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Are Home Dopplers Safe? What Doulas Should Know

April 5, 2022

home dopplerHome Doppler use has increased over the years. With affordable home dopplers available for under $100, many are intrigued by their use. Often used either for reassurance due to concerns over miscarriage or to utilize as a method for bonding.

As a doula, you are likely to be asked if home dopplers are safe.

Pregnancy can be an extremely exciting time, but it can also bring anxieties. One in four pregnant people will experience a pregnancy or infant loss at some point in their life. Even if you have not personally experienced loss, you likely know someone who has. Looking at the numbers, you will inevitably have clients who are pregnant after a previous loss.

There is also a desire to bond early in pregnancy, leading to pregnant people wanting to learn more about or use at home Dopplers.

While they are available, is there a benefit to use? Are they safe? As with all pregnancy choices, it comes down to benefit vs risk.

A Home Doppler Cannot Prevent Miscarriage

A miscarriage is a devastating experience. Many pregnant people who experience one wonder if there was something they could have done to prevent it.

However, most early miscarriages are due to chromosomal issues and thus the pregnancy could not progress beyond a certain point. Most chromosomal losses also occur around or prior to ten weeks. This is often well before a home Doppler can.

Early Doppler use (some people can use one around 8 weeks, while many are unable until 10-14 weeks) can only offer a certain amount of information. If it can pick up a heartbeat, you will be able to determine the heartrate.

However, inability to pick up a heartbeat prior to 14 weeks is generally deemed inconclusive due to the limitations of Dopplers in early pregnancy. This can create unnecessary stress and anxiety for some unable to catch the heartbeat at home.

If one can pick up a heartrate and it is low or concerning and the same is confirmed by a healthcare provider, an ultrasound might be ordered. Unfortunately, even if an ultrasound can confirm a concern, early miscarriages are rarely preventable.

Aside from concerns picked up incredibly early, such as low progesterone due to hormonal imbalances (treated with progesterone supplements) or a thyroid issue (treated with thyroid medications), there’s not much treatment available for first trimester concerns.

Neither progesterone or thyroid issues can be detected by Doppler use, they can only be tested for and treated by a healthcare provider. It is also important to note that low progesterone can be caused by an unviable pregnancy, meaning even tracking progesterone cannot always prevent a loss. Most early losses are because the pregnancy is not viable.

Home Dopplers Use The Same Technology As Ultrasounds

Hand held Dopplers utilize the same high frequency sound waves as the ultrasounds used to make a picture on a screen. Ultrasound technology has never been proven safe during pregnancy, nor has it been proven dangerous. For this reason, ACOG (the leading obstetrical organization in the US) recommends only one to two routine ultrasounds during pregnancy unless others are truly medically necessary.

The FDA also advised against keepsake ultrasound imaging as they are not medically necessary.

Being that hand held home Dopplers utilize the same technology, one might assume it is a good idea to limit their use. The FDA also advises against home Doppler use. While hand held Dopplers are utilized by a midwife or OB during prenatal appointments, it is likely used for less than a minute or two every 2-6 weeks.

For a trained healthcare provider, the information gained likely outweighs any potential risk. They can assume a pregnancy is progressing well with a proper heartrate (along with checking other things such as fundal height). If they are concerned, they are able to refer for a picture ultrasound.

Utilizing one at home does not necessarily provide a medical benefit and could carry potential risks. One risk is unnecessary concerns which could lead to unnecessary and expensive interventions. If a client is unable to find a heartbeat or interpret heartrate, they are likely to be concerned and reach out to their provider.

If one is unable to locate and heartbeat and it is confirmed by their care provider, the only benefit would be shortening the length of a missed miscarriage. This possible benefit, however, may not outweigh other possible risks in most circumstances.

Midwives And OBs Receive Training For Proper Home Doppler Use

On one hand it seems that a home Doppler is simple to use. While it looks easy, it is important to remember midwives and OBs receive training and likely have years of experience locating fetal heartbeats. It is helpful to remind clients of this.

It can be easy to accidentally pick up the blood flow of the placenta or the pregnant person’s own heartrate. Also, it is easy to miss a heartbeat. This could lead to unnecessary concern and intervention. For this reason, most midwives and OBs advise against home Doppler use.

There are a small number of providers who even avoid Doppler or home doppler use all together as they have concern over the safety of ultrasound technology; or they simply prefer other methods. These providers utilize another method to check heartrate, a device called a fetoscope.

This is essentially a stethoscope shaped differently to pick up a fetal heartbeat. These can be used starting at 18-22 weeks gestation.

Kick Counts Are More Important Later In Pregnancy

For clients beyond the first half of pregnancy, they may have less concerns about miscarriage. That said, it is still not uncommon to have other concerns. This is especially common among parents who have experienced late miscarriages or stillbirths.

Home Dopplers might sound ideal, but lack of professional training can mean they are not the most effective when catching concerns later in pregnancy. Once a heartbeat stops, it is unfortunately too late to prevent anything. As someone without medical training, if a client is able to find a heartbeat but they’re unsure how to interpret heartrate, the information could provide false security.

For this reason, healthcare providers recommend parents use kick counts to monitor their pregnancy between prenatal visits. Abrupt changes in fetal movement can indicate fetal distress. If this happens, your client’s healthcare provider would have you come in for more monitoring. Often baby is simply resting. However, if a concern is found, their midwife or OB will determine what steps to take, including inducing labor or giving birth via c-section so baby can receive treatment.

There Are Many Ways To Bond With Baby

For many parents, hearing the heartbeat at each prenatal visit brings excitement. This experience can help parents connect with their pregnancy and feel as though they are already bonding with their little one.

Recreating this feeling on a regular basis is appealing. This may be especially true for parents with previous losses who are hesitant to connect; or those facing really difficult pregnancies (such as hyperemesis gravidarum). When one faces a challenging pregnancy, it can be really hard to remember they are also carrying a baby and that they’re not just ill.

While a home Doppler is tempting to help with bonding, there are many other ways to bond with baby. Some parents find prenatal exercise and yoga great for bonding. Journaling about pregnancy and/or writing to baby is another way to connect. Taking a childbirth class, going for a prenatal massage and other activities that focus on relaxation and pregnancy can help.

It is important to remember that many parents do not feel a bond or connection with baby until after birth. How one feels during pregnancy is not necessarily a correlation between how they will feel about baby once born. It is completely within the realm of normal to take time to bond and connect with baby, just like any other relationship.

As with all pregnancy choices, home Doppler use comes down to benefit vs risk. If your clients have concerns about pregnancy, they need to discuss them with their midwife or OB. While home Doppler use is quite appealing, it is important to understand and acknowledge the limitations of use.  Also, potential risks (e.g., unknown concerns about repeat ultrasound exposure, concerns leading to unnecessary intervention). Do this before making a decision about use.

Pregnancy Tips For Your Doula Clients

April 3, 2022

pregnancy tips

As a doula, you will be asked about everything pregnancy. Here is a quick list of pregnancy tips to help your clients be truly prepared for birth and parenting. We don’t know what we don’t know. So, as a doula, you can help prepare your clients for all things beyond the registry.

Most importantly, however, you can help them prepare without adding to their stress load. The inner dialogue during pregnancy can feel like a never-ending task list. As a doula, you can provide these tips in low stress way.

9 Pregnancy Tips

I wish I could say I made fully informed decisions with my first pregnancy. In reality, I happened to choose an amazing midwife. I was in the space of doing whatever the provider recommended. Again, fortunately she was a wonderful midwife so doing everything led to a positive experience.

As I ventured into birth work, I learned that this is rarely the case for first time birthing parents. Many follow the standard recommendations set forth by providers which are not always comprehensive in preparing for a positive pregnancy, birth and start to parenthood.

As a birth worker, you may find these helpful for clients:

Encourage Clients to Make Informed Provider Choice

It is common for pregnant people to continue care with a previous OB/GYN they saw for birth control and well woman care. They might choose a provider based on proximity to their work for appointments or whomever their friends recommended.

These are not inherently bad options. However, depending on the type of birth they are planning for, they might find another provider helpful.

Encourage your clients to think about their birth goals. Then, encourage them to ask their OB or midwife about these goals. If they do not feel their provider is going to be supportive in these goals, looking into other options might be helpful.

Pregnancy Tip – Learn About Nutrition

It is always beneficial to learn about nutrition. However, during pregnancy, nutrition has the power to improve birth outcomes. Certain dietary choices can aid in managing pregnancy hypertension and gestational diabetes.

In some cases, we cannot prevent hypertensive disorders in pregnancy, nor can we stop gestational diabetes. However, dietary choices can be a massive part of managing these conditions and improving birth outcomes.

Aside from pregnancy complications, good prenatal nutrition can help pregnant people maintain overall wellness. Regardless of how one eats during pregnancy, the baby is often getting what it needs. However, the pregnant person is at risk for losing iron, calcium, etc., from their body if they are not consuming enough.

Encourage your clients to reach out to a registered dietician if they have GD or hypertensive disorders. As a doula, you cannot prescribe a specific diet. However, you can share information about healthy food options during pregnancy including:

  • Using herbs and spices for flavor and limiting excessive sodium
  • Reading labels
  • Choosing protein over empty carbs
  • Choosing whole grains over processed white grains
  • Pairing fruit and other sugars with protein to help balance blood sugar
  • Small frequent meals versus large meals
  • Eating whole foods at home more often than takeout
  • Making lower sodium choices at restaurants and takeout
  • Choosing whole foods and eating the rainbow

Encourage Clients to Practice Self-Care and Relaxation

As a doula, you know the importance of rest and relaxation during pregnancy. However, you also know how difficult it can be to incorporate in a society that encourages always being “productive” and busy.

Remind clients about the importance of mental wellness during pregnancy for themselves and their babies. You can encourage them to try things like guided relaxation, delegating tasks where possible, learning to say “no” to overcommitting themselves, and more.

Sometimes we feel like we need permission to care for ourselves. While this is not at all necessary, we sometimes feel like we need it. Give your clients permission to put themselves first and practice true self care.

Talk to Clients About Using Both Birth and Postpartum Support

Clients and potential clients are not always aware of the benefits of birth and postpartum doula support. Taking time to explain all you can do is a wonderful way

to help clients prepare for birth and parenting.

We do not know what we do not know, and thus many new pregnant parents are unaware of all the support available to them.

Pregnancy Tip – Comprehensive Childbirth Classes

Doulas provide invaluable pregnancy support and birth preparation. However, in the context of a couple prenatal visits, it is not possible to provide full comprehensive childbirth education.

Encouraging clients to take your childbirth class, if you teach classes, or another private class (not including the hospital offered classes) can help them be fully prepared for birth. As a doula, it will also make it easier for you to provide true birth doula support as you will not be tasked with having to explain extra things before, during and after the birth experience.

Remind Clients to Get and Keep Moving

We do not need to encourage clients to run a marathon or train to be a competitive lifter. However, studies show remaining active during pregnancy can improve birth outcomes and overall health.

In the absence of high-risk pregnancy contradictions, encourage clients to walk, continue normal exercise if their providers give them the okay, and to consider things such as prenatal yoga and Pilates.

Exercise can also make their postpartum recovery easier.

Vitamin D and Sunshine!

Getting adequate vitamin D is beneficial any time, but especially during and after pregnancy. It is necessary for immune support. However, vitamin D is found to improve mental health.

Pregnancy and the postpartum periods are times of stress for many. Setting clients up for helpful things which can reduce the risk and severity of perinatal mood and anxiety disorders is a wonderful way to help.

Remind Clients to Prepare for The Postpartum Period

Many parents plan a lot for pregnancy and birth. They take classes, read the books, and of course, hire you as their doula. However, it is common for parents to be underprepared for the postpartum period.

As a doula, discussing the reality of postpartum healing and demands, is important. You can help them understand the need to prepare for where their meals will come from, how they will heal, manage tasks, etc.

Encourage Clients to Learn and Prepare for Breastfeeding

Breastfeeding is natural and it is easy to assume it will be an easy task. However, while it is a natural body process, it can take time and practice to navigate it.

Helping clients have a positive but realistic understanding of breastfeeding is an important part of preparing for birth.

As a doula, providing pregnancy tips is an important part of your job. The better you prepare clients, the more positive of an experience they are likely to have.

Can Pineapple Start Labor?

March 30, 2022

can pineapple start laborClients frequently ask their doulas many questions. A common question is how to start labor. There are many myths surrounding what might start labor. “Can pineapple start labor?” – a common question doulas hear.

So, can pineapple start labor? In short, there is no evidence it helps. Anecdotally, some believe it does. As a doula, however, it is important we stick with evidence. In terms of anecdotal experiences starting labor, we must remember that labor is going to begin for most people regardless of anything. This can mean the “trick” did not do anything, the timing was simply a coincidence.

Why Would A Client Want Labor to Start?

In many cases, people reach what they believe is full term and assume baby is ready to be born. Understandably, the final weeks of pregnancy can be draining. However, as doulas, we can help remind them that generally, babies are born when they are ready. Estimated due dates are just that, estimates.

A typical pregnancy lasts 37-42 weeks. However, that does not necessarily mean a baby is ready to be born simply because they’re 37-38 weeks. Generally, 37-38 weeks means they often have mature lungs, are capable of feeding, and are less likely to need NICU support compared to their preterm peers.

However, the 37-38 weekers are still more likely to have feeding difficulties, jaundice, and other concerns compared to their 39 or more-week peers.

Birth at:

  • Weeks 37 and 38 is early term.
  • Weeks 39-40+6 is full term.
  • Week 41 is late term

Post dates are after week 42.

In some cases, a client might attempt to start labor due to an impeding induction. This induction might be medically indicated, or they chose an elective induction. Regardless of the reason, your role as a doula is to help educate them about each “term” stage of birth.

Can Pineapple Start Labor? What Does Evidence Show?

As doulas, it’s important we provide evidenced based information to our clients. It’s important to share the difference between anecdotal information and accepted peer reviewed evidence.

There was one study which found using pineapple extract directly on uterine tissue samples caused the tissue to contract.

However, we don’t know whether simply eating pineapple can trigger uterine contractions. We would certainly never suggest they attempt to use pineapple internally either.

As with many home remedies and ‘old wives’ tales’, there aren’t many studies showing efficiency.

To get enough bromelain to potentially trigger labor, some suggest you’d need to consume seven pineapples. Chances are, long before one consumes seven pineapples, they’d feel quite sick!

If your clients tend to browse the internet, they may find some recipes for labor starting pineapple smoothies and such. If you’re asked about using them, remember you cannot prescribe anything. You might answer something like:

“There is not much evidence that pineapple can start labor. That said, many people enjoy pineapple. It’s unlikely to hurt anything, and perhaps labor will begin. It’s important you talk to your doctor about any supplements or herbs that might be in a smoothie though.”

You can also let them know that the bromelain which is thought to possibly impact uterine tissue can cause irritation in their mouth. Consuming too much could cause significant discomfort with low chance of triggering labor.

Does Canned Pineapple or Pineapple Juice Start Labor?

You might notice your tongue feeling funny after consuming fresh pineapple. However, this rarely happens with canned pineapple or processed pineapple juice. The process of canning or pasteurizing juice reduces bromelain and thus is unlikely to impact anything.

Pineapple can be a healthy part of a diet. It can also help stay hydrated. This means it isn’t a problem for clients to consume either, it’s just unlikely to trigger labor.

Is It Safe to Try to Start Labor?

As a doula, you should not be advising a client to start labor. However, you can provide general information which some people try to start labor.

That said, it’s also important you remind clients that correlation does not equal causation. Many people are already term, trying walking, sex, bouncing on birth balls, etc. This makes it hard to know what, if anything, triggered labor.

Unless there is a medical reason, as doulas, it can be helpful to remind clients that labor beginning on its own is often the easiest route.

Prevent Tearing During Birth – What Doulas Need to Know

March 28, 2022

prevent tearing during birthOne of the most common fears birthing people have is tearing during birth. Many of your clients will want to know ways to prevent tearing during birth. As a doula, you can help support, educate, and reassure them about typical birth.

Sometimes tears happen. However, the majority are quite minor and will heal well within six weeks. Occasionally, severe tears do occur.

The good news? There are many things you can share with your clients to help them reduce their risk of tearing.

Here are ways to prevent tearing during birth:

Choose an Evidenced Based Care Provider

Encouraging clients to choose a midwife or obstetrician who stays up to date with evidenced-based care is an important part of being a doula. We never should pressure, push, nor say negative things about their providers.

However, we can provide them with questions to help them make informed decisions. Things such as:

  • You can ask your provider under what circumstances they recommend an episiotomy
  • Are they used to patients giving birth in a variety of positions?
  • What, if any, movement restrictions do you try to use with patients?
  • Does your birthing facility (e.g. hospital) implement any restrictions?

When you share the evidence about birthing upright, the few situations an episiotomy may be warranted, and patients’ rights, they might decide a provider is no longer a good fit for their birth plan.

Prevent Tearing During Birth – Stay Upright!

When we look at the pelvic space, often called the pelvic floor, it is easy to understand why birth position matters. While pelvic floor is the typical term used by medical providers, as educators we understand how words impact thoughts.

In general, floors are hard, have no give, and are not flexible. The pelvic floor is made of muscles, ligaments, nerves, glands, and more. It is flexible and the space ebbs and flows.

As a doula, you can help educate clients about their pelvic area. Using language such as pelvic space can help them understand how it functions.

When people give birth in more upright positions, there is less pressure on the bottom of the pelvic space. Less nerves are compressed. Muscles have less weight and pressure on them. And in terms of tearing, there is less pressure on the perineum where most tearing occurs.

When one tears while giving birth upright, the tear is often minor.

Positions for reducing tearing can be used in unmedicated births as well as epidural births. For unmedicated births, some positions include:

  • Standing upright
  • Standing and leaning over the bed
  • Leaning over the birth ball while on all fours
  • Using the “throne” position on the L&D bed
  • Using a CUB birthing device
  • Assisted squat
  • Using the squat position with the L&D bed
  • Being on all fours on the bed
  • A variety of positions in a birthing tub

For those who have had an epidural, these positions can help:

  • Using squat bar in the bed with support
  • The “throne” position with L&D bed
  • Pushing on your left side – not upright but aids in keeping pelvis open
  • Occasionally, if there’s some movement in legs, assisted all fours or leaning over headboard

Staying upright is an excellent way to reduce tearing. As a doula, having this discussion before birth can help prepare your clients for active birthing. Reminders during the pushing phase can also help.

Water Birth to Reduce Tearing During Birth

As a doula, you’re not going to tell clients where and how to give birth. However, you can provide information about birthing options. The option for water birth can vary significantly based on available practitioners and facilities in your clients’ area.

Some hospitals have birthing tubs. Most birth centers have birthing tubs and the option to birth baby in the water. Many homebirth midwives have rental tubs or assist with birthing in a home tub.

During prenatal consults, if a client is concerned about tearing, you can discuss water birth as one potential option for reducing their risks.

Warm Perineal Support During Pushing

This is a hands-on option which is typically done by a medical provider. In some cases, perhaps home births, doulas have aided with this. Be sure to never apply anything to a client without permission and only in a non-medical way (e.g. before crowning).

Perineal support can reduce tearing. However, not every birthing person is comfortable with any hands-on touch during the birthing process. Some birthers will even apply support themselves.

The warmth aids in improving circulation which can be beneficial for tissue stretching.

Avoid Episiotomy to Prevent Tearing During Birth

Once upon a time, episiotomies became a standard of care for a while. We quickly learned they were rarely beneficial, but practices can be slow to change.

As a doula you can help your clients understand the importance of asking their providers about episiotomies. Questions to ask include:

  • Under what circumstance do you recommend an episiotomy? (A good answer is rarely, except if baby is in true distress, a tear is occurring upwards rather than down by perineum, angled to avoid rectal tear when it looks like a rectal tear is likely)
  • Do you always ask for expressed, informed consent before giving an episiotomy?
  • How frequently do your do episiotomies?

The reason episiotomies first became practice was providers assumed it would be easier to repair. However, there’s no evidence a straight cut is easier to repair. In fact, it increases the risk of a deeper tear due compromising in tact tissue.

Breath Baby Out, Don’t Push

Gone are the days of purple pushing. When birthing people push as hard as they possibly can, they are more likely to tear. Aggressive pushing does not allow much time for the tissue to expand.

Breathing, rather than pushing hard, as baby is crowning, allows time for the tissue to expand. This can greatly reduce the risk of a severe tear.

As a doula, you can spend time during the prenatal period helping to alleviate your client’s concern about tearing. During birth, you can remind them of all their options.

Can You Be A Doula While Breastfeeding?

March 18, 2022

doula while breastfeedingMany people decide to become a doula while growing their families. If you’re a new parent looking to become a doula, it can be hard to figure out how to balance doula work and your family. Can you be a doula while breastfeeding?

It can take work and planning, and there are lots of variables, but many are able to be a doula while breastfeeding.

Here is what you need to know about breastfeeding as a doula:

Make Sure You Take Adequate Maternity Leave

There are many variables when it comes to deciding on maternity leave. As a doula, you might have more flexibility than some. However, you could have less flexibility as most doulas are self-employed.

One of the main reasons to make sure you take adequate maternity leave is to ensure you have an established milk supply. Early mother baby separation is often associated with supply difficulties. It can even lead to shorter durations in breastfeeding.

If you have a personal breastfeeding goal of 6, 12, or more months, it’s important to establish a strong supply. The easiest way for most to establish a good supply is frequent and on-demand feeds at the breast.

Write Time For Pumping/Nursing into Your Contracts

Ensure your clients are aware that you are breastfeeding, and you will need to take about 20-minute break every 3-4 hours to pump. In some cases, doulas will have their partner or childcare bring the baby so they can breastfeed instead.

Occasionally, doulas working home births will bring and wear a young baby and feed as needed. This is only considered typical in some birth work circles. It is important that if this is your plan you have an additional support person to care for baby if they become fussy.

You need to ensure your client is not distracted nor left unsupported. Plan thoroughly and make sure there are realistic expectations.

Wearing a milk collection cup can be useful if you’re needing to pump but your client is in transition or pushing. You might have to delay a pumping session here and there; be sure you’re prepared.

Have An Easily Portable Breast Pump

As a birth worker, you’re likely aware of the benefits of a strong, double electric. However, many doulas have some items in their bag making it difficult to carry a large pump.

As a doula, you’re likely only attending a max of one birth per week while having an infant. If that’s the case, unlike full-time work separation, you may not need a heavy-duty pump. Many find a Hakka pump, hand pump, battery or charger operated pump, or smaller double electric pump to be adequate.

Some will also leave their double electric pump in their care and utilize a car charger. This makes for one less item to carry and provides a quiet place to pump. You can also easily store a cooler in your car and not worry about carrying milk out after the birth.

Rest and Recoup With Your Baby

When you’re a doula while breastfeeding, you can take a “nursecation” when you return from a long birth. Take some time to relax in bed with your infant and allow them to feed on demand. Feeding on demand and access to skin-to-skin can ensure your supply is good despite occasional separation.

You can also try a power pump session if you notice a dip after a long birth. Occasionally, our clients don’t follow their estimated due dates (exactly why it’s just an estimate!). If one client goes early and another late, you could find yourself away back-to-back. This might lead to a temporary supply dip. A power pumping session could help.

Have Realistic Expectations If You’re A Doula While Breastfeeding

Both doula work and lactating can be physically and emotionally taxing. Many doulas find that they need to wait several months after giving birth to jump back into work. This allows for healing and establishing a good milk supply.

As a doula, you know the importance of proper birth support. It’s important that if you are a doula while breastfeeding, your lactation needs won’t interfere with your client’s birth support.

You may need to take off longer than anticipated, or you may need to adjust personal lactation goals. There’s no right or wrong, it simply depends on your circumstances as well as your clients. Always be clear and honest with your clients so they can make an informed decision about working with you

Balancing Doula Work With Kids

March 17, 2022

doula work with kidsMany doulas come to the profession shortly after expanding their family. Maybe you’ve had a positive birth experience and hope to help others have the same. Perhaps you had a difficult birth and want to help others avoid that experience. But how do you balance doula work with kids?

It can be a challenge to plan, but it isn’t impossible! In fact, many doulas are also parents. Part of our training at the International Doula Institute includes helping student doulas prepare for real work. This includes learning how to balance doula work with kids.

Here are some helpful tips for balancing work and kids:

Back Up, Back Up, Back Up!

The most important thing you need as a doula with kids is childcare. However, you also need multiple back up childcare options. If your primary childcare is sick, who do you call?

In addition to backup childcare, it’s also important to have a backup doula. What if you’re sick? Being a parent often means being exposed to lots of viruses. If you’re sick, you need to be cautious about sharing any germs with clients.

Be sure to network early in your doula training and career. Getting to know other doulas with similar training and doula philosophies as you is important. Your clients should know that in the event of an emergency, their care will not be compromised.

Plan Ahead – Always Be Ready!

Being on-call can be hard. Kids make things even more difficult. Who is taking care of meals when you’re gone? Who is responsible to ensure you always have gas in your car? Is another parent, partner, grandparent, etc., aware of school project deadlines?

If you are the default parent in your home, you retain quite a bit of important facts to keep the home running smoothly. As an on-call worker, it’s important others have easy access to this information. Keeping a physical or digital calendar your support can see is important. It’s also important to trust your partner to take on some responsibilities. Perhaps during the weeks you’re on-call, it’s their responsibility to check all school emails.

What works varies home to home. Before you take on any clients, have the important conversations with your support people.

Have freezer meals ready or budget for takeout. If your partner also works, you might both be quite tired and mentally stretched thin to meal plan last minute.

Pack Your Bags, Their Bags, Everyone’s Bags!

Trying to balance doula work with kids can be hard. Being ready is an important part of balance. Make sure you pack your doula bag and keep it ready. I

When you have children, make sure their bags are packed too. Diaper bags, overnight bags, school bags. Make sure you have everyone’s items ready if you need to drop them off for childcare. If you have a childcare provider coming to you, or your partner is home, this might be an extra chore you can avoid.

Even if you have someone planning to come to you, having an extra bag ready for your kids is important for emergencies. In some cases, you may need to drop your children with a back up provider.

When everyone’s bags are ready, it makes being on-call a bit easier.

Have Realistic Expectations When Balancing Doula Work and Kids

It is absolutely possible to balance doula work and kids. However, it is important to have realistic expectations. Expect there to be some challenges as you adjust to life on-call.

It’s important you and your family are prepared for the change. Ensure your kids understand you could miss an event here and there. Let your partner know what, if any, tasks you will need to delegate to them or others.

Know that as you get used to the on-call life, you will adjust and find what works for your home. Expect there to be difficult conversations with your partner/co-parent. It will take time to adjust and find what works best for your family. Be patient. Expect changes. Trust that you will all find your groove with time.

It’s also important to learn your limit for clients. Do not overextend yourself to the point you cannot balance work and family responsibilities.

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