For a birth professional, there are many options when it comes to establishing, continuing, and expanding your career.  We all seem to have our “main gig,” as well as several related side projects that keep us interested and busy in the inevitable lulls between clients.

Some midwives and doulas work in teams, some work solo, but have an emergency backup ready, and some work for an agency.

Lately, in my own regional community of birth professionals, working for an agency has been questioned—politely, but nonetheless with an undeniable air of mistrust.

I guess the feeling is that an “agency” is intrinsically “big business” and that a team of doulas, trained and maintained by one company, must be—as opposed to the individual—somewhat impersonal, while trying to work in an environment that calls for intimacy.

I find myself feeling pretty heated up about this, to be honest; not because I’m adamantly in favor of the agency over the individual, but because I am an individual, who happens to work for an agency.  And I’m a damn good doula.

One point of clarification that may be crucial in dissipating this vague mistrust and misunderstanding is the fact that postpartum doulas, while perhaps similar in personality and capacity for compassion, do very different work than birth doulas.

Birth is a singular event—one that is fluid and varied, of course, but one that takes place within a relatively small period of time.  I can see why it would be hard for a birth doula to envision a mother hiring an agency.  Birth doulas are not supposed to do shift changes and there is hardly the opportunity to swap mid-labor if a doula and birthing mother “don’t click.”  Birth doulas almost always provide at least one at home check-in in the postpartum period, but their work is mainly isolated to the labor event.

Postpartum doulas usually care for a family over the period of several shifts.  They are in the home, in the most intimate and turbulent of times.  Many postpartum doulas are able to take on this work as an individual practitioner by scheduling shifts around their other obligations, and they do a great job.  I have tried working on my own myself and found it to be challenging.

I work for an agency, first and foremost, because I can’t handle the amount of hours required by families with multiples, which—in my recent experience—make up at least half of the client base seeking postpartum care.  Families with two or more newborns need ‘round the clock care for the first few weeks, sometimes for the first few months.  As a mother and a writer and a human being who needs sleep, I literally could not give a mom of multiples what she truly needs!

Much like a birth doula, a postpartum doula often faces scheduling conflicts, or too many women needing care at one time.  Unlike a birth doula, a postpartum doula does not have to worry about overlapping hours occurring when two women go into labor on the same day.  She has to worry about weeks, and sometimes months, of overlapping need.

Ideally, a new mother will have one doula.  At our agency we try to keep it to as few as possible.  The job sometimes mandates that two doulas share a client, just to keep up with the logistics of her genuine need.  This isn’t a bad thing, however.  Usually, a client likes having two!  Perhaps Doula Lisa is a great cook, while Doula Amanda is a breastfeeding genius.  A client will learn to reserve certain tasks for specific doulas, and she has the benefit of two different perspectives and two professionals with different areas of expertise.

Many doulas encourage prospective clients to interview a variety of doulas so that they might find “just the right fit.”  I love working for an agency, because I know that the new mother seeking care can always find the right fit, through trial and error if need be.  She can trade me in if our personalities don’t mesh.  In fact, I would rather she did.  She deserves care that is tailor-made.  On that note, most clients are thrilled with their doula, because our director knows the staff very well and is skilled at matching the caregiver to the family.

The benefits of working for an agency, for me, don’t end at general shift coverage.  I use my fellow doulas for advice and information.  We share and trade and learn.  I become 10 doulas in one with the varied experience of my coworkers.  Also, the agency provides continuing education and training opportunities, different speakers and invitations to conferences.  I feel constantly updated and on top of the latest information in my field, in a way that I might not if left to my own devices.

In the beginning, I shied away from the idea of a company.  I too thought it might be impersonal.  I wanted to be creative in my practice and forge my own way in the childbirth and maternal care community.  As it turns out, I do my own thing with a few agency guidelines which are good and not at all limiting.  I still work as I would if running my own personal practice, but I enjoy the benefits of education and support.

A doula has many choices when it comes to her twisting, turning, feast or famine practice.  This is what works for me.