and baby are ok and help with establishing feeding etc, so I was there for 6h). The longest was 4 days. The average was 21h.

We spend hours supporting you and your partner, holding you, massaging you or whatever other comfort method helps at the time, managing on very little sleep and food.

We help you navigate unexpected curve balls. We stay strong. We cheer you on.

We have a firm commitment to the families with support and we’re not going anywhere until the baby has been born.

When we get home after a birth, we often take days to recover.

Then there is the post birth support. I offer a minimum of one postnatal visit and unlimited phone and email support for 6 weeks after the birth. I also offer standalone postnatal support for an hourly rate of £25.

Some parents take to parenthood like a duck to water and require very little support from us. The shortest postnatal job I’ve done was a one-off visit of 3h. The longest one was 2 years.

Some parents have very complex situations to deal with and this can mean hours of support.

I recently supported a new mother of premature twins so she could achieve her goals of breastfeeding them and this took much hard work, sweat and heartache, with incredibly rewarding results at the end.

Some parents struggle with feeding, with adjusting to being parents, with sleepless nights, with conflict with their partner, with being a single parent, with complex medical situations and more.

We’re there for them and we don’t go anywhere until we have helped them achieve their goals. We move heaven and earth, we reach out to other knowledgeable people, we spend hours talking and researching topics.

I haven’t written this to moan about it all and I sincerely hope it doesn’t come across this way.

I do this because it’s all worthwhile and I don’t resent it.

I do this because it’s a calling and because I care about birth, and about women.

But I just want you to know what it means to be a doula, and how challenging it can be at times.

I want you to know that when you hire a doula, she puts her life aside for you for weeks or even months at a time.

Because you are worth it.

And your doula is worth it too.