Doulaing With A Disability

Sep 16, 2013 by

Often becoming a professional doula is an achievable goal.  But for others becoming or continuing as a doula with its physical demands is extremely difficult.  In my thirty years of doing labor support I have met several doulas who were able to maintain their careers.  After thirty years, I have had to make adaptations myself.  As my colleague Cory Silverberg once said, “If you live long enough you will end up with a disability.”  Here are some helpful steps if you receive a diagnosis that will significantly change your abilities.

  1. Feel your feelings.  Anything that is significant enough that you will have to adapt your life around it will bring up a mix of feelings.  Relief, fear, anger, anxiety, sadness, and other emotions are all important.  Take some time to grieve – your body and your life are no longer the same.  It is when you push away your emotions that they control you.
  2. Adjust to the diagnosis.  Will any medications or health care regimens have unknown affects?  Are there any procedures that need to be planned for?  Remember you are a person with an illness or disability, not the disability.   Utilize your doula skills:  seek out resources, confide in those your trust, enlist others in your support circle, and advocate for your own needs.
  3. Be realistic about your circumstances.  How does your condition affect your ability to fulfill the doula’s responsibilities?  How do your changed circumstances affect your client and her labor support experience? How do they affect you?  Examples:  If you have a joint ailment, you may not be able to support a larger mother in her positioning or while walking or dancing.  As a cancer survivor, you may tire more easily.  With multiple sclerosis, you may have a flare that requires a cane or wheelchair.  Perhaps an endocrine condition requires at least five hours of sleep each night.  A benign tremor may mean your pictures are usually out of focus.  As a postpartum doula, arthritis may mean it is unwieldy to pick up a baby.
  4. Brainstorm possible solutions.  You might not be able to pick up the baby, but you’re fine if someone hands you the baby.  Maybe it is time for you to take on an apprentice doula who can do the more physical tasks.  Perhaps attending births together or in overlapping shifts with a doula partner would work for you.  Maybe you just don’t take photos.  When you look at your solutions, which ones would you need to choose and which might be up to your client?  For example, maybe your client would get to choose the second doula from three you like to work with.
  5. Readjust your marketing. You want to emphasize the positive while not misleading potential clients.  On your web site show a photo of you holding a client’s baby at a postpartum visit with your cane on the chair. At the introductory visit, state the adjustments that are required and how you intend to address them.  Focus on what you uniquely offer and don’t apologize for yourself!  Emphasize that prenatal planning affects birth outcomes tremendously and is not affected by your disability.  Maybe instead of three prenatal visits, you offer four.  Maybe you can turn a problem into an opportunity –  offer an incentive for a particular birth photographer which benefits both businesses.  It may be that if you work with an apprentice or a partner, no explanation is needed.  Your potential clients will choose based on your business model and feelings of safety with you.  Depending on what you are asking of clients and how open they are to your solutions, business may stay the same or even pick up.  “Two experienced doulas for the price of one – that’s great!”
  6. What if my business drops off?  Birth and postpartum doula support are market driven businesses and also relationship based businesses.  It may be that potential clients prefer not to make adjustments to work with you.  May be your confidence has declined or your grief over these changes is coming across.  Mothers may decide you are not the best fit because of your disability.  It always feels bad to be rejected  – and this may be your worst fear.  Less or no business may stimulate the grief process all over again – which is entirely appropriate.  In thirty years there have been many times I could not attend births even though I wanted to.  This was due mainly to my life circumstances and needs of my children. But eventually it was due to a health condition.  I swore a lot and then went through the process I have outlined here.
  7. Shifting your doula energy.  Maybe you can’t attend client’s births or postpartums anymore.  Notice I did not say, “can’t be a doula anymore”.  You’ll always be a doula – it is a way of being in the world.  Maybe you’ll open a mentor doula business:  attending a few births with novice doulas, and have monthly educational and support meetings.  There is a huge need for this type of additional education and support for emerging doulas.  Some birth doulas become postpartum doulas.  Some become childbirth educators, birth activists, support group leaders, parenting educators, home visitors, or run doula programs.  Some go back to school and get certificates and degrees that enable them to affect birth in a positive way.  There is still a place for you at the table it just has a different setting.

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  1. Tricia O.

    This article is what I specifically came to find! I have my birth doula certification through Childbirth International (CBI) and am a volunteer doula. I do it very seldom, averaging only one per year…Local area professional doulas haven’t been quick to network. I would love to do it more. I’m in the process of moving to a wheelchair for a muscle condition called mitochondrial disease. I have a client due in a few months and have filled her in on the situation, and that my service offering is different from a full time professional doula. I love the work and don’t want to give up the work that I love.

  2. Thanks for this thoughtful post. I just had an injury that has put me in a wheelchair and on crutches, temporarily. I am humbled and angered by how many obstacles I’ve encountered, and I now will advocate for more accomodation for others who encounter barriers on a permanent basis. When you mention doula business concerns, it brought up for me that sometimes we assume those doulas practicing as a business are the only doulas. However, that assumption does not reflect doulas who serve as community health workers, in volunteer programs, as Promotoras, as Americorps doulas and others.

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