Become a Doula but Get Over Yourself… It’s Not About You

Posted on: December 27, 2015 | Become a Doula, Doula, Doula Inspiration

This week I had the opportunity to speak with a very seasoned doula from another doula certification organization.

We had a pleasant conversation and we always appreciate one another’s perspective.

We were discussing a variety of topics relating to the doula industry and in passing, she mentioned the…

POSTPARTUM FOLLOW UP VISIT.

The postpartum follow up visit, is what we consider, the finalization of the Labor doula contract. Typically, what is included in the labor or birth doula contract is:

• 1-2 Prenatal visits to discuss plans and wishes for labor and birth. At this time, we discover any concerns that we might address through conversation or that might require the doula to provide some sort of a resource.
• On call services; meaning the doula is available by phone and prepared to meet the client to provide supportive services throughout the labor and birth.
• The postpartum follow up visit.

What struck a chord with me was when this doula said,

“The postpartum visit is about getting feedback about your services.”

I didn’t respond to the comment because we were speaking about something else and I didn’t want to de-rail our conversation….

But I couldn’t disagree more with what she said.

I wanted to be sure that I wasn’t feeling strange about this concept based only on my thoughts about it, so I reached out to others.

I looked towards other seasoned doulas to see what they had been taught during doula training about what the postpartum visit should consist of.

To be fair, I reached out to doulas with 5 or more years of experience, who had trained with a variety of doula certification organizations and who had been consistently serving families in birth.

The following information was given to them during training…

• “When I was trained, we were advised to charge a fee (I think like $250) and if our clients felt we did a good job, they could pay an additional $150 at the postpartum visit. (This was 14-15 years ago and I can’t remember exactly how it was worded or how it worked)”

• “Yes, to get an evaluation filled out or to talk about if I had done a good job for them or not. What I could have done differently for them, etc.”

• “We were encouraged to get evaluations filled out from our clients even after our certifying births were completed.”

• “I was told it was to get closure and feedback from clients about my service.”

• “I was taught that it was a good idea to get feedback about services. I also used to get the remaining balance at the postpartum visit and felt I needed to write a birth story for her.”

• “I was never taught to solicit feedback about my performance outside of an evaluation. The idea sounds really self serving which really doesn’t seem right to me.”

• “Process the birth, give them their birth story, collect 2nd payment and get feedback on my role.”

• “That I should process the birth with her.”

• “It is a time to collect final payment, & get feedback for my support.”

With the variety of information and advice being given regarding the postpartum visit, I decided to add my two cents.

• Closure… yea, right. The early days of the postpartum period are not a separate event for birthing families. Instead, they are part of a larger process. Most women are not looking for “closure” from their birth in these days. They are navigating a wondrous, emotional and sometimes difficult time in their lives. Compartmentalizing the birth and the postpartum period takes time and focus. Closure from one is not required or expected in order to step into the other. My experience tells me that birthing women may have a single question on day 4 about the birth and one or two more a few days later. Sometimes they are flooded by many questions at once. Thoughts occur to them about their birth over time and you can not “make an appointment” to discuss these things. Processing a birth experience is personal and happens organically. It can not be timed or rushed and does not happen when anyone other than the mother would like it to.

• Discussing payment is inappropriate during this visit. Invoices should be submitted online or by mail and payments can be arranged by phone or email. If a client or their partner has a check prepared for you, accepting it is within reason but finalizing financial obligations changes the intended nature of this meeting.

• Asking for an evaluation of your services as her doula is beyond awkward, completely absurd and terribly ineffective. This meeting is not about the doula, how the doula performed or what the doula could have done better! Those things are for the doula to discuss with her trainer or mentor. For a doula in certification requiring a form to be filled out, it should be done after this meeting, as this meeting is PART of the care the doula is providing according to the contract. Since this visit is part of the care provided, it should be considered by the client when offering the evaluation. Talk about putting someone on the spot…

So what is this postpartum follow up visit with the doula about? Why does it happen and why is it included in the labor doula package?

All great questions.

This meeting is for the doula to discuss the present experience that the client is having. Yes. The present experience.

When a person gives birth with a team, either at home or in a hospital, the support is very consistent.

When a woman births in a hospital, for 48 hours the nursing staff and her providers work with her on breastfeeding, newborn care and her own physical recovery.

None of these people work to “process the birth” with her or help her find “closure.”

They don’t give her a bill or expect payment during this time.

They certainly aren’t asking for evaluations or for advice on what they could have done differently.

They are solely focused on what the mother needs now.

Has she eaten.

Has she rested.

Is the baby eating well.

Is the baby sleeping much.

Do they have questions.

Are they comfortable.

How is their perineum or incision.

Do they need a more comfortable position for feeding.

Do they need a recommendation for a chiropractor or massage therapist.

Do they need to talk with a professional.

There is so much going on in the postpartum period and the adjustment to motherhood can be difficult. Just like in labor, a doula helps a woman stay “present.”. The postpartum visit should share that focus.

Staying present, focusing on what is going on in “THIS” moment.

There is time later for processing, billing and evaluating.

This is a time of nurturing and supporting and the doula’s role should continue in the same vein as in birth.

Upon completion of this visit, the birth doula role ends. From there the client continues on her journey or has the option to engage the service of a postpartum doula who is trained to help the mother in processing the birth.

At ProDoula, we believe it is best to be trained and certified as both a labor doula and a postpartum doula so that you may provide “full circle” care for your clients.

To be able to support a woman and her partner through birth and then provide postpartum care for the family, opens the door to a level of communication that knows no boundaries.

Talk about a rewarding career. This work is amazing!