Birth Work: Life-Giving, Fatigue-Causing
Being a birth worker is amazing. I get to witness growth, love, and connection every day in my job. It might be the best job I'll ever have. But this job is also the pits.
Don't get me wrong- I absolutely adore my doula and childbirth education clients, still feel awe when attending births, marvel at the immense stamina of women and other postpartum people during postpartum doula visits, get happy when an expecting family feels confident in how to use their new car seat...I love my work, and hardly feel like it's work sometimes. Heck, I'm even in a field where I admire and respect many of the collaborative professionals I get to interact with (obstetricians, midwives, nurses, acupuncturists, doula colleague, and more).
So what sucks about this baby-cuddling, oxytocin-infusing job? Well, for starters, it's really hard to press pause, take a time-out, or even just check out for a few minutes each day. Being on-call for expectant parents in Southern California means my phone (and therefore my brain) must be nearby and at the ready every moment of almost all my days. Babies don't wait for weekdays to make their entrances-in fact, most like to come riiiiight as I'm getting in bed on what happens to be my busiest day out of the month. In an active doula practice like mine, being on-call means planning days off so far in advance that no one on the planet is yet expecting a baby during that window.
And sometimes, days off aren't for vacations on the beach. Everyone needs to see a doctor, dentist, and/or therapist here and there, right? Being a birth worker, I'm one of those terrible patients/clients who has to reschedule at the last moment because I was up at a birth all night. I have anxiety any time I climb into the dentist's chair because I know I might be mid-filling when a client calls. I'm the chick at the grocery store only picking up a few items because leaving a whole cart behind in the middle of an aisle is beyond awful as a thought.
Yes, backup doulas can be helpful for those times where an appointment or a big event takes precedence, but don't let the title fool ya. Backup doulas are available in the background in theory, but can't guarantee they won't be at their own client's birth when yours rings. Sometimes backups can work like a relay team, and other times they fall through. They also have lives of their own, sick kiddos to care for at random, and even need to visit the doctor themselves at times. So, even when I do have a backup plan (or 3), there's still an ever-present voice in my head reminding me that I have to be ready to drop everything, leave my husband behind to take an uber home, and go to my clients. And I'm okay with all of this. I sign on for all of it again and again because it's better than any alternative job for someone like me.
You might be reading this and thinking "Aren't there doulas who don't go on call at all and only work around birth?" And there are! I myself have spent upwards of two months at a time off-call only working as a postpartum doula with families bringing a newborn into the world. But this isn't a quick fix to the fatigue doulas and perinatal professionals experience for a couple reasons:
1) Birth and perinatal work (and running your own business of any type) means taking the work that comes your
way sometimes to ensure you make the bank you need to. Sometimes my region (Orange County) sees a flux
in demand where there aren't enough birth workers to keep up with the clients available, but that's usually true
of birth doulas more than postpartum doulas. The reality is that this is still an undervalued,
under-recognized profession, so doulas who can be flexible in the roles they are able to fulfill are much more
likely to keep their calendars at capacity and experience higher financial stability.
2) I'm a better postpartum doula, lactation counselor, and childbirth educator because I'm also an active birth
doula. Understanding what my currently 3-days-out-from-birth client just went through earlier in the week
helps me have more empathy, less judgment, and the ability to offer way more tailored advice to address
whatever hardship they are experiencing. I know some great doulas who only offer postnatal support, but I've
seen first-hand advice about postpartum recovery given that didn't make sense for my birth doula client-and
that could have been individualized for this unique human if more awareness of or presence at the labor and
birth were a part of the doula's knowledge bank. The same thing applies for childbirth education classes. The
classes I teach are directly informed by countless experiences in labor and birth with my clients. I don't rely on
textbooks and research alone, even though these pieces are discussed as well.
The other thing to keep in mind, whether you're just curious about what doulas' lives are like or you're interested in becoming a doula yourself, is that even when I'm not on call as a birth doula, I'm "on" for my other clients and for my business. I'm fielding texts from mothers troubleshooting latch pain, calling potential clients back to schedule consultations, editing my website, processing invoices, connecting with complimentary care providers, processing placentas, and so much more.
I'd be in full on denial if I didn't share here that there are times each month that I consider just finding a job somewhere that wouldn't require such intense care and attention to detail, such weighty responsibility day in and day out. A job where punching in, doing the thing, and punching out all happen within a neat little 8- or 9-hour window sounds so foreign at this point. A job where nothing life-altering or life and death is happening and I can leave whatever challenges do exist behind at the end of the day...I literally can't even remember what that feels like because it's been so long since I was employed by anyone else. I love running my own business, being my own boss, choosing who I work with...I really, truly do. Yet, I also experience fatigue related to this autonomy that can’t be helped. I can’t go far from home on my days off or simply stop answering my phone for a few days. I can't be without my phone near me, on, and loud (especially when sleeping, which is when most get to turn it off or put it on silent). I don't schedule my days off over the weekends like everyone else because that's when most of my clients have time for meetings and prenatal visits with me.
I have to think first about my on-call status before making any recreational decision, but also before making any other professional or personal decision. My hobbies, my down time, my personal commitments outside of work-they are all dependent on and affected by my work on a daily basis. My autonomy in life automatically comes with many limitations due to the field I’ve chosen that I sometimes lose focus on the autonomy piece altogether. Ironically, I have days where I feel held down or even fully trapped by the constants- the requirement to perform, to show up, to give my all, to experience life-altering events on a regular basis, and to help honor the incredibly special, yet uniquely mundane-for-me experiences of pregnancy, birth, and postpartum life. I started this article by saying I love my work, and that's undeniably true. I love the good things and the weird, the rad and the not so lovely. I love the perfect-on-paper births where I leave with a smile on my face not because everything went according to a plan, but because everything went and growth happened all around. I love being a source of compassion and respect in a birth where some folks aren't as kind or yummy as my clients deserve. I love educating pregnant people and guiding them to decision-making that works for them. I love being someone’s person during the best and/or hardest and/or most magical and/or most tragic day of their lives. Even the experiences where I incur direct and indirect trauma, such as the incredibly humbling stillbirths I've attended or the home births where the midwives don't make it in time for a speedy arrival, I still get so much from the work.
Yes, I love what I do immensely. And, this work is probably the most challenging field I could have gravitated toward. There is so little desire in me to do anything else. There is also constant desire to simplify and care for my life, my family, my own magical moments. Struggling to find balance is a constant, ache-inducing task that cannot be ignored. Yet, it also cannot be realized easily or regularly. This is what being a doula is, for me anyway. A constant, challenging, expansive, irking search for balance, health, & fulfillment coming up against the intense knowledge that it may not exist in the ways I want it to as long as I continue doing the work I love. And an acceptance of those pieces because I am not yet, and may never be, willing to leave behind my role as a doula, birth educator, and labor support person.
About the author: Amanda Cagle is the owner of Your Birth Team, a full-service perinatal education and support practice. She serves Orange County, Long Beach, and some surrounding areas of Southern California and has been a doula since 2011. Amanda provides compassionate, evidence-based care to families of all types and offers extensive financial aid to families who qualify for Medi-Cal, SNAP benefits, TANF or WIC.