The Lifestyle of Being a Doula & Virtual Doula Support

SUMMARY KEYWORDS

doula, birth, virtual, families, happening, pandemic, people, skills, support, worker, labor, nurse, denise, birthing, space, contract, barter, hear, postpartum doula, exchange

SPEAKERS

Ravae Sinclair, Denise Bolds

Ravae Sinclair: 00:00

Yeah. Hi, everybody. I'm Ravae Sinclair. Hi, I'm Denise Bolds with the sirens behind me.

Denise Bolds: 00:08

New York City life. Well, we're here to help you doDoula That!

Ravae Sinclair: 00:16

So thank you for joining us today we are winding down 2023. And we've got we've got a few things that we want to share with you and hopefully they'll resonate with you and build you up. So alright, let's dive in. We always start with doula skills. So let's talk about the lifestyle of being a doula. Hmm, okay. Let me okay, I forgot just that fast. Oh, I have to read something to y'all. Okay. So we were, you know, we spend time and in social media places, and there was a post that was, you know, it was really helpful, I think, to make us remember, we're, you know, veterans in the birth space, to help us remember what it might be like to be outside of the birth world and be an aspiring doula and like, how do you make these decisions, it can be kind of tough to know. So here's the posts, someone posted that they're an aspiring birth doula, but they're having doubts that the schedule will work with their life. They are a mom to two, a five and three year old and they don't have a ton of support, in order to like step in at any time to care for their children while they're at work. So they say that they're very passionate about birth work, but not sure that the on call nature would be the right fit for them. They would love to hear from doulas out there that were moms to little ones when they were doulaing, how to manage it and make it all work. The other question was, how stressful is it to make it all work? And she thanked us in advance for our comments. So, a couple of comments. I hadn't-- I haven't read the comments. But I know we have our own commentary. So what are your initial thoughts when you hear this about an aspiring birth doula who's a single mom to two little kids under the age of five?

Denise Bolds: 02:08

As you know, I'm a single mom, I'm an empty nester now and raising Jordan, back in my I had him at 26. So raising him all that time, there's a lot of stress. There's a lot of stress as a single parent, because you are playing the role of multiple people, multiple things all at the same time, there's a lot happening. And then to have someone else come in and say, Hey, I need you. I need you. I'm I'm in labor. Now I need you to come, you have really have to have an excellent team behind you. I was very fortunate. My parents were amazing backup people for the things that I wanted to do, like, go back to school change jobs, I was able to do that because I have that support. But it is a lot of stress. And I don't know if adding on the stress of being on call is really going to enhance the quality of life for that single parent family.

Ravae Sinclair: 03:05

Yeah, I know. So I was reading this and I'm like, ooh, five year old three year old, you're on your own and you don't have a lot of like community or family support around you. Okay, so the doula trainer in me says, work that out first, like for you become a doula. What I really would love for you to do is to address the net--netting that you need like a safety net, and community that you would need to be able to leave on a dime. So figure out is there that neighbor, that girlfriend that childcare provider--In some places they do provide daycare, 24 hours a day for like perinatal health workers, nurses, doulas and things,-if you can find that in your community Great. Work out what it might cost, how you're going to pay that like how that will come out of your like your birth fee or whatnot. But think about creating that, that net, before you get started doing this work. Yeah, because I immediately thought, well, what is she going to do when she gets up like when they get the 2am call and you have to move very quickly. You really have to have a plan for who's going to assume care for your children.

Denise Bolds: 04:19

or some type of a childcare Co Op where there's another single mom on your block that you guys can get together and take care of the kids together. I know two doulas right now they live they bought a house together and they're helping each other raise each other's children and they have a very thriving doula practice in North Carolina. They're doing very well. Because while one is out the other one is at home holding down the fort with the kids. Yeah. So it's, you know, that kind of situation is helpful, but anything else is going to be a lot stressful. So getting your skills of other avenues of birth work during the daytime when the kids are in day school or preschool. Getting your childbirth ed certification, lactation certification. There's other skills that you can get and do that work until the kids are older and more independent. But just remember, the older they are, the more you've got to watch, because now you've got to watch their friends.

Ravae Sinclair: 05:15

Oh,myeah. So yeah, only a mama would know that. Right. Not a tip I could give. Yeah, I mean, I think I think there was a couple of things to consider. So you spoke to creating what doesn't exist. So if the idea of a 24 hour daycare or that, you know, like sort of daycare provider that caters to birth workers, if that doesn't exist, create what doesn't exist, create what you need. But hopefully this will help you identify some of the things that you need, make a whole list of the things that you need to get the work done, and make sure you establish it. But also, as Denise said, I really love the idea of looking at birth work in a broader perspective, like what are all the things that birthing and postpartum families need. And they do need lactation support, that is something you can schedule. Those are things you can pursue from home virtually and all of that, maybe going into lactation, or what about childbirth education, you can take your doula training, which will help you get an overview of like the whole process of birth and postpartum. But then go forward and get more formal training where you can work with parents, and get to know them and really be in the world growing your your education business. And then if you decide you want to actually activate the birth doula credential, and do the work, then you can do that once that once they do get all into full time school, maybe that's when you can be more flexible, or when you build community when you have a bigger community network. But I do think that there are so many things around birthing and postpartum bodies that you can consider maybe you can do meals, meal prep, there's a lot of services that you can do that help you stay in this world and swim in this world very well and support a be supportive of families without taxing you. Because the other thing that I thought was, wow, as a single mom, you're serving your five year old, your three year old all day, and then you'll go into doula work where it's your it's pulling on your intuition on your energy, on your knowledge. But it's like all consuming for that period of time, like for that birth space. So I just thought in terms of like your physical health and your mental health, it birth work might be a little hard to manage. So perhaps you do consider postpartum doula training, right, because it is something that's scheduled, it can be regular can be incremental, it can be something more predictable. So you can figure out how you can do the work and when your children are with a scheduled care provider. So

Denise Bolds: 07:49

there's a growing business in nutrition, and even meal prepping for families.

Ravae Sinclair: 07:53

Yeah, or if you have any skills around, like yoga, or fitness, or any of that, like all of that those skills translate very well into the parenting space. If you are a former educator, you know, early childhood development, like any of that, if you're artists, and like doing art therapy, like there's a lot of things that are like parenting and Family Development adjacent that might allow you to schedule and not be so taxing. Also, you can just decide to do birth work, and you only do one birth a month or one birth every other month. So you don't have to be so heavy and frequent. The poster did not say that they need to replace their income or that they have to rely on. So I think some of these recommendations are like making assumptions that they like need to do it big. You don't have to do a big you can do it, like put your toe in it. I also I also think if you do birth work, consider is there an agency in your area where you can have built in backup, and there's some flexibility and it's an understanding, like tag teaming. People definitely have tag teams. And so the parent families know it could be her or it could be him coming to be your doula. So like that flexibility built in. Some people build their birth doula practices as partnerships so that they do alternate and they can schedule so you have there's definitely some options.

Denise Bolds: 09:19

Good options, good options. Okay,

Ravae Sinclair: 09:21

so we cover that. All right. The next thing I think we want to cover is the birth worker business tip.

Denise Bolds: 09:29

Oh, yeah, we we heard the B word here and that the other day on social media posts b word for bartering.

Ravae Sinclair: 09:39

Yeah.Okay, so when Denise brought this up, I saw the post and I'm like, barter. I haven't heard that in so long. No. So I feel like when I became a doula as 20 years ago, people did barter because families didn't necessarily have money for what seemed like something really new expense. But tell me what is your experience Share with us. What's your experience with bartering is are your thoughts around it.

Denise Bolds: 10:03

Not very much with bartering. For me, it has not happened as much here in New York City. You know, unless I unless I hook up with a massage therapist, a plumber, a carpenter, electrician, an auto mechanic, something really or a pet veterinarian, then you could barter but you also have to think about what what expertise are they in? Do they have their own business, or are they working for someone else? There's very little, they can barter with you if they if they're working for somebody else. Because now that expense becomes the other person's too. So bartering is not as much here it really and truly isn't. What we do have here a lot is paying doula services off and installment payments.

Ravae Sinclair: 10:45

Okay. Okay, I see that I see that a lot here as well, I would say, um, I used to hear people barter. So like, if they lived in a rural area, they would be the birth doula for the family. And if they their family was, if they were farmers, if they made some kind of food product, they would pay them in that food product, which is it can be very valuable. So yeah, exchanging services, I think you would sont, you would set up your contract very much the same and just be very specific about who's giving what and when and how much and when I wouldn't have we like, completed the exchange,

Denise Bolds: 11:21

please have an agreement, please have an accord, please have something in writing in case something falls through or something happens to one of the families, please make sure you have something documented?

Ravae Sinclair: 11:34

Yeah. Okay. So here's the thing, you can have a verbal agreement, but when things fall apart, and I'm using the word "when" because it's not, it happens, okay. So that's not "if". But when things fall apart, you want to make sure you are clear about what everyone was supposed to give in the in the agreement. And so just writing it down is super, super helpful. So I, you know, I'm always going to endorse contracts. And people definitely should do that. I also want to just talk through this idea of exchange. So the definition of a contract is when you are exchanging a thing of value. Okay? So one, it has to be something that has value that everybody can see very clearly, this is something valuable. And it has to be an exchange, the exchange word is really important. So it's an exchange of a thing of value. Okay. So here's what happens. Typically, if we're doing birth, doula work, or even postpartum work, people give us money up front, and they sign a contract. And then we wait. The problem with the wait, is we haven't exchanged. So in that wait, there is some opportunity for people to say I don't want to do this anymore, or they want to cancel or whatnot. And I know everybody has these non refundable clauses in their contract, which I will tell you can be challenged. Everybody, because you're so secure in those, but they can be challenged if you haven't done this exchange. So I remember years ago, on people were starting to have trouble with Pay Pal. Families were paying with PayPal, and then going to pay pal and asking for their refund and Pay Pal was very consumer, very customer friendly. And so they were giving these refunds back and birth workers were like, wait a minute, and what was the issue? The issue, part of it was these families had paid. And services hadn't been rendered yet. Because the birth hadn't happened or the postpartum doula work had happened yet. And so they can back out Pay Pal was like, Oh, holy, they haven't gotten anything, I gave you money. And you didn't service them yet. So they can get their money back because they haven't gotten anything yet. So there became this practice. And so for those who are a little bit newer, probably totally missed this on the social media platforms or weren't one around for it yet. You need to give them something, you need to engage with them, you need to get the service like let's get this party started. Okay, I literally have an email that goes out within 24 hours of a deposit and a signed contract coming to me, and it's called, let's get started. And so it is, and it's predicated is really initiated because of this experience of PayPal, the other the other financial institution I know will give money back is American Express. So I don't take American American Express payments, I don't take PayPal payments, because they are very consumer friendly, which can be good for some folk and not necessarily good for you as a business owner. But the main thing about this particular point is make sure that you start services ASAP. And you exchange something, a thing of value, right? So I know we're going into it thinking it's the birth doula support or it's a postpartum doula support, which Yeah, it is. But you know, what you can do right away is get them some PDFs, some some teachables some teaching documents, you can get on a call a zoom, call a telephone call a voxxer or something. And we'll put them in Yeah, put them in a Google Drive but you can get them on a Call for a prenatal start talking through their birth preferences start talking through how has the pregnancy been so far to take intake? Yeah, go ahead and make sure you're documenting that you making connections at your prenatal. And you want to do that. I mean, I'm saying this in a technical way you want to do this anyway to build the relationship. But when you wait, you actually risk not having that exchange of a thing of value and the contract actually not being completed. So, so think about how you're onboarding folks. And because this is a this tip is a cya tip. It's a Cover Ya SSA tip.

Denise Bolds: 15:33

it really is. And you know, you may be busy with birch, you may like me have back to back birds. Meanwhile, a client just signed your contract and sent over the deposit cha ching, hey, that's great. But I've been stuck in a berth for the past two days, well up as tired as you are, when you get home, make sure you onboard that client and you get connected with them, you let them know that their deposit was received. And here's the onboarding materials for you to be my client. Make sure that you initiate that as soon as you can.

Ravae Sinclair: 16:04

Yeah, give them the next step so that they can start looking through things, reading things. Give us an email or resources. So guess what, the fact that they sign the contract is not a surprise to you. You interviewed with them didn't you? You, you gave them access to the contract. So you know, it's coming. So let's go ahead and manifest as these are manifesting energy and manifest, they're gonna say yes, get ready for them. Go ahead and set up the email with all the links and a welcome packet, if that's what you have, or even just say, welcome. I'm so excited to get started. Here are the next steps, here's a link to scheduling our first prenatal something to kind of get to dive in and have it set so that if you are busy in a birth, like what Denise just described, when you get home, I have to just pull up your email, go into your drafts, make sure their email address is correct, make sure the email is you know, totally complete, and hit send. And then go to bed, right and

Denise Bolds: 17:00

go sleep it off and get ready. But definitely do not leave that person who gave you a nice deposit. Do not leave them hanging.

Ravae Sinclair: 17:09

Yeah, don't do it. It feels good to have that responsiveness. Like when they pay, they're, you know, they're excited and probably a little nervous. So when they actually get a response from you right away, it's like, oh, my gosh, she's on it, they're on it. Okay, that you like you kind of like solidify their decision they made, they made a really good decision because their birth worker that they hired is going to be responsive. So alright, so there's that wanting to make sure that people are understanding that you need to do an exchange and it's it can be really helpful to do it quickly.

Denise Bolds: 17:42

Right.

Ravae Sinclair: 17:43

All right. Okay. So birth worker excellence. So one of the things Oh, see, here I go, Chile talking, I got to get ready. One of the things that we saw, and I think both between the two of us were like, is it birth worker or excellence? Okay, so it's a thing, it's a thing that we definitely wanted to make sure we covered. So we saw an article, some researchers recently came out about virtual doula support reducing the need for C sections by 60%.

Denise Bolds: 18:15

Right.

Ravae Sinclair: 18:16

Of course, that's amazing news. Nobody's doubting that. Part of one of the things that were wondering is, you know, we're Black birth workers. We know the black maternal health crisis is front and center for a lot of us. How does that impact Black folks? How is that in fact, impacting the folks that we serve? And there was a statistic, I will link this article in the show notes, but there was a statistic that said it had a higher than expected impact on black women. And so there's a pause that I have to take whenever we talk about virtual doula work and how effective it is, right? Because having done in person doula work for 22 years, I'm like, virtual doula work is hard. It's very hard. Well, who's out here doing this? This is actually kind of a new ish thing. So who's doing this? And what I see from all this mentoring, all this conversating is that we're all these conference. It's not a word. That's a jail word. All these conversations, I learned that as a public defender, but all these conversations with birth workers, then a lot of the folks who are doing virtual work or you know, new with new fairly new doulas and don't have as much in person experience, as I personally think people need in order to do virtual doula work very well.

Denise Bolds: 19:52

I agree. I totally agree. You know, virtual doula work to me, the energy that you're projecting is because you have to now project your energy into a space that you're not physically. Therefore, you also have to really hone in on your five senses of assessment. What are you seeing on that video cam? What are you hearing? What does a What? What are you saying back in response to them? And what is the overall appearance of the environment? So you're using a lot of your five senses in the assessment skills, what's happening with the nurse? What is it what is her body cues, saying? So as a social worker trained, I'm using a lot of my skills when I'm doing virtual doula work. And I noticed, you know, a lot of things but mom's blood pressure is up, we get on the video cam and her shoulders are up to her ears. And as I'm slowly talking to her, those shoulders are slowly coming down and she's relaxing, and her blood pressure is going down. And her contractions are more manageable. You have to have assessment skills for me, over 150 births to really come out and say that I can walk into a room and just off with my five senses. I can assess what's going on in that environment. And I can tell you where that mom's stage of labor is. That's virtual doula work, you are really projecting a lot of your energy there. Now quickly, I'll say this and let Ravae have a turn. Back a couple of years ago in the pandemic, DONA did a conference and had some virtual doulas present. And these virtual doulas had been virtual doulaing for a long time when before pre pandemic virtual do the work was kind of poo pooed Oh, no, you have to be in person to do that. You really can't do that virtually. These virtual doulas came on the scene and they were like, nope, nope. No, I'm virtual doulaing in Hawaii on virtual doulaing in England, on virtual doulaing and rural communities. And it's a very successful business for them. And they were doing this before it became chic with the pandemic. So virtual duel work is a lot of work. It's hard work. It's a lot of assessment, a lot of communication. You have to make sure your technology is on board. The parents have to be on board to really engage with you and promote this and keep the keep the communication going in the birth space. The facility has to be okay with it. Because they very well, very well may not be so virtual doula work is very, very interesting. And what I found out about this article that Ravae turned me on to the author gave Penny Simkin a lot of kudos. But Penny Simkin really wasn't a big fan of virtual doula work. So I thought the irony of that was pretty funny to me. But virtual doula work really jumped off with the pandemic. But pre pandemic, virtual doula work was almost a taboo word to say.

Ravae Sinclair: 22:39

Absolutely. Like it was I remember people trying to, like, capture the concept while we were shooting while the world was shutting down and putting on makeshift trainings and things like that, like, you know, having 1000s of people on a call, just trying to figure out how to do it. Okay, so here, here's my read on it. Virtual doula, right, you're absolutely right, Denise, you have to project yourself into the space. Here's what I know is happening. People are not constantly connected. So you know, that I that concept of, I'm gonna be your doula, and I'm gonna give you continuous support. Well, that doesn't end because you're on, you know, using a device that exists that still exists. Most folk ain't doing it. So they're not even there. No, so the brokenness is there already. So it's a disruption, I would say, and it can be create a barrier to understanding what's happening all along the way. You don't have a full picture. The beauty of continuous support is as a birth doula, you have to you have the full picture, you have a fuller picture than a doctor, the nurse anybody because you are consistent, present. So you are the continuity from generally from home, even if you didn't weren't in the home, you know, what happened- You Oh, they were vomiting. They lost a lot of fluids. Yes, they need IV right now, like you have a sense of what's going on. When you do virtual doula work, a lot of people are disrupting it. And they're like coming on and off the phone. And sometimes people aren't even answering these devices. Sometimes these devices aren't even charged. Sometimes, people who didn't really even want them to have the birthing person have a doula, they use this opportunity to disrupt and make sure the devices aren't available. Sometimes devices aren't turned into the direction that you need. So here's the thing. You want to know what like is the what's the vibe of the nurse? Well, you got to be able to see them, or like observe them, they usually are trying to run away from the camera. You you want to know like what the partners are feeling what the birthing person is feeling. Well, I do that by by cheque but also looking in their eyes. It's hard sometimes when you have these devices. So the biggest skill that I think is missing, and I love that you gave a number like 150 because that quantifies it for folks. That's how much you need to be in a hospital space or continuously in a birth center space, because if I've been in one hospital at this point, 800 plus births. I know that I know what's in the room. I don't necessarily know where it is, but I'm All the basic equipment that's in a room so I can actually tell a partner, okay, there's a drawer, there's going to be a drawer somewhere. And I don't know if it's going to be in the rolling on wheels or if it's going to be a built in, but there's going to be some pads, there's going to be a toothbrush, it's going to be I can say what I know. All right. And so I also have enough experience that I can anticipate the needs. Oh, that's what happened. Okay. So they're out there thinking, blah, blah, blah, get ready, because they're probably going to come in and start having a conversation about this. I am anticipating things to help the families get ready, because now I'm trying to hurry up and have a conversation before the staff comes in. Before the vibe changes. I'm trying to prep them on what they're going to say, because now I can't do the advocacy in the way that I could if I was in person, so I have to equip them. I also have to rely on somebody else to do the physicality of the work. So I'm like, remember, we practiced this? Remember you tried this, okay, this is a good time to try this, oh, can you turn the camera, sometimes the rooms, they they actually block your signal. So it's hard for you to actually have visual and audio, there's a lot of tech stuff that can happen. And so you have to prep them, you have to prep the partner for the physical stuff. And sometimes guess what you you're actually in your space, you're also navigating all the noise and stuff in your own space. You know, stable, stay plugged in, stay consistent and connected. Virtual doula work is not easy when you are not--when you're not seasoned, it can be really challenging. So let's, let's pause here for a minute. Let's toggle back because of time, I want to do some closing thoughts here. Just give us a second. okay, we're back. Alright. So I wanted to make sure that we hit on the topic of like pricing for virtual doula services, but also training. So I have heard, and it like feels like a little to me about people charging the same amount for virtual doula support as they do for in person.

Denise Bolds: 27:15

Oh, Lord,

Ravae Sinclair: 27:16

doula support. Now listen, I know I literally just said how hard it is to project yourself into the birth space. I know I just said that. However, I also said, you have to rely on somebody else to do physical comfort measures, you have to rely on somebody else that's actually in that room to do the communication with you to make sure all the devices are charged, that you have the right like little stands to turn like the little nick goosenecks and stuff. Like you have to rely on other people to do the work that you would normally do. So there's some part of me that feels like it doesn't feel right to charge the exact amount, same amount that I would charge in person because other people are doing my work.

Denise Bolds: 28:08

Mm hmm.

Ravae Sinclair: 28:09

I also think about so I know, the argument is, well, I have to be, you know, I have to keep my schedule open, I have to be on call for the same amount of time. And so it's the same well, we just talked about, like, there's a lot of ways it's not the same because you're literally not doing the same thing. So I am a fan of it not being the same price as if you were doing in person support. In some ways, I would encourage more people to have virtual doula support, which this research says it's effective. But I also think it acknowledges a lot of the work, the heavy lifting that you're not doing in the space. I don't know if you have something to share around pricing.

Denise Bolds: 28:51

Yeah, you know, it's once again, it's going to also come on experience. Because I'm sorry, you know, for these younger doulas, but you have to put in the time of being hands on and doing birth work and birthing spaces. So like Ravae said, earlier, you can direct families to something and that might be in the bathroom, you can direct families a certain way. If you've never been in a birth room, then it's very hard for you to do that virtual work. Also to the assessment skills. This is a practice I call doula work a practice. Every birth, you're learning something. And for you to be able to walk into that birthing space, look at the environment and be able to make that call on where that person is in their labor. Where is this baby? How was his father reacting? How is the nurse maintaining the room? What's the environment here in this department? All of those things come with experience in hands on assessment skills, your assessment skills, body cues, what's being said what's not being said? How disheveled is this room? How's the mom in the bed? Is she like all slumped? down into bed or, or she's sitting up and she's has her refreshments and she's being cared for. So there's a lot of things to be looked at here. And I'm sorry, but newer doulas, you have to put in the time. In order for your practice to be honed, you really do Ravae has over 800 births. I've been doing this now going into my 10th year now, I have 287 births. Okay, so it takes time to really get in there and assess what's happening. And you can't do that with if you don't have enough skill. So charging the same thing like you would for an in person? Ah, no, I think I think that's not that's not fair that that that doesn't make sense to me.

Ravae Sinclair: 30:42

Now, here's the beauty. People can do whatever they want to do whatever you want to do, do I guess what I get to have an opinion, and I got a podcast. So I can say what I want to say, right? Because here's the thing, doula that! here's the thing, somebody else has to be your eyes and ears, you're not doing the same level of work. And so I think just to make it more accessible, I think a lower price makes sense. Because also people have to make sure they have these devices and all the cords and the goosenecks. And stuff like they're making an investment, right, in order to have this virtual doula support. So price what you want, whatever. But I definitely have an opinion that I don't think you're doing the same level of work, I do think you have to work harder on the prenatal side to make sure that there's a tech rehearsal. So I also I always do that with my virtual doula clients. So I'm like, What are you going to use? Oh, you're going to use that, let's, let's use it right now. Hang up with me. If you're gonna do Google duo right out, let's

Denise Bolds: 31:41

try it out.

Ravae Sinclair: 31:43

I want you to see how it looks. And if you have a, you know, some kind of like stand or arm or leverage that you're using, then put it let's try it. That's when we learned learn, oh, the button doesn't work, or oh, it used to work some Oh, somebody that and the other kid broke it in the meantime, and you didn't realize it? Yeah, let's work out the kinks. So we don't have any of these surprises when we're trying to use the equipment, you know, when get in the hospital. So even like comfort measures, I actually do the comfort measures using one of the devices, right, because I gotta practice how to coach them into these different positions. They've got the partner has to practice like helping me see and visualize while they actually have to do it. So one of the other things I'm very open to is even though you chose me as your virtual doula, I might identify a birth worker in their city where they are to do the comfort measures session in person. Because there's nothing we all know that it's a different sensibility, when somebody's helping you learn how to do the double hip squeeze or counter pressure, or using you know, sheets or towels or blankets or rebozo, or something like that, or really proper assessment of like, if the birth ball is the right fill for them if it's big enough, or too big for for them. So I like to so I'm willing to pay a birth worker who's local, who will come and do that in person comfort measures while I'm on the technology. So we get it all done in the rehearsal at one time. I also am a big fan of having someone who see given away stuff for free here on this podcast, but I just think it's the responsible thing to do. I also think that you should have someone who is at the ready in the event that you actually need somebody to look at your client like hands on some other birth worker, it could even be a childbirth educator, if they literally just don't have doulas in the area, like just somebody who can physically show up and be supportive because things happen if there is a loss.

Denise Bolds: 33:42

Yeah, and you know, not for nothing when the pandemic first jumped off. And New York was the epicenter of everything. I found myself in a virtual doula situation that I didn't ask for my client. We labored in the back of the parking lot because they weren't allowing partners nor doulas in these moms had to birth alone. Okay, so we labored we got her to active labor, we got her to pushing. And when that baby started to crown, we pushed her into the hospital lobby, and they took her upstairs and she gave birth now, she kept her cell phone on, the nurses upstairs bought into it, and really supported that to happen. So I say all of this to say to you, the team in the labor and delivery department also has to really support this endeavor. Otherwise, it's going to be very difficult. They knew we weren't there trying to videotape anything because videotaping is prohibitive. Okay, in these labor delivery

Ravae Sinclair: 34:39

at that hospital

Denise Bolds: 34:40

at that at that hospital, many hospitals Believe it or not, they do not go for that for their reasons, but they really supported us in keeping the phones on so we could stay connected to this mom and her husband could stay supported to his wife and his new baby being born. And it worked out very well. We didn't plan for this virtual Situation didn't turn out that way. But it did. But it was successful because the labor and delivery team also supported it.

Ravae Sinclair: 35:07

Yeah, that's the other part. Like if it's part of the birth plan, and they can go into it, having conversations with their provider, are they on board with this. And then when you check in, there's a, you know, a way, again, I probably should just do a class on this, because you have a way that you need to introduce yourself to the staff and understand what their boundaries are limits are comfort level, with the technology with them being in a camera and on, you know, everybody has different boundaries. And so you have to assess it, and you can't assess it until you're in the moment. But just to wrap up the idea about having an in town support person in case something goes wrong, if there is a loss, you will be at a loss, right on virtuals. On a camera,

Denise Bolds: 35:50

right?

Ravae Sinclair: 35:51

Folks need somebody in that space. And so being prepared for all the possibilities when you're taking on virtual doula support is important. Now, I might have just given you a couple of reasons why you should have your price higher, right? Because if I gotta have an in town person kind of on call or in town person who might I have to pay people, right, or somebody to do comfort measures, but do whatever you want. I just think it's a virtual work can be really powerful. I think it's obviously important. And sometimes it's what we have to do, we might not be facing another pandemic, but maybe we have to flip to a virtual doula support because you're out of town, and the mom had the baby week 30. And you're like, Whoa, whoa, wait, let me

Denise Bolds: 36:33

There you go.

Ravae Sinclair: 36:33

You might have to pivot very quickly. I think it can be a valuable tool. But I think it requires like formal training. So I I don't know Do you know of any like trainings like virtual doula trainings that you can call out off off the top of your head?

Denise Bolds: 36:51

um, there's, there's some who are out here doing it. There's some agencies that are out here doing it. I don't know if they're doing it as hard as they were in the pandemic. But that is definitely something that the major organizations, doula certifying, organizations need to look into. Because we're all one step away from a catastrophic incident, whether the mom has COVID or something is happening, or there's some other extraneous reason why the hospital was shut down, terrorist activity, baby has been taken, there's so many things that you would want to have that situation happened. And as Ravae said earlier, preterm labor mom goes into labor 29 weeks, well, I'm not really on call for this mom, really, technically, I'm not really supposed to be around until 36 weeks, well, here we are several weeks early. And I'm not even in the state right now.

Ravae Sinclair: 37:40

Right! And your backup doula is prepared for birth to happen at that same time interval rec might not be available either.

Denise Bolds: 37:47

So having a virtual clause in your contract is helpful understanding the support, making sure the partner is okay with those, it's a lot of responsibility to put on the partner for the phone hookup, and keeping the communication engagement open. There's a lot of factors at play with virtual work. And it does take skill. That's why I'm going to bring it back to skilled professionals, skilled birth workers really can pull this off. I did it in the pandemic, it made the six o'clock news. But to be honest with you, that was like a wing and a prayer at the time, because we were at the height of the pandemic with no with no vaccine then. So this was really tough, you know, here was tied up, you know, wrapped up, you know, we were praying that we didn't get COVID Even going near a hospital.So there was

Ravae Sinclair: 38:37

or near each other you were in the car

Denise Bolds: 38:40

together yet we were in the car together, I just could not leave this man alone because he was terrified not being you know, near his wife and child and in a situation like that. So there's many things to think about. Your families will hire you for virtual work if the if the spouse is deployed in the armed services, if they're incarcerated, if they themselves are immunocompromised for cancer treatment, if they're out of town for an emergency, if there was a death in the family, and they have to go, but you stay behind because you're pregnant. And now you go into labor. There's so many scenarios that can come up that will require you to suddenly become a virtual doula. So I think what Ravae and I are saying here is really hone in on those skills, and be prepared because you can pivot yourself into a virtual support in just a matter of seconds.

Ravae Sinclair: 39:29

Absolutely. And this might be so we talked a little bit earlier about like the aspiring doula and trying to find a way to like do this work. Maybe that is what you do is virtual doula support for the family where the partner and the family are very willing to be very hands on and very interested in having that interaction but don't necessarily want another person in their space? So I think this is a, you know, place where people need continuing education, like solid solid training Um, and you know, you may not be anywhere close to the 150 births that like Denise spoke about. But if you actually get formal training, you'll you can close the gap. There are just things that you need to know about like things. The biggest thing for me that the skills or the experience offer someone is anticipation.

Denise Bolds: 40:20

Right

Ravae Sinclair: 40:20

If you are, you've experienced enough birth in a hospital setting, you can anticipate the action that anticipate the need for advocacy, you can anticipate what the next step may be, and you can prepare the family for it. There are just some things, you can't prepare them for prenatally, you shouldn't. But when you're in it, you're like, Ah, I can see what's coming down the pipe. And then you can kind of get them ready. So they're not in shock. As you know, conversations are being had proposals are being made, and action is being taken or decisions have to be made quickly. That's a lot of where your value comes as anticipating the next step for a family. So

Denise Bolds: 40:59

right because you are the lighthouse, in this ocean in this place, where this family's trying to steer their boat away from the rocks, you are the lighthouse to really guide them through so they can get there safely with their goals and their baby in their family. So being able to be proactive and being able to as as Ravae said, pivot and be able to move quickly and anticipate what's going to happen next. That does take skill. And then when you're all done, you can do what I do. You can go in your car and cry and vomit and like, Oh my God, I don't believe I did that. That was just so intense. It was so intense. You know, we react later. We don't yeah, we react later.

Ravae Sinclair: 41:36

Yeah. You know, I just two things I want to emphasize. One is the continuous part. I think I spoke about it earlier. But I think people are cheating. I think people are like hanging up and calling back and kind of doing a periodic check in. Right. I definitely have an opinion about that. I'm like, let's just figure out sometimes we ramp up, right, I might do the check ins the way I would for early labor anyway, we're not going to constantly be on the phone in early labor. But once we get to active, yeah, I we might be, first of all, I need to see my person, you know, I need to see the birthing person because the way they look how they sound, all of that really matters. And so we might start off on FaceTime or Google duo. And then we ended up shifting to because there may be transporting to the place of birth or hospital, the birth center where we come off video, and now we're on I'm on speaker because I want to hear how close those surges are coming, what kind of sound is being made. I want to hear the reactions I want to hear like what people like just what's happening. Once you get into triage, keep me on speakerphone like right I'm I can keep giving tips, I can remind you about where the IV can go and all of that stuff. I don't have to say anything, I'm just there, present and listening. And then when we get you when you actually get to your own space, then we can go back on video, right, we set up the gooseneck, the little stand and everything and we kind of get situated. So I think the continuous piece, it can be like very variations of electronic connection. But it should be pretty consistent because you run the risk of like disconnecting and you miss things you can miss so many things. So many things that were said, Now, you know, maybe the staff says something sideways, right? And you check in two hours later, and your client is like not trusting you're like, wait, wait, wait, what happened? Now you got to get caught up. So a lot of times those things happen, those microaggressions and the client just keeps it moving. You never hear about it until they actually debrief after the birth. And you're like, Oh my God, I wish I had known because I've done you could have called the nurse desk, you could have actually advocated for them to swap out the nurse because they no longer feeling comfortable. And then they had to do the rest of the birth with somebody they weren't comfortable with. So there are things that you can miss when you are disconnected. So I really encourage folks if you're doing this to least work at continuous support on the virtual side.

Denise Bolds: 44:00

Absolutely, absolutely.

Ravae Sinclair: 44:02

So clearly I need to do a class on this.

Denise Bolds: 44:05

Because I just want to say one more thing. It's important to have those extra phone numbers if you are doing virtual support, like to have those phone numbers, Nurse Manager, family member, the

Ravae Sinclair: 44:17

partner the partner, home with

Denise Bolds: 44:20

a lot of things you have to have in place so that you are like control center, you're the lighthouse and you've got to have these things in place to empower you to really be you know, the supportive thing for the families and home births of virtual doulas. Sure, why not? It but as Ravae said she's going to do a class on this I can feel it. Oh,

Ravae Sinclair: 44:41

well I mean we're Yeah, click taught a third of it just to hear on the podcast but there's so much more I like people really need to work out their insecurities, their their concerns, their what ifs. What if that which if you're a new doula, you probably have a lot of that especially if people are training virtually during the pandemic. We don't have a lot of in person experience and so you don't even know what you don't know. But for those who are giving it to the good old fashioned try kudos because obviously by the research we talked about, it's making a difference. So it

Denise Bolds: 45:12

is making a difference and you better know your stages of labor when you're jumping into this. Okay.

Ravae Sinclair: 45:16

There you go. Okay, I have an alarm going off. So I think it's a good sign from the universe that we should sign off. So thank you all. We we hope that this was valuable to you. We look forward to you doing the work and giving us feedback. Don't forget you can email us you doulaThat-- doulathatpodcast@gmail.com We want to hear from you want to start bringing some people on we want to hear what your take is what your feeling is. Join us on our Facebook page. Which is @doulathatpodcast on Facebook. We also have @doulathatpodcast on Instagram, follow us likes and share so we can make sure we get the word out. So thank you all, and we hope that you Doula That! All right, everybody.