One question I hear often from Doulas starting out in the industry is: How do I be on-call for a client?
If someone has never experienced an on-call schedule for employment, then this can seem like a daunting concept. Rest assured, there are many options for on-call doula work. We will talk about their benefits and drawbacks.
There are two key elements to on-call doula work.
- #1: Being on-call means being available to your client so they can call with any alarming questions or concerns. This could mean a 2 a.m. call about cramps, or a 4 p.m. text about the best way to sleep with back pain.
- #2: Being available to attend your client’s birth whenever it happens. This part of on-call is what I think most new doulas are worried about, and want to know how to navigate.
When should I be on-call for my doula clients?
The most prevalent options are to either be on-call 24/7 immediately after signing a contract, or only on-call after a certain point in pregnancy.
On-call 24/7 immediately after signing a contract.
When you are on call 24/7 immediately after signing a contract, it means exactly how it sounds. You are available to the client for questions, reassurance, and delivery by text or phone call at any time.
This option is great at putting your clients at ease. They know you will be there for them as an immediate support person whenever a question or concern arises. It often squelches the question: what if I go into labor early?
The downside to this option is that can be easy to overextend yourself past your personal boundaries. Sometimes personal boundaries are hard to honor for ourselves. When a client needs constant reassurance, it can be difficult to not want to help them any way we can.
Only on-call at a certain point in pregnancy.
This option is when the on-call portion begins after roughly 30 weeks of pregnancy. Before the designated time, clients know they can call, text or email at any time, but you are not obligated to respond right away.
This option holds a firm personal boundary line for you as the doula. Clients know you are available to answer questions, but sometimes answers could take longer. This is a great way to not overextend yourself with clients, and honor your boundaries.
Some clients may be wary about what happens if they go into labor before the designated on-call time. They wonder if you be there to attend their birth? The answer is yes, you will be there, just not as quickly. Most doula contracts have a predetermined amount of grace time from the “Please come, I am in labor” call to arrival estimate. That buffer is often 2 hours. If the client goes into labor before the on-call window, then it may take you longer to arrive at the birth.
But, as soon as the on-call portion starts, your schedule clears and you are there 24/7 for them.
How do I manage the on-call load?
Some doulas form a rotating on-call schedule with a doula partner.
This allows them to block out days that each doula is on-call and be available for the client’s needs. One example is: one week on-call, one week off. Or, 3 days on-call, 4 days off, 4 days on-call, and 3 days off. The agreement between the two doulas should be discussed and organized. Often the doula fee splits equally. Both doulas should attend prenatal visits, and the one who attended the birth should do the post-partum visits.
Some doula partnerships use a text group with both doulas and the client to communicate, and the doula who is on-call answers the client. This keeps everyone in contact through shift changes. And it doesn’t confuse the client about who they should be contacting when they need help.
On-call with a backup doula.
Most doulas choose to be the only doula on-call with their client, with a back-up doula for emergencies. This means the client only contacts one person throughout their entire pregnancy and labor. The back-up doula receives a small portion of the doula fee for their availability, and about half of the fee if they attend the birth. If you come off call for a family emergency, sickness, etc. then you should immediately inform the back-up doula and your client.
Reassuring a client who your back-up doula is and why you have selected them goes a long way in easing any concerns they may have about not knowing who they are. Also a quick meet can, and should, be arranged.
On-call without a backup doula.
The least recommended way to be on-call for a client is without a back-up doula. It can be difficult to find a like-minded doula to share the load. But, I feel this option may be the most stressful for you and the client. If you or a family member were to get sick or injured and you couldn’t attend the birth, then that would leave your client without the support they wanted. In most cases you would forfeit the doula fee, minus the deposit, back to the client for missing their birth.
Finding a back-up is an important part of doula business. It is a safety net for both you and your client.
What forms of communication can I use while on-call and which one do I use when it’s time to come to the birth?
Always indicate which forms of communication you prefer for your client to use during your on-call and off-call periods. You have many options, including email, text, or video, or phone calls.
The most important form of communication to consider is how to contact you when it’s time to come for their birth. Most doulas require the client to call and explicitly say something like, I need you to come now. No texts or emails will be accepted for this call to action. This policy ensures an important notification never goes unheard and unanswered. You know to wait for your client’s phone call, and only a phone call.
Being on-call for a birth client for the first time may be scary, but remember, you trained for this moment.
You are the one your client chose, therefore you are the best support person for them.